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OBSERVATIONS
O N T H E
NATURE, CAUSES, and CURE
of thofe Disorders which have been commonly called
NERVOUS HYPOCHONDRIAC,
or HYSTERIC,
To which are prefixed fome Remarks on the
Sympathy of the Nerves.
B Y
ROBERT WHYTT, M. D. F. R. S.
Phyfician to his Majefly, Prefident of the Royal
College of Phyficians, and Profeffor of Medicine
in the Univerfity of Edinburgh.
2u/!A7»-a9£« TTctj/Tfls, Hippocrat. de aliment, § 4.
EDINBURGH:
Printed for T. Becket, and P. Du Hondt, London ;
and J. Balfour, Edinburgh.
M DCG LXV,
[ iii ]
PREFACE.
*' I ^HE diforders which are the fubjcct
-■- of the following Obfervations, have
been treated of by authors, under the
names of Flatulent, Spaiiiiodic, Hypo-
chondriac or Hyfteric. Of late, they
have alfo got the name of Nervous ;
which appellation having been com-
monly given to many fymptoms feem-
ingly diiferent, and very obfcure in their
nature, has often made it be £aid that
Phylicians have bellowed the characfter
of nervous on all thofe diforders whole
nature and caufes they were ignorant of.
To wipe off this reproach, and, at the
fame time, to throw fome light on ner-
vous, hypochondriac and hyfteric com-
plaints, is the defign of the following
Obfervations ; which are alfo intended
to fliew, how far the principles laid
down in my Effay on the vital and other
involuntary
iV
PREFACE.
involuntary Motions of Animals, may
be of life in explaining the nature of
(everal difeafes, and confequently, in
leading to the moft proper method of
cure *.
Since, in almofl every difeafe, the
nerves fuffer more or lefs, and there
are very few difbrders which may not
in a large fenie be called nervous, it
might be thought that a treatife on ner-
vous difeafes fliould comprehend almofl
all the complaints to which the human
body is liable. The deiign, however,
of the following Obfervations is far dif-
ferent. In them, it is only propofed
to treat of thole diibrders, which in a
peculiar fenfe deferve the name of nervotiSy
in fo far as they are, in a great meafiire,
owing to an uncommon delicacy or
unnatural feniibility of the nerves, and
are therefore obferved chiefly to afFe^l
perfons of flich a conftitution.
As
* See a.i ECay on the vital, SiC. motions, edit, ifl, p. 390.
PREFACE. V
As many of thefe complaints depend
upon that fympathy which obtains be-
tween the various parts of the body, it
feemed neceilary to begin with fome
oblervations on the fympathy of the
nerves ; a flibje^l of the greateil impor-
tance in pathology !
In reafoning on the nature and caufes
of nervous diforders, I have endeavour-
ed to avoid uncertain bypothefcs ; and
therefore have had no recourfe to
any imaginary flight, reperciijfion, dijper-
fioiiy confitfion or jarring coiiteft of the
animal fpirits ; for whole exigence we
have only probability, and of whofe
peculiar nature and properties, we are
altogether ignorant. Bat altho* the
minute flrucflure of the nerves, the na-
ture of their fluid, and thofe conditions
on which depend their powers of feeling
and communicating motion to the bo-
dy, lie much beyond our reach ; yet
we know certainly, that the nerves are
endued with feeling, and that as there
is
vi PREFACE.
is a general iympathy which prevails
through the whole f} Item ; fo there is a
particular and a very remarkable conjhit
between various parts of the body.
From this fentient and lympathetic
power of the nerves, I have endeavour-
ed to deduce the various fymptoms of
the nervous kind : and have thought
it better to flop fliort here, than to a-
mufe myfelf or others, with fubtile fpe-
culations concerning matters that are
involved in the greateft obfcurity.
If it fhould be faid, that to account
for difeafes from tlie fenfibility or Iym-
pathy of the nerves, while we know
not wherein thefe powers conflfl, is no
better than referring them to a faciiltas
incognita^ or to the hypothetical motions
and cQuntermotions of the animal ipi-
rits ; I Ihall only anfwer, that altho* we
cannot explain why grief or joy (liould,
by means of the nerves, excite a greater
motion than ufual, in the vefTels of the
lachrymal glands, yet it is leading us to
the truth, and advancing one ftep far-
ther
PREFACE. vli
ther in our knowledge, to (liew that
the increafed fecretion of tears, occa-
lioned by thole palfions of the mmd, pro-
ceeds from this caufe, and not from any
comprellion of the lachrymal glands or
their du(^ts,by the neighbouring mufcles,
as has been commonly imagined : And,
to afcend from fmall things to great,
altho' Sir Ifaac Newton did not pretend
to explain the caufe of gravity, yet he
made no fmall improvement in phyfical
Aftronomy, when, from this principle
alone, he accounted for the various mo-
tions of the planets, and baniflied the
imaginary vortices oi DefcarteSy which had
been contrived, bvit unfuccefs fully, to
explain the phenomena of the folar fyllem.
In the practical part, I have confined
myfelf chiefly to what experience had
fuggefted ; and have only advifed fucli
remedies as I have ufed with fuccels my-
felf, or had recommended to me by
thofe whom I could trufl.
As many of the fubjecfls I have treated
of, are not a little obfcure, it cannot be
expecl:ed
Vlll
PREFACE.
expefed that they fliould admit of as
clear an explication as matters that are
lefs intricate ; and this, it is hoped, will
make the learned in the profeliion over-
look, with candor, the defects which
may be found in the following Obfer-
vations. However, if, with all their
imperfedlions, they ihall be of any nle
in conveying to the younger and lels
experienced Phyficians, a clearer notion
of the natui'e of thofe diforders, which
have been commonly called nervous, hy-
pochondriac or hyfleric, or in any cafe
direct them more happily in the cure ;
I fliall have my aim, and be fufficiently
rewarded in the fatisfaction of thinking
that my labour has not been, altogether,
ufelefs to the Public, the good of which
ought to be the principal view of every
writer.
Hoc opus, hoc Jlitdiimi, parvi properemus
et ampliy
Si patriis vohmitu, fi nobis vivere chari.
Edinburgh, Nov. 15.
1764.
THE
CONTENTS.
CHAP. I.
Of the Jiru&ure, ufe and fimfath'^ of the
nerves Page i.
CHAP. n.
Of nervous, h'jpochondriac and hyjieric dif
orders in general 85
CHAP. HI.
Of the predifpofing caifes of nervotis, h'jpQ-
chondriac and hy ft eric dif orders in
CHAP. IV.
Of the general occafional caifes of nervous,
hypochondriac and hyfleric diforders 143
CHAP.
CONTENTS.
CHAP. V.
Of the particular occaJJonal cmtfcs of nervous,
h-^pochondriac and byjie?-ic diforders 1 8'8
CHAP. VI.
Obfervations on fome of the moft remarkable
fymptoms of the nervous, h'jpochondriac or
hyjlcjic kind 224
I. ^n tincojmnon fenfe of cold Or heat in
different parts of the bodj 224
n. Pains in different parts of the bod-y
fuddenly moving from one place to
another 220
ni. Hyjicric faintings and convulfions
231
IV. y^catalepfis and tetanus 235
V. TVind in the fomach and bowels
237
VI. A great craving for food 240
VII. y^ black vomiting 242
vni. J
CONTENTS.
VIII. A judden and great flux of pale
^inne Pag. 246
IX. A nervous atrophy 253
X. A nervous or fpafmodic afthma
260
XI. A nervous cough 265
XII. Palpitations of the heart 286
XIII. The piilfe often varying in quick-
nefsy ftrength and fulnefs 287
XIV. Periodical headachs 305
XV. A giddincfs 308
XVI. A dimnefs of fight vjithout awj vi-
fhle faidt in the eys 310
XVII. Lovj fpiritSf melancholy and a
mania 311
XVIII. The incubus or night-marc
315
CHAP.
CONTENTS.
CHAP. VII.
Of the cure of nervous, hypochondriac and
hyfteric diforders P^g* 329
CHAP. vm.
Of the cure of fome of the moft remarkable
nervous, h'^pochondriac or hyjleric fnip-
toms 440
I. Convidfive motions, or fixed fpafms
of the mifcles 440
II. Hyfteric faintings vjith convtdfions
470
III. A violent pain with cramps in the
Jlomach 474
IV. An indigeftion and vomiting, ivith
pains in the Jlomach ^•jy
V. A colic of the hyjieric or flatulent
kind 484
VI. Flatulence in the fomach and bovjcls
487
VIII. J
CONTENTS.
VII. A nervous or fpafmodic aflhma
Pag. 491
VIII. A palpitation of the heart 503
IX. An immoderate dif charge of pale
tirine 505
X. Periodical headachs 511
XI. Low fpirits 517
ERRATA.
Page 96. Line 17. for inconjijlent lege inconfiant.
■ 100. L. ult. leg. at the Jiomach.
1 1 1. L. 3. after ner^vous add hypechondriac or hyjleric,
. 166. L. 21. for returnin leg. returning.
176. L 21. place I. before That.
. 209. L. 21. for 4. leg. 3.
'— — 210. L. 6. for 5. leg. 4.
». 229. L. 21. iox finking \t^. Jiicking,
■ 266. L. 14. for /ra^ leg. truely.
— — 284. L. 5. after Theriaca dele ,
— — 314. L. 20. dele i«/.
Lately publiflied and fold by John Bal-
four Bookfeller in Edinburgh,
I. An Eifay on the Vital and other Involuntary
Motions of Animals.
The fecond Edition with Corrections and
Additions.
II. Phyfiological Effays.
The fecond Edition corre<5led and enlarged,
with an Appendix containing a review of
the Controverfy concerning the Senfibi'
lity and moving Power of the Parts of
Men and other Animals; in anfwer to
M. de Mailer's Remarks.
N. B. The Appendix may be had fe-
parately.
III. An ElTay on the Virtues of Lime-v/ater and
Soap in the Cure of the Stone.
The third Edition corrected and enlarged.
The above by Robert JVJiytt, M. D.
F, R. S, Phyfician to his M.ajesty, &c.
C H A p. L
Of the Structure, Use, and S y m*
PATHY 0/ r/);^ Nerves.
EFORE we enter upon the fub-
jecl of the folio whig obfervations,
it may be proper to make a few remarks
concerning the ftru(fb.ire, ufe and fym-
pathy of the Nerves.
