be called SCLEROTIN. Its properties have been sufficiently detailed in the course of the experiments. It may seem a little surprising that a new vegetable principle should hitherto have been entirely overlooked; but when we consider that only about 30 species of Fungi have as yet been carefully analyzed, of many hundred known: that in most of these, some remarkable substances, such as adipocire, have been detected: we may expect, when more of this neglected tribe of plants are examined, several principles, now unknown, will then be brought to light.

With sentiments of the greatest respect,
I remain, Sir,

Your obedient servant,

JOHN TORREY.

Reflections and Observations on Entero-Mesenteritis, a disease of Children, commonly called Tabes Mesenterica, by H. M. J. DESRUELLES, M. D.

Translated for the Medical Repository from the Journal Universel des Sciences Medicales.

EVERY disease which terminates gradually by disorganizing one or more of the internal viscera, arises from inflammation. If the disease be properly treated from its commencement, this lesion of the vital tissue is sooner or later arrested; but left to the influence of that combination of forces and actions usually denominated by the vague appellation of the vis natura, the inflammation runs through its stages, sometimes terminating by resolution, but more frequently producing morbid alteration in the organ, which finally proves fatal. These reflections are especially applicable to Entero-Mesenteritis, commonly called Tabes Mesenterica, on which I propose to make a few practical and theoretical remarks.

The improper regimen to which young children are sub

ease.

jected, appears to me to be the principal cause of the disIf we examine the treatises on this subject which authors have left us, we shall be convinced, that it has been caused by feeding them too abundantly on nutritious and stimulating food; that a protracted and obstinate diarrhoea has almost always preceded it; and that the examinations after death have shown considerable morbid altera. tion of the alimentary canal.

Irritation of the mucous membrane of the intestines, in children endowed with great irritability of the lymphatic system, constitutes what may be called the first stage of Tabes Mesenterica. We should be very careful how we permit the diarrhea to continue in this disease, from an opinion that it is favourable to dentition; for it is not true that its protracted condition aids that process: neither must it, on the other hand, be checked by astringents ånd corroborants, for very far from being induced by debility, it is caused by an irritation which will be best allayed by means of a mild and muciluginous diet.

As soon as the irritation of the mucous membrane of the intestines becomes chronic, it is propagated by continuous sympathy to the absorbents and lacteals, and thence to the mesenteric glands, which become red and enlarged. If the irritation be moderate, these glands will remain stationary for years; but if the disease be further aggravated by heating medicines and stimulating diet, they will then rapidly increase, and soon become tuberculous. At this period they will be found to resemble encrysted tumours, and to contain a thick granulated matter, of a yellow or whitish colour. The absorbent vessels continue for a long time to perform their functions imperfectly, so that the child becomes more and more emaciated, and the abdomen more tumid, till at length the glands being totally disorganized, absorption ceases, lientery supervenes, and the child dies tabid.

The numerous observations which I have made from examinations of adult persons who have died of chronic enteritis, have suggested to me these ideas on the nature of Tabes

Mensenterica. In those cases where the lymphatic temperament was strongly marked, I have seen the mesenteric glands in the condition I have just described, forming enormous masses, containing a melicerous substance; and these tumours I found to correspond exactly with those parts of the alimentary canal that were most diseased. In those subjects on the contrary, that were less disposed to lymphatic irritations, the mesenteric glands were merely swelled, and of a dark red colour. Whenever astringent and tonic medicines are employed in these cases, they aggravate the disease, and convert the chronic inflammation into one of an acute character, which constitutes the disease improperly called Entero-Mesenteric fever, about which we have lately had so much written; which can serve no other purpose than to mislead us on the nature of the disease and the remedies to be employed for its removal.

