TEN
TEN
them formed the Tendo Achillis ; and as the union of thefe two is very ftr'ict, the pain fucceeding the reparation of one, and the retraction of its ends, cannot but be proportionably violent and great.
The pain felt in the diTifion of one of thefe Tendons, or the imperfect: rupture of the Tendo Achillis, is only perceived up- wards or above the wound, not below it ; the rcafon of which is, that the upper part of the divided Tendon is forcibly drawn up by the rnufcle by which it is contracted, while it is alfo drawn downward at the fame time by the Tendon to which it is intimately and firmly united, and which yet remains whole; and this contrary force mult produce the molt exquifite pain in the fibres which refift ; while the inferior portion, having no force applied to it but what tends to draw it downwards, ea- fily yields to that, and is in no condition to fuffer a like pain. This difference between the fenfation of the two extremities is, however, only to be felt at firft ; fince, after fome time, the inflammation fpreading, afreets the neighbouring parts, and the lower extremity mult: feel its {hare ; though even then the pain is much lefs acute in that portion than in the upper. Jn cafe of a compleat rupture of this Tendon, the foot may be bent without cauling any pain to the patient ; the only effect is the encreafing the fpace which is between the divided ends of the Tendon: But the cafe is far other wife in an imperfect rupture of this Tendon ; the fuot then cannot be bent without the utmoft pain and agony, becaufe the fpace between the di- vided ends of the Tendon, which mult be enlarged by this bend- ing, cannot be enlarged without a tearing, and violently forcing the imperfectly divided parts.
In the imperfect rupture of this Tendon, the patient may walk, though it is with very violent pain ; but in the perfect rupture, the perfon cannot walk, though he buffers no pain at all. In walking, at every ftep that we take, the whole weight of the body is fuftained by the hinder foot ; now the Tendo Achillis is the only fupport, by means of which the foot can fuftain that weight, or regulate its prellure ; and therefore when that Tendon can no more perforin its office, we can no more walk. Thefe are the feveral fymptoms by which the imperfect ruptures of this Tendon may be known from the compleat ones ; a knowledge highly necefTary to all who are to undertake their cure. Memoirs Acad, Par. 1728. There have been inftances of the Tendo Achillh having been cut through, and cured without Hitching. See Commerc. Norimb, 1740. hebd. 46.
When a Tendon is wounded or divided, the part to which it belongs lofes its motion ; but if it is divided only in part, the fymptoms "it produces are much the fame with thofe arifing from a nerve wounded in the fame manner. Meijfer's Surg. p. 28.
Tendon, in the manege, a fort of grifHe that furrounds one part of a horfe's foot, and is fcated between the hoof and the coffin-bone, near the cronet. When a horfe has a quitter- bone, the matter that gathers between the coffin-bone and the hoof, fpoils the Tendon, and makes it black ; and the cure of fuch a quitter-bone confifts in cutting and extirpating the Ten- don.
TENESMUS, (Cycl.) a name given by medical writers to a complaint, which is a continual defire of going to ftocl, but ufually without any ftool being ready to be voided. This is ufually attended with fome tumour, fometimes with a very , confiderable one in the part. This is properly no primary dif- eafe, but merely a fymptomatic one, and differs in degree ac- cording to the difeafe on which it is an attendant.
Signs of it. Thefe are a titillation and itching about the anus, attended with a violent burning pain, and a defire of com- preffing and voiding fomething, and this attended ufually ei- ther with no excrement, or only a pulpous and mucous matter, and very often a procidentia ani, or falling down of the rectum.
Perfons fuhjefi to it. This difeafe very often happens to people labouring under hemorrhoidal difurders, cfpecially when the difcharges attending them do not fucceed regularly, though nature gives all the neceiiary motions for their excretion. It happens alfo to people who are fubject to void an acrid and bilious matter by ftool, and not unfrequently to thofe who have a ftone in the bladder. Women in the latter part of their time, in going with child, have alfo very often terrible fits of it, attended with confiderable fwelling ; this happens to them from the preffure of the uterus, with its burden, upon the rectum and hemorrhoidal veins. The procidentia ani hap- pens alfo to all thefe fubjects, and, belide thefe, is very fami- liar to infants, from their voiding an acrid matter by ftool, and to all perfons who are fubject to great coftivenefs, and void their itools with great difficulty and pain ; and finally, people who have paralytic weaknefles of the fphincter of the anus, incur this troublefbme difordcr after a time.
Caufcs of it. The caufes of zTenejinus, befide thofe already mentioned, of fupprefliom of the hemorrhoidal difcharges, and voiding acrid matter by ftool, are the afcarides, a fmall fort of worms which ufually infeft the rectum, and occafion a continual iching and tickling there; the abufe of refinous purging medicines j and, among thefe, the refinous parts of aloes, and black hellebore, are, above all, molt fubject to remain in the rectum, and bring on this complaint : Much
riding will alfo fometimes occafion it j and many people have been thrown into it by wiping their backlide with paper in which pepper, ginger, or other hot and acrid' things have been kept. The procidentia ani is owing ufually to the fame ge- neral caufes, as alfo to the relaxation of the nervous and glan- dulous coat of the rectum, occafioned by long continued diarrhoeas.
