This section is from the book "The London Medical Dictionary", by Bartholomew Parr. Also available from Amazon: London Medical Dictionary.
A defluxion, (from and to flow down). Called also bronchos, catarrheuma, fluxio, rheuma, capiplenium. It is an inflammation of, or an increased and morbid secretion from, the mucous membrane of the nose, eyes, throat, mouth, or lungs, which, in a slight degree, is called a cold. Dr. Cullen ranks this genus of disease in the class pyrexiae, and order profluvia. He enumerates two species: the first from cold, called also amphimerina tusiculosa, tussis catarrhalis, rheuma catarrhale, cephalalgia catarrhalis, coryza catarrhalis, phlegmatorrhagia febricosa; the second from contagion, called catarrhus epidemicus. Hippocrates mentions seven species of de-fluxions under the appellation of catarrh; and, with Coelius Aurelianus, under this term comprehends coryza. Dr. Cullen uses the last as a synonym to catarrhus.
As this is the first disease of importance in which the idea of a defluxion has occurred, we may take the opportunity of making some remarks on an opinion which has, for more than two thousand years, influenced the language of medicine. When, from any cause, a tumour, increased action of, or an increased discharge from, a part, occurred, it was called a defluxion, or rather a from fluo: in fact, it meant no more than that the vessels contained an over proportion of fluids which were sent to the part. Yet, even in the earliest periods, the word rheum made a fixed impression on the mind, as a peculiar substance; and we had a cold, a hot, a saline, an acrid, and viscid rheum, in almost every complaint. The former editions of this Dictionary repeated this language more often than the pages recurred; and, in cleansing an Augean stable, who can say that every atom of offensive matter is removed? It is necessary, however, in this place, to observe, that rheum, as a peculiar morbid fluid, has no existence; and that it cannot be, therefore, hot, cold, acrid, saline, or viscid. When an increased action of any part is preceded by fever, it was styled a hot rheum; when fever was the effect, the rheum was cold. If a sore was irritable, the rheum was acrid; if a tumour did not readily suppurate, it was viscid; while every appearance depended on the increased action being an effect or a cause, on the state of the vessels, or on the nature of the organ. We still preserve the term in rheumatism, and, "a graeco fonte parce detorta,"in catarrh.
In this place we consider only the catarrh attended by fever; whether it affects the nose, the breast, or the fauces, according to the following lines.
Si fluit ad pectus dicatur Rheuma Catarrhus.
Ad fauces Bronchus ad nares esto Coryza.
The seat of the catarrh is in the membrane of the nose, the frontal sinuses, the antra Highmoriana, all the cells of the os sphenoides, the mouth, fauces, eyes, the aspera arteria, and its branches in the lungs. It is most frequent in cold climes, in spring and autumn, or in variable seasons; and is said to be be more common with those who have narrow chests, long necks, are disposed to coughs; the phlegmatic and weak.
Its general cause is supposed to be suppressed perspiration; and this so often occurs in our climate, that we can account for every catarrh. It may appear singular to reject this cause; yet, how often is perspiration suppressed without catarrh; how often catarrh occurs without the supposed source. We remember a period, not during an epidemic influenza, that in one evening, nearly at the same hour, six persons were seized with violent catarrhs: two of these had not been out of their bed, from a gouty paroxysm, for six weeks; and two others had been confined for many days to their room. The fact, recorded by Martin, of an epidemic catarrh happening at St. Kilda, when the steward went to this remote island to receive the rents, is well known; and we, for many succeeding years, witnessed the fact of a lady who regularly had a cold when she returned from her country to her town house; though servants, for many days, preceded her, fires were made in every room, and her removal was always before Michaelmas. It is common also, on beginning a course of sea bathing, to direct a little delay, lest a cold should occur on the change of air; and though we can more readily account for a person catching an infectious disease, on removing from a healthy to an infectious atmosphere, the contrary is not equally probable, unless some cause should concur to facilitate the action of the miasmata. Yet the latter sometimes happens, and may be owing to a cold. A late author, if we mistake not, a Mr. Kelson, has adduced many arguments to prove this position; and, when we reflect that no epidemic is so universal, so steady in its progress and so constant in its returns, as influenza, we must at least doubt whether catarrh is not more often owing to miasmata than change of temperature. We should indeed doubt whether it were not always owing to the former, but that we know an organ builder constantly affected with a catarrh on tuning an organ: and the connection is general and constant between the discharge from the skin and the lungs; the defect of one is so often supplied by the excess of the other, that cold must be a very frequent cause.
In the inflammatory catarrh the symptoms are a redness, heat, soreness and sense of distention in the eyes and eye lids; at the same time there is an unusual secretion of tears, and watery mucus, which, running down the cheeks, inflame them. When the nose is affected there is a sense of stuffing and swelling in the nostrils, an alteration in the voice, a loss of smell: and, if the inflammation runs high, a thin mucus is secreted, which produces heat and soreness of the nostrils, sneezing, and sometimes inflammation, with excoriation of the upper lip. If the throat, trachea, or lungs, are the seat of the disease, the thin mucus separated in these parts inflames them: sometimes a swelling of the nose attends, or perhaps the. whole face is puffed; a languor, stupor, deafness, and soreness of the ears, are common complaints. When the throat is affected, the tonsils and parts adjacent are red, sore, and hot, accompanied with a secretion of watery mucus, which stimulates and occasions a constant, troublesome, and tickling cough: sometimes the whole mouth is sore; there are little excoriations on the tongue, and a constant flow of saliva, with a soreness of the salivary glands, and the lips are inflamed and excoriated. When the larynx or trachea is affected, a soreness is felt in them, attended with a hoarseness, and generally with a troublesome tickling cough. In the lungs, this dis-ease produces a soreness, tightness, and sense of fulness in the breast, with a difficulty of breathing, and a violent cough, with which nothing, or only a watery mucus, is at first spit up: the cough produces soreness under the sternum and in the sides, and sometimes head ach, sickness, and retching. All these parts are occasionally affected at once; but more generally it happens that one only is first diseased. The inflammation spreads more or less, as circumstances concur to favour its progress. The inflammation too varies, according to the strength of the patient, or the violence of the attack. In the evening the symptoms are more troublesome; but in the morning a gentle moisture in the skin appears, and the patient is easier. In weakly habits the pulse is frequent, but not very hard; the appetite is lost, and the increase of the evening paroxysm is considerable.