A widow lady was left in narrow circumstances with a boy and a girl, two

beautiful and lively children, the one six and the other seven years of

age; as her circumstances allowed her to keep but one maid-servant, these

two children were the sole attention, employment, and consolation of her

life; she fed them, dressed them, slept with them, and taught them herself;

they were both snatched from her by the gangrenous sore throat in one week:

so that she lost at once all that employed her, as well as all that was

dear to her. For the first three or four days after their death, when any

friend visited her, she sat upright, with her eyes wide open, without

shedding tears, and affected to speak of indifferent things. Afterwards she

began to weep much, and for some weeks talked to her friends of nothing

else but her dear children. But did not for many years, even to her dying

hour, get quite over a gloom, which was left upon her countenance.

In violent grief, when tears flow, it is esteemed a good symptom; because

then the actions caused by sensitive association take the place of those

caused by volition; that is, they prevent the voluntary exertions of ideas,

or muscular actions, which constitute insanity.

The sobbing and sighing attendant upon grief are not convulsive movements,

they are occasioned by the sensorial power being so expended on the painful

ideas, and their connections, that the person neglects to breathe for a

time, and then a violent sigh or sob is necessary to carry on the blood,

which oppresses the pulmonary vessels, which is then performed by deep or

quick inspirations, and laborious expirations. Sometimes nevertheless the

breath is probably for a while voluntarily held, as an effort to relieve

pain. The paleness and ill health occasioned by long grief is spoken of in

Class IV. 2. 1. 9.

The melioration of grief by time, and its being at length even attended

with pleasure, depends on our retaining a distinct idea of the lost object,

and forgetting for a time the idea of the loss of it. This pleasure of

grief is beautifully described by Akenside. Pleasures of Imagination, Book

II. l. 680.

----------Ask the faithful youth,

Why the cold urn of her, whom long he loved,

So often fills his arms; so often draws

His lonely footsteps at the silent hour

To pay the mournful tribute of his tears?

Oh! he will tell thee, that the wealth of worlds

Should ne'er seduce his bosom to forego

That sacred hour; when, stealing from the noise

Of care and envy, sweet remembrance soothes

With Virtue's kindest looks his aching breast,

And turns his tears to rapture.

M. M. Consolation is best supplied by the Christian doctrine of a happy

immortality. In the pagan religion the power of dying was the great

consolation in irremediable distress. Seneca says, "no one need be unhappy

unless by his own fault." And the author of Telemachus begins his work by

saying, that Calypso could not console herself for the loss of Ulysses, and

found herself unhappy in being immortal. In the first hours of grief the

methods of consolation used by uncle Toby, in Tristram Shandy, is probably

the best; "he sat down in an arm chair by the bed of his distressed friend,

and said nothing."

11. _Taedium vitae._ The inanity of sublunary things has afforded a theme

to philosophers, moralists, and divines, from the earliest records of

antiquity; "Vanity of vanities!" says the preacher, "all is vanity!" Nor is

there any one, I suppose, who has passed the meridian of life, who has not

at some moments felt the nihility of all things.

Weariness of life in its moderate degree has been esteemed a motive to

action by some philosophers. See Sect. XXXIV. 2. 3. But in those men, who

have run through the usual amusements of life early in respect to their

age; and who have not industry or ability to cultivate those sciences,

which afford a perpetual fund of novelty, and of consequent entertainment,

are liable to become tired of life, as they suppose there is nothing new to

be found in it, that can afford them pleasure; like Alexander, who is said

to have shed tears, because he had not another world to conquer.

Mr. ----, a gentleman about fifty, of polished manners, who in a few months

afterwards destroyed himself, said to me one day, "a ride out in the

morning, and a warm parlour and a pack of cards in the afternoon, is all

that life affords." He was persuaded to have an issue on the top of his

head, as he complained of a dull head-ach, which being unskilfully managed,

destroyed the pericranium to the size of an inch in diameter; during the

time this took in healing, he was indignant about it, and endured life, but

soon afterwards shot himself.

Mr. ----, a gentleman of Gray's Inn, some years ago was prevailed upon by

his friends to dismiss a mistress, by whom he had a child, but who was so

great a termagant and scold, that she was believed to use him very ill, and

even to beat him. He became melancholy in two days from the want of his

usual stimulus to action, and cut his throat on the third so completely,

that he died immediately.

Mr. Anson, the brother to the late Lord Anson, related to me the following

anecdote of the death of Lord Sc----. His Lordship sent to see Mr. Anson on

the Monday preceding his death, and said, "You are the only friend I value

in the world, I determined therefore to acquaint you, that I am tired of

the insipidity of life, and intend to-morrow to leave it." Mr. Anson said,

after much conversation, that he was obliged to leave town till Friday, and

added, "As you profess a friendship for me, do me this last favour, I

entreat you, live till I return." Lord Sc---- believed this to be a pious

artifice to gain time, but nevertheless agreed, if he should return by four

o'clock on that day. Mr. Anson did not return till five, and found, by the

countenances of the domestics, that the deed was done. He went into his

chamber and found the corpse of his friend leaning over the arm of a great

chair, with the pistol on the ground by him, the ball of which had been

discharged into the roof of his mouth, and passed into his brain.

Mr. ---- and Mr. ----, two young men, heirs to considerable fortunes, shot

themselves at the age of four or five and twenty, without their friends

being able to conjecture any cause for those rash actions. One of them I

had long known to express himself with dissatisfaction of the world; at

eighteen years of age he complained, that he could not entertain himself;

he tried to study the law at Cambridge, and afterwards went abroad for a

year or two by my advice; but returned dissatisfied with all things. As he

had had an eruption for some years on a part of his face, which he probably

endeavoured to remove by external applications; I was induced to ascribe

his perpetual ennui to the pain or disagreeable sensation of a diseased

liver. The other young gentleman shot himself in his bed-room, and I was

informed that there was found written on a scrap of paper on his table, "I

am impotent, and therefore not fit to live." From whence there was reason

to conclude, that this was the hallucinatio maniacalis, the delirious idea,

which caused him to destroy himself. The case therefore belongs to mania

mutabilis, and not to taedium vitae.

M. M. Some restraint in exhausting the usual pleasures of the world early

in life. The agreeable cares of a matrimonial life. The cultivation of

science, as of chemistry, natural philosophy, natural history, which

supplies an inexhaustible source of pleasurable novelty, and relieves ennui

by the exertions it occasions.

In many of these cases, whence irksomeness of life has been the ostensible

cause of suicide, there has probably existed a maniacal hallucination, a

painful idea, which the patient has concealed even to his dying hour;

except where the mania has evidently arisen from hereditary or acquired

disease of the membranous or glandular parts of the system.

12. _Pulchritudinis desiderium._ The loss of beauty, either by disease, as

by the small-pox, or by age, as life advances, is sometimes painfully felt

by ladies, who have been much flattered on account of it. There is a

curious case of this kind related in Le Sage's Bachelor of Salamanca, which

is too nicely described to be totally imaginary.

In this situation some ladies apply to what are termed cosmetics under

various names, which crowd the newspapers. Of these the white has destroyed

the health of thousands; a calx, or magistery, of bismuth is supposed to be

sold in the shops for this purpose; but it is either, I am informed, in

part or entirely white lead or cerussa. The pernicious effects of the

external use of those saturnine applications are spoken of in gutta rosea,

Class II. 1. 4. 6. The real calx of bismuth would probably have the same

ill effect. As the red paint is prepared from cochineal, which is an animal

body, less if any injury arises from its use, as it only lies on the skin

like other filth.

The tan of the skin occasioned by the sun may be removed by lemon juice

evaporated by the fire to half its original quantity, or by diluted marine

acid; which cleans the cuticle, by eroding its surface, but requires much

caution in the application; the marine acid must be diluted with water, and

when put upon the hand or face, after a second of time, as soon as the tan

disappears, the part must be washed with a wet towel and much warm water.

Freckles lie too deep for this operation, nor are they in general

removeable by a blister, as I once experienced. See Class I. 2. 2. 9.

It is probable, that those materials which stain silk, or ivory, might be

used to stain the cuticle, or hair, permanently; as they are all animal

substances. But I do not know, that any trials of this kind have been made

on the skin. I endeavoured in vain to whiten the back of my hand by marine

acid oxygenated by manganese, which so instantly whitens cotton.

The cure therefore must be sought from moral writers, and the cultivation

of the graces of the mind, which are frequently a more valuable possession

than celebrated beauty.

13. _Paupertatis timor._ The fear of poverty is one kind of avarice; it is

liable to affect people who have left off a profitable and active business;

as they are thus deprived of their usual exertions, and are liable to

observe the daily expenditure of money, without calculating the source from

whence it flows. It is also liable to occur with a sudden and unexpected

increase of fortune. Mr. ----, a surgeon, about fifty years of age, who was

always rather of a parsimonious disposition, had a large house, with a

fortune of forty thousand pounds, left him by a distant relation; and in a

few weeks became insane from the fear of poverty, lamenting that he should

die in a jail or workhouse. He had left off a laborious country business,

and the daily perception of profit in his books; he also now saw greater

expences going forwards in his new house, than he had been accustomed to

observe, and did not so distinctly see the source of supply; which seems to

have occasioned the maniacal hallucination.--This idea of approaching

poverty is a very frequent and very painful disease, so as to have induced

many to become suicides, who were in good circumstances; more perhaps than

any other maniacal hallucination, except the fear of hell.

The covetousness of age is more liable to affect single men, than those who

have families; though an accumulation of wealth would seem to be more

desirable to the latter. But an old man in the former situation, has no

personal connections to induce him to open his purse; and having lost the

friends of his youth, and not easily acquiring new ones, feels himself

alone in the world; feels himself unprotected, as his strength declines,

and is thus led to depend for assistance on money, and on that account

wishes to accumulate it. Whereas the father of a family has not only those

connections, which demand the frequent expenditure of money, but feels a

consolation in the friendship of his children, when age may render their

good offices necessary to him.

M. M. I have been well informed of a medical person in good circumstances

in London, who always carries an account of his affairs, as debtor and

creditor, in his pocket-book; and looks over it frequently in a day, when

this disease returns upon him; and thus, by counteracting the maniacal

hallucination, wisely prevents the increase of his insanity. Another

medical person, in London, is said to have cured himself of this disease by

studying mathematics with great attention; which exertions of the mind

relieved the pain of the maniacal hallucination.

Many moral writers have stigmatised this insanity; the covetous, they say,

commit crimes and mortify themselves without hopes of reward; and thus

become miserable both in this world and the next. Thus Juvenal:

Cum furor haud dubius, cum sit manifesta phrenitis,

Ut locuples moriaris, egenti vivere fato!

The covetous man thought he gave good advice to the spendthrift, when he

said, "Live like me," who well answered him,

----------"Like you, Sir John?

"That I can do, when all I have is gone!"

POPE.

