English
n . of the lids which become thick, reddened and crusted with cheesy secretions, is indicative of scrofula or 148 ANCIENT HINDU MEDICINE of minute ulceration, resulting from a previous ophthalmia or measles, anemia or in tuberculous diathesis ; verruca—warts upon the eye-lids, are ■usually found in the old people, indicating the possibility of commencing epithelioma ; syphilic ulceration is generally deeply indurated and accompanies other stigmata of the tertiary stage ; a dusky color of the lids and under the eyes is seen in women during menstruation, in menorrh¬ agia, long-continued leucorrhea and early in pregnancy: it may also accompany anemia, loss of sleep and in exhausting diseases ; dark circles round the eyes are symptomatic of the abuses of masturbation ; the yellow color of the sclera of the eye is symptomatic of jaundice ; bluish-white or pearly sclerotic is seen in anemia, pthisis and nephritis ; inflamed conjunctiva is usually caused by gonorrheal infection, though it may be present in lesser degree in diphtheria, measles, hay fever, coryza and influenza of the catarrhal type ; the eye may be dry and glazed in collapse or the typhoid status ; an increased secretion of the watery fluid of the eye {lachry- mation) accompanies conjunctivitis, irritation of any kind and in alcoholism : inflammation of the cornea (keratitis) is mainly of syphilic origin, while the ulceration of the cornea—a reddened, PATHOLOGY 149 painful, photophobic eye may be in relation with exophthalmic goitre ; protrusion of the eye-ball {exophthalmos) is symptomatic of exoph¬ thalmic goitre and may be also present in lesser degree in spasmodic asthma or other conditions- attended by dyspnoea ; recession of the eye-ball or the sinking of the eye-ball into the orbit (enophthalmos)vcL2ij be provoked by any wasting disease as consumption, malaria, cancerous- cachexia, by absorbing the cushion of fat of the orbital cavity; dimness of vision may be provoked by uremia, diabetes, excessive abuse of tobacco, hysteria and raigrane • light appears yellowish in jaundice, and reddish after nervous irritation, fatigue and in wasting diseases), ear (uuusally promi¬ nent, long or misplaced ears with absence of helix, antihelix, or lobule, are degenerative stigmata ; tophi—small, hard, gritty accretions of chalky masses of sodium urate, seen as nodules in the external ear along the margin or in the depressions, is of gouty diathesis ; a very thin, waxy and bluish ear may indicate- general anemia or chlorosis; but a thickened and a deformed ear with the effusion of blood between the cartilages and the perichondrium {hematoma miris), is a trophoneurosis of the general 150 ANCIENT HINDU MEDICINE paralytic and the insane; the flow of pus {otorrhea) from the meatus, which is very common among children and often associated with intense pain, due to inflammation of the tympanum {otitis media,) caused by tonsilitis, influenza or measles, is usually without serious consequences, deafness is indicative of the disease of the tympanum, eustacian tube or the auditory nerve : it can be easily found out by placing a watch at a varying distance from the car and if its ticking sound is not audible by aerial conduction, and then if the same watch is placed upon the mastoid process and the sound becomes audible by bone conduction, then it clearly indicates that there is no nervous lesion and the deafness is due to local hindranc¬ es : the auditory nerve and its cortical center may be affected by syphilis, which is usually the case or by tuberculosis by injuring the nerve endings : quinine, salicylic acid or the salicylates may also provoke temporary deafness by causing labyrinthine hyperemia ; hypersen- sitiyeness of hearing (oxyacoia) and the buzzing, roaring, hissing sound {tinnitus aurium), are due either to nervous irritability or to rhino- pharyngeal catarrh, with involvment of the eustacian tube or the middle ear), nose [a coarse i PATHOLOGY 151 and broad nose is symptomatic of myxedema and cretanism ; a depressed and sunken nose is syphilitic unless there is traumatic fracture of the hone ; a pinched and distorted nose may 'be due to obstruction of polypus, tumor or adenoid growth ; a chronic redness of the nose with dilated capillaries is indicative of alcoholism, otherwise of chi’onic digestive disorders or amenorrhea ; an intense pain in the nose is •symptomatic of syphilic lesion and a burning pain, to catarrhal inflammations ; a sensation of dryness is felt in the preliminary stages of •coryza ; sneezing—the spasmodic expiration, is due to the direct (presence of any foreign body or the inhalation of irritant substances as pep¬ per, snuff and in the early stage of coryza, mesales, pertussis, hay fever, asthma) or reflex {as in hysteria) irritation of the sensory nerves of the nose ; nasal stenosis—difficulty