And this monument is now to be feen in BunhillFields.

Equally remarkable, but happier in the event, is the cafe contained in the following account. A maiden gentlewoman of feventeen years of age, obferved, that her belly fwelled gradually, and that she made but little urine. She took various medicines, but still grew worse for a whole year; when her abdomen was as much diftended as if she had been far gone with child. At this juncture fhe married, in hopes that a husband would prove her best physician. But it happened quite otherwife; the dropfy went on increafing for three years, when it came to that height, that there was reafon to fear her belly would burft. Her pain becoming now intolerable, fhe defired me to order her to be tapped by a furgeon of the hofpital, who was faid to have good fuccefs in that operation, in order to give her fome cafe at least. Whereupon, as I did not care to be thought to kill a patient, whom I could not cure, I told her, that it could not be done in fo emaciated a body without extreme danger. However, the miferable patient still continuing to urge me with earnest entreaties, not to abandon her to conftant tortures and a lingering death, I granted her requeft; and at one tapping, managed in the manner above described, there were drawn off fixty pints of clear water, quite free from any offensive fmell. From that time fhe gathered ftrength daily, the disease never returned, and at the end of ten months she was delivered of a lufty boy, and has fince had feveral children.

In fine, a strong argument for the neceffity of this. operation is, that it is much fafer, under proper reM 2 strictions,

ftrictions, to let out the water, than to wait till it bursts the belly, and comes forth. For this cafe fometimes happens, and is always attended with the utmost danger. However, I have feen one inftance of a recovery from it, in a woman, to whom I was called. Her belly was fo vaftly ftretched with water, that I pronounced the cafe incurable; because the seemed not to have ftrength enough to bear the proper evacuations but I was miftaken. For, in a few days, hearing that she was ftill alive, I made her another vifit, and was much furprised on feeing two vessels full of water, one containing twelve pints nearly, and the other fix. The first quantity came away in one day through a crack in the abdomen near the navel and the fecond iffued the next day from another crack, which happened near the fame place; thus nature wifely divided her remedy, and allowed it two days to operate. As I now found the patient exceffively weak and faint, I ordered her nothing inwardly but cordials; but gave directions to foment the abdomen with fpirit of wine; and withal made my prognoftic that fhe would foon die. But mulieri, ne mortuæ quidem, vix credendum eft; I was miftaken a second time; for I faw her fome months afterwards, quite recovered; nor did fhe ever relapse as far as I could learn; and the cracks and burstings of her belly united, without any other application but that above mentioned.

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I clofe this long chapter with the hiftory of a cafe, whereby it will appear, that nature fometimes employs a very different method from that above described, to eafe herself of her load. I attended a certain merchant for an afcitical dropfy, with another phyfician

of

of great experience; and after trying the ufual remedies to no purpose, we refolved upon the paracentefis, as the ultimate refource. Accordingly the operation was performed, and about twenty pints of thin clear water were drawn off. In a few weeks his belly filled again. Whereupon, we agreed to meet the furgeon the next morning, in order to draw off the water by a fecond tapping. As foon as we came to the patient, he looked at us, and fmiled; faying, that he had no occafion for any fort of affiftance; and ftripping off the cloaths, he fhewed his abdomen, which was foft and relaxed. At this we were vaftly furprifed, and having afked him if he had had any kind of evacuation in the night, he affured us that he had had none, either by ftool, urine, or fweat, more than ufual, Wherefore all the water must have been abforbed by the glands and capillaries of the petitonæum and adjacent membranes. But afterwards this patient very imprudently committed himself to the care of a certain quack, who, to prevent a return of the disease, gave him very ftrong cathartics, which fo exhaufted him that he foon died confumptive. Yet, upon diffection, there was little or no water found in the abdomen.

Anatomifts have long fince discovered, that water is abforbed from the belly into the circumjacent parts. For if a pint of warm water be injected, through a fmall wound, into the abdomen of a live dog, and his abdomen be laid open a few hours afterwards, not a fingle drop of the water will be found therein. Thus, as Hippocrates has juftly obferved, every part of the body, both outward and inward, is perfpirable *. But I refer the reader to the perufal of what * Εκπνοὶν καὶ εἰσπνοὸν ἔςιν ὅλον τὸ σῶμα. Epidem. vi.

the

the learned Dr Abraham Kaav has published on this fubject, who demonftrates, that the humours are admitted into, and tranfude through all the membranes of the body, both in health and fickness *.

T

CHA P. IX.

Of the diseases of the liver.

HE liver is liable to very many diseases; becaufe the affections of this organ are for the most part owing to the bile, which may be vitiated feveral ways. But the most common of all is the jaundice; and as what authors have written on this diftemper has not given me thorough fatisfaction, I think proper to inquire with fome care into its nature.

ΤΗ

'HE bile is a kind of natural fapo, that is, a mixture of oil, water, and falt, both vola-" tile and fixed, feparated from the blood in the liver for various ufes of the animal body. And as the blood itself may be vitiated many ways, it is no wonder, that this humour is fometimes rendered unfit for its offices. Now, it is often faulty by its lentor or vifcidity, and fometimes alfo by its exceffive thinnefs. In the first cafe, the fecretory glands of the bile are * In a book, entitled, Perfpiratio dicta Hippocrati per univerfum corpus anatomice illuftrata. Leyden, 1738.

obftructed,

obftructed, and the fmall quantity of it that is fecreted ftagnates in the hepatic ducts; whence the liver grows hard, and under its tunicle are formed whitish concretions, refembling hard foap. But this difeafe arifes, not only from the vifcidity of the bile, whereby it ftops in its paffage, but alfo from its want of due confiftence. For here the volatile falt, which is one of the compounding principles of the bile, overabounds; whence the bile becomes too thin, hot, and irritating to the intestines. In the former cafe, the body is too coftive, and the fæces are hard, and of a clay colour; in the latter a diarrhoea, attended with a fever and thin yellow ftools, conftantly teafes the patient. Perfons who spend their lives in a fedentary manner, without proper exercife, are moft liable to the former because the oily part of the bile grows too thick and vifcid for want of a due proportion of falt and those who render their faculties ufelefs, by too high feeding and drinking spirituous liquors, are generally most expofed to the latter.

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But there is another fpecies of jaundice, owing to a very different caufe from thofe above defcribed, and that is, to nervous fpafms; when the fubtile, elastic fluid of the nerves, by becoming too acrid and irritating, conftringes the bile-ducts to a degree of hindering its paffage through the liver; and confequently, it muft remain in the blood, and thence be thrown on the different parts of the body. That fomething of this fame kind follows upon violent colic pains, and the bite of the viper, we have shewn in another place *.

I muft alfo obferve, that there fometimes happens * Mechanical account of poisons, essay 1.

another