1. The nerves are thofe fmall cords,
which rifing from the brain and ipinal
marrow, are diilributed to every part
of the body. They appear to be no
more than continuations of the medul-
lary fubftance of the parts from whence
they proceed, and owe their ftrength
and firmnefs to the membranes and cel-
lular texture which flirround them.
2. The larger nerves (i.) are evi-
dently compofed of many fmaller ones,
A which
t Of the Sy UP AT uY
which run parallel to each other, and
feem to be quite diflin(fl from their ori-
gin to their termination, without 2iny fiich
communications between their branches,
as are obferved every where in the fy-
ftem of arteries and veins.
3. The fmallefl nervous filaments
that can be traced by diife^lion, are flill
compofed of lefTer threads, fo that we
can have no idea of the exility of a fingle
nervous fibril.
4. Alt ho' it fecms probable that
the nerves (3.), which are continuations
of the medullary flibflance of the brain
and Ipinal marrow, derive from thence a
fluid ; yet the extreme fmallnefs of the
nervous tubes, and the fubtility of that
fluid which they contain, make us alto-
gether ignorant of its peculiar nature
and properties. Nor do we know, cer-
tainly, whether this fluid ferves only for
the nourifhment and fupport of the
nerves, or whether it be not the medium
by which all their ad:ions are performed.
5. The
of r/;^ Nerves. 3
5. The nerves communicate fenfe
and a power of motion to the body.
Since opiuniy without entering the
blood, or being carried to the feveral
parts of the body, lelfens or deflroys their
powers of feehng and motion, mere-
ly by ailing on the extremities of the
nerves to which it is applied *, it fol-
lows, that the nerves mull be the inftru-
ments of fenfation, and necefTary for
performing motion. Many other expe-
riments and arguments might be menti-
oned to the fame purpole ; but as this
agency of the nerves is a point general-
ly acknowledged, it would be unnecef*
iary to enter here into a more particular
proof of it.
6. Alt ho' every part of the body
furniflied with nerves, has either more
or lefs of feeling f ; yet there are only
A 2 fome
* See Edinburgh Phyfical EiTays, vol. ii. p. 304. 309.
310, &c.
t There are fome exceptions to this, fuch as the honej and
carriages, which, tho' not deftitute of nerves, are yet, in a
natural ftate, infenfible.
4 Of the Sympathy
fbme of thofe parts, whofe ftruclure ren-
ders them capable of motion, viz, the
mufcles, and fuch organs as are in part
mufcular ; and the blood vefTels, which,
from the eifeCl:s of bliflers and other fti-
muli, appear evidently to be poflelled of
irritability, or a power of alternate con-
trad:ion.
7. There are only two kinds of
motion obferved in the bodies of living
animals, viz, voluntary, and involunta-
ry from Jiimuli, In order to the perfor-
mance of the fit'fty the nervous power
is not only neceffary, but alfo a free
communication, by means of the nerves,
between the brain and the parts to be
moved. The fccond continues for fome
time, tho' in a much weaker degree,
even in thofe mufcles, whofe connexion
with the brain is wholly cut off; whence
it has been concluded that this kind of
motion is independent of the nerves,
and owing to fome power or property in
the mufcular fibres themfelves, or in the
glutinous
of the Nerves. 5
glutinous matter connecting the ele-
ments of whicii they are compofed *.
That this concluiion, however, is not
well founded, I have formerly fliewn by
fever al arguments and experiments t ;
and fhall, therefore, at prefent only ob-
ferve, that, llnce a folution of o-piiim, by
afte6ling the extremities of the nerves
to which it is applied, and without be-
in 2: received into the blood, or carried
to the brain or mufcles, deflroys, not
only the power of voluntary motion in
animals, but alfo renders their mufcles
incapable of being excited into contrac-
tion by the ftrongefl flimidi % ; it evident-
ly follows, that involuntaiy, as well as
voluntary motion, depends upon fome
power or influence of the nerves ||.
But
• Ada Getting, vol. ii. p. 152, &c.
f See Edinb. Phyfical EfTays, vol. ii. p. 309, ic. and
Phyfiological Effays, edit. 2d, &c.
X See Eflay on the vital motions of animals, edit. 2d,
p. 418.
jj See this argument farther purfued in Phyfical ElTays,
vol. ii. p. 304, 310, &c.
6 Of the S Y xM P A T H Y
But be this as it will ; from the con-
tinuance of the motion of the heart, and
other mufcles, after they are feparated
from the body, one may fafely conclude,
that the contraction of imtated mufcles
is not owing to the diflenlion of their
hollow fibres by a more copious influx of
the nervous fluid at that time. Does this
fluid aft in fome other way than by di-
ftending the mufcular fibres ? or is it
only neceffary to keep them in a proper
ftate for being acted upon by that living
principle from which all their motions
ai'e to be derived * ?
8. As
* Since it has been the prevailing opinion among Phyfiolo-
gifts, that the contraftion of the mufcles is owing to the dilata-
tion of their hollqw fibres by a greater influx of the nervous
fluid into them, it may not be amifs, briefly, to mention the
principal argum€;nC9 which render this opinion, at leaft, very
improbable.
I. As far as we can judge from experiments, the mufcles
become lefs bulky in ? fliate of contraaion, than they were be-
fore. The hearts of frogs, when taken out of the body, be-
come really lefs every time they contraft, and their contrac-
tion feems not to be owing to an inflation of their fibres or
%'eflels, but to the particles, of which they arccompofed, ap-
proachino- nearer to one another, and running into clofer con-'
of the Nerves, y
8. As the nerves are continuations of the
medullary fubftance of the brain and fpi-
nal marrow, it is probable that they are
partly nouriilied by thofe velTels which
are
z. The extraordinary fmallnefs of the nerves, and the very
flow fecretion and raotion of their fluid, makes it improbable
that mufcularmotionis owing to the diflenfion of the fibres of
the mufcles by a fudden influx of that fluid. Nor have we
anyreafon to think, that the nervous juice dilates the iriuicu-
lar fibres by means of any rarefaftion or efi^ervefcence.
3. The mufcles grow more tendinous by age, /. e. their
fibres towards their extremities degenerate into folid threads ;
and this happens foonefl when the mufcles are much ufed :
but if the contraftion of a mufcle were owing to the Inflation
of its fibres by any fluid, the more frequently it was moved,
it would be the lefs apt to become tendinonjs.
4. If the mufcular fibres are hollow, and of a cylindrical
form, or made up of veficles, it may be demonftrated, that
they cannot be rendered, in the firfl: cafe, above ~, and ia
the fecond above j part ftiorter, by the influx of a fluid into
their cavities ; but we know that the difference between
x!iit fphincler pupill^ a.nd ani, and the ftomach and bladder, in
their grcatefl: fl&te of contraction and diflenfion, is much more
than any of thefe proportions.
5. The regular alternate contraflion of the hearts of froo-?,
for five or fix hours after decollation and the deflruclion of
their fpinal marrow, and for half an hour or more after they
arc feparated from their bodies, clearly proves, that an influx
of a fluid from the nerves into the mufcles, is- not neceffary
for their contra£i.ion : For although the fpirits remaining in
thp nerves of the heart, fhoald be fuppofed to occafion a few
contradtions
8 Of the Sympathy
are fpread on that production of the pia
'mater v.^hich (lirrounds them, in like man-
ner as the brain derives its nonrifliment
from the arteries of the pia mater. If this
be true, we may readily fee why the
nerves lole their powers, when they are
Vv^holly deprived of the arterial blood ;
and, on the other hand, retain them , in
fome meafure, after die brain is offiiied
or petrified.
It has been thought by fome, that,
nutrition is cliiefly performed by means
of the nervous fluid, becaufe thofe parts,
whofe nerves are deftroyed, or wholly
deprived of their uiual power, are ob-
ierved to become fnialler.
But whoever confiders the incon-*
ceiveable exility of the nerves, and how
flo^vly
contradlioRS of this mufcle, yet they cannot be fafficient for
producing feveral thoufand diftenfions of its hollow fibres.
The above arguments, if they do not entirely overthrow the
common opinion, will, at lead, juflify me in not having re-
courfe, in the following treatife, to the irregular motion, increaf.
ed derivation, reperatffion , csnfufton, or hurrj o£ the animal fpi-
rits, in accounting for the fymptoms of nervous hypochondriac
or hyftenc diforders.
■o/ the IM ERVEs,,^^ .. ^
llowly any fluid miift be derived by their
means from the brain *, will fcarcely
think that the nutrition and growth of
the body can be performed in this way.
Nor does the withering of fuch mufcles
as are totally palfied, prove, that nutriti^
on is owing to the nervous fluid ; for
we know, from certain experiments and
obfervations, that the motion of the
fluids in the very fmall velTels, depends,
in a great meafure, upon the influence
of their nerves ; and that when this is
wanting, the fluids either do not circu-
late at all through thofe vefl^els, or, at
leaft, in a very languid manner : whence
the parts, to which they belong, collapfe,
and are not properly nourifhed f*
c;. Our bodies are, by means of the
nerves, not only endowed with feeling,
and a power of motion, but with a re-
markable fympathy, which is either ge-
neral and extended through the whole
fyftem,
* See Phyfiological Effays, edit. 2. p. 22, &c.
f Ibid. p. 49. and 50.
I o of the Sympathy
fyftem, or confined, in a great meafure,
to certain parts.
lo. That every fenlible part of the
body has a fympathy with the whole,
Avill fufficiently appear from the follow-
ing facls.