14. _Lethi timor._ The fear of death perpetually employs the thoughts of

these patients; hence they are devising new medicines, and applying to

physicians and quacks without number. It is confounded with

hypochondriasis, Class I. 2. 4. 10. in popular conversation, but is in

reality an insanity.

A young gentleman, whom I advised to go abroad as a cure for this disease,

assured me, that during the three years he was in Italy and France he never

passed a quarter of an hour without fearing he should die. But has now for

above twenty years experienced the contrary.

The sufferers under this malady are generally at once discoverable by their

telling you, amidst an unconnected description of their complaints, that

they are nevertheless not afraid of dying. They are also easily led to

complain of pains in almost any part of the body, and are thus soon

discovered.

M. M. As the maniacal hallucination has generally arisen in early infancy

from some dreadful account of the struggles and pain of dying, I have

sometimes observed, that these patients have received great consolation

from the instances I have related to them of people dying without pain.

Some of these, which I think curious, I shall concisely relate, as a part

of the method of cure.

Mr. ----, an elderly gentleman, had sent for me one whole day before I

could attend him; on my arrival he said he was glad to see me, but that he

was now quite well, except that he was weak, but had had a pain in his

bowels the day before. He then lay in bed with his legs cold up to the

knees, his hands and arms cold, and his pulse scarcely discernible, and

died in about six hours. Mr. ----, another gentleman about sixty, lay in

the act of dying, with difficult respiration like groaning, but in a kind

of stupor or coma vigil, and every ten or twelve minutes, while I sat by

him, he waked, looked up, and said, "who is it groans so, I am sure there

is somebody dying in the room," and then sunk again into a kind of sleep.

From these two cases there appeared to be no pain in the act of dying,

which may afford consolation to all, but particularly to those who are

afflicted with the fear of death.

15. _Orci timor._ The fear of hell. Many theatric preachers among the

Methodists successfully inspire this terror, and live comfortably upon the

folly of their hearers. In this kind of madness the poor patients

frequently commit suicide; although they believe they run headlong into the

hell, which they dread! Such is the power of oratory, and such the debility

of the human understanding!

Those, who suffer under this insanity, are generally the most innocent and

harmless people; who are then liable to accuse themselves of the greatest

imaginary crimes, and have so much intellectual cowardice, that they dare

not reason about those things, which they are directed by their priests to

believe, however contradictory to human apprehension, or derogatory to the

great Creator of all things. The maniacal hallucination at length becomes

so painful, that the poor insane flies from life to become free from it.

M. M. Where the intellectual cowardice is great, the voice of reason is

ineffectual; but that of ridicule may save many from those mad-making

doctors; though it is too weak to cure those, who are already hallucinated.

Foot's Farces are recommended for this purpose.

16. _Satyriasis._ An ungovernable desire of venereal indulgence. The remote

cause is probably the stimulus of the semen; whence the phallus becomes

distended with blood by the arterial propulsion of it being more strongly

excited than the correspondent venous absorption. At the same time a new

sense is produced in the other termination of the urethra; which, like

itching, requires some exterior friction to facilitate the removal of the

cause of the maniacal actions, which may probably be increased in those

cases by some associated hallucinations of ideas. It differs from

priapismus chronicus in the desire of its appropriated object, which is not

experienced in the latter, Class I. 1. 4. 6. and from the priapismus

amatorius, Class II. 1. 7. 9. in the maniacal actions in consequence of

desire. The furor uterius, or nymphomania, is a similar disease.

M. M. Venesection. Cathartics. Torpentia. Marriage.

17. _Ira._ Anger is caused by the pain of offended pride. We are not angry

at breaking a bone, but become quite insane from the smallest stroke of a

whip from an inferior. Ira furor brevis. Anger is not only itself a

temporary madness, but is a frequent attendant on other insanities, and as,

whenever it appears, it distinguishes insanity from delirium, it is

generally a good sign in fevers with debility.

An injury voluntarily inflicted on us by others excites our exertions of

self-defence or of revenge against the perpetrator of it; but anger does

not succeed in any great degree unless our pride is offended; this idea is

the maniacal hallucination, the pain of which sometimes produces such

violent and general exertions of our muscles and ideas, as to disappoint

the revenge we meditate, and vainly to exhaust our sensorial power. Hence

angry people, if not further excited by disagreeable language, are liable

in an hour or two to become humble, and sorry for their violence, and

willing to make greater concessions than required.

M. M. Be silent, when you feel yourself angry. Never use loud oaths,

violent upbraidings, or strong expressions of countenance, or

gesticulations of the arms, or clenched fists; as these by their former

associations with anger will contribute to increase it. I have been told of

a sergeant or corporal, who began moderately to cane his soldiers, when

they were awkward in their exercise, but being addicted to swearing and

coarse language, he used soon to enrage himself by his own expressions of

anger, till toward the end he was liable to beat the delinquents

unmercifully.

18. _Rabies._ Rage. A desire of biting others, most frequently attendant on

canine madness. Animals in great pain, as in the colica saturnina, are said

to bite the ground they lie upon, and even their own flesh. I have seen

patients bite the attendants, and even their own arms, in the epilepsia

dolorifica. It seems to be an exertion to relieve pain, as explained in

Sect. XXXIV. 1. 3. The dread of water in hydrophobia is occasioned by the

repeated painful attempts to swallow it, and is therefore not an essential

or original part of the disease called canine madness. See Class III. 1. 1.

15.

There is a mania reported to exist in some parts of the east, in which a

man is said to run a muck; and these furious maniacs are believed to have

induced their calamity by unlucky gaming, and afterwards by taking large

quantities of opium; whence the pain of despair is joined with the energy

of drunkenness; they are then said to sally forth into the most populous

streets, and to wound and slay all they meet, till they receive their own

death, which they desire to procure without the greater guilt, as they

suppose, of suicide.

M. M. When there appears a tendency to bite in the painful epilepsy, the

end of a rolled-up towel, or a wedge of soft wood, should be put into the

mouth of the patient. As a bullet is said sometimes to be given to a

soldier, who is to be severely flogged, that he may by biting it better

bear his punishment.

19. _Citta._ A desire to swallow indigestible substances. I once saw a

young lady, about ten years of age, who filled her stomach with the earth

out of a flower-pot, and vomited it up with small stones, bits of wood, and

wings of infects amongst it. She had the bombycinous complexion, and looked

like a chlorotic patient, though so young; this generally proceeds from an

acid in the stomach.

M. M. A vomit. Magnesia alba. Armenian bole. Rhubarb. Bark. Steel. A

blister. See Class I. 2. 4. 5.

20. _Cacositia._ Aversion to food. This may arise, without disease of the

stomach, from connecting nauseous ideas to our usual food, as by calling a

ham a hog's a----. This madness is much inculcated by the stoic philosophy.

See Antoninus' Meditations. See two cases of patients who refused to take

nourishment, Class III. 1. 2. 1.

Aversions to peculiar kinds of food are thus formed early in life by

association of some maniacal hallucination with them. I remember a child,

who on tasting the gristle of sturgeon, asked what gristle was? And being

told it was like the division of a man's nose, received an ideal

hallucination; and for twenty years afterwards could not be persuaded to

taste sturgeon.

The great fear or aversion, which some people experience at the sight of

spiders, toads, crickets, and the like, have generally had a similar

origin.

M. M. Associate agreeable ideas with those which disgust; as call a spider

ingenious, a frog clean and innocent; and repress all expressions of

disgust by the countenance, as such expressions contribute to preserve, or

even to increase, the energy of the ideas associated with them; as

mentioned above in Species 17. Ira.

21. _Syphilis imaginaria._ The fear that they are infested with the

venereal disease, when they have only deserved it, is a very common

insanity amongst modest young men; and is not to be cured without applying

artfully to the mind; a little mercury must be given, and hopes of a cure

added weekly and gradually by interview or correspondence for six or eight

weeks. Many of these patients have been repeatedly salivated without curing

the mind!

22. _Psora imaginaria._ I have twice seen an imaginary itch, and twice an

imaginary diabaetes, where there was not the least vestige of either of

those diseases, and once an imaginary deafness, where the patient heard

perfectly well. In all these cases the hallucinated idea is so powerfully

excited, that it is not to be changed suddenly by occular sensation, or

reason. Yet great perseverance in the frequently presenting contrary ideas

will sometimes slowly remove this hallucination, or in great length of time

oblivion, or forgetfulness, performs a cure, by other means in vain

attempted.

23. _Tabes imaginaria._ This imaginary disease, or hallucination, is caused

by the supposed too great frequency of parting with the semen, and had long

imposed upon the physician as well as the patient, till Mr. John Hunter

first endeavoured to shew, that in general the morbid effects of this

pollution was in the imagination; and that those were only liable to those

effects in general, who had been terrified by the villainous books, which

pretend to prevent or to cure it, but which were purposely written to vend

some quack medicine. Most of those unhappy patients, whom I have seen, had

evidently great impression of fear and self-condemnation on their minds,

and might be led to make contradictory complaints in almost any part of the

body, and if their confessions could be depended on, had not used this

pollution to any great excess.

M. M. 1. Assure them if the loss of the semen happens but twice a week, it

will not injure them. 2. Marry them. The last is a certain cure; whether

the disease be real or imaginary. Cold partial bath, and astringent

medicines frequently taken, only recal the mind to the disease, or to the

delinquency; and thence increase the imaginary effects and the real cause,

if such exists. Mr. ---- destroyed himself to get free from the pain of

fear of the supposed ill consequences of self-pollution, without any other

apparent disease; whose parents I had in vain advised to marry him, if

possible.

24. _Sympathia aliena._ Pity. Our sympathy with the pleasures and pains of

others distinguishes men from other animals; and is probably the foundation

of what is termed our moral sense and the source of all our virtues. See

Sect. XXII. 3. 3. When our sympathy with those miseries of mankind, which

we cannot alleviate, rises to excess, the mind becomes its own tormentor;

and we add to the aggregate sum of human misery, which we ought to labour

to diminish; as in the following eloquent lamentation from Akenside's

Pleasures of Imagination, Book II. 1. 200.

----------------Dark,

As midnight storms, the scene of human things

Appear'd before me; deserts, burning sands,

Where the parch'd adder dies; the frozen south;

And desolation blasting all the west

With rapine and with murder. Tyrant power

Here sits enthroned in blood; the baleful charms

Of superstition there infect the skies,

And turn the sun to horror. Gracious Heaven!

What is the life of man? Or cannot these,

Not these portents thy awful will suffice?

That, propagated thus beyond their scope,

They rise to act their cruelties anew

In my afflicted bosom, thus decreed

The universal sensitive of pain,

The wretched heir of evils not its own!

