(From α, and to nourish). Contabescentia; inutritio; marasmus; ariditas corporis; an atrophy. It is a wasting, with loss of strength; but without hectic fever. Dr. Cullen remarks, that an atrophy perhaps is never without fever, at least the pulse is quicker than usual; but the absence of the true hectic fever distinguishes this disease from the tabes. It is also called a nervous consumption. Dr. Cullen places atrophy in the class cachexiae, and order marcores. He enumerates four species.
1. Atrophia inanitorum, from too great evacuations; tabes nutricum, sudatoria, and a sangui-fluxu.
2. Atrophia famelicorum, from deficient nourishment.
3. Atrophia cacochymica, from bad nourishment, depraved digestion, or acrimony: tabes syphilitica, and ab hydrope.
4. Atrophia debilium, where the powers of digestion areweakened or destroyed. The atrophy-of children is called paidotrophia, and the tabes dorsalis belongs to the fourth species.
An atrophy, from whatever it may proceed, arises from a defective exertion of the assimilating powers of the constitution, an impediment to the application of the nourishment obtained; by which even the functions of the machine, ordained for the support, becomes its destruction; or from a preternatural discharge of the healthy fluids: acrimony, requiring excessive absorption for its attenuation or sheathing, is scarcely an object of the present article, as it is most commonly connected with hectic fever.
The signs in the beginning are, a decrease of strength, loss of appetite without fever, cough, or short breath, though in the progress, when atrophy has induced great weakness, there is some degree of difficulty in the breathing; the urine is inconstant in its colour, though generally high, and small in quantity; sometimes it is pale and profuse; in time the blood seems to grow hot and acrid for want of its due supplies, a febrile heat increases, as well as a cough, and difficulty of breathing. In children this disease frequently happens; and, besides the above mentioned causes, they are subject to it from a sudden change from the breast to more solid food; in which case their legs become pendulous, the habit flaccid, their skin corrugated, and, in many instances, their appetite for food is almost insatiable. As a weakness in their chylopoietic organs is the cause, so, on dissecting those patients after death, their mesenteric glands are tumefied, their livers much disordered, their intestines filled with black fetid sordes, and the muscles of their bellies extenuated almost to a membrane. It is, however, doubtful whether this disease is not rather referable to scrofula. Sec Tabes Mesenterica.
Atrophy should be distinguished from leanness, the rickets, and that weakness and leanness in some children, who pine only for want of a due supply from the breast the cure will be regulated by the cause.
If the cause is indigestion, with a viscid obstruction of the mesentery, which is the case in children, and sometimes in old people, gentle occasional doses of rhubarb with calomel, or sal polychrest, and in the intervals, stomachics, with warm tonics, are useful. Irritating purges weaken the patient too much. Ferrugineous medicines, and the bark, contribute to the cure; though in this complaint the best plans often fail.
The scrofulous and cancerous cases only admit of palliation, by keeping the circulation as low as the general health will admit. A thin light diet is the most proper, such as jellies of vegetable and animal substances, and broths; supporting the strength by the bark, and dilute vitriolic acid.
When excessive evacuations have been the cause, the decoction of sarsaparilla, salep, chalybeate waters, bark, cold bathing, and gentle riding, are proper. A species is mentioned by authors, arising from a compression of the thoracic duct by a tumour; but this is evidently beyond the reach of medicine, as atrophy from a rupture of this duct would be.
A venereal taint is often an unsuspected cause; in which case mild mercurials, with sarsaparilla, and a milk diet, are the cure. See Sauvages' Nosologia Me-thodica. Hoffman, Syst. Rat. Medicinae. Morton. Willis.