Cold water thrown on any part of
the body that is warm, produces a fud-
den contraction of the whole veflels and
pores of the ikin, and by that means
frequently puts a flop to fmall hasmor-
rhages. The effaivia of certain fubflances
when fnielled to, inftantly communicate
new life and vigour to the whole body,
while others affe(ffc fome delicate women
with fainting and convulfions. — By
means of different mufical founds, vari-
ous pailions may be excited or calmed,
and. difeafes are faid to have been Ibme-
times cured *. By doleful ftories, or
fliocldng lights, delicate people have
beei:^
■ * Hijioir: Acad. B.oyale des Sciences^ An. 1717.
r
af the l<i ERv ES. ' jx
been often afFecred with fainting and
general convuliions *. "
When the brain is wounded, inflam-
ed, iiippurated, or otherwife hurt, al-
moft every part of the body is liable to
fliffer, and vomithigs, tremors, convul-
iions, palfies, <^c. often enflie. In ani- -^
mals newly dead, the vv'hole mufcles of
the trunk and extremities are flrongly
convulfed, when a probe is puili^d down
through the ipinal marrow,
Wh en the ftomach is in a found ftate,
and digeflicn is properly performed,
the fpirits are good, and the body is
light and eaiy; but when that organ is
out of order, a languor, debility, melan-
choly, watchfulnefs, or troublefome
dreams, the night mare, (j^^r. are the
coniequences. — Grateful food, flrong
wine, or other ipirltuous liquors, no
fooner
♦ Although in thefe cafes, the changes produced in the bo-
,dy are owing to the paflions of the mind, yet as the mind is
only affedled through the intervention of the optic and audi-
tory nerves, they feem proper enough inftances of the gene-
ral fympathy that extends through the whole nervous fyllera.
XI Of the Sy Isi? AT HY
fboner touch the ftomach of one ready
to faint from emptinefs, than they com-
municate new Ufe and flrength to the
whole body: And, on the other hand,
feveral poilbns occalion violent iicknefs,
vomiting, fainting, tremors, convulfi-
ons, ftupidity, an intermitting pulie, dif-
ficult breathing, coldnefs of the extre-
mities, and other fymptoms. — A fever,
delirium, and violent convulfions, have
been produced by a pin flicking in the
coats of the flomach * : And worms, af-
fefting either this part or the inteftines,
occafion a llirprifing variety of fymp-
toms.
Epileptic fits have proceeded from
a rough bone or cartilaginous fubftance,
irritating the nerves of the great toe, or
the calf of the leg ; and the wound of
a tendon or nerve has been the caufe of
a fever, delirium, tremors, violent convul-
fions, a tetanus and death.
Many
* Hildan. Centar. ii. obfervat, 3 ^.
o/ r/;f Nerves. ij
Many more examples might be men-
tioned, were it necelTary, of that gene-
ral iympathy which prevails throughout
the whole body. But there is nothing
which lets this matter in fo clear and in-
difputed a light, as the effects of opiimi :
For a folution of this fubflance injected
into the great guts of a dog, in a few
minutes brought on a paify of his po-
llerior extremities, attended with a flu-
por and convulfions *. Some days af-
ter, a like folution being injected, by a
perforation through the teguments into
the abdomen of the fame dog, he became
almoft inftantaneoufly paralytic, and
died in a few minutes f*
A SOLUTION of opiitm inje^ied either
into the flomach or inteilines of frogs,
or even applied to the mufcles of their
belly laid bare, produces a paralytic
weaknefs, a ftupor and death at laft ;
although fiich is the nature of thefe ani-
mals,
♦ Edinburgh Phyfical EfTays, vol. ii, p. 297.
f Ibid. p. 298.
14 Of the Sy UV AT HY
mals, that opium docs not kill them neaf
fo foon as it does dogs *.
From thefe experiments it appears,
that not only thole nerves, to which opi-
um is immediately applied, are rendered
incapable of performing their office ; but
that the brain, fpinal marrow, and whole
nervous fyftem are afFe(^ed in the fame
manner, folcly by the action of the opi~
tim on the nerves which it touches. For
its effects upon dogs are too initantane-
ous to allow of the fuppofition, that the
more HTbtile parts of tliis poifon are re-
ceived into the blood, and by that means
are conveyed to the brain: And in frogs,
after the heart is taken out, and confe-
quently a ftop put to the chxulation,
yet a folution of opiimi inje^led into the
flomach and inteftines, has the fame ef-
fect, as vv^hen thefe animals are entiref.
ir. Besides
* Edinburgh Phyfical Effay;, vol. ii. p. 281 292.
t Ibid. vol. ii. p. 281. and 302. and Efiay on the vitaP
motions of animals, edit. 2. p. 413.
of the Nerves. 15
II. Besides this general confent
(10.) ^vhich prevails throughout the
whole body, there is a particular and
very remarkable fympathy between fe-
veral of its organs, by means of which
many operations are carried on in a
found flate ; and pain, convulfive moti-
ons, and other morbid fymptoms are of-
ten produced in fuch parts, as have no
near connexion with thofe that are im-
mediately affecled.
To illuflrate this, I fhall give feveral
inflances, beginning with the head, and
taking the parts in their order down-
wards.
{a) The PI E A D. Violent pains in
the head, which have their feat moft
commonly in the membranes of the
brain or pericranium, are frequently at-
tended with a ficknefs at the ftomach,
and vomiting. — The fpafmus cyiiciis,
locldng of the jaws, and an univerial
tetanus have followed a wound of the left
fide of the head, by which the temporal
miufcle
1 6 Of ?/;^ S Y iM P A t H Y
mufcle was divided *.— Light and noiie
are offenfive both to the eyes and ears
in fevere headachs. — Wounds and con-
tuiions of the brain generally occafion
bilious vomitings. — Certaiil imprefiions
made on the J en for mm commune by exter-
nal objects, inftantly give the eyes either
a dull, a lively, or a fierce look.
Grief, vexation, or fear, leflen the
fecretion of the falivay deilroy the ap-
petite, and fometimes occafion a loofe-
nefs. — The great confent between the
brain and heart appears from the fudden
and remarkable effects of the paflions on
the latter.
(b) The Eyes. When one eye is af-
fefted with an inflammation, a catarad:,
or the giitta fcrcna^ the other is often fbon
after attacked with the fame difeafe.
The contraction of the pupil is not ow-
ing to light afting as a ftimukis on the
iris, but folely to the fympathy between
this
* Kil<3an. Centur. v. obfervat. 9.
of the 'Nerves. 17
this membrane and the retina *.
There is iiich a iympathy between the
two pupils, that, even in a gutta ferefin,
the pupil of the morbid eye is obferved
to follow the motions of the found
one. — We fliut both eye-lids, whether
we will or no, as often as any thing
threatens to hurt either eye. — A bright -»^
light coming fiiddenly on the eyes fome-
times occafions fneezing. Hippocrates
has observed, that the unexped:ed fight
of a ferpent will make the countenance
pale f. — The light of grateful food oc-
cafions an uncommon flux of the faliva,
in a hungry perfon. — Yawning and vo-
miting are often catching.
(c) The Ears. The noife of a file and
other harfli founds affei^l the teeth with
an uneaiy fenfation. — The whetting of /-
a knife has caufed the gums to bleed $.-• »
Great and unexpefted founds, fuch as
B the
* See an EfTay on the vital motions of animals, edit. z.
§ vii.
f Lib. de humorihus..
t Boyle's ufefulnefs of experimental Phllof. part 2. p. 34S.
1 8 Of the Sympathy
the explolion of a cannon or mufket,
make us inftantly clofe our eye-lids. —
y- As the ear is frequently pained when the
fauces are inflamed, fo an irritation of the
■meatus auditorins will often excite cough-
ing, and fometinies vomiting *. A
f conftant pain of one fide of the head,
with a numbnefs of the left arm and leg,
a fupprellion of the ?nenjes, and epileptic
fits, have all been occafioned by a glafsr
ball, not larger than a pea, flicking in
the ear t-
{d) The Nose. The effluvia of Hunga ry
water, or fpirit of wine drawn ftrongly
into the noftrils, increafe thq derivation
of the fdlival juice into the mouth, and
fometimes flop a tickling cough. — The
iinell of grateful food makes the faliva
liow when one is hungry. Sternuta-
tories not only increafe the fecretion
from the nofe, but alfb from the lachry-
mal veflels. After finelling to volatile
falts,
* Pechlin. obfervat. med. lib. 2. No. 45.
f Hildan. Centur. i. obfervat. 4.,
of the Nerves. 19
{alts, or eating too much ftrong muftard
with one's meat, a pain is often felt a-
bove the eye-brows ; and it is obfervable, -/-
that after taking a large draught of
very cold water m winter, that part of the
fore-head immediately above the nofe,
is affecled with a painful fenfation. — A-
crid flibftances applied to the olfaftory
nerves bring the diaplu-agm, intercoflal
and abdominal mufcles into convulfive
motions.
Mr. Bo)le mentions feveral, who were •/-
purged by fmelling to a cathartic medi-
cine * ; and we are told, that, in fbme,
the effect failed, when, from a cor^zdy
or obftrud:ion of the membrane of the
nofe, the olfadlory nerves had loft their
power of diftinguifliing fmells.
[e) The Teeth. A rotten tooth will f-
fometimes occafion a violent pain in a
found one, tho' at a diftance from it ;
and the pain will ceafe as foon as the
fpoilt tooth is drawn, or its nerve de-
ftroyed. A pain in the teeth often
B 2 affed:s
* Ufefulnefs of Experimental Philof. part 2. p. 242.
20 Of the S Y xM P A T H Y
affecls the cheek-bone, one fide of the
head, the throat, and the correii3onding
ear. Children, from the irritation of
the gums in teething, are liable to vo-
miting, purging, a cough, a fever and
convuliions.
(/) The Trachea. An irritation of
the V. indpipe, or any of its fmall branch-
es, raiies coughing, or a convulfive mo-
tion of the mulcles employed in expli^a^
f- tion ; and a 7iaufea, vomiting and con-
vuliions are, fometimes, the coniequence
of a violent or long continued irritation
of thefe parts.
(^g) The Lungs. The fympathy of
the hmgs, with the diaphragm and in-
tercoftal mufcles, is evident from their
motion even in ordinary reipiration ;
but dill more fo in the laborious breath-
ing, which is always the confequence
of a difficult paflage of the blood thro'
the pulmonary veflels.
{k) The Diaphragm. When the dia^
piiragra is inflamed, the ftomach, brain
and
of the Nerves. 21
and mufcles of the face are affedled by
fympathy, as appears from the delirmn,
vomiting and ?'ifij fardonicusy which at*
tend this difeafe.
(/) The Stomach and Intestines.