A poet of antiquity, whose name I do not recollect, is said to have written

a book describing the miseries of the world, and to have destroyed himself

at the conclusion of his task. This sympathy, with all sensitive beings,

has been carried so far by some individuals, and even by whole tribes, as

the Gentoos, as not only to restrain them from killing animals for their

support, but even to induce them to permit insects to prey upon their

bodies. Such is however the condition of mortality, that the first law of

nature is, "Eat or be eaten." We cannot long exist without the destruction

of other animal or vegetable beings, either in their mature or their

embryon state. Unless the fruits, which surround the seeds of some

vegetables, or the honey stolen from them by the bee, may be said to be an

exception to this assertion. See Botanic Garden, P. I. Cant. I. l. 278.

Note. Hence, from the necessity of our nature, we may be supposed to have a

right to kill those creatures, which we want to eat, or which want to eat

us. But to destroy even insects wantonly shews an unreflecting mind or a

depraved heart.

Nevertheless mankind may be well divided into the selfish and the social;

that is, into those whose pleasures arise from gratifying their appetites,

and those whose pleasures arise from their sympathizing with others. And

according to the prevalence of these opposing propensities we value or

dislike the possessor of them.

In conducting the education of young people, it is a nice matter to inspire

them with so much benevolent sympathy, or compassion, as may render them

good and amiable; and yet not so much as to make them unhappy at the sight

of incurable distress. We should endeavour to make them alive to sympathize

with all remediable evils, and at the same time to arm them with fortitude

to bear the sight of such irremediable evils, as the accidents of life must

frequently present before their eyes. About this I have treated more at

large in a plan for the conduct of a boarding school for ladies, which I

intend to publish in the course of the next year.

25. _Educatio heroica._ From the kinds and degrees of insanities already

enumerated, the reader will probably recollect many more from his own

observation; he will perceive that all extraordinary exertions of voluntary

action in consequence of some false idea or hallucination, which strongly

affects us, may philosophically, though not popularly, be termed an

insanity; he will then be liable to divide these voluntary exertions into

disagreeable, pernicious, detestable, or into meritorious, delectable, and

even amiable, insanities. And will lastly be induced to conceive, that a

good education consists in the art of producing such happy hallucinations

of ideas, as may be followed by such voluntary exertions, as may be termed

meritorious or amiable insanities.

The old man of the mountain in Syria, who governed a small nation of people

called Assassines, is recorded thus to have educated those of his army who

were designed to assassinate the princes with whom he was at war. A young

man of natural activity was chosen for the purpose, and thrown into a deep

sleep by opium mixed with his food; he was then carried into a garden made

to represent the paradise of Mahomet, with flowers of great beauty and

fragrance, fruits of delicious flavor, and beautiful houries beckoning him

into the shades. After a while, on being a second time stupified with

opium, the young enthusiast was reconveyed to his apartment; and on the

next day was assured by a priest, that he was designed for some great

exploit, and that by obeying the commands of their prince, immortal

happiness awaited him.

Hence it is easy to collect how the first impressions made on us by

accidental circumstances in our infancy continue through life to bias our

affections, or mislead our judgments. One of my acquaintance can trace the

origin of his own energies of action from some such remote sources; which

justifies the observation of M. Rousseau, that the seeds of future virtues

or vices are oftener sown by the mother, than the tutor.

* * * * *

ORDO II.

_Decreased Volition._

GENUS I.

_With decreased Actions of the Muscles._

Our muscles become fatigued by long contraction, and cease for a time to be

excitable by the will; owing to exhaustion of the sensorial power, which

resides in them. After a short interval of relaxation the muscle regains

its power of voluntary contraction; which is probably occasioned by a new

supply of the spirit of animation. In weaker people these contractions

cease sooner, and therefore recur more frequently, and are attended with

shorter intervals of relaxation, as exemplified in the quickness of the

pulse in fevers with debility, and in the tremors of the hands of aged or

feeble people.

After a common degree of exhaustion of the sensorial power in a muscle, it

becomes again gradually restored by the rest of the muscle; and even

accumulated in those muscles, which are most frequently used; as in those

which constitute the capillaries of the skin after having been rendered

torpid by cold. But in those muscles, which are generally obedient to

volition, as those of locomotion, though their usual quantity of sensorial

power is restored by their quiescence, or in sleep (for sleep affects these

parts of the system only), yet but little accumulation of it succeeds. And

this want of accumulation of the sensorial power in these muscles, which

are chiefly subservient to volition, explains to us one cause of their

greater tendency to paralytic affection.

It must be observed, that those parts of the system, which have been for a

time quiescent from want of stimulus, as the vessels of the skin, when

exposed to cold, acquire an accumulation of sensorial power during their

inactivity; but this does not happen at all, or in much less quantity, from

their quiescence after great expenditure of sensorial power by a previous

excessive stimulus, as after intoxication. In this case the muscles or

organs of sense gradually acquire their natural quantity of sensorial

power, as after sleep; but not an accumulation or superabundance of it. And

by frequent repetitions of exhaustion by great stimulus, these vessels

cease to acquire their whole natural quantity of sensorial power; as in the

schirrous stomach, and schirrous liver, occasioned by the great and

frequent stimulus of vinous spirit; which may properly be termed irritative

paralysis of those parts of the system.

In the same manner in common palsies the inaction of the paralytic muscle

seems not to be owing to defect of the stimulus of the will, but to

exhaustion of sensorial power. Whence it frequently follows great exertion,

as in Sect. XXXIV. 1. 7. Thus some parts of the system may cease to obey

the will, as in common paralysis; others may cease to be obedient to

sensation, as in the impotency of age; others to irritation, as in

schirrous viscera; and others to association, as in impediment of speech;

yet though all these may become inexcitable, or dead, in respect to that

kind of stimulus, which has previously exhausted them, whether of volition,

or sensation, or irritation, or association, they may still in many cases

be excited by the others.

SPECIES.

1. _Lassitudo._ Fatigue or weariness after much voluntary exertion. From

the too great expenditure of sensorial power the muscles are with

difficulty brought again into voluntary contraction; and seem to require a

greater quantity or energy of volition for this purpose. At the same time

they still remain obedient to the stimulus of agreeable sensation, as

appears in tired dancers finding a renovation of their aptitude to motion

on the acquisition of an agreeable partner; or from a tired child riding on

a gold-headed cane, as in Sect. XXXIV. 2. 6. These muscles are likewise

still obedient to the sensorial power of association, because the motions,

when thus excited, are performed in their designed directions, and are not

broken into variety of gesticulation, as in St. Vitus's dance.

A lassitude likewise frequently occurs with yawning at the beginning of

ague-fits; where the production of sensorial power in the brain is less

than its expenditure. For in this case the torpor may either originate in

the brain, or the torpor of some distant parts of the system may by

sympathy affect the brain, though in a less proportionate degree than the

parts primarily affected.

2. _Vacillatio senilis._ Some elderly people acquire a see-saw motion of

their bodies from one side to the other, as they sit, like the oscillation

of a pendulum. By these motions the muscles, which preserve the

perpendicularity of the body, are alternately quiescent, and exerted; and

are thus less liable to fatigue or exhaustion. This therefore resembles the

tremors of old people above mentioned, and not those spasmodic movements of

the face or limbs, which are called tricks, described in Class IV. 1. 3. 2.

which originate from excess of sensorial power, or from efforts to relieve

disagreeable sensation, and are afterwards continued by habit.

3. _Tremor senilis._ Tremor of old age consists of a perpetual trembling of

the hands, or of the head, or of other muscles, when they are exerted; and

is erroneously called paralytic; and seems owing to the small quantity of

animal power residing in the muscular fibres. These tremors only exist when

the affected muscles are excited into action, as in lifting a glass to the

mouth, or in writing, or in keeping the body upright; and cease again, when

no voluntary exertion is attempted, as in lying down. Hence these tremors

evidently originate from the too quick exhaustion of the lessened quantity

of the spirit of animation. So many people tremble from fear or anger, when

too great a part of the sensorial power is exerted on the organs of sense,

so as to deprive the muscles, which support the body erect, of their due

quantity.

4. _Brachiorum paralysis._ A numbness of the arms is a frequent symptom in

hydrops thoracis, as explained in Class I. 2. 3. 14. and in Sect. XXIX. 5.

2.; it also accompanies the asthma dolorificum, Class III. 1. 1. 11. and is

owing probably to the same cause in both. In the colica saturnina a

paralysis affects the wrists, as appears on the patient extending his arm

horizontally with the palm downwards, and is often attended with a tumor on

the carpal or metacarpal bones. See Class IV. 1. 2. 10.

Mr. M----, a miner and well-sinker, about three years ago, lost the power

of contracting both his thumbs; the balls or muscles of the thumbs are much

emaciated, and remain paralytic. He ascribes his disease to immersing his

hands too long in cold water in the execution of his business. He says his

hands had frequently been much benumbed before, so that he could not

without difficulty clench them; but that they recovered their motion, as

soon as they began to glow, after he had dried and covered them.

In this case there existed two injurious circumstances of different kinds;

one the violent and continued action of the muscles, which destroys by

exhausting the sensorial power; and the other, the application of cold,

which destroys by defect of stimulus. The cold seems to have contributed to

the paralysis by its long application, as well as the continued exertion;

but as during the torpor occasioned by the exposure to cold, if the degree

of it be not so great as to extinguish life, the sensorial power becomes

accumulated; there is reason to believe, that the exposing a paralytic limb

to the cold for a certain time, as by covering it with snow or iced water

for a few minutes, and then covering it with warm flannel, and this

frequently repeated, might, by accumulation of sensorial power, contribute

to restore it to a state of voluntary excitability. As this accumulation of

sensorial power, and consequent glow, seems, in the present case, several

times to have contributed to restore the numbness or inability of those

muscles, which at length became paralytic. See Class I. 2. 3. 21.

M. M. Ether externally. Friction. Saline warm bath. Electricity.

5. _Raucedo paralytica._ Paralytic hoarseness consists in the almost total

loss of voice, which sometimes continues for months, or even years, and is

occasioned by inability or paralysis of the recurrent nerves, which serve

the muscles of vocality, by opening or closing the larynx. The voice

generally returns suddenly, even so as to alarm the patient. A young lady,

who had many months been affected with almost a total loss of voice, and

had in vain tried variety of advice, recovered her voice in an instant, on

some alarm as she was dancing at an assembly. Was this owing to a greater

exertion of volition than usual? like the dumb young man, the son of

Croesus, who is related to have cried out, when he saw his father's life

endangered by the sword of his enemy, and to have continued to speak ever

afterwards. Two young ladies in this complaint seemed to be cured by

electric shocks passed through the larynx every day for a fortnight. See

Raucedo catarrhalis, Class II. 1. 3. 5.

M. M. An emetic. Electric shocks. Mustard-seed, a large spoonful swallowed

whole, or a little bruised, every morning. Valerian. Burnt sponge. Blisters

on each side of the larynx. Sea-bathing. A gargle of decoction of seneca.

Friction. Frequent endeavours to shout and sing.