Prognojlics in a Tenesmus. When a hiccough comes on upon a perfon in a Tenefmus i it is ufually a bad omen ; a vio- lent Tenefmus coming upon women with child, fometimes oc- cafions them to mifcarry. In the mildeft fymptoms of the falling down of the anus, which is a frequent attendant on a Tenefmus, it is a very troublefome and painful diforder, efpe- cially when it continues fome time, as it often does : And when there happens a tumour, and coldnefs in the part that is fallen, it very often becomes dangerous, threatening in- flammation and mortification. In common cafes, and where the diftemperature has not before been frequent, the reducing the inteftine to its place is ufually an eafy thing ; but when there is any thing paralytic in the origin, it is more difficult both to reftore it, and to prevent relapfes.
Method of Cure. As the Tenefmus is merely a fymptomatic dif- eafe, the primary diforder is to be examined, and treated, in order to a cure. Thus, when it is occafioned by afcarides, worm-medicines are to be given, and clyftersof a proper kind injected, fuch as decoctions of tanzy, wormwood, and myrrh ; When the worms are by this means deftroyed, the Tenefmus, which was no more than a fymptom, naturally ceafes. In cafes where it is caufed by a flux of bilious matter by ftool, or by a retention of the hemorrhoidal difcharges, it will be proper to give medicines to obtund the acrimony of the humours, and take off the fpaftic motions occafioned by them. To this purpofe powders of nitre, crabs- eyes, and cinnabar, are to be given, and jellies of hartfhorn, and the like, with gum- arabic, tragacanth, and fuch other agglutinants. The vapours of turpentine, and of the carminative feeds, received on the part, are alfo of great benefit ; and hot fomentations of de- coctions of the herbs of marfhm allows and pellitory, and cha- momile flowers. Thefe ingredients may alfo be applied as a cataplafm ; for beyond all things, external heat is of the moft immediate ferv.ice. The fitting over the ftcam of hot water is a very good thing, and the rubbing the part with an oint- ment made of mucilage of quince feeds, with oil of mullin, and the yolk of an egg. In cafes where there is a procidentia ani, the gut is to be replaced as foon as poffible; the perfon is, to this end, to be laid upon his belly, and a moderate force to be ufed in putting it back, the fingers being firft rubbed over with oil of fwect almonds, before they touch' the gut. If this is not to be done at the firft attempts, the patient muft, be fuffercd to lie down again in a natural pofture, and fpunges, wetted with aftringent dedoctions, are to be applied to the part; powders ofmaftic, with a very fmall quantity of alum among it, alfo is ufeful to be fprinkled on the gut on this oc- cafion. The fitting upon a bag of oatmeal, boiled to the con- fidence of pap, and fprinkled over with a fmall quantity of al- lum, is alfo a very good method. And fo long as the inte- ftine remains out of its place, it muft be carefully kept warm, for fear of a mortification. If there is an inflammation attending it, this muft be firft carefully difcufled by epithems of fcordium, fage, chamomile, and rofe and elder flowers ; and, after this, the ufual methods of attempting a reduction are to be em- ployed. And finally, when the fphincter has a paralytic weaknefs, the ordinary methods arc to be affifted by bandages, to prevent its return ; but in a cafe of this kind, all that is to be done, is fimply palliative, fince the cure is not to be hoped. In cafes where the Tenefmus is owing to bilious ftooh, or to the fuppreffions of the hemorrhoidal difcharges, the patients are carefully to abftain from all medicines in which aloes is an ingredient, as the elixir proprietatis, and the like. In cafes of the Tcncfims from the prcflure of the womb in women with child, there is no cure but delivery ; but the me- thods before propofed will palliate and give eafe. When milk is given in clyfters, in thefe cafes there muft be great care taken that it is perfectly frefh, not the leaft turned four. If there be a colic attendant on the Tenefmus, provided that it. be not a bilious one, it is always proper to inject clyfters with a fmall quantity of common fait, to abfterge the mucous hu- mours ; and when powders of the aftringent kind are ufed, they mult always be extremely fine, left their particles, flick- ing to the inner coats of the inteftine, fhould increafe, in- ftead of mitigating the dtfeafe. Alum muft be added, but in very fmall quantities, to thefe powders, left it. aftringe too violently, and by that means prevent inftead of forwarding the reducing the part. Hartman commends the beetles found in horfe-dung, dried and powdered, as a very powerful remedy in all cafes of this kind. Junk. Confp. Med. p. 583. feq.
TENGA, in botany, a name by which fome authors have cal- led the coco -nut-tree, or Palma lnd\ca nucifera of other writers. Hort. Maiab. vol. 1. p. 1.
TENSION, (Cycl.) Ten/to, TW K » in the antient mufic, was ufed to fignify any pitch of found, whether produced by in- tention or remimon. Vid. Arijhxen. p. 10— — 13, Edit, Meibom-
2 Ariftoxenus