A difordered flate of the ftomach and
inteftines, with wind or noxious hu-
mours lodging in them, will fometimes
fo aiFecl the brain, as to deprive people
of their reafon. At other times, the
fame caufes will produce a vertigo y cepha^
Ua, heinicrania, clavtis hyjlerictts, palpitati-
ons, intermiflions of the pulfe, difficul-
ty of breathing, fudden fiufhes of heat
and Aveating, &c. — — After hard drink-
ing, or a large doze of opiunty the eyes
lofe their luftre. — The headach, after a
debauch, proceeds chiefly from the flo-
mach, as appears by the removal of the
pain, upon drinking a few glafTes of
ftrong wine. The diforder of the
ftomach will fometimes occafion dimneis
of light *. I know a Lady, to Avhom
every
* Lomrr.ii obfenrat. med. lib. ?.
22 Of the Sympathy
jf every object appears, as if covered with
a thick fmoke, as often as her ftomach
is loaded with an acid; and who, there-
fore, finds vomits, abforbent powders
and bitters her beft ophthahnic medi-
cines. — Another Lady, with tender eyes,
feldom has any confiderable pain or lick-
nefs at ftomach, without her head being
afFefted, and her eyehds or eyes becom-
ing, in fome degree, inflamed. In
little more than half an hour after fwal-
lowing fifteen or twenty grains of the
extracmm ciciit£y I have been often affedled
with a weaknefs and dazzling of my eyes,
together with a giddinefs and a debility
of my whole body, efpecially the muf-
cles of my legs and arms ; fo that, when
I attempted to walk, I was apt to flag-
ger like a perfon who had drunk too
much.
A CONVULSIVE motion of the flo-
mach and inteflines often fpreads to the
throat, where it occafions a difficulty of
breathing, and a fenfe of fufFocation :
On
of r/je "N ERVEs, 23
On the other hand, an irritation of the
fauces J or pharynx, excites vomiting
A natfea or difagreeable fenfation in the
ftomach makes the pulfe quicker and
fmaller, raifes a Iweat, and fometimes
greatly in-creafes the fecretion o^ the fa-
liva or urine. When the ftomach is
empty, and affected with a {^eni^e of hun-
ger, the faUval juice flows much more
copioufly into the mouth, than after a
full meal, or when the natural appetite
for food is wanting. — An inflammation
of the flomach and bowels is attended,
in the beginning, with a fhuddering of
the whole body, and a great coldnels of
the hands and feet. Long continued
vomiting and purging occafion violent
cramps of the mufcles of the legs and
thighs ; and the dry belly-ach brings on
a palfy of the extremities. — A tremor of
the hamds is often leflened or removed,
for a while, by a dram, or fome ftrong
wine ; and tliis effecfl is owing fokly to
the adion of thefe liquors on the fto-
mach,
24 ^f the Sympathy
mach, and not to their having entered
the blood, which does not happen fo
foon. — The particular fympathy of the
ftomach with the diaphragm and abdo-
minal mufcles, appears from their con-
vulfive motions in vomiting, and in the
^ hiccup. A violent fpafmodic pain in the
ftomach or inteftines, often renders the
pulfe much flower than natural.
An inflammation of the inteftines is
frequently attended with vomiting and
a flippreflion of urine. An opijlhotomis
ju or a tetanus is often occafioned, in hot
climates, by a retention of the mecQuium^
or other acrid humours, in the bowels of
infants. — That itching of the nofe, which
is a common fign of worms, feems to
indicate a particular fympathy between
this part and the inteftines ; and the ma-
ny other fymptoms produced by worms,
which I fhall have occaiion to mention
afterwards, ftiew a remarkable and ex-
tenfive confent between the firft palla-
ges, and many other parts of the body.
{k) The
of the Nerves. 25
{k) The Liver. Stones irritating the
biliary dudls, frequently occafion a nati-
fea and vomiting. — An inflammation of
the liver is generally accompanied with
a vomiting and the hiccup, and often
with a pain between the vertebrae of the
neck and top of the flioulder. In a fup-
puration of the liver, I have twice i^cGn j^
the patients affected with a numbnefs and
debility of the right arm, tliigh and leg.
(I) The Kidneys and Ureters.
A naiijea, vomiting, coftivenefs and infla-
tion of the bowels, are often produced
by an inflammation in the kidneys, or
ftones in the ureters. — A flone in the
-pelvis of the kidney, or in the ureter^
fometimes occafions a frequent inclina-
tion to make urine, and a heat in the
extremity of the urethra, — When one of
the kidneys is inflamed, little urine is fe-
parated by the other, probably on ac-
count of a fpafmodic fl:rifture of its fe-
cretory veflels. — 'When a fl:one is pafling
through the ureter, the tefticle of the fame
fide
26 'Of the Sympathy
fide is fometimes drawn upwards and
fwells ; and an ered: pofture is then pain-
ful.
(m) The Bladder and Rectum.
An irritation of the neck of the bladder,
or extremity of the reBum, is the caufe
of a conflant contraction of the dia-
phragm and abdominal mufcles. — A
ftrangm'y and tenejmu mutually occafion
each other. — The pain of the h^emor--
rhoids is fometimes accompanied with a
licknefs at the ftomach, and faintiflmefs.
A ftone or ulcer in the bladder is attend-
ed with a fliarp pain near the end of the
urethra, efpecially after making water. I
^ had fome years iince a patient with an
ulcer in the bladder, who, when he paf-
fed his urine, had not only a violent pain
in the point of the penis, but this pain de-
fcended down his thighs and legs, and af-
fecled the foles of his feet, as if he had
been {landing barefooted on bmniing
coals.
(n) The Genitals in Men. At
the time of puberty, not only the voice,
but
of the Nerves. 27
but the whole body vindergoes a fenfible
change, which is probably owing to the
jiimidiis communicated to the nerves of
the genital parts by the jhnen ; for we
certainly know that other fi'miuli applied
to the nerves of the nofe or flomach, ac-
cording to their nature, will either in-
ftantaneouily impart new vigour to the
whole body, or foon occalion a general
Jlupor and debility. — It is owing to a fym-
pathy with the glans, that the vefiaiU fe-
minales are contracted in time of coition ;
and, when the membrane which lines
the lower part of the urethra is flimulated
by the Jhnen, the acceleratores iiririfS are ex-
cited into convulfive motions.
(0) The Uterus. The great variety
of fymptoms in the hyfteric difeafe is the
reafon, why a more extenfive fympathy
has been afcribed to the womb, than to
any other part, except the brain. But,
altho' thefe fymptoms proceed from the
womb, much lefs frequently than has
been imagined ; yet the vomiting which
2:enera]lv
28 Of the Sympathy
generally accompanies an inflammation
of that organ, the naufea^ and depraved
appetite after conception, the violent
contracT:ion of the diaphragm and abdo-
minal mnfcles in delivery, the headach,
and the heat and pain in the back and
bowels about the time of menflruation,
are iiifficient proofs of the confent be-
tween the uterus and feveral other part^
of the body. But there is no part fo
much alFed:ed by the different ftates of
the womb as the breafts, which become
more turgid before every appearance of
the meufes, and fublide after the period is
over. The changes that happen to the
breafts in time of pregnancy, and after
delivery, are ftill more remarkable.
J- (P) The Extremities. Strait flioes
give fome people a headach ; while fina-
pifms applied to the foles, or blifters to
the legs, often lelTen, and fometimes re-
move a delirium, — In an obftinate coftive-
nefs, cold water thrown on the feet and
legs, has fometimes opened the body.
after
of r/;5 Nerves. 29
after many other remedies had failed. —
f^ By tickling the foles, not only the miil^
cles of the legs, but of the whole body,
may be thrown into convuliions. — An
opijihotonusy with convuliions returning
every day, has been owing to a wound
in the fole of the foot by a nail ;* and
the fpafmus cyniciu to a violent pain in
the toes.f — The locking of the jaws
fometimes happens after amputations of
the extremities, or lacerations of the
nerves or membranes.
Many other examples o^fpipath^y both
in a found and morbid ftate of the bo-
dy, might be mentioned ; but the above
will be fulficient at prefent, as I iliall
have, afterwards, frequent occafion to
touch on the fame llibje<^.
12. All fynpath-j or conjhnt flippofes
feeling, and therefore muft be owing to
the nerves, which are the fole inftru-
ments
^ ♦ Nova A£l. Acad. Caefar. natur. curlof. torn. i. p. i6.
f Hoffjnan. Syilem, med, torn. iii. feft. i.cap. 5. No. 39*
3© Of the Sympathy
Tnents of renfation(5). The truth of this
Items to be fully evinced, by the follow-
ing experiment. When the liinder toes
of a frog are wounded, immediately af-
ter cutting off its head, there is either
no motion at all excited in the mufcles
of the legs, or a very inconfiderable one.
But if the toes of this animal be pinch-
ed, or wounded with a pen-knife, ten
or fifteen minutes after decollation, the
mufcles, not only of the legs and thighs,
but alfo of the trunk of the body, are,
for the m.oft part, ftrongly convulfed,
and the frog fometimes moves from one
place to another. In this caie, is not
the irritation of the toes, immediately
after decollation, rendered ineffectual to
produce any motion in the mufcles of
the legs a;nd thighs, by the greater pain
occaiioned by cutting off the head ? And
are not the mufcles of the pollerior ex-
tremities, as well as of the trunk of the
body, brought into aftion by wounding
the toes fifteen minutes after decollation,
becaufe
of the Nerves. .3J
|3ecaufe the pain produced by cutting
off the head, is now {o much leflened,
as not to prevent the animal from feel-
ing very fenilbly when its toes are hurt.
But further, that tAI fympathy is ow-
ing to feeling, and confequently pro-
ceeds from the nerves, appears evident,
becauie the changes in the body, occa-.
iioned by the fympathy of the parts, are
ftopt by v/hatever affe(!l:s the nervous fy-
ftem fb ftrongly, as to overcome the feur-
fations that produced thole changes. —
Thus the hiccup is flopt by terror, fear,
furprife, or other ftrong padions. — An
irritation of the noie Avill not occalion
fneezing, when the firft effort to fneeze
is attended with an acute pain in fome
of the mufcles of the back or ^des from
a rheumatic caufe. — Hungary water, or
volatile ipirits, drawn ftrongly into the
nofe, will often ftop a tickHng cough ;
and laudanmn taken by the mouth, or gi-
ven in a clyfter, by weakening the fen-
dent pov/er of the nerves, will leil'en or
remove
$2. cy r/;^ Sympathy
remove the fympathetic vomiting, ari-
sing from a ftone in the kidney or ui*eter,
and the violent contradlions of the dia-
phragm and abdominal mufcles, occafl-
oned by a tenefmiis or ftrangury.