6. _Vesicae urinariae paralysis._ Paralysis of the bladder is frequently a

symptom in inirritative fever; in this case the patient makes no water for

a day or two; and the tumor of the bladder distended with urine may be seen

by the shape of the abdomen, as if girt by a cord below the navel, or

distinguished by the hand. Many patients in this situation make no

complaint, and suffer great injury by the inattention of their attendants;

the water must be drawn off once or twice a day by means of a catheter, and

the region of the bladder gently pressed by the hand, whilst the patient be

kept in a sitting or erect posture.

M. M. Bark. Wine. Opium, a quarter of a grain every six hours. Balsam of

copaiva or of Peru. Tincture of cantharides 20 drops twice a day, or

repeated small blisters.

7. _Recti paralysis._ Palsy of the rectum. The rectum intestinum, like the

urinary bladder in the preceding article, possesses voluntary power of

motion; though these volitions are at times uncontrollable by the will,

when the acrimony of the contained feces, or their bulk, stimulate it to a

greater degree. Hence it happens, that this part is liable to lose its

voluntary power by paralysis, but is still liable to be stimulated into

action by the contained feces. This frequently occurs in fevers, and is a

bad sign as a symptom of general debility; and it is the sensibility of the

muscular fibres of this and of the urinary bladder remaining, after the

voluntarity has ceased, which occasions these two reservoirs so soon to

regain, as the fever ceases, their obedience to volition; because the

paralysis is thus shewn to be less complete in those cases than in common

hemiplegia; as in the latter the sense of touch, though perhaps not the

sense of pain, is generally destroyed in the paralytic limb.

M. M. A sponge introduced within the sphincter ani to prevent the constant

discharge, which should have a string put through it, by which it may be

retracted.

8. _Paresis voluntaria._ Indolence; or inaptitude to voluntary action. This

debility of the exertion of voluntary efforts prevents the accomplishment

of all great events in life. It often originates from a mistaken education,

in which pleasure or flattery is made the immediate motive of action, and

not future advantage; or what is termed duty. This observation is of great

value to those, who attend to the education of their own children. I have

seen one or two young married ladies of fortune, who perpetually became

uneasy, and believed themselves ill, a week after their arrival in the

country, and continued so uniformly during their stay; yet on their return

to London or Bath immediately lost all their complaints, and this

repeatedly; which I was led to ascribe to their being in their infancy

surrounded with menial attendants, who had flattered them into the

exertions they then used. And that in their riper years, they became torpid

for want of this stimulus, and could not amuse themselves by any voluntary

employment; but required ever after, either to be amused by other people,

or to be flattered into activity. This I suppose, in the other sex, to have

supplied one source of ennui and suicide.

9. _Catalepsis_ is sometimes used for fixed spasmodic contractions or

tetanus, as described in Sect. XXXIV. 1. 5. and in Class III. 1. 1. 13. but

is properly simply an inaptitude to muscular motion, the limbs remaining in

any attitude in which they are placed. One patient, whom I saw in this

situation, had taken much mercury, and appeared universally torpid. He sat

in a chair in any posture he was put, and held a glass to his mouth for

many minutes without attempting to drink, or withdrawing his hand. He never

spoke, and it was at first necessary to compel him to drink broth; he

recovered in a few weeks without relapse.

10. _Hemiplegia._ Palsy of one side consists in the total disobedience of

the affected muscles to the power of volition. As the voluntary motions are

not perpetually exerted, there is little sensorial power accumulated during

their quiescence, whence they are less liable to recover from torpor, and

are thus more frequently left paralytic, or disobedient to the power of

volition, though they are sometimes still alive to painful sensation, as to

the prick of a pin, and to heat; also to irritation, as in stretching and

yawning; or to electric shocks. Where the paralysis is complete the patient

seems gradually to learn to use his limbs over again by repeated efforts,

as in infancy; and, as time is required for this purpose, it becomes

difficult to know, whether the cure is owing to the effect of medicines, or

to the repeated efforts of the voluntary power.

The dispute, whether the nerves decussate or cross each other before they

leave the cavities of the skull or spine, seems to be decided in the

affirmative by comparative anatomy; as the optic nerves of some fish have

been shewn evidently to cross each other; as seen by Haller, Elem. Physiol.

t. v. p. 349. Hence the application of blisters, or of ether, or of warm

fomentations, should be on the side of the head opposite to that of the

affected muscles. This subject should nevertheless be nicely determined,

before any one should trepan for the hydrocephalus internus, when the

disease is shewn to exist only on one side of the brain, by a squinting

affecting but one eye; as proposed in Class I. 2. 5. 4. Dr. Sommering has

shewn, that a true decussation of the optic nerves in the human subject

actually exists, Elem. of Physiology by Blumenbach, translated by C.

Caldwell, Philadelphia. This further appears probable from the oblique

direction and insertion of each optic nerve, into the side of the eye next

to the nose, in a direct line from the opposite side of the brain.

The vomiting, which generally attends the attack of hemiplegia, is

mentioned in Sect. XX. 8. and is similar to that attending vertigo in

sea-sickness, and at the commencement of some fevers. Black stools

sometimes attend the commencement of hemiplegia, which is probably an

effusion of blood from the biliary duct, where the liver is previously

affected; or some blood may be derived to the intestines by its escaping

from the vena cava into the receptacle of chyle during the distress of the

paralytic attack; and may be conveyed from thence into the intestines by

the retrograde motions of the lacteals; as probably sometimes happens in

diabaetes. See Sect. XXVII. 2. Palsy of one side of the face is mentioned

in Class II. 1. 4. 6. Paralysis of the lacteals, of the liver, and of the

veins, which are described in Sect. XXVIII. XXX. and XXVII. do not belong

to this class, as they are not diseases of voluntary motions.

M. M. The electric sparks and shocks, if used early in the disease, are

frequently of service. A purge of aloes, or calomel. A vomit. Blister.

Saline draughts. Then the bark. Mercurial ointment or sublimate, where the

liver is evidently diseased; or where the gutta rosea has previously

existed. Sudden alarm. Frequent voluntary efforts. Externally ether.

Volatile alcali. Fomentation on the head. Friction. When children, who have

suffered an hemiplegia, begin to use the affected arm, the other hand

should be tied up for half an hour three or four times a day; which obliges

them at their play to use more frequent voluntary efforts with the diseased

limb, and thus sooner to restore the dissevered associations of motion.

Dr. J. Alderson has lately much recommended the leaves of rhus toxicodendon

(sumach), from one gr. to iv. of the dried powder to be taken three or four

times a day. Essay on Rhus Toxic. Johnson, London, 1793. But it is

difficult to know what medicine is of service, as the movements of the

muscles must be learned, as in infancy, by frequent efforts.

11. _Paraplegia._ A palsy of the lower half of the body divided

horizontally. Animals may be conceived to have double bodies, one half in

general resembling so exactly the other, and being supplied with separate

sets of nerves; this gives rise to hemiplegia, or palsy of one half of the

body divided vertically; but the paraplegia, or palsy of the lower parts of

the system, depends on an injury of the spinal marrow, or that part of the

brain which is contained in the vertebrae of the back; by which all the

nerves situated below the injured part are deprived of their nutriment, or

precluded from doing their proper offices; and the muscles, to which they

are derived, are in consequence disobedient to the power of volition.

This sometimes occurs from an external injury, as a fall from an eminence;

of which I saw a deplorable instance, where the bladder and rectum, as well

as the lower limbs, were deprived of so much of their powers of motion, as

depended on volition or sensation; but I suppose not of that part of it,

which depends on irritation. In the same manner as the voluntary muscles in

hemiplegia are sometimes brought into action by irritation, as in

stretching or pendiculation, described in Sect. VII. 1. 3.

But the most frequent cause of paraplegia is from a protuberance of one of

the spinal vertebrae; which is owing to the innutrition or softness of

bones, described in Class I. 2. 2. 17. The cure of this deplorable disease

is frequently effected by the stimulus of an issue placed on each side of

the prominent spine, as first published by Mr. Pott. The other means

recommended in softness of bones should also be attended to; both in

respect to the internal medicines, and to the mechanical methods of

supporting, or extending the spine; which last, however, in this case

requires particular caution.

12. _Somnus._ In sleep all voluntary power is suspended, see Sect. XVIII.

An unusual quantity of sleep is often produced by weakness. In this case

small doses of opium, wine, and bark, may be given with advantage. For the

periods of sleep, see Class IV. 2. 4. 1.

The subsequent ingenious observations on the frequency of the pulse, which

sometimes occurs in sleep, are copied from a letter of Dr. Currie of

Liverpool to the author.

"Though rest in general perhaps renders the healthy pulse slower, yet

under certain circumstances the contrary is the truth. A full meal

without wine or other strong liquor does not increase the frequency of

my pulse, while I sit upright, and have my attention engaged. But if I

take a recumbent posture after eating, my pulse becomes more frequent,

especially if my mind be vacant, and I become drowsy; and, if I

slumber, this increased frequency is more considerable with heat and

flushing.

"This I apprehend to be a general truth. The observation may be

frequently made upon children; and the restless and feverish nights

experienced by many people after a full supper are, I believe, owing to

this cause. The supper occasions no inconvenience, whilst the person is

upright and awake; but, when he lies down and begins to sleep,

especially if he does not perspire, the symptoms above mentioned occur.

Which may be thus explained in part from your principles. When the

power of volition is abolished, the other sensorial actions are

increased. In ordinary sleep this does not occasion increased frequency

of the pulse; but where sleep takes place during the process of

digestion, the digestion itself goes on with increased rapidity. Heat

is excited in the system faster than it is expended; and operating on

the sensitive actions, it carries them beyond the limitation of

pleasure, producing, as is common in such cases, increased frequency of

pulse.

"It is to be observed, that in speaking of the heat generated under

these circumstances, I do not allude to any chemical evolution of heat

from the food in the process of digestion. I doubt if this takes place

to any considerable degree, for I do not observe that the parts

incumbent on the stomach are increased in heat during the most hurried

digestion. It is on some parts of the surface, but more particularly on

the extremities of the body, that the increased heat excited by

digestion appears, and the heat thus produced arises, as it should

seem, from the sympathy between the stomach and the vessels of the

skin. The parts most affected are the palms of the hands and the soles

of the feet. Even there the thermometer seldom rises above 97 or 98

degrees, a temperature not higher than that of the trunk of the body;

but three or four degrees higher than the common temperature of these

parts, and therefore producing an uneasy sensation of heat, a sensation

increased by the great sensibility of the parts affected.

"That the increased heat excited by digestion in sleep is the cause of

the accompanying fever, seems to be confirmed by observing, that if an

increased expenditure of heat accompanies the increased generation of

it (as when perspiration on the extremities or surface attends this

kind of sleep) the frequent pulse and flushed countenance do not occur,

as I know by experiment. If, during the feverish sleep already

mentioned, I am awakened, and my attention engaged powerfully, my pulse

becomes almost immediately slower, and the fever gradually subsides."