Perhaps it may be objected to me, that the adult subjects in whom these two conditions of the mesenteric viscera were observed, had the abdomen only slightly tumid; whereas the swelling and hardness of this part are the principal characteristic symptoms of the Tabes Mesenterica of children. But in order to obviate this objection, it is only necessary to call to mind the relative state of the abdominal viscera in adults and children. Perhaps it may also be objected that the swelling of the mesenteric glands is idiopathic in certain cases-as, for example, in scrophulous subjects. I have already remarked with what facility lymphatic disorganizations occur in individuals of that predisposition, so that even a slight irritation, but for a short time applied, will often be sufficient to produce them. If any one will show me a single case of Tabes Mesenterica that is not in its first stage attended with diarrhoea, or some other alteration of the alimentary canal, as well as the tumid state of the abdomen, I will allow the objection to be well founded; but, until then, I shall persist in believing the primitive seat of the disease to be in the mucous membrane of the intestinal canal.

Tabes Mesenterica is not an idiopathic disease, but the termination of a chronic enteritis. It is very seldom that i is cured after the mesenteric glands have become greatly enlarged and schirrous; and hence the necessity of directing all our care to combating the inflammatory symptoms in the early stage, that we may hinder its further progress. Heretofore practitioners have never thought of treating this disease until the swelling of the abdomen had made considerable progress; and of course all the preceding symptoms have been wholly unknown and neglected: and, indeed, we are chiefly indebted to the author of the work on Chronic Inflammations (M. Broussais) for our knowledge of the symptoms of this class of diseases; for before the appearance of his book, no one knew how to appreciate justly their symptoms.

In the advanced stage of this affection, the pathologist should not confine his attention to the mucous membrane of the intestinal canal; the other organs of the digestive system do probably also exert a great influence over the disease. Is not the circulation in the vena portarum retarded by the swelled and tuberculous state of the mesenteric glands? May we not suppose that the two principal viscera, the liver and spleen, which serve as a kind of diverticula to the stomach, intestines, and epiploon, are also considerably enlarged, and contribute greatly to render the abdomen tumid in this disease? Furthermore, we know that the vena portarum receives its blood from the intestinal canal by numerous very small vessels. May not these vessels absorb from the canal some of the morbid matter that is there formed, and transmit it to the liver, and thence to the other organs of the system and impair their tone and vigour?

These ideas on the enlargement of the liver and spleen, and the absorption of morbid matters by the hepatic vessels, might seem to warrant the employment of evacuant remedies. Nevertheless I do not believe them suitable to the treatment of Entero-Mesenteritis; because purgatives

must necessarily augment the inflammation; and every thing stimulating must hasten on the morbid alterations that are, already taking place.

CASE I.

A child, aged six and a half years, born of healthy parents, nursed by the mother, living in a salubrious country, and enjoying all the conveniences of life, was attacked towards the end of the year 1815 with symptoms which the attending physician judged to indicate a scrophulous disease. The extremities were greatly emaciated; the skin pale, and covered here and there with red patches; the face suffused; the eyes piercing, fixed and heavy, and the temper peevish and fretful. The antiscorbutic sirup, the vinous tincture of Peruvian bark, bitters, and generous wine, were administered, and the child fed on the most nutritious aliment, without producing any alleviation of the disease.

September 1st, 1817.-Mr. Dupont, a practitioner of Lille, was requested to see the child. He found her very much emaciated; the skin pale, with the trunk and face swelled, and disfigured with red stripes; the eyes animated and piercing; the pulse irregular, intermitting, vibrating and slow; the tongue in the centre covered with a white fur, its sides of a pale red, and the papillæ of a brighter red than the other parts. The epigastric and hypogastric regions were very painful and sore, and hot to the touch. The child was subject to colic pains on taking the lightest food; the abdomen was tumid and hard; the alvine discharges were frequent, fluid and light-coloured; the urine deposited a lateritious sediment; all the other functions were natural. M. Dupont prescribed a mild diluent farinaceous diet, with barley water for ordinary drink, &c.; forbid the use of sirups, medicated wines, and every kind of animal food. His advice was strictly pursued, and an alleviation of the symptoms soon followed.