Could we fuppofe the circulation of
the blood were to remain after a total
abolition of the fentient powers of the
brain and nerves, there would be no
more fjmpathyheuveen the parts of fuch
an animal body, than between thofe of
any hydraulic machine. As in this cafe
the motion of the fluids would be mere-
ly mechanical, fo every change made in
any of its parts, mufl be the refult of
mechanifm alone, and confequently
wholly different from confmt^ which, as
it depends upon feeling, cannot be ex-
plained upon mechanical principles.
13, Those f-jmpathies which have been
afcribed bv fome authors to the tela ccl-
lulofa^ blood-velTels, membranes, and the
fimilarity of parts, if duly confldered,
will appear either to proceed from the
nerves,
of the 'Nek WES. 33
nerves, or not to deferve the name of
confent orfjjnpathy.
With regard to the ceUular mem-
brane, as in a natm*al flate, it has little
or no fenfibility, fo it muft, of all other
parts j be the leall fubjed: to j)mpathctic
aife^lions. Its cells have every vv^here a
free communication ; and therefore air,
water, purulent matter, or other hu-
mours, are often conveyed, by their
means, from one part of the body to
another. But this cannot be properly
referred to fpnpathj, and is no more than
what happens to a fpunge, a piece of
fugar, or other porous fub fiances.
The fyflem of blood veffels affords us
no more inftances of true fyinpathy than
the tela cellulofa, except what may be ow-
ing to the nerves which belong to thefe
veffels. The changes made in the cir-
culation, and the morbid fymptoms pro-
duced, or removed by the force of the
blood being turned upon different parts
of the body ; the abforption of the ve-
C nereal
34 ^f i^^S S Y M P A T H Y
nereal contagion, oi pus, or other hu-*
mours, and their tranilation to diftant
parts, are not, ftri(5lly fpeaking, inftan-
c£S of confentf but are folely the confe-
quences of the circulation of the fluids,
aad the communication between the fe-
veral parts of the vafcular fyflem. The
changes, indeed, produced in the moti-
on of the blood, and in the various fe-
cretory organs, by different affedlions of
the mind, are undoubtedly owing to
jjmpathy ; not, however, of the blood-
vefTels, but of the brain and nerves, as
will appear afterwards.
The various inftances o( conjhit froin
the continuity of mertibranes, are, ftricft:-
ly fpeaking, owing to the nerves them-
felves, with which thofe membranes are
fupplied ; far, were they deftitute of
nerves and feeling, no fuch confent could
iiappen. If the heat and pain in the ex-
tremity of the zirerbray from a flone or
ulcer in the bladder ; and the itching in
die nofe, from worms in the inteflines,
and
of the Nerves* 35
tind fuch like fymptoms, were owing to
the continuity of the membranes affect-
ed, the gullet and fauces ought to fuffer
more than the nofe ; and the lower or
middle parts of the urethra fliould be
more pained than its extremity. Fur-
ther, if thefe inftances of f^m-path) were
merely owing to the continuity of mem^
branes, why does not the bladder fuffer
in a gonorrhaa, where there is a great ir*
ritation and pain near the extremity of
the urethra?
Although a deafnefs. has been fome
times cured by purging, this no more ar-
gues a fjiipathy between the ears and in-
teftines from the continuity of the mem-
brane that lines them,* than the cure of
an ophthalmia by the fame remedy, proves
a fympathy between the eyes and bow-
els. The elie6l in both cafes is chiefly
owing to the derivation of the humours
from the parts affected ; and hence bli-
Itering the head often affords a more
C 1 fpeedy
* Haller. prim. lin. phyfiolog. § 555.
3^ Of the S Y MP AT H Y
ipeedy relief, in thofe difeafes, than piU'^
Th e fjjnpathy between the breads and
the uterus, has been derived from the fi-
milarity of their ftrud:ure, or of the li-
quors fecreted by them. But although
thofe parts were much more fimilar in
thefe refpecls than they really are, yet
if there were no conned:ion between
them by means of blood-vefTels, or con-
fent by means of nerv^es, it would be
difficult to conceive, how the condition
of the one could be fo much affected
by that of the other ; and much more,
how a titillation of the one fhould com-
municate a particular fenfation to the
other. The iimilarity of flrudnre be-
tween the mufcles of the legs and arms,
between the tefticles, and between the
parotid glands, is confiderably greater
than between the womb and breafts ; and
yet the former have no iuch fynpath) as
the latter.
14. Although
of the Nekwes. 37
14. Although it may appear, from
what has been faid, that all real confent
between the different parts of the body,
is owing to the nerves, yet it will be
found very hard to account, particular-
ly, for the various inftances o^ fjmpath'^y
either in a found or morbid ftate.
The prevailing opinion has been,
that thele pjmpathies are owing to the
communications between the nerves,
and particularly to the connexion which
the intercoftah have with the fifth, fixth,
and eighth pairs, and with almoft all
thofe which proceed from the fpinal
marrow *. Upon this principle it has
been
* Hippocrates was not ignorant of a general fympathy be-
tween the parts of the body ; and Galen treats particularly of
thofe difeafes which arife ixova fympathy qi confent: but he was
fo far from having any notion that fympathetic afFe£lions were
owing to the nerves, that he afcribes thofe headaclis, which
do not proceed from any fault in the head, to vapours afcend-
ing from the llomach or uterus. The following writers, even
as far down as Fernelius and Sennertus, feem to do little more
than copy what Galen had faid on this fubjeft. Andrea:
l^anreniius, who wrote about the 1600, afcribes the fympathy
between
3^ Of the Sympathy
been thought eafy to trace the various
J)mpathics, not only between the feveral
parts of the abdomen, but alfo between
them and the head, neck, thorax, and ex-
tremities. But however plaufible thi>
theory may appear at firft view, and
how readily loever it may feem to ex-
plain many remarkable inflances of to;/-
fent,
between the mammee and uterus, partly to the intercoftal nerve,
which fends fome branches to the organs of generation, and
partly to the itna ^.zjgcs, which terminates in the left fperma-
tic vein. He deduces the vomiting in a nephritis partly from
the nerves, which- the kidneys have from the ftomachic plexus,
and partly from their exterior coat, being a continuation of
that which covers the bottom of the ftomach. Cafpar Bauhi-
nus derives the confent between the noftrils aad exterior parts
of the abdomen, from the communication between the epiga-
ftric and mammary veins. Riclan, who fiourifhed before the
middle of the feventeentli century, has not, with all his learn-
ing, made any Improvement in the doctrine of fympathy j and
his cotemporary Ri'verius afcribes fympathetic difeafes to five
caufes, fvix. the connexion, fituation, vicinity, or fimilarity of
the parts, or to their having the fame kind of office. Doctor
Willis, who has given a more accurate dcfcriptionof the brain
and nen'es, than any anatomifi: before him, endeavoured, firil,
to explain the various inllances of fympathy between the p^rts
of the body, from the connexion or communication of their
nerves. This dodtrine was afterwards further illuftrated by
Vieu£ens, and has been embraced by moft of the later writers.
of the Nerves. ^s^
fent^ yet a more ftri6l examination will
fliew it to be liable to iniiiperable diffi-
culties.
(a) Since every individual nerve
appears to be quite difdnct from every
other, not only in its rife from the me-
dullary fobflance of the brain or Ipinal
marrow, but alfo in its progrefs to that
part where it terminates (2.), it follows,
that the various inflanccs o^ fynpath^, ob-
ferved between the different parts of the
body, cannot be owing to any communi-
cation or anajlomofis of their nerves ; and
confequently, that it can be here of no
ufe, minutely to enquire into the nu-
merous connexions, which the intercojial
nerves have with the fifth, fixth, and
eighth pairs, and with thofe of the fpi-
nal marrow.
But left it fhould be alledged, that
the courfe of the nervous filaments in
the ganglia is fo intricate, that it is not
altogether clear, whether they may not
intermix or communicate with one an-
other
4<* Of the Sympathy
other in their paflage through thofe bo-,
dies, it will be necefTary to offer fome
lefs doubtful arguments for proving that
t\iQ fympathy of thefeveral parts, does not
depend on any union or anajiojnofis be-^
tween their nerves.
(b) If there Avere any anaJio?nofis, or
real communication between the nerves
of the fame or different trunks, either in
the ganglia or elfewhere, it is natural to
think, that a confuiion would necellari-
ly happen in our fenfations, as well as
in the motions of our leveral mufcles ;
for the imprellions of external objedls
would be communicated, at the places
of union, to other nerves than thofe af^.
fedled ; and the change produced by the
will in any nerve at its origin in the
brain or Ipinal marrow, in order for
moving a particular mufcle, would af-
i'e^t all thofe nerves with which it has
any communication, by means of the
o-atidia or otherwife.
(cJlT
of the Nerves. ai
(c) It does not appear, that there is
zny J^mpath-j between the nerves that are
derived from the fame trunk, by means
of the membranes that furronnd them.
If the dura mater were endowed with that
degree of fenfibility, and with thole
powers of ofcillation which have been
afcribed to it by leveral authors, this o-
pinion would not appear altogether im-
probable ; but as the membranes of the
brain, and thofe productions of them
which furround the nerves, feem, in a
natural ftate, to be poflefTed only of a ve-
ry obtufe kind of feeling*, and are alto-
gether deftitute of motion, we have no
reafon to afcribe 'the various inftances of
fjinpath'^, between the different parts of
the body, to their fenfibility or moving
power.
(d) We
* The experiments of the learned M. de Haller, altho' they
do not prove thefe membranes to be wholly infenfible, yet they
certainly (hew them to have no painful or acute feeling in a,
found ftate, vid. Afta Gottingen. vol. ii. and Phyliological
]Eilays, edit. 2.