From these observations of Dr. Currie it appears, that, while in common

sleep the actions of the heart, arteries, and capillaries, are strengthened

by the accumulation of sensorial power during the suspension of voluntary

action, and the pulse in consequence becomes fuller and slower; in the

feverish sleep above described the actions of the heart, arteries, and

capillaries, are quickened as well as strengthened by their consent with

the increased actions of the stomach, as well as by the stimulus of the new

chyle introduced into the circulation. For the stomach, and all other parts

of the system, being more sensible and more irritable during sleep, Sect.

XVIII. 15. and probably more ready to act from association, are now exerted

with greater velocity as well as strength, constituting a temporary fever

of the sensitive irritated kind, resembling the fever excited by wine in

the beginning of intoxication; or in some people by a full meal in their

waking hours. Sect. XXXV. 1.

On waking, this increased sensibility and irritability of the system ceases

by the renewed exertions of volition; in the same manner as more violent

exertions of volition destroy greater pains; and the pulse in consequence

subsides along with the increase of heat; if more violent efforts of

volition are exerted, the system becomes still less affected by sensation

or irritation. Hence the fever and vertigo of intoxication are lessened by

intense thinking, Sect. XXI. 8; and insane people are known to bear the

pain of cold and hunger better than others, Sect. XXXIV. 2. 5; and lastly,

if greater voluntary efforts exist, as in violent anger or violent

exercise, the whole system is thrown into more energetic action, and a

voluntary fever is induced, as appears by the red skin, quickened pulse,

and increase of heat; whence dropsies and fevers with debility are not

unfrequently removed by insanity.

Hence the exertion of the voluntary power in its natural degree diminishes

the increased sensibility, and irritability, and probably the increased

associability, which occurs during sleep; and thus reduces the frequency of

the pulse in the feverish sleep after a full meal. In its more powerful

state of exertion, it diminishes or destroys sensations and irritations,

which are stronger than natural, as in intoxication, or which precede

convulsions, or insanity. In its still more powerful degree, the

superabundance of this sensorial power actuates and invigorates the whole

moving system, giving strength and frequency to the pulse, and an universal

glow both of colour and of heat, as in violent anger, or outrageous

insanities.

If, in the feverish sleep above described, the skin becomes cooled by the

evaporation of much perspirable matter, or by the application of cooler

air, or thinner clothes, the actions of the cutaneous capillaries are

lessened by defect of the stimulus of heat, which counteracts the increase

of sensibility during sleep, and the pulsations of the heart and arteries

become slower from the lessened stimulus of the particles of blood thus

cooled in the cutaneous and pulmonary vessels. Hence the admission of cold

air, or ablution with subtepid or with cold water, in fevers with hot skin,

whether they be attended with arterial strength, or arterial debility,

renders the pulse slower; in the former case by diminishing the stimulus of

the blood, and in the latter by lessening the expenditure of sensorial

power. See Suppl. I. 8. and 15.

13. _Incubus._ The night-mare is an imperfect sleep, where the desire of

locomotion is vehement, but the muscles do not obey the will; it is

attended with great uneasiness, a sense of suffocation, and frequently with

fear. It is caused by violent fatigue, or drunkenness, or indigestible

food, or lying on the back, or perhaps from many other kinds of uneasiness

in our sleep, which may originate either from the body or mind.

Now as the action of respiration is partly voluntary, this complaint may be

owing to the irritability of the system being too small to carry on the

circulation of the blood through the lungs during sleep, when the voluntary

power is suspended. Whence the blood may accumulate in them, and a painful

oppression supervene; as in some haemorrhages of the lungs, which occur

during sleep; and in patients much debilitated by fevers. See Somnus

interruptus, Class I. 2. 1. 3. and I. 2. 1. 9.

Great fatigue with a full supper and much wine, I have been well informed

by one patient, always produced this disease in himself to a great degree.

Now the general irritability of the system is much decreased by fatigue, as

it exhausts the sensorial power; and secondly, too much wine and

stimulating food will again diminish the irritability of some parts of the

system, by employing a part of the sensorial power, which is already too

small, in digesting a great quantity of aliment; and in increasing the

motions of the organs of sense in consequence of some degree of

intoxication, whence difficulty of breathing may occur from the

inirritability of the lungs, as in Class I. 2. 1. 3.

M. M. To sleep on a hard bed with the head raised. Moderate supper. The

bark. By sleeping on a harder bed the patient will turn himself more

frequently, and not be liable to sleep too profoundly, or lie too long in

one posture. To be awakened frequently by an alarm clock.

14. _Lethargus._ The lethargy is a slighter apoplexy. It is supposed to

originate from universal pressure on the brain, and is said to be produced

by compressing the spinal marrow, where there is a deficiency of the bone

in the spina bifida. See Sect. XVIII. 20. Whereas in the hydrocephalus

there is only a partial pressure of the brain; and probably in nervous

fevers with stupor the pressure on the brain may affect only the nerves of

the senses, which lie within the skull, and not those nerves of the medulla

oblongata, which principally contribute to move the heart and arteries;

whence in the lethargic or apoplectic stupor the pulse is slow as in sleep,

whereas in nervous fever the pulse is very quick and feeble, and generally

so in hydrocephalus.

In cases of obstructed kidneys, whether owing to the tubuli uriniferi being

totally obstructed by calculous matter, or by their paralysis, a kind of

drowsiness or lethargy comes on about the eighth or ninth day, and the

patient gradually sinks. See Class I. 1. 3. 9.

15. _Syncope epileptica_, is a temporary apoplexy, the pulse continuing in

its natural state, and the voluntary power suspended. This terminates the

paroxysms of epilepsy.

When the animal power is much exhausted by the preceding convulsions, so

that the motions from sensation as well as those from volition are

suspended; in a quarter or half an hour the sensorial power becomes

restored, and if no pain, or irritation producing pain, recurs, the fit of

epilepsy ceases; if the pain recurs, or the irritation, which used to

produce it, a new fit of convulsion takes place, and is succeeded again by

a syncope. See Epilepsy, Class III. 1. 1. 7.

16. _Apoplexia._ Apoplexy may be termed an universal palsy, or a permanent

sleep. In which, where the pulse is weak, copious bleeding must be

injurious; as is well observed by Dr. Heberden, Trans. of the College.

Mr. ----, about 70 years of age, had an apoplectic seizure. His pulse was

strong and full. One of the temporal arteries was opened, and about ten

ounces of blood suddenly taken from it. He seemed to receive no benefit

from this operation; but gradually sunk, and lived but a day or two.

If apoplexy arises from the pressure of blood extravasated on the brain,

one moderate venesection may be of service to prevent the further effusion

of blood; but copious venesection must be injurious by weakening the

patient; since the effused blood must have time, as in common vibices or

bruises, to undergo a chemico-animal process, so to change its nature as to

fit it for absorption; which may take two or three weeks, which time a

patient weakened by repeated venesection or arteriotomy may not survive.

Mrs. ----, about 40 years old, had an apoplectic seizure after great

exertion from fear; she had lain about 24 hours without speech, or having

swallowed any liquid. She was then forcibly raised in bed, and a spoonful

of solution of aloes in wine put into her mouth, and the end of the spoon

withdrawn, that she might more easily swallow the liquid.--This was done

every hour, with broth, and wine and water intervening, till evacuations

were procured; which with other means had good effect, and she recovered,

except that a considerable degree of hemiplegia remained, and some

imperfection of her speech.

Many people, who have taken so much vinous spirit as to acquire the

temporary apoplexy of intoxication, and are not improperly said to be

dead-drunk, have died after copious venesection, I suppose in consequence

of it. I once saw at a public meeting two gentlemen in the drunken

apoplexy; they were totally insensible with low pulse, on this account they

were directed not to lose blood, but to be laid on a bed with their heads

high, and to be turned every half hour; as soon as they could swallow, warm

tea was given them, which evacuated their stomachs, and they gradually

recovered, as people do from less degrees of intoxication.

M. M. Cupping on the occiput. Venesection once in moderate quantity. Warm

fomentations long continued and frequently repeated on the shaved head.

Solution of aloes. Clysters with solution of aloe and oil of amber. A

blister on the spine. An emetic. Afterwards the bark, and small doses of

chalybeates. Small electric shocks through the head. Errhines. If small

doses of opium?

17. _Mors a frigore._ Death from cold. The unfortunate travellers, who

almost every winter perish in the snow, are much exhausted by their efforts

to proceed on their journey, as well as benumbed by cold. And as much

greater exercise can be borne without fatigue in cold weather than in warm;

because the excessive motions of the cutaneous vessels are thus prevented,

and the consequent waste of sensorial power; it may be inferred, that the

fatigued traveller becomes paralytic from violent exertion as well as by

the application of cold.

Great degrees of cold affect the motions of those vessels most, which have

been generally excited into action by irritation; for when the feet are

much benumbed by cold, and painful, and at the same time almost insensible

to the touch of external objects, the voluntary muscles retain their

motions, and we continue to walk on; the same happens to the fingers of

children in throwing snow-balls, the voluntary motions of the muscles

continue, though those of the cutaneous vessels are benumbed into

inactivity.

Mr. Thompson, an elderly gentleman of Shrewsbury, was seized with

hemiplegia in the cold bath; which I suppose might be owing to some great

energy of exertion, as much as to the coldness of the water. As in the

instance given of Mr. Nairn, who, by the exertion to save his relation,

perished himself. See Sect. XXXIV. 1. 7.

Whence I conclude, that though heat is a fluid necessary to muscular

motion, both perhaps by its stimulus, and by its keeping the minute

component parts of the ultimate fibrils of the muscles or organs of sense

at a proper distance from each other; yet that paralysis, properly so

called, is the consequence of exhaustion of sensorial power by exertion.

And that the accumulations of it during the torpor of the cutaneous vessels

by exposure to cold, or of some internal viscus in the cold fits of agues,

are frequently instrumental in recovering the use of paralytic limbs, or of

the motions of other paralytic parts of the system. See Spec. 4. of this

genus.

