156 CHANNEL i s l a n d s :
constitutional derangement is not urgent; and the
functions of the sensorium are not disturbed ; although
vertigo is sometimes present, and pain is often referred
to the scalp, the cheek, or jaw of one side. These
symptoms vary as to the length of their continuance ;
sometimes ceasing within four or five days;—at others
extending to as many weeks. But the health of the
patient is re-established ; and frequently remains for
a time better than before the attack ; which, however,
in a month or tvvo, generally recurs from some slight
cause; and again runs through the circuit of its course.
These symptoms, however, are rarely present simultaneously,
or even in the same case ; and some of
them are occasionally altogether absent. The disease
chiefly affects persons between the ages of twenty and
fifty; and generally such as have been previously subject
to rheumatism. But what especially marks the
relationship of this disease with rheumatism (in addition
to many of the symptoms detailed, which will bè
recognized as belonging to the latter) is this: that it is
often consecutive upon fugitive pains, shifting from
joint to joint, or lodging in the region of some of the
great aponeurotic or ligamentous expansions of the
back or trunk; or else it is actually accompanied by
such pains,—the latter being by far the more frequent
occurrence. In three cases, however, I have known
this disease put an end to attacks of rheumatism that
had for many years before greatly harassed the individuals,
on any sudden changes of the wind to any particular
quarters,—or of the moisture and temperature
of the atmosphere. Lastly, the two diseases are assimilated
in another respect,—being both prevalent in
JERSEY. 1 5 7
the same season ; and under a similitude of circumstances,
as touching the habits and locality of the persons
affected by them.
These points of analogy in the symptoms, are, I
think, sufficiently close and numerous to warrant the
opinion here advanced, that those disorders of the
chylopo'ietic viscera, attended with vomitings, and
which are so universally met with in Jersey, and often
in some of the damper counties of England also, are
in truth, only another form of rheumatism : but one
in which that disease, instead of being seated in the
aponeuroses and ligamentous expansions ot the large
joints of the limbs and trunk, has its seat in the fibrous
capsule of the liver ; and hence comes, at length, to
involve the other tissues of that gland on whose action
the function of the organ depends.
Being well aware of the deep interest attached to
an opinion involving a total change in our pathological
views of an important class of diseases, I shall submit
my views on this matter to the medical world, at
greater length and in another form. From the views
that I shall there develope, it will be seen, that the
derangements in the function of the liver in these diseases,
although primarily arising from sub-acute inflammation
of the fibrous tissues abovementioned,
more immediately result from an extension of the inflammatory
action along the dense cellular membrane
investing (like an arterial coat) the ramifications of
the portal veins; since it is acknowledgedly from
these veins (whose functions be it remembered are
arterial), that, in the parenchyma of the liver, the bile
is ultimately secreted: in the same manner as other
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