42 Of the Sympathy
(dj We obferve a remarkable fympa-
thy between many parts, whofe nerves
have certainly not the fmallefl commu-
nication with one another. Thus the
dimnefs of fight occafioned by a difor-
der of the flomach, the naiifea upon fee-
ing others vomit, and the fiux of the
faliva mto the mouth of a hungry per-
Ibn at the fight of favouiy food *, are
proofs, that the flomach and falivary
glands f^mpathize with the retinay though
there is no communication between the
optic nerves and any other. — A fliud-
dering is excited by particular founds,
and yet the portio mollis of the auditory
fierve, after it leaves the brain, does not
appear
* In thefe inftances the change in the ftomaeh and falivary
glands are produced, through the intervention of the brain
and fentient principle : for thinking flrongly on favoury vi-
ftuals, or difagreeable medicines, will have almoft the fame ef-
fedls on fome people, as feeing them. But fince an imprellion
on the optic nerve can, by means of the brain, occafion vo-
miting, and an increafed difcharge of the falival juice, why
may not impreflions on the other nerves produce various other
fympathies in t\ic/ame m(inmr ? But of this more hereafter.
of the Nerves, 43
appear to communicate with the portio
dura, nor any other nerve. — Although
the optic nerves unite at the cella "turcica,
yet it has been fliewn, that their fibres
do not crofs, intermix, or truly commu-
nicate with each other * ; neverthelefs,
there is a confiderable fympathy between
the two eyes. — -Although the nerves of
the two kidneys do not appear to have
any connexion with each other, yet,
when one of thefe glands is inflamed,
or irritated by a flone, the iecretion
from the other is frequently much di-
miniflied. — We know for certain, that
the different fize of the pupil in diffe-
rent lights, is owing to a canjent between
the retina and itvea, and yet the optic
nerves, and thoie belonging to the uvcay
have no communication, in their courle,
from the brain to the eye. Nor can a-
ny fympathy be fuppofed to arife from •
|:he nerves of the iroca, palfmg between
the
^ See VefuL anatom. corp. human, lib, iv. cap. iv. and
^anton'n. obfervat. anatom. p. 63.
44 O/' r/;^ Sympathy
•the retina and tunica choroidea, as there
is no anajlojnofuy nor any other kind
of union between them. — The nerves,
with which the uvea of the two eyes are
furniflied, have no connexion, and yet
we find a moil remarkable fympathy be-
tween the motions of the two pupils.
Almost the whole mufcles of the
body may be brought into convulfive
motions by tickling the foles, or the
fides ; nay, the dread of this will affed:
fome people. Now, thefe motions can-
not reafonably be deduced from the con-
nexion of the intercoftal nerves with
thofe of the fliine ; or, if they could,
it would follow that the flomach and
bowels fhould fufFer, at leafl, equally
with the cliaphragm and mufcles of the
trunk of the body.
(e) If the confent between the vifcera
of the abdomen y and the other parts of
the body, be owing to a communication
of nerves, by means of the inter coftals ;
why do not all thofe ip3.rtsr)'mpathize,
v/hofe
of the Nerves. 45
whofe nerves are either derived from, or
communicate with the intercoftals ? —
Why, in the nephritis, does the ftomach
fufFer more than the inteftines ? and why
are not the kings and other parts at all
afFefted in this difeafe ? — Why does not
an irritation of the bladder from a ilone,
commonly occalion a naufea and vomi-
ting; fince the bladder, as well as the
kidneys, has its nerves partly from the
eighth pair and intercoflals ? — Wliy does
an irritation of the nofe occafion fneez-
ing only, and not coughing, vomiting,
purging, or the hiccup ? — Why does
not a blifler, applied from the ear to the
top of the fhoulder, bring on a convul-
five motion, or Ibme other affecflion of
the diaphragm, flnce the connexion of
the phrenic nerves with the 2d and 3d
cervical pairs is much greater, and lefs
remote than with the nerves of the
nofe * ?
If
* The pain between the vertebra of the neck and top of
the Ihoulder, which fometimes attends an inflammation of
the
46 Of the S Y M P A T H V
If the delirium y which generally at-
tends an inflammation of the diaphragm,
were owing, as has been alledged, to the
remote connexion between the phrenic,
and fifth pair of nerves which fends fi-
laments to the dura mater ; why flioukl
not an inflammation of the lungs, flo-
mach and inteflines be attended with
that f^^mptom as often, and in a greater
degree ; lince thefifth pair of nerves have
a more immediate connexion with the in-
tercoftal than with the phrenic nerves ? — >
Why does an irritation of thefphin^lers of
the
the liver or diaphragm, has been afcribed to the connexion
between the phrenic nerves, and the 2d and 3d cervical pairs :
Bat, if this were the cafe, why fhould this fymptom be fo
rarely obferved in a paraphrenitis, as to be omitted by moil
authors ? and why fhould not the diaphragm be difturbed in
its motions, when the zd and 3d pairs of cervical nerves are
irritated by bliflers, the extirpation of tumours or other cau-
fes ? It is net eafy to fay what may be the caufc of that pain
in the neck, and top of the flioulder, which often attends a
hepatitis ; but there fcems to be good reafon to doubt of its
proceeding from any connexion between the phrenic and 2d
and 3d cervical nerves. Some of the older phyficians afcrib-
ed this fymptom to the weight of the inflamed and fwelled
liver drawing downwards, and ilretching the membranes that
line the thorax *.
• N. Pifo de cognofcend. et cur and, morh, lib. iii. cap. xx'v.
of the Nerves. 47
the anus or bladder, occafion a continued
contra^ion of the diaphragm and abdo-
minal mufcles, rather than an alternate
motion of thole parts, as in coughing
and the hiccup, when either the trachea
or left orifice of the flomach is irrita-
ted ? — Since the diaphragm fympathizes
with the nole, lungs, titeriiSy rectum, and
bladder, why do not thefe parts lufFer
equally, when that mufcle is inflamed, or
otherwife violently affected? — If the f\^m-
pathy between the nofe and diaphragm,
be owing, not to the olfactory nerves, but
to a branch of the fifth pair fent to the
nofe, why do not flernutatories excite
convulfive motions of the mufcles of the
face (to which the 5th pair is diftribu-
ted) as well as fpafms of the diaphragm*
whofe nerves can have only a remote
connexion with the fifth pair by means
of the intercoflals * ? — And wliy does
not
* When fneezing is ftopt, by preffing with one's finger and
thumb, the nofe near the internal angle of each eye ;
this effeft is not owing, as fomc have thought, to the prefTure
made
48 Of the Sympathy
not the great irritation of fome of thef
filaments of the fifth pair of nerves, in
the toothach, produce the convulfive
motion of fneezing ? — If the fiux of
tears occafioned by grief or joy, were
owing, as Dr. Willis alledges, to the
communication between the fifth pan
of nerves which ferves the lachrymal
glands, and the inter coftals winch are
diftributed to the pracordia * ; why do
not thofe affeftions of the mind produce
an increafed excretion of the falival as
well as lachrymal juice ? — If the diftur-
bance of the motion of the heart, from
certain founds, were owing, as Vieujjhts
imagines, to the feventh and eighth pair
of nerves being partly compofed of me-
dullary fibres, derived from a particular
fafciculiis
made on the nerves lent to the nofe from the ophthalmic
branch of the fifth pair j for fneezing may be flopt, almoft
as readily, by preffing hard with one's fingers on the fore-
head. In both cafes, fneezing is prevented in the fame
manner, nji-z,. by the uneafy fenfation occafioned by ftrong-
\y pre/Ting on the brow or nofe.
* Anatom. cerebri, edit, in 410. p. 288-
of the Nerves. 49
fafcictihis ariiing from the cerehdhim % why
ihould not the mulcles, which are fup-
piied with nerves from the fixth pair and
the portio dura of the feventh, be equally
affefted ; lince their connexion, at their
origin, with the portio mollis is not lefs
than that of the eightli pair f ? Or why,
in violent palpitations of the heart, are
not the auditory nerves at all alfecled?
The truth is, the changes in the motion
of the heart occalioned by external ob-
jects, ailing either on the organs of iight,
or hearing, are not ov/ing to any com-
munication of then* nerves with thole of
the heart, but to the impreilions made
on the fenforiiim commune^ and the affecti-
ons of the mind excited thereby %. — If
the fympathy between the different parts
be owing to their nerves being derived
from the fame trunk, w^hy is there not
the fame confcnt between theleveral muf-
cles of the foot, of the leg, and of the
D thigh,
* Neurograph. lib. iii. cap. 4.
f Id. lib. i. cap. 1 2.
X See belcv/, No. 17.
50 0/ //;^ S Y M P A T H Y
thigh, as between the kidneys and the
flomach, or between the nofe and the dia-
phragm ? — Lallly, if an irritation of the a-
limentary canal in hyfteric women, fome-
times produces convulfions of the legs,
by reafonof the communication between
the intercoflals and the two lafl lumbar
nerves ; why are not the fiomach and
bowels feized with Ipalins or convulfive
motions from the violent pain of the
gout in the knees, ancles, or feet? Thefe
queftions, I doubt, will fcarce admit of
a fatisfatloiy anfxver, upon the principle
of fympathy depending on the commu-
nication, or connexion of nerves.
15. If, therefore, the various inftan-
ces of fympathy cannot be accounted for,
from any union or aiiajiomofis of the
nerves in tlieir way from the brain to
the leveral organs ; and if there are ma-
ny remarkable inflances of confent be-
tween parts whofe nerves have no con-
nexion at all ; it follows, that all fympa-
tliy
of tht Nerves, 51
thy mud be referred to the brain itlelf
and fpinal marrow, the fource of all the
nerves.
But for a more dire<ft proof of tliis,
^ve may obferve, that the confent of the
ieveral parts hiflantly ceafes, when their
communication with the origin of the
nerves is interrupted. Thus, tho' the
mufcular coat of the ftomach, in an a-
nimal newly dead, is excited into con-
traftion by irritation, yet the diaphragm
is noways affected by this Jiimuhis. In
like manner, when any of the mufcles
of the legs of a frog are pricked, moft
of the mufcles of the legs and thighs
contraft, even after cutting off its head,
if the fpinal marrow be left entire ; but
when that is deftroyed, altho' the fibres
of the llimulated mufcle are alFed:ed
with a weak tremulous motion, yet the
neighbouring mufcles remain wholly at
reft.
Further, the effects of pain, and
of fear and other paffions, in preventing
D 2 feveral
52 Of the Symv AT H Y
'feveral fympathetic motions, fecm to
fhew, that the caiile of that confent which
obtains between the parts of animals, is
to be referred to the origin of the nerves :
And, fince certain aifecl:ions of the mind
excited by the action of external objefts
on the organs of fenfe, produce extra-
ordinary motions and other effedls in
the body, merely by affecting the brain;
why may not imprellions made on the
nerves in other parts, produce likewile,
through the intervention of the brain,
various motions and other effedls in di-
flant parts of the body ? The analogy is
obvious.
