ONEIRODYNYA.

Uneasiness in Sleep.

Somnium, Vog. 339. Somnambulismus, Sauv. gen. 221. Lin. 77. Sag. 333. Hypnobatafis, Vog. 340. Noctambulatio, The greatest uneasiness which people feel in sleep is that commonly called the incubus or night-mare. Those seized with it seem to have a weight on their breasts and about their precordia. Sometimes they imagine they see spectres of various kinds which opprest or threaten them with suffocation. Neither does this uneasiness continue only while they are asleep; for it is some time after they awake before they can turn themselves in their beds or speak; nay, sometimes, though rarely, the distemper has proved mortal.—The incubus rarely leaves people except when the stomach is oppressed with aliment of hard digestion, and the patient lies on his back. It is to be cured by eating light suppers, and raising the head high; or, if it become very troublesome, antipathodic medicines are to be administered, and the body strengthened by chalybeates. The same method is to be followed by those who are subject to walking in their sleep; a practice which must necessarily be attended with the greatest danger: and somnambulism may justly be considered as merely a different modification of this distemper. Accordingly Dr Cullen has distinguished the one by the title of onicirdynia activa, and the other by that of onicirdynia gravis.

**Class III. CACHEXIÆ.**

Cachexiae, Sauv. Clas X. and Clas VIII. Sag. Clas III.

Deformes, Lin. Clas X.

**Order I. MARCORES.**

Macies, Sauv. Clas X. Order I. Sag. Clas III.

Emaciantes, Lin. Clas X. Order I.

**Genus LXIX. TABES.**

Wasting of the Body.

Tabes, Sauv. gen. 275. Lin. 209. Veg. 306. Sag. 100.

This disorder is occasioned by the absorption of pus from some ulcer, external or internal, which produces an hectic fever. The primary indication therefore must be to heal the ulcer, and thus take away the cause of the distemper. If the ulcer cannot be healed, the patient will certainly die in an emaciated state. But the proper treatment of the tabes proceeding from this cause, falls to be considered under the head of Ulcer in Surgery, and likewise under the genera Syphilis, Scrofula, Scorbutics, &c., diseases in which ulcers are at least a very common symptom.

**Genus LXX. ATROPHIA.**

Nervous Consumption.

Description. This affection consists principally in a wasting of the body, without any remarkable fever, cough, or difficulty of breathing; but attended with want of appetite and a bad digestion, whence the whole body grows languid, and wastes by degrees.—Atropnia. Dr Cullen, however, affirms, that some degree of fever, or at least of increased quickness of the pulse, always attends this distemper.

Cause. Sometimes this distemper will come on without any evident cause. Sometimes it will arise from passions of the mind; from an abuse of spirituous liquors; from excessive evacuations, especially of the semen, in which case the distemper has got the name of tabes dorsalis. It may arise from mere old age, or from famine.

Prognosis. This distemper, from whatever cause it may arise, is very difficult to cure, and often terminates in a fatal dropsy.

Cure. The general principles on which the treatment of this distemper is to be regulated, very much depend on the cause by which it is induced; and it is unnecessary to add, that this must be removed as far as possible. Next to this, the distemper is most effectually combated by the introduction of nutritious aliment into the system, and by obtaining the proper assimilation and digestion of this. With the first of these intentions, recourse must be had to the diet which is most nutritious, and at the same time of easiest digestion. But from the condition of the stomach commonly attending this distemper, it is necessary that small quantities only should be taken at a time, and that it should be frequently repeated. With the second intention, stomachic and nervous medicines are the articles chiefly at least to be depended upon in this case. The Peruvian bark, sulphuric acid, and chalybeates, are excellent; and these should be conjoined with gentle exercise, as far as the strength and other circumstances of the patient will admit. In that species of the distemper occasioned by venereal excesses, it is so essentially necessary to abstain from them, that without it the best remedies will prove altogether useless.

