IV.

MEDICINAL SEMEIOTICS; OR THE SIGNS OF HEALTH AND SICKNESS.

Nor I, but an experienced physician ought to write on the physiognomonical, and pathognomonical semeiotica of health and sickness, and describe the physiological character of the body, and its propensities to this or that disorder. I am beyond description ignorant with respect to the nature of disorders and their signs; still may I, in consequence of the few observations I have made, declare, with some certainty, by repeatedly examining the firm parts and outlines of the bodies and countenances of the sick, that it is not difficult to predict what are the diseases to which the man in health is most liable. Of what infinite importance would such physiognomonical semeiotics, or prognostics of possible or probable disorders be, founded on the nature and form of the body! How essential were it, could the physician say to the healthy, "You naturally have, some time in your life, to expect this or that disorder. Take the necessary precautions against such or such a disease.

"The virus of the small-pox slumbers in your body, and may thus or thus be put in motion. Thus the hectic, thus the intermittent, and thus the putrid fever.”—Oh how worthy, Zimmermann, would a treatise on physiognomonical Diætetice (or regimen) be of thee!

Whoever shall read this author's work, on Experience, will see how characteristically he describes various diseases which originate in the passions. Some quotations from this work, which will justify my wish, and contain the most valuable semeiotical remarks, cannot be unacceptable to the reader. The first is from Part I. chap. viii. page 401. f. "The observing mind examines the physiog nomy of the sick, the signs of which extend over the whole body, but the progress and change of the disease is principally to be found in the countenance and its parts. Sometimes the patient carries the marks of his disease. In burning, bilious, and hectic fevers; in the chlorosis; the common and black jaundice; in worm cases.”—(I, who know so little of physic, have several times discovered the disease of the tape worm in the countenance.)" In the furor uterinus, the least observant can read the disease. The more the countenance is changed, in

burning fevers, the greater is the danger. A man whose natural aspect is mild and calm, but who stares at me, with a florid complexion, and wildness in his eyes, prognosticates an approaching delirium. I have likewise seen a look indescribably wild, accompanied by paleness, when nature, in an inflammation of the lungs, was approaching a crisis, and the patient was become excessively cold and frantic. The countenance relaxed, the lips pale and hanging, in burning fevers, are bad symptoms, as they denote great debility; and, if the change and decay of the countenance be sudden, the danger is great. When the nose is pointed, the face of a lead colour, and the lips livid, inflammation has produced gangrene. There is, frequently, something dangerous to be observed in the countenance, which cannot be known from other symptoms, and which, yet, is very significant. Much is to be observed in the eyes. Boerhaave examined the eyes of the patient with a magnifying glass, that he might see if the blood entered the smaller vessels. Hippocrates held that the avoiding of light, involuntary tears, squinting, one eye less than the other, the white of the eye inflamed, the small veins inclined to be black, too much swelled, or

too much sunken, were, each and all, bad symptoms (page 432). The motion of the patient, and his position in bed, ought, likewise, to be enumerated among the particular symptoms of disease. The hand carried to the forehead, waved, or groping in the air, scratching on the wall, and pulling up the bed clothes, are of this kind. The position in bed is a very significant sign of the internal situation of the patient, and therefore deserves every attention. The more unusual the position is, in any inflammatory disease, the more certainly may we conclude that the anguish is great, and, consequently, the danger. Hippocrates has described the position of the sick, in such cases, with accuracy that leaves nothing to be desired.The best position in sickness is the usual position in health,"

I shall add some other remarks from this physician and physiognomist, whose abilities are superior to envy, ignorance, and quackery. (Page 452) "Swift was lean while he was the prey of ambition, chagrin, and ill temper; but after the loss of his understanding he became fat."-His description of envy and its effects on the body are incompa rable. (Part II. chap. xi.) "The effects of envy are visible, even in children. They become thin, and easily fall into consump

tions. Envy takes away the appetite, and sleep, and causes feverish motion; it produces gloom, shortness of breath, impatience, restlessness, and a narrow chest. The good name of others, on which it seeks to avenge itself by slander, and feigned but not real contempt, hangs like the sword suspended by a hair over the head of Envy, that continually wishes to torture others, and is itself continually on the rack.-The laughing simpleton becomes disturbed as soon as Envy, that worst of fiends, takes possession of him, and he perceives that he vainly labours to debase that merit which he cannot rival. His eyes roll, he knits his forehead, he becomes morose, peevish, and hangs his lips. There is, it is true, a kind of envy that arrives at old age. Envy in her dark cave, possessed by toothless furies, there hoards her poison, which, with infernal wickedness, she endeavours to eject, over each worthy person, and honourable act. She defends the cause of vice, endeavours to confound right and wrong. She vitally

wounds the purest innocence."

The writers most known, and oftenest quoted, by physicians, on semeiotics, are Aretæus, Lomnius, Æmilius Campolongus, Wolf, Hoffman, Wedel, Schroeder, Vater.