Lastly, Notwithftanding the man)/
lympathetic motions, which are daily
obferved, by Phyficians, to arife from
an irritation of the nerves in diifereht
parts of the body; yet, when the nerve
going to any mufcle is irritated, there
is no motion excited in any part, except
in the mufcle to which it is diftributed *.
Does it not hence appear highly proba-
ble,
* Memoire fur la nature fenfible et irritable, tovi. i. p. 237,
of the Nerves. 53
ble, that the various iympathetic moti-
ons of animals produced by ii'ritation,
whether in a found or morbid ftate, are
owing, not to any union or connexion
of their nerves, but to particular fenfa-
tions excited in certain organs, and
thence communicated to the brain or
fpinal marrow ? For, if this were not
the cafe, why fliould not the diaphragm,
for example, be convulfed, by irritating
the nerves that go to the bladder and
intefiinum reduniy as well as when thefe
parts themfelvcs are affected by an unuflial
Jimuluj ?
If the fympathies obferved betv/een
the different parts of the body be owing
to particular fenfations excited in them,
and thence communicated to the brain ;
we may eafily fee why an irritation of
the intejliniim jejunum does not affect the
diaphragm fo much as an irritation of
the reBimi ; for, tho* the jejiinimi is not
lefs feniible than the rectum, and the
nerves of both have the fame remote
connexion
54 0/ the Sympathy
connexion with the nerves of the dia-
phragm ; yet the fenfations excited by
the fame fthuidi ad:ing oi> the jejimmn and
return are very different, and therefore
mufl affect the brain or common fenjori'
wn differently. — An irritation of the
nerves of the face does not produce any
fuch convulfive motion of the mufcles
of relj^iration as happens in ' fneezing,
becaule it does not occaiion that kind of
fenfation v/hich is excited by fiimtili
appUed to the nofe : And the dia-
phragm, wliich is brought into a conti-
nued contraction when the extremity of
the rectum or neck of the bladder is pain-
fully affected, is agitated with alternate
convulfions, when the left orifice of the
ffomach is irritated, becaule very diffe-
rent fenfations are excited by an irrita-
on of thole parts.
Further, when the meatus audi tor ius
is irritated, by introducing into it a fea-
ther, or any fuch flibftance ; an incli-
nation to cough is often excited, efpeci-
allv
(f the Nerves. ^^
ally if tli€ membrane of the trachea has
been rendered more fenfible than uiual
by catchhig cold ; but, when the mea-
JUS miditoriiu is violently pained, in con-
lequence of an inflammation in it, no
coughing is occafioned : From which it
follows, that the fympathy between that
meatus and the organs of refplration in
the former cafe, cannot be owing to any
connexion between their nerves, or m-
deed to any mechanical caufe, but pro-
ceeds from a -particular feeling, and mufl
be referred to the fenforium commune^ — In
like manner, neither an acrid injedlion
of a folutlon of the corrofive iliblimate
in water, nor the introduction of a ca-
theter into the urethra^ occalions any al-
ternate convulflve motions of the mufculi
accelerator es urin£ ; altho' the J emeu, which
ftimulates the nerves of the urethra much
more gently, produces this eife^l. Lafl-
ly, on this head, altho' when the fides
or folcs of the feet arc tickled, the bo-
dy is often thrown into convulfive mo-
tions ;
5(i Of the Sympathy
tions ; yet nothing of this kind happens
when thefe parts are either inflamed or
wounded ; from which it evidently fol-
lows, that thofe motions are occafioned
by the particular fenfation excited by the
tickling, and do not proceed from any
lympathy, which the nerves of the fides
and foles have v/ith thofe of the other
parts of the body, in confequence of
any connexion betv»^een them,
I 6. But altho', from what has been
faid, it may appear probable, that all
nervous conjhit proceeds from the brain ;
yet we cannot pretend, from this prin-
ciple, to account, in a fatisfacfory man-
ner, for all the various imlances o^ fjm-
path"^ obfervable in the bodies of animals,
fince many of them may depend on fuch
a flate of the brain, and other parts, as
cannot be the objecl: of our fenfes *.
The
* If it fhould be obieaed, that it is as difficult to ac-
toa.it for a fvmpathy between the nerves at their origin in
l\\t brain, as in their cour.e to the feveral partj, where they
happen to be connefled ; I anfwer, that the purpofe of thefe
obfervations J5 not to explain how the diilcrent pnrts of the
body
of the 'Nek VES. 57
The fympathy between every indivi-
dual nerve and the whole fyftem *, will
be readily allowed to be owing to the
mediation of the brain, and not to any
connexion or communication among the
nerves proceeding from it : I fhall, how-
ever, mention one experiment as the
moft dccifive of this queflion.
A SOLUTION of opium y applied to the
abdominal mulcles of a frog, whole
brain
body can be endued, by means of the nerves, either with
a fentient or a fympathetic power ; but, to endeavour to
trace the fympathy of the nerves to its true fource, which
I take to be the brain and fpinal marrow. It would be in
vain to inquire further into this matter, unlefs we knew the
minute ftrufture and connexions of the feveral parts of the
brain, and were better acquainted with the laws of anion be-
tween the body and foul, to whofe fentient power the fym-
pathy of the nerves, at their origin, muft be at laft refer-
red : For, if con/ent iupvoks feeling (12.), and if feeling
cannot, any more than intelligence, be a property of ^:atfer
however modified; it muft follow, tnat Jympathy depends
upon a principle that is not mechanical ; and that, to fup-
pofe it may be owing folely to the particular fituation, ar-
rangement, or connexion of the medullary fibres of the
brain, or to the union of the nerves proceeding from it, is
as unreafonable, as to imagine that thought may be the
rcfult of a motion among the particles of the animal fpi-
fits, or other fubtile matter in the brain.
* See No. 10. above.
58 Of the Sympathy
braiii and Ipinal marrow had been de-
ftroyed, did not itop the motion of the
heart near fo foon, as it would have
done, if tb.e brain and fpinal marrow
had been entire *. A clear proof, tirat
the power of opiimi, to deftroy the moti-
on of thofe parts which it does not
touch, is owing folely to the mediation
of the brain and ipinal marrow, and not
to any other communication among the
nerves.
'Tis true, when a frog is deprived of
the brain and fpinal marrow, upon ap-
plying a folution of opium to the abdomi-
nal mufcles, its heart will ccaie from mo-
tion fomevvhat fooner than it would o-
therways do ; but this effect is not to be
afcribed to the action of the opmm on the
nerves which it touches, but to fome of
its finer parts being taken up by the ab-
forbent veins f? ^'^'^^ carried with the
blood to the heart.
That
* See Euinburgh Phyfical Effays, vol. ii. p. 283 — 288.
and p. 303.
t Ibid. p. 304, and 505. and Phyfiologlcai Eflays, edir.
ii. p ■J.o:.
of the Nerves, 59
That life and vigour, wliich is, al-
moft inflantaneoiifly, communicated to
the whole body, by volatile fpirits appli-
ed to the nofe, or cordial medicines recei-
ved into the ftomach, are, like the ef-
fects of opium, to be referred to fome fti^
mulus or imprefllon communicated to the
brain by the nerves of the nofe and fto-
mach. A dram of brandy ad:3 in the
fame manner, when it fettles a fliaking
of the hands : and as thofe epileptic fits,
which are occafioned by fome extraordi-
nary irritation of the nerves of the arms,
legs, or toes, do not begin till after a
certain fenfation has been propagated
from the part irritated to the head; we
may fafely conclude, that thefe fympa-
thetic motions proceed from the brain^
and not from any connexion which the
nerves of the parts aifecled can have, by
means of the intercoftals, with the other
nerves of the body *. Nor is it more
furprifing,
* Doctor Hilaiy has remarked, in the cclica plSlotium, that
jyben the pain in the bowels has continued long, and at laft
begins
6o Of the S Y xM P A T H Y
flirprifing, that an uncommon irritation
of any feniible part, fiiould, efpecially in
thoie of a delicate frame, produce con-
vulfive motions of almoft the whole bo-
dy, tlii'o' the intervention of the brain,
than that opium applied to the nerves of
die flomach, inteftines, or abdominal
niulcles, lliould quickly deitroy the pow-
ers of feeling and motion, throughout
the whole nervous fyftem *.
17. Nothing makes more fudden,
or more furpriiing changes in the body,
than the feveral pallions of the mind.
Theie, howxver, acl folely by the medi-
ation of the brain, and, in a Itrong light,
Oiew
begins to abate, a pain in the llioulder points and adjoin-
ing mufcles, conies on, with an unufual fenfation and
tingling along the fpinal marrow, that foon extends it-
felf from thence to the nerves of the arms and legs ; which
members firft become weak, and afterwards quite paralytic.
Fid. Hita'j on the epidemical difeafes of Barbadoes,
p. 1S4, and 185. Does not this obfervation feera to fhew,
that the paify of the extremities, occafioned by the colica
pi^onnm, is not owing to any communication between the
nerves of the bowels and of thofe parts, but proceeds from
the fpinal marrow, which is firfl: afFefled ?
* Fid. Edinburgh Phyfical EfTays, vol. ii. p. 303.
of the Nerves. 6r
iliew its fympathy with every part of
the fyftem.
Such is the conftitution of the ani-
mal frame, that certain ideas or affec-
tions excited in the mind, are ahvays ac-
companied with correlponding motions
or feehngs in the body ; and thefe are
owing to fome change made in the brain
and nerves, by the mind or Jhitient prin-
ciple^: but what that change is, or how
it produces thofe effects, we know not :
as httle can we tell, why fliame fliould
raife a heat and rednefs in the face,
while fear is attended with a palenefs.
Thefe and many other effects of the dif-
ferent paffions miifl be referred to the
original conftitution of our frame, or
the laws of union between the foul and
body.
But although, in thefe matters, we
muft confefs our ignorance, yet, from
what
* By \\ie/ent'.ent principle, I underftand the mind or foul
in man, and that principle in brutes which refembles it.
Pld. An EiTay on the vital and other involuntary moti-
ons, edit. ii. p. 307 323.