of brea¬ thing through the nose, if acute, is symptomatic of an acute coryza, diphtheria, hay fever or prodromal of typhus fever, glanders and variola, and if chronic, it is either due to the obstruction to lymphoid growths as in children or to congeni¬ tal syphilis; ulceration of the mucous mem¬ brane is usually a manifestation of tertiary syphilis or tuberculosis and might be followed 152 ANCIENT HINDU MEDICINE by necrosis and caries of the bones ; tlie ulcera¬ ted surfaces of syphilic origin is covered with a dry, greenish crust and the stench of the breath is sickening ; non-offensive, watery discharge from the nose marks the beginning of acute coryza, hay fever, pertussis, measles, typhus fever, catarrhal form of influenza and iodism; offensive discharge accompanied with greenish-gray crusts and its foul odor impercep¬ tible to the subject, is symptomatic of syphilic necrosis or of atrophic rhinitis ; a discharge of blood from the nose (epistaxis) may have varied causes as alcoholism which renders the vessels to rupture, adenoid growths, ulceration in the nose, suppressed menstruation, chronic nephri¬ tis, cerebral thrombosis, and may be prodromal of typhoid or other eruptive fever infection; loss of sense of smell (anosmia) may be due to local obstruction as polipi or adenoid growths, or chronic rhinitis and if it be only temporary, it may be of neurotic origin as hysteria or neurasthenia, and if it be permanent, the olfactoiy anesthesia may be caused by nasal necrosis of the bone, supporting the tract, or a tumor involving the nerve; hypersensitiveness to smell (hyperosmia), hallucinary smell Cijoros- mia) and an offensive smell (kahosmia) PATHOLOGY 153 without any physical basis, are all o£ neurotic origin], tongue [the colour of the tongue, the only mucous membrane of the body, except the oral and the faucial, that is open to naked eye inspection, changes according to health, digestion and especially to the gastric condition to which it is closely related ; it is pallid in anemia, bluish in cyanosis, reddish in gastric hyper-acidity, bright-red in the first stage of scarlet fever and in the inflammation of the tongue ( glossitis ), and greyish in nigrities ; a great enlargement of the tongue takes place in acromegaly and myxedema, but the tongue also swells considerably in variola, salivary calculus and in angina Ludovici ; the coating of the tongue consists of the accumulated epithelium, micro-organisms and food detritus : a thin-white coated tongue may be normal among the smokers or those who are accustomed to breathe through the mouth, but it usually accompanies mild gastro-intestinal disorder, nasopharyngeal catarrh or light fevers; a flabby, swollen, indented tongue, covered with a yellow, pasty fur, is symptomatic of catarrhal gastritis, gastro-duode- nitis or febrile conditions ; a narrow tongue with a deep median fissure on each side of which there is a rough, thick, brownish fur, or if it be 154 ANCIENT HINDU MEDICINE dry, red and glazed, is characteristic in typhoid status in its early and late stages ; a covered tongue with Avhite fur through which project swollen and bright-red fungiform pajoilla, is indicative of measles and other eruptive fevers ; if one side of the tongue is higher than theother, this is due to the unilateral lingual paralysis and associated with hemiplegia; if the tongue lies motionless in the floor of the mouth and the •subject is unable to protrude it and the functions of speech, mastication and deglutition are serious¬ ly impaired, it is due to the total lingual paralysis, caused by thrombosis or syphilic lesion], skin [ dryness of the skin {anidrosis) is observed in cholera, myxedema, diabetes, Bright’s disease, dropsy and in the first stage of many acute diseases, attended by high fever; moist skin and increased perspiration {liype7'idrosis) occurs in typhoid fever, tuberculosis, trichinosis, tetanus and in rheumatism, but the rheumatic sweat is strong in odor and acid in reaction ; in many acute diseases ''critical stoeats’ suddenly break out with the fall of temperature as in pneumonia with the termination of paroxysm as in mahxria, or the night sweats of tuberculosis and other wasting diseases ; partial or localized sweating is caused by the deranged innervation of the PATHOLOGY 155 Yaso-motor nerves and by the local vaso-motor paresis : tbis is particularly marked in rbacbitis and in which disease, which usually occurs among children, the sweat is confined to the head and the patient rolls his head at night and the hair on the back of the head is rubbed off; sweating of the hands and feet are seen in gener¬ al debility ; unilateral or one-sided sweating of the head and face may arise from destructive pressure on the sympathetic nerves, causing paralysis of the dilator fibers of the ciliospinal branches, as in thoraci