**Order II. INTUMESCENTIÆ.**

Intumescentiae, Sauv. Clas X. Ord. II. Sag. Clas III. Ord. II.

Tumidofii, Lin. Clas X. Ord. II.

**Genus LXXI. POLYSARCIA.**

Corpulency.

Polysarcia, Sauv. gen. 279. Lin. 213. Veg. 340. Sag. 160. Stearites, Veg. 390.

In a natural and healthy state, the fat, or animal oil, is not allowed to diffuse itself throughout the cellular interstices at large, but is confined to the places where such an oily fluid is necessary, by a particular apparatus of distinct vesicles. But in some constitutions, the oily part of the blood appears to exceed the requisite proportion, and easily separates from the other constituent parts; or there is an uncommon tendency to the separation of oily matter. In these cases it is apt to accumulate in such quantities, that we may suppose it to burst those vesicles which were originally destined to hinder it from spreading too far; or almost every cell of the membrana adiposa, many of which are in ordinary cases altogether empty, may be completely filled and distended with fat.

The increase of the omentum particularly, and the accumulation accumulation of fat about the kidneys and melentery, swell the abdomen, and obstruct the motions of the diaphragm; whence one reason of the difficulty of breathing which is peculiar to corpulent people; while the heart, and the large vessels connected with it, are in like manner so encumbered, that neither the systolic nor sublatory motion can be performed with sufficient freedom, whence weakness and slowness of the pulse; but when the whole habit is in a manner overwhelmed with an oily fluid, the enlargement of the cellular interfaces will necessarily interrupt the general distribution and circulation throughout the nervous and vascular systems; impeding the action of the muscular fibres, and producing infirmity, somnolence, and death.

These cases are the more deplorable, as there is but little prospect of a cure. For the animal oil is of too gross a nature to be easily taken up by absorption; and we know, that when fluids are accumulated in the cellular system, there are only two ways in which they can be carried off or escape; namely, by the absorbents, which take their rise from the cellular interfaces, and through the pores of the skin by transudation.

Another misfortune is, that the disease steals on so imperceptibly, that it becomes inveterate before people begin to think of pursuing the proper means of relief.

In this disease the cure must turn upon two points: First, on preventing the farther deposition of fat, by avoiding the introduction of superfluous aliment, particularly of fatty matters, into the system; and, secondly, on promoting and forwarding the absorption of fat. On these grounds, besides what may be done by proper regimen, a variety of articles have been recommended in the way of medicine.

Soap has been proposed as a remedy to melt down and facilitate the absorption of the fat in corpulent people; and Dr Fleming some years ago published a little treatise, wherein he recommends this medicine, and relates the case of a gentleman who is said to have received considerable benefit from it. But perhaps the soap-les would be more powerful, and might be more easily taken theathed, in the manner directed when used as a dissolvent of the stone.

Lieutaud advises to take acium seillitium in small doses, with frequent purging and brisk exercise. But it will seldom happen that the patients will be found sufficiently steady to persist in any of these courses, it being the nature of the disorder to render them irritable and inattentive to their condition. Therefore the principal use of rules must be with a view to prevention; and persons who are disposed to corpulency should take care in time to prevent it from becoming an absolute disease, by using a great deal of exercise, not indulging in sleep, and abridging their meals, especially that of supper. Salted meats are less fattening than such as are fresh; and drinking freely of coffee is recommended to corpulent people.

But Dr Fothergill observes, that a strict adherence to vegetable diet reduces exuberant fat more certainly than any other means that he knows; and gives two cases in which this regimen succeeded remarkably well. The famous Dr Cheyne brought himself down in this way, from a most unwieldy bulk to a reasonable degree of weight; as he himself informs us. It deserves, however, to be remarked, that every practice for the removal or prevention of fatness must be used with great caution and prudence: for not a few, anxious to prevent this affection, have had recourse to a regimen and to medicines which have proved fatal. This has particularly arisen from the excessive use of acids, probably operating by entirely destroying the action of the chylopoietic viscera.