Animal bodies resist the power of cold probably by their exertions in

consequence of the pain of cold, see Botan. Gard. V. 1. additional note

xii. But if these increased exertions be too violent, so as to exhaust the

sensorial power in producing unnecessary motions, the animal will probably

sooner perish. Thus a moderate quantity of wine or spirit repeated at

proper intervals of time might be of service to those, who are long exposed

to excessive cold, both by increasing the action of the capillary vessels,

and thus producing heat, and perhaps by increasing in some degree the

secretion of sensorial power in the brain. But the contrary must happen

when taken immoderately, and not at due intervals. A well attested history

was once related to me of two men, who set out on foot to travel in the

snow, one of whom drank two or three glasses of brandy before they began

their journey, the other contented himself with his usual diet and

potation; the former of whom perished in spite of any assistance his

companion could afford him; and the other performed his journey with

safety. In this case the sensorial power was exhausted by the unnecessary

motions of incipient intoxication by the stimulus of the brandy, as well as

by the exertions of walking; which so weakened the dram-drinker, that the

cold sooner destroyed him; that is, he had not power to produce sufficient

muscular or arterial action, and in consequence sufficient heat, to supply

the great expenditure of it. Hence the capillaries of the skin first cease

to act, and become pale and empty; next those which are immediately

associated with them, as the extremities of the pulmonary artery, as

happens on going into the cold bath. By the continued inaction of these

parts of the vascular system the blood becomes accumulated in the internal

arteries, and the brain is supposed to be affected by its compression;

because these patients are said to sleep, or to become apoplectic, before

they die. I overtook a fishman asleep on his panniers on a very cold frosty

night, but on waking him he did not appear to be in any degree of stupor.

See Class I. 2. 2. 1.

When travellers are benighted in deep snow, they might frequently be saved

by covering themselves in it, except a small aperture for air; in which

situation the lives of hares, sheep, and other animals, are so often

preserved. The snow, both in respect to its component parts, and to the air

contained in its pores, is a bad conductor of heat, and will therefore well

keep out the external cold; and as the water, when part of it dissolves, is

attracted into the pores of the remainder of it, the situation of an animal

beneath it is perfectly dry; and, if he is in contact with the earth, he is

in a degree of heat between 48, the medium heat of the earth, and 32, the

freezing point; that is, in 40 degrees of heat, in which a man thus covered

will be as warm as in bed. See Botan. Garden, V. II. notes on Anemone,

Barometz, and Muschus. If these facts were more generally understood, it

might annually save the lives of many.

After any part of the vascular system of the body has been long exposed to

cold, the sensorial power is so much accumulated in it, that on coming into

a warm room the pain of hotach is produced, and inflammation, and

consequent mortification, owing to the great exertion of those vessels,

when again exposed to a moderate degree of warmth. See Sect. XII. 5. Whence

the propriety of applying but very low degrees of heat to limbs benumbed

with cold at first, as of snow in its state of dissolving, which is at 32

degrees of heat, or of very cold water. A French writer has observed, that

if frozen apples be thawed gradually by covering them with thawing snow, or

immersing them in very cold water, that they do not lose their taste; if

this fact was well ascertained, it might teach us how to preserve other

ripe fruits in ice-houses for winter consumption.

* * * * *

ORDO II.

_Decreased Volition._

GENUS II.

_With decreased Actions of the Organs of Sense._

SPECIES.

1. _Recollectionis jactura._ Loss of recollection. This is the defect of

memory in old people, who forget the actions of yesterday, being incapable

of voluntary recollection, and yet remember those of their youth, which by

frequent repetition are introduced by association or suggestion. This is

properly the paralysis of the mind; the organs of sense do not obey the

voluntary power; that is, our ideas cannot be recollected, or acted over

again by the will.

After an apoplectic attack the patients, on beginning to recover, find

themselves most at a loss in recollecting proper names of persons or

places; as those words have not been so frequently associated with the

ideas they stand for, as the common words of a language. Mr. ----, a man of

strong mind, of a short necked family, many of whom had suffered by

apoplexy, after an apoplectic fit on his recovering the use of speech,

after repeated trials to remember the name of a person or place, applauded

himself, when he succeeded, with such a childish smile on the partial

return of his sagacity, as very much affected me.--Not long, alas! to

return; for another attack in a few weeks destroyed the whole.

I saw a child after the small-pox, which was left in this situation; it was

lively, active, and even vigorous; but shewed that kind of surprise, which

novelty excites, at every object it viewed; and that as often as it viewed

it. I never heard the termination of the case.

2. _Stultitia voluntaria._ Voluntary folly. The absence of voluntary power

and consequent incapacity to compare the ideas of present and future good.

Brute animals may be said to be in this situation, as they are in general

excited into action only by their present painful or pleasurable

sensations. Hence though they are liable to surprise, when their passing

trains of ideas are dissevered by violent stimuli; yet are they not

affected with wonder or astonishment at the novelty of objects; as they

possess but in a very inferior degree, that voluntary power of comparing

the present ideas with those previously acquired, which distinguishes

mankind; and is termed analogical reasoning, when deliberatively exerted;

and intuitive analogy, when used without our attention to it, and which

always preserves our hourly trains of ideas consistent with truth and

nature. See Sect. XVII. 3. 7.

3. _Credulitas._ Credulity. Life is short, opportunities of knowledge rare;

our senses are fallacious, our reasonings uncertain, mankind therefore

struggles with perpetual error from the cradle to the coffin. He is

necessitated to correct experiment by analogy, and analogy by experiment;

and not always to rest satisfied in the belief of facts even with this

two-fold testimony, till future opportunities, or the observations of

others, concur in their support.

Ignorance and credulity have ever been companions, and have misled and

enslaved mankind; philosophy has in all ages endeavoured to oppose their

progress, and to loosen the shackles they had imposed; philosophers have on

this account been called unbelievers: unbelievers of what? of the fictions

of fancy, of witchcraft, hobgobblins, apparitions, vampires, fairies; of

the influence of stars on human actions, miracles wrought by the bones of

saints, the flights of ominous birds, the predictions from the bowels of

dying animals, expounders of dreams, fortune-tellers, conjurors, modern

prophets, necromancy, cheiromancy, animal magnetism, with endless variety

of folly? These they have disbelieved and despised, but have ever bowed

their hoary heads to Truth and Nature.

Mankind may be divided in respect to the facility of their belief or

conviction into two classes; those, who are ready to assent to single facts

from the evidence of their senses, or from the serious assertions of

others; and those, who require analogy to corroborate or authenticate them.

Our first knowledge is acquired by our senses; but these are liable to

deceive us, and we learn to detect these deceptions by comparing the ideas

presented to us by one sense with those presented by another. Thus when we

first view a cylinder, it appears to the eye as a flat surface with

different shades on it, till we correct this idea by the sense of touch,

and find its surface to be circular; that is, having some parts gradually

receding further from the eye than others. So when a child, or a cat, or a

bird, first sees its own image in a looking-glass, it believes that another

animal exists before it, and detects this fallacy by going behind the glass

to examine, if another tangible animal really exists there.

Another exuberant source of error consists in the false notions, which we

receive in our early years from the design or ignorance of our instructors,

which affect all our future reasoning by their perpetual intrusions; as

those habits of muscular actions of the face or limbs, which are called

tricks, when contracted in infancy continue to the end of our lives.

A third great source of error is the vivacity of our ideas of imagination,

which perpetually intrude themselves by various associations, and compose

the farrago of our dreams; in which, by the suspension of volition, we are

precluded from comparing the ideas of one sense with those of another, or

the incongruity of their successions with the usual course of nature, and

thus to detect their fallacy. Which we do in our waking hours by a

perpetual voluntary exertion, a process of the mind above mentioned, which

we have termed intuitive analogy. Sect. XVII. 3. 7.

This analogy presupposes an acquired knowledge of things, hence children

and ignorant people are the most credulous, as not possessing much

knowledge of the usual course of nature; and secondly, those are most

credulous, whose faculty of comparing ideas, or the voluntary exertion of

it, is slow or imperfect. Thus if the power of the magnetic needle of

turning towards the north, or the shock given by touching both sides of an

electrized coated jar, was related for the first time to a philosopher, and

to an ignorant person; the former would be less ready to believe them, than

the latter; as he would find nothing similar in nature to compare them to,

he would again and again repeat the experiment, before he would give it his

entire credence; till by these repetitions it would cease to be a single

fact, and would therefore gain the evidence of analogy. But the latter, as

having less knowledge of nature, and less facility of voluntary exertion,

would more readily believe the assertions of others, or a single fact, as

presented to his own observation. Of this kind are the bulk of mankind;

they continue throughout their lives in a state of childhood, and have thus

been the dupes of priests and politicians in all countries and in all ages

of the world.

In regard to religious matters, there is an intellectual cowardice

instilled into the minds of the people from their infancy; which prevents

their inquiry: credulity is made an indispensable virtue; to inquire or

exert their reason in religious matters is denounced as sinful; and in the

catholic church is punished with more severe penances than moral crimes.

But in respect to our belief of the supposed medical facts, which are

published by variety of authors; many of whom are ignorant, and therefore

credulous; the golden rule of David Hume may be applied with great

advantage. "When two miraculous assertions oppose each other, believe the

less miraculous." Thus if a person is said to have received the small-pox a

second time, and to have gone through all the stages of it, one may thus

reason: twenty thousand people have been exposed to the variolous contagion

a second time without receiving the variolous fever, to every one who has

been said to have thus received it; it appears therefore less miraculous,

that the assertor of this supposed fact has been deceived, or wishes to

deceive, than that it has so happened contrary to the long experienced

order of nature.

M. M. The method of cure is to increase our knowledge of the laws of

nature, and our habit of comparing whatever ideas are presented to us with

those known laws, and thus to counteract the fallacies of our senses, to

emancipate ourselves from the false impressions which we have imbibed in

our infancy, and to set the faculty of reason above that of imagination.

* * * * *

_The Orders and Genera of the Fourth Class of Diseases._

CLASS IV.

DISEASES OF ASSOCIATION.

ORDO I.

_Increased Associate Motions._

GENERA.

1. Catenated with irritative motions.

2. Catenated with sensitive motions.

3. Catenated with voluntary motions.

4. Catenated with external influences.

ORDO II.

_Decreased Associate Motions._

GENERA.

1. Catenated with irritative motions.

2. Catenated with sensitive motions.

3. Catenated with voluntary motions.

4. Catenated with external influences.

ORDO III.

_Retrograde Associate Motions._

GENERA.

1. Catenated with irritative motions.

2. Catenated with sensitive motions.

3. Catenated with voluntary motions.

4. Catenated with external influences.

* * * * *

_The Orders, Genera, and Species, of the Fourth Class of Diseases._

* * * * *

CLASS IV.

DISEASES OF ASSOCIATION.

ORDO I.

_Increased Associate Motions._

GENUS I.

_Catenated with Irritative Motions._

SPECIES.

1. _Rubor vultus pransorum._ Flushing of the face after dinner.

2. _Sudor stragulis immersorum._ Sweat from covering the face

in bed.

3. _Cessatio aegritudinis cute_ Cure of sickness by stimulating

_excitata._ the skin.

4. _Digestio aucta frigore cutaneo._ Digestion increased by coldness of

the skin.

5. _Catarrhus a frigore cutaneo._ Catarrh from cold skin.

6. _Absorptio cellularis aucta_ Cellular absorption increased by

_vomitu._ vomiting.

7. _Syngultus nephriticus._ Nephritic hiccough.

8. _Febris irritativa._ Irritative fever.

GENUS II.

