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 2).

  • Copland, James, 1791-1870.
Date:
1834-59
Catalogue details

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 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.)

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    DEBILITY —OF THE WHOLE Frame. well as other parts immediately controlled by the cerebro-spinal system, have their functions enfeebled and impaired in proportion to the de- bility it experiences. But they may also be individually affected, and in various degrees, without this system being materially disordered. Such occurrences generally arise from the oper- ation of local causes,—as over excitement of the organ, and exhaustion of its sensibility by its peculiar stimuli ; as weakness or loss of sight from over-exertion, or the intense or prolonged action of light; and loss of hearing from great noises, &c. 18. D. The muscular structures, from their connection with the ganglial and cerebro-spinal systems, necessarily experience the effects of de- pression of the energies of these systems, varying, according to its acute and chronic form, its degree, its simple or complicated state, and the progress it has made. But debility seldom originates in, or is limited to, these structures. Its earliest and simplest manifestations in them are diminished tone, flaccidity, wasting, particularly of volun- tary muscles ; lowered, or, in some cases, mor- bidly increased irritability, according as the nerv- ous systems experience a diminution or increase of their susceptibility (§ 17.) ; occasioning, in some cases, irregular and tremulous motions, and a disposition to spasmodic or convulsive action, but more frequently defective energy of contraction, or power of continuing and repeat- ing it, in both the involuntary and voluntary classes of muscles. In the more acute, or the more advanced and complicated states of ady- namia, the insensible tonic contractility of mus- cular fibres are in a great measure lost ; their vital cohesion is also so much diminished as to admit of their being more easily torn ; they are incapable of performing even a portion of their functions ; and their contractions are feeble, vi- bratory, or oscillating, productive of the utmost fatigue, sometimes of death ; and the least ex- ertion, even that requisite to preserve the body recumbent upon one side, cannot be sustained for a few minutes. These extreme states of debility occur in the most dangerous and severe cases of disease, as in adynamic fevers, scurvy, &c., and when the circulating and secreted fluids have become sensibly changed from their healthy condition. 19. JS. The sexual organs, whilst they par- ticipate in the vital depression of the general systems, are often themselves chiefly affected. It is by no means uncommon to meet with in- stances, particularly in the male sex, of the most complete debility of these organs, amounting sometimes to entire loss of function, from preco- cious and inordinate excitement and indulgence ; there being little or no other disorder, excepting enfeebled mental manifestation, in some cases. In others, however, all the organic and cerebro- spinal functions have become remarkably weak- ened, although not to the extent experienced by the organs in question. (See Impotency.) 20. iii. The Manifestations of Debility in particular Tissues are less evident than in the general systems and associated organs ; and they are later in becoming evident. It is usually not until they are extreme, long-continued, or compli- cated, that they are remarkable.—(a)The cellular tissue at first evinces deficient firmness and elas- ticity, with softness, and, as debility increases, loss of its vital cohesion : it at Isat presents a ten- dency to oedematous or serous infiltration, and even to hajmorrhage, owing to weakness of the extreme vessels terminating and originating in it, and the insufficient support it yields them. When it is thus changed, the spread of other diseases through it is thereby remarkably promoted, and an unfavourable termination hastened,—as in cases of diffusive inflammation, erysipelas, punc- tured or poisoned wounds, &c.; its vessels having lost their power to limit the extension of inflam- mation by forming coagulable lymph. — (6) Mu- cous membranes are amongst the earliest of the particular tissues to experience the effects of de- bility, thereby increasing and perpetuating many of its phenomena. At first their functions merely are impeded ; their secretions either diminished, or imperfectly excreted, or increased from relax- ation of their vessels, or in other respects viti- ated. As debility, whether of them especially, or of the frame in general, advances, vital cohe- sion becomes impaired, and they yield not the requisite support to their vessels ; whence result softening, hsemorrliage from their .surface, ecchy- mosis, asthenic ulceration, atrophy, &c. — (c) The serous tissues undergo a partial diminution of their cohesion, and permit an aqueous or serous fluid, in some extreme cases tinged with blood, to escape through their exhaling pores.— (d) The erectile textures at first evince greater susceptibility, particularly when debility has been induced by inordinate excitement of the sexual organs ; but as it increases, they lose their pecu- liar functions.— (e) The fibrous tissue also ex- periences relaxation, becomes less elastic, and more readily yields than in health, giving rise to almost spontaneous dislocations, — results which have occurred in the chronic debility caused by masturbation, as remarked by Sir Astley Coop- er and Mr. Copland Hutchison, and by my- self in one case.— (/) The osseous texture occa- sionally experiences, in children, an imperfect deposition of ossific matter, or even absorption of a great part of that already secreted ; and, in aged persons, the removal of the animal matter which gives due cohesion to this structure : and, {g) The corneous tissues are often variously changed ; the hair either falling out, or becoming thin, weak, or gray; the epidermis inclined to ex- foliate, and rough or scaly; and the nails thin, long, crooked, or irregular. 21. III. Debility of the whole Frame. —Debility seems, as already stated, most frequent- ly to originate in the ganglial and vascular sys- tems, which I have viewed as the chief factors of life ; the digestive, assimilative, excretory, and cerebro-spinal organs being subsequently affected. But it may also commence in, and continue for a considerable time limited to, either of these, or even, although rarely, to one or more of the in- dividual tissues. When existing thus locally, it usually springs from local and indirect causes, and is at first of a slight grade, the functions of the part merely being impeded ; but, as it continues, the rest of the economy becomes implicated in various degrees, owing to the reciprocity of vital action and function existing throughout the frame. With this universal diffiision of asthenia, the part primarily disordered may still continue affected in a greater degree, exhibiting the changes of func-