6l Of the S Y xM P A T H Y
what we certainly know of die action of
the nerves, we can ealily fee, that a
change in them may occafion many of
thofe effects which are produced by the
paffions.
As the force of the heart, and the re-
gularity with which it contra(^ls, de-
pend, in a great meaiiu-e, on the flate
of its nerves, fo does the action of the
arterial fyllem, in carrying on the cir-
culation; and particularly thofe alter-
nate contractions, with which the mi-
nuter veflels are continually agitated,
and to which the motion of the fluids
in them is, in a great meailire, owing*.
The
* It has been (hewn, from a variety of facls, as well as
from analogy, (Phyfiological Efiays, edit. ii. p. 35. &c.) that
the very fmall veflels, to which the direft force of the heart
does not feem to reach, are endued with a power or mo-
tion, excited by the Jhmulus of the fluids, as they pafs a-
long ; and that thefe vibratory or ofcillatory motions of
thofe veflels are much increafed, when they are more than
ordinarily irritated, or when, throjgh fl;rong pafiions or
. other caufes, the nerves are greatly afFedled.
The fpeedy inflammation of the eyes, by acrid fubftances,
the inflammation of the fiiin by blifters and finapifms, and
th^ increafed fecretion from the nofe and falivary glands,
when
of the Nerves. 6.^
The other muicles of the body are
often, by an uncommon exertion of the
nervous power, alfed:ed either with al-
ternate convullive motions, or a conti-
nued fpafm. It is reafonable, therefore,
to think, that the heart and vafcular fy-
ftem may fulfer in the fame manner ; and
that, when the influence of the nerves
is much weakened, or in fome meafure
flifpended, the veilels Avill be relaxed,
the circulation will become languid, and
an univerfal debility ^^'ill eniiie.
The increafed force of the heart, and
fometimes indeed of the whole mufcles
of the body, from great anger or rage, is
to be afcribed to a llronger exertion of
the nervous power ; while the trembling
and
when ftimulating fubllances are taken into the mouth, or
applied to the noftrils, can only be accounted for, from an
increafed motion of the fmall vefiels of thofe parts. And
that the circulation of the fluids, in the very fmall veffels,
depends,, greatly on fome influence communicatrd to them
by the nerves, appears from Dr. Niick's having obfcrved the
fecretion by the glands to be much diminifhed, or entirely
llopt, after their nerves were obftrufted or comprefTed *.
* Ademgraph, {uriof. p. 16.
64 ^f t^^^ Sympathy
and debility produced by fear, arife from
a contraiy caufe.
The palpitation of the heai't from
terror, feems to proceed from the blood
returning to it, in too great a quantity,
in confequence of a Hidden fpafm or
contradlion of the veins. It is aUo, in
part, occalioned by the heart being ren-
dered more irritable, or being otherwile
difturbed by the violent agitation of the
nervous fyflem.
The rcdnefs and glow of the face
from a ^gw^q of fliame, are mod proba-
bly owing to an increafed motion of the
fmall arteries of that part ; for the florid
colour and Hidden warmth, feem to be
more the confequences of a quicker mo-
tion of the blood in thefe veflels, than
a flagnation of it from any compreilion
or fpafm of the veins, which would pro-
duce but a livid rednefs and lefs heat.
Belides, we know, that a greater degree
of rednefs is, inftantly, brought on the
eyes, and, in a fhort time, on the fkin,
by
ef the Nerves. 65
by an increafed motion of their fmall
velFels, upon the apphcation of acrid
fubilances to them.
Some grow pale upon anger, which
effect may be owing to a fpafm, or con-
tinued contraction of the fmall arteries
of the face, by which the motion of the
blood in them will be retarded.
The palenefs from fear may arife
from a different caufe, "oiz, a deficiency
of the nervous poiucr : Hence, tho' the
fmall vefTels are not affed:ed with any
fpafm, as in anger ; yet they are, in a
great meafure, deprived of their alter-
nate contractions, to which the motion
of the blood in them is principally ow-
ing. But the more than ufual flow of
the blood towai'ds the heart, occafion-
ed by terror, fcems to fliev/, that the
veins, at leaft, are fuddenly contracted.
The diminution of perfpiration at-
tending fuch paifions as affed: us with
fadnefs, may be owing to the impaired
force of the heart and arteries : and
E the
66 Of ihe Sympathy
the diarrhtsa from fear, may be a confe-
quence of obflrucled perlpiration, or of
that debility and relaxation, which fear,
or grief, is obferved to bring on the a-
limentary canal.
Th e increafed fecretion of tears from
gi'ief, and the great flux of limpid urine,
which is often occafioned by fear or
A^exation, are owing to an increafed mo-
tion, excited by thefe pailions, in the
fmall arteries and excretory du6ls of the
lachrymal glands and kidneys.
The dull look of the eyes in grief,
and their lively appearance from joy,
depend upon a diminution or increafe
of the motion of the fluids through the
fmall velTels of that organ, particulai'ly
of the cornea^ in confequence of their vi-
bratory motions being lefTened or aug-
mented, by the change which thofe dif-
ferent palfions produce in their nerves.
It ^vould be eafy, upon the fame
principles, to account for various other
eifed;s produced by the paffions ; but
what
of the Nerves. 67
what is already faid, will be fufficieiit
for fliewins: in what manner we can rea-
fon upon this fubjed;.
18. Because the nerves are obfer-
ved, in many parts of the body, to fur-
round the arteries and veins like fmall
cords ; it has been thought, that the
fudden changes in the motion of the
fluids made by the palfions, are owing
to theie velTels being contracted by fuch
ligatures. But this opinion, tho' flip-
ported by authors of great character *,
will, upon a further inquiry, appear in-
confiflent with what we know for cer-
tain of the nature and ufe of the nerves.
Every part endowed with a power
of contraction, owes that adlion either
to its mufcular flru6ture, or to its ela-
flicity ; but as the nerves are in no fenfe
mufcular, fo they have been proved to
be among the leafl elaflic parts of the
body. Further, in a natural ftate, the
nerves lie pretty loofe in that cellular
E 2 fubflance
t
• Willist VieuJJins, &c.
6^ Of the S Y xM P A T H Y
fubftance which fvirrounds the arteries^,
and ai'e never on the ftretch : and, upon
making the experiment, we fhall find,
that the trunks of thofe nervous branch-
es, that encompafs the large arteries and
veins, muft be coniiderably pulled be-
fore thefe veffels can be feniibly con-
trat1:ed. There is no example of any
motion being performed by a contrac-
tion of the nerves, whofe action does
not confifl in pulling, or in growing
more tenfe at one time than another,
but in fupplying the mufcular fibres
with that influence or power, which leems
to be immediately necefTary for their
contra^lion.
Last LY, it appears from experiments,
that the nerves are utterly incapable of
any fiich contracflion as is here iiippo-
fed. Nothing occafions a more fudden
or ftronger exertion of the nervous
power, than an irritation of the brain,
fpinal marrow, or nerves ; as appears
from the violent convulfions in the
mulcles
of r/;^ Nerves. 6^
mufcles and mufcular organs, when tliofe
parts are injured : but, on fuch occafl-
ons, it has never been obferved, that
the nerves themfelves became iliorter,
or underwent any feniible change. Nay,
the ilhiftrious M. de Halkr has, after ma-
ny experiments, jullly concluded, that
the nerves are not endowed with irrita-
bility, or a power of contradlion when
ftimulated *.
But, fuppofing the nervous filaments
could, like cords, fcraiten the blood-
vellels, as feveral writers have imagined ;
yet, upon refleclion, we fliall be con-
vinced, that the changes produced in
the body by the feveral paffions, cannot
be explained upon that principle.
Thus the rednefs and glow of the
face attending a confcioufnefs of fliame,
cannot
* It may be proper here to take notice, that, altho' M,
de Halkr had embraced the doftrine of the nervous laquei,
and faid more in fupport of it than any other author; yet he
has candidly given up this opinion, upon finding it not con-
firmed by any of thofe numerous experiments he has made
on living animals. Vid. Memoires fur la nature fenfible n
irritable, torn. i. p, 238, and Z'^g,
yo Of the Sy "SIT AT HY
cannot be owing to a conftriclion of the
temporal or jugular veins by the ner-r
vous cords furrounding them * ; for
this v/ould not raife a florid colour, but
a rednefs of a different kind, and ac-
companied but with little heat.
In like manner, a comprefTion of the
vieins of the penis by the nerves, will not
account for its erection f, ^^ hich is ow-
ing more to an increafed motion of the
blood in the ai*teries, than to any ob-
flruction of its veins t- Nor is it lefs
credible, that the fmall arteries of the
penis fliould, in confequence of an affec-
tion of the mind, be agitated with an
uncommon motion, than that the fmell,
fight, or even remembrance of grateful
food, fhould affect the falivary veffels of
a hungry perfon in a fimilar manner.
A CONVULSIVE contraction of the
plexus renalis occafioned by fear, might
render
* Vieujfcjis Neurogrcph. lib. iii. cap. \v.
t Du'verncy in aSI. Petropol. torn. ii. p. 379 383. 384.
X See an Eflay on the vital motion?, \ vi. and the cele-?
bratcd Albir.uis annotationes Academiccti lib, ii. cap. xviii.
of the Nerves. 71
render the urine limpid by flraltening
the fecretory vefTels of the kidneys ; but,
upon the lame principle, it ought alio
to leflen its quantity, contrary to what
happens.
I SHALL only add, that it may ap-
pear from what has been faid, that fuch
exprellions as the increafed motions, con-
viilfiomy or Jpaf?nodic coiitradions of the
nerves are all improper, altho' they have
been frequently ufed by many learned
writers.
19. There are many of the mod
remarkable fympathetic motions, both
in a found and clifeafed flate, in which
we can plainly perceive a wife inten-
tion. Thus, the contraction of the pu-
pil when light offends the eyes, and of
the eye-lids when grofler bodies threat-
en to hurt them ; — The vomitmg, trom
a ftone in the kidneys and m^eters; —
The coughing, occalioned by an u'rita-
tion of the meatus auditor his \ — The conti-
nued contrailion of the abdominal muf-
cles
72 Of the Sympathy
clc3 and diaphragm in a tenefmuSy a
ftranguns and during the pains in la-
bour; — The alternate contraftions of
the