_Catenated with Sensitive Motions._

SPECIES.

1. _Lacrymarum fluxus_ Sympathetic tears.

_sympatheticus._

2. _Sternutatio a lumine._ Sneezing from light.

3. _Dolor dentium a Stridore._ Tooth-edge from grating sounds.

4. _Risus sardonicus._ Sardonic smile.

5. _Salivae fluxus cibo viso._ Flux of saliva at sight of food.

6. _Tensio mamularum viso puerulo._ Tension of the nipples of lactescent

women at sight of the child.

7. _Tensio penis in hydrophobia._ Tension of the penis in hydrophobia.

8. _Tenesmus calculosus._ Tenesmus from stone.

9. _Polypus narium ex ascaride._ Polypus of the nose from ascarides.

10. _Crampus surarum in diarrhoea._ Cramp from diarrhoea.

11. _Zona ignea nephritica._ Nephritic shingles.

12. _Eruptio variolarum._ Eruption of small-pox.

13. _Gutta rosea stomatica._ Stomatic rosy drop.

14. ---- _hepatica._ Hepatic rosy drop.

15. _Podagra._ Gout.

16. _Rheumatismus._ Rheumatism.

17. _Erysipelas._ Erysipelas.

18. _Testium tumor in gonorrhoea._ Swelled testis in gonorrhoea.

19. ---- _in parotitide._ ---- in mumps.

GENUS III.

_Catenated with Voluntary Motions._

SPECIES.

1. _Deglutitio invita._ Involuntary deglutition.

2. _Nictitatio invita._ ---- nictitation.

3. _Risus invitus._ ---- laughter.

4. _Lusus digitorum invitus._ ---- actions with the fingers.

5. _Unguium morsiuncula invita._ ---- biting the nails.

6. _Vigilia invita._ ---- watchfulness.

GENUS IV.

_Catenated with External Influences._

SPECIES.

1. _Vita ovi._ Life of an egg.

2. _Vita hiemi-dormientium._ Life of winter-sleepers.

3. _Pullulatio arborum._ Budding of trees.

4. _Orgasmatis venerei periodus._ Periods of venereal desire.

5. _Brachii concussio electrica._ Electric shock through the arm.

6. _Oxygenatio sanguinis._ Oxygenation of the blood.

7. _Humectatio corporis._ Humectation of the body.

ORDO II.

_Decreased Associate Motions._

GENUS I.

_Catenated with Irritative Motions._

SPECIES.

1. _Cutis frigida pransorum._ Chillness after dinner.

2. _Pallor urinae pransorum._ Pale urine after dinner.

3. ---- _a frigore cutaneo._ ---- from cold skin.

4. _Pallor ex aegritudine._ Paleness from sickness.

5. _Dyspnoea a balneo frigido._ Shortness of breath from cold

bathing.

6. _Dyspepsia a pedibus frigidis._ Indigestion from cold feet.

7. _Tussis a pedibus frigidis._ Cough from cold feet.

8. ---- _hepatica._ Liver-cough.

9. ---- _arthritica._ Gout-cough.

10. _Vertigo rotatoria._ Vertigo rotatory.

11. ---- _visualis._ ---- visual.

12. ---- _ebriosa._ ---- inebriate.

13. ---- _febriculosa._ ---- feverish.

14. ---- _cerebrosa._ ---- from the brain.

15. _Murmur aurium vertiginosum._ Noise in the ears.

16. _Tactus, gustus, olfactus_ Vertiginous touch, taste, smell.

_vertiginosi._

17. _Pulsus mollis a vomitione._ Soft pulse in vomiting.

18. ---- _intermittens a ventriculo._ Intermittent pulse from the

stomach.

19. _Febris inirritativa._ Inirritative fever.

GENUS II.

_Catenated with Sensitive Motions._

SPECIES.

1. _Torpor genae a dolore dentis._ Coldness of the cheek from tooth-ach.

2. _Stranguria a dolore vesicae._ Strangury from pain of the bladder.

3. ---- _convulsiva._ Convulsive strangury.

4. _Dolor termini ductus_ Pain of the end of the bile-duct.

_choledochi._

5. _Dolor pharyngis ab acido_ Pain of the throat from gastric acid.

_gastrico._

6. _Pruritus narium a vermibus._ Itching of the nose from worms.

7. _Cephalaea._ Head-ach.

8. _Hemicrania et otalgia._ Partial head-ach, and ear-ach.

9. _Dolor humeri in hepatitide._ Pain of shoulder in hepatitis.

10. _Torpor pedum variola_ Cold feet in eruption of small-pox.

_erumpente._

11. _Testium dolor nephriticus._ Nephritic pain of testis.

12. _Dolor digiti minimi_ Pain of little finger from sympathy.

_sympatheticus._

13. _Dolor brachii in hydrope_ Pain of the arm in dropsy of the

_pectoris._ chest.

14. _Diarrhoea a dentitione._ Diarrhoea from toothing.

GENUS III.

_Catenated with Voluntary Motions._

SPECIES.

1. _Titubatio linguae._ Impediment of speech.

2. _Chorea sancti viti._ St. Vitus' dance.

3. _Risus._ Laughter.

4. _Tremor ex ira._ Trembling from anger.

5. _Rubor ex ira._ Redness from anger.

6. ---- _criminati._ Blush of guilt.

7. _Tarditas paralytica._ Slowness from palsy.

8. ---- _senilis._ ---- of age.

GENUS IV.

_Catenated with External Influences._

SPECIES.

1. _Somni periodus._ Periods of sleep.

2. _Studii inanis periodus._ ---- of reverie.

3. _Hemicraniae periodus._ ---- of head-ach.

4. _Epilepsiae dolorificae periodus._ ---- of painful epilepsy.

5. _Convulsionis dolorificae periodus._ ---- of painful convulsion.

6. _Tussis periodicae periodus._ ---- of periodic cough.

7. _Catameniae periodus._ ---- of catamenia.

8. _Haemorrhoidis periodus._ ---- of the piles.

9. _Podagrae periodus._ ---- of the gout.

10. _Erysipelatis periodus._ ---- of erysipelas.

11. _Febrium periodus._ ---- of fevers.

ORDO III.

_Retrograde Associate Motions._

GENUS I.

_Catenated with Irritative Motions._

SPECIES.

1. _Diabaetes irritata._ Diabetes from irritation.

2. _Sudor frigidus in asthmate._ Cold sweat in asthma.

3. _Diabaetes a timore._ Diabetes from fear.

4. _Diarrhoea a timore._ Diarrhoea from fear.

5. _Pallor et tremor a timore._ Paleness and trembling from fear.

6. _Palpitatio cordis a timore._ Palpitation of the heart from fear.

7. _Abortio a timore._ Abortion from fear.

8. _Hysteria a timore._ Hysterics from fear.

GENUS II.

_Catenated with Sensitive Motions._

SPECIES.

1. _Nausea idealis._ Nausea from ideas.

2. ---- _a conceptu._ Nausea from conception.

3. _Vomitio vertiginosa._ Vomiting from vertigo.

4. ---- _a calculo in uretere._ ---- from stone in the ureter.

5. ---- _ab insultu paralytico._ ---- from stroke of palsy.

6. ---- _a titilatione faucium._ ---- from tickling the throat.

7. ---- _cute sympathetica._ ---- from sympathy with the skin.

GENUS III.

_Catenated with Voluntary Motions._

SPECIES.

1. _Ruminatio._ Rumination.

2. _Vomitio voluntaria._ Voluntary vomiting.

3. _Eructatio voluntaria._ ---- eructation.

GENUS IV.

_Catenated with External Influences._

SPECIES.

1. _Catarrhus periodicus._ Periodical catarrh.

2. _Tussis periodica._ Periodic cough.

3. _Histeria a frigore._ Hysterics from cold.

4. _Nausea pluvialis._ Sickness against rain.

* * * * *

CLASS IV.

DISEASES OF ASSOCIATION.

ORDO I.

_Increased Associate Motions._

GENUS I.

_Catenated with Irritative Motion._

The importance of the subsequent class not only consists in its elucidating

all the sympathetic diseases, but in its opening _a road to the knowledge

of fever_. The difficulty and novelty of the subject must plead in excuse

for the present imperfect state of it. The reader is entreated previously

to attend to the following circumstances for the greater facility of

investigating their intricate connections; which I shall enumerate under

the following heads.

A. Associate motions distinguished from catenations.

B. Associate motions of three kinds.

C. Associations affected by external influences.

D. Associations affected by other sensorial motions.

E. Associations catenated with sensation.

F. Direct and reverse sympathy.

G. Associations affected four ways.

H. Origin of associations.

I. Of the action of vomiting.

K. Tertian associations.

A. _Associate Motions distinguished from Catenations._

Associate motions properly mean only those, which are caused by the

sensorial power of association. Whence it appears, that those fibrous

motions, which constitute the introductory link of an associate train of

motions, are excluded from this definition, as not being themselves caused

by the sensorial power of association, but by irritation, or sensation, or

volition. I shall give for example the flushing of the face after dinner;

the capillary vessels of the face increase their actions in consequence of

their catenation, not their association, with those of the stomach; which

latter are caused to act with greater energy by the irritation excited by

the stimulus of food. These capillaries of the face are associated with

each other reciprocally, as being all of them excited by the sensorial

power of association; but they are only catenated with those of the

stomach, which are not in this case associate motions but irritative ones.

The common use of the word association for almost every kind of connection

has rendered this subject difficult; from which inaccuracy I fear some

parts of this work are not exempt.

B. _Associate Motions of three Kinds._

Those trains or tribes of associate motions, whose introductory link

consists of an irritative motion, are termed irritative associations; as

when the muscles of the eyelids close the eye in common nictitation. Those,

whose introductory link consists of a sensitive motion, are termed

sensitive associations; as when the pectoral and intercostal muscles act in

sneezing. And lastly, those, whose introductory link consists of a

voluntary motion, are termed voluntary associations; as when the muscles of

the lower limbs act in concert with those of the arm in fencing.

C. _Associations affected by external Influences._

Circles of associate motions, as well as trains and tribes of them, are

liable to be affected by external influences, which consist of etherial

fluids, and which, by penetrating the system, act upon it perhaps rather as

a causa sine qua non of its movements, than directly as a stimulus; except

when they are accumulated in unusual quantity. We have a sense adapted to

the perception of the excess or defect of one of these fluids; I mean that

of elementary heat; in which all things are immersed. See Class IV. 1. 4.

7. But there are others of them, which as we have no power to evade their

influence, so we have no sense to perceive it; these are the solar, and

lunar, and terrestrial gravitation, in which also all things are immersed;

the electric aura, which pervades us, and is perpetually varying, See Class

IV. 1. 4. 5; the magnetic fluid, Class IV. 1. 4. 5; and lastly, the great

life-preserver oxygen gas, and the aqueous vapour of the atmosphere, see

Class IV. 1. 4. 6. and 7. and 2.

Of these external influences those of heat, and of gravity, have diurnal

periods of increase and decrease; besides their greater periods of monthly

or annual variation. The manner in which they act by periodical increments

on the system, till some effect is produced, is spoken of in Sect. XXXII.

3. and 6.

D. _Associations affected by other Sensorial Motions._

Circles and trains of associate motions are also liable to be affected by

their catenations with other sensorial powers, as of irritation, or

sensation, or volition; which other sensorial powers either thus simply

form some of the links of the catenation, or add to the energy of the

associated motions. Thus when vomiting is caused by the stimulus of a stone

in the ureter, the sensation of pain seems to be a link of the catenation

rather than an efficient cause of the vomiting. But when the capillary

vessels of the skin increase their action from the influence of external

heat, they are excited both by the stimulus of unusual heat, as well as by

the stimulus of the blood, and by their accustomed association with the

actions of the heart and arteries. And lastly, in the blush of anger the

sensorial power of volition is added to that of association, and

irritation, to excite the capillaries of the face with increased action.

See Class IV. 2. 3. 5.

E. _Associations catenated with Sensation._

Pain frequently accompanies associate trains or circles of motion without

its being a cause, or a link, of them, but simply an attendant symptom;

though it frequently gives name to the disease, as head-ach. Thus in the

cramp of the calves of the legs in diarrhoea, the increased sensorial power

of association is the proximate cause; the preceding increased action of

the bowels is the remote cause; and the proximate effect is the violent

contractions of the musculi gastrocnemii; but the pain of these muscles is

only an attendant symptom, or a remote effect. See Sect. XVIII. 15. Other

sensitive associations are mentioned in Class IV. 1. 2. and IV. 1. 2. 15.

Thus, if the flushing of the face above mentioned after dinner be called a

disease, the immediate or proximate cause is the increased power of

association, the remote cause is the increased irritative motions of the

stomach in consequence of the stimulus of food and wine. The disease or

proximate effect consists in the increased actions of the cutaneous vessels

of the face; and the sensation of heat, the existence of heat, and the red

colour, are attendants or symptoms, or remote effects, of the increased

actions of these cutaneous vessels.

F. _Direct and reverse Sympathy._

The increased actions of the primary part of the trains of associated

motions are sometimes succeeded by increased actions of the secondary part

of the train; and sometimes by decreased actions of it. So likewise the

decreased actions of the primary part of a train of associate motions are

sometimes succeeded by decreased actions of the secondary part, and

sometimes by increased actions of it. The former of these situations is

called direct sympathy, and the latter reverse sympathy. In general I

believe, where the primary part of the train of associated motions is

exerted more than natural, it produces direct sympathy in strong people,

and reverse sympathy in weak ones, as a full meal makes some people hot,

and others chill. And where the primary part of the train is exerted less

than natural, it produces direct sympathy in weak people, and reverse

sympathy in strong ones, as on being exposed for a certain length of time

on horseback in a cold day gives indigestion and consequent heart-burn to

weak people, and strengthens the digestion, and induces consequent hunger

in strong ones. See Sect. XXXV. 1.

This may perhaps be more easily understood, by considering strength and

weakness, when applied to animal bodies, as consisting in the quantity of

sensorial power residing in the contracting fibres, and the quantity of

stimulus applied, as shewn in Sect. XII. 2. 1. Now when defective stimulus,

within certain limits, is partially applied to parts subject to perpetual

motion, the expenditure of sensorial power is for a while lessened, but not

its general production in the brain, nor its derivation into the

weakly-stimulated part. Hence in strong people, or such whose fibres abound

with sensorial power, if the first tribe of an associate train of motions

be deprived in part of its accustomed stimulus, its action becomes

diminished; and the sensorial power becomes accumulated, and by its

superabundance, or overflowing as it were, increases the action of the

second tribe of the associate actions by reverse sympathy. As exposing the

warm skin for a moderate time to cold air increases the action of the

stomach, and thus strengthens the power of digestion.

On the reverse, when additional stimulus within certain limits is partially

applied to parts, which are deficient in respect to the natural quantity of

sensorial power, the expenditure of sensorial power is increased, but in a

less degree than the increased production of it in the brain, or its

increased derivation into the strongly-stimulated organ. Hence in weak

people, or such whose fibres are deficient of sensorial power, if the first

tribe of an associate train of motions be subjected for a while to greater

stimulus than usual, a greater production of sensorial power, or a greater

derivation of it into the stimulated parts occurs; which by its excess, or

overflowing as it were, increases the actions of the second tribe of the

associate motions by direct sympathy. Thus when vomiting occurs with cold

extremities, a blister on the back in a few hours occasions universal

warmth of the skin, and stops the vomiting. And when a diarrhoea occurs

with pale skin and cold extremities, the pricking of the points of a

flannel shirt, worn next the skin, occasions universal warmth of it, and

checks or cures the diarrhoea.

In some associate trains of action nevertheless reverse sympathies more

frequently occur than direct ones, and in others direct ones more

frequently than reverse ones. Thus in continued fever with debility there

appears to be a reverse sympathy between the capillary vessels of the

stomach and those of the skin; because there exists a total aversion to

solid food, and constant heat on the surface of the body. Yet these two

systems of vessels are at other times actuated by direct sympathy, as when

paleness attends sickness, or cold feet induces indigestion. This subject

requires to be further investigated, as it probably depends not only on the

present or previous plus or minus of the sensorial power of association,

but also on the introduction of other kinds of sensorial power, as in Class

IV. 1. 1. D; or the increased production of it in the brain, or the greater

mobility of one part of a train of actions than another.

Thus when much food or wine is taken into the stomach, if there be no

superfluity of sensorial power in the system, that is, none to be spared

from the continual actions of it, a paleness and chillness succeeds for a

time; because now the expenditure of it by the increased actions of the

stomach is greater than the present production of it. In a little time

however the stimulus of the food and wine increases the production of

sensorial power in the brain, and this produces a superfluity of it in the

system; in consequence of which the skin now becomes warm and florid, which

was at first cold and pale; and thus the reverse sympathy is shortly

converted into a direct one; which is probably owing to the introduction of

a second sensorial power, that of pleasurable sensation.

On the contrary, when an emetic drug produces sickness, the skin is at

first pale for a time by direct sympathy with the capillaries of the

stomach; but in a few minutes, by the accumulation of sensorial power in

the stomach during its less active state in sickness, the capillaries of

the skin, which are associated with those of the stomach, act with greater

energy by reverse sympathy, and a florid colour returns. Where the quantity

of action is diminished in the first part of a train of motions, whether by

previous diminution of sensorial power, or present diminution of stimulus,

the second part of the train becomes torpid by direct sympathy. And when

the quantity of action of the first part becomes increased by the

accumulation of sensorial power during its previous torpor, or by increase

of stimulus, the actions of the second part of it likewise become increased

by direct sympathy.

In moderate hunger the skin is pale, as before dinner, and in moderate

sickness, as no great accumulation of sensorial power has commenced; but in

violent hunger, and in greater torpor of the stomach, as from contagious

matter, the accumulation of sensorial power becomes so great as to affect

the arterial and capillary system, and fever is produced in both cases.

In contagious fevers with arterial debilities commencing with torpor of the

stomach, why is the action of the heart weakened, and that of the

capillaries increased? Is it because the mobility of the heart is less than

that of the stomach, and the mobility of the capillaries greater? Or is it

because the association between the muscular fibres of the stomach and

those of the heart have been uniformly associated by direct sympathy; and

the capillaries of the stomach and those of the skin have been more

frequently associated by reverse sympathy?

Where the actions of the stomach have been previously exhausted by long

stimulus, as on the day after intoxication, little or no accumulation of

sensorial power occurs, during the torpor of the organ, beyond what is

required to replace the deficiency of it, and hence fever seldom follows

intoxication. And a repetition of the stimulus sometimes becomes necessary

even to induce its natural action, as in dram-drinkers.

Where there has been no previous exhaustion of sensorial power, and the

primary link of associate motions is violently actuated by the sensorial

power of sensation, the secondary link is also violently actuated by direct

sympathy, as in inflammatory fevers. Where however the sensorial power of

the system is less than natural, the secondary link of associated motions

becomes torpid by reverse sympathy, as in the inoculated small-pox during

the eruption on the face the feet are frequently cold.

G. _Associations affected four Ways._

Hence associated trains or circles of motions may be affected four

different ways. 1. By the greater or less energy of action of the first

link with which they are catenated, and from which they take their names;

as irritative, sensitive, or voluntary associations. 2. By being excited by

two or more sensorial powers at the same time, as by irritation and

association, as in the instance of the application of the stimulus of

increased external heat to the cutaneous capillaries. 3. By catenation with

other sensorial powers, as with pain or pleasure, which are in this case

not the proximate cause of motion, but which, by becoming a link of

catenation, excites the sensorial power of association into action; as the

pain at the neck of the gall-bladder occasioned by a gall-stone is

transferred to the other end of that canal, and becomes a link of

catenation between the action of the two extremities of it. 4. The

influence of ethereal fluids, as of heat and gravitation. To which last

perhaps might be added moisture and oxygen gas as constituting necessary

parts of the system, rather than stimuli to excite it into action.

H. _The Origin of Associations._

Some trains or circles of associate motions must have been formed before

our nativity, as those of the heart, arteries, and capillaries; others have

been associated, as occasion required them, as the muscles of the diaphragm

and abdomen in vomiting; and others by perpetual habit, as those of the

stomach with the heart and arteries directly, as in weak pulse during

sickness; with the capillaries directly, as in the flushed skin after

dinner; and lastly, with the cellular absorbents reversely, as in the

increased absorption in anasarca during sickness; and with the irritative

motions of the organs of sense reversely, as in vertigo, or sea-sickness.

Some of these associations shall be here shortly described to facilitate

the investigation of others.

First, other congeries of glands occupy but a particular part of the

system, or constitute a particular organ, as the liver, or kidneys; but

those glands, which secrete the mucus, and perspirable matter, which are

called capillaries, are of very great extent; they receive the blood from

the arteries, separate from it the mucus, which lines every cell, and

covers every cavity of body; and the perspirable matter, which softens and

lubricates the whole surface of the skin, and the more extensive surface of

the air-vessels, which compose the lungs. These are supplied with blood by

the perpetual action of the heart and arteries, and have therefore their

motions associated with the former, and with each other, by sympathy, which

is sometimes direct, and sometimes reverse.

One branch of this association, the capillaries of the skin, are very

irritable by the increased quantities of cold and heat, another branch,

that of the lungs, has not the perception of cold and heat, but is liable

by direct sympathy to act in concert with the former, as in going into the

cold bath. And it is probable the capillaries of the internal membranes are

likewise directly affected by their sympathy with those of the skin, as

appears from the defect of secretion in ulcers during the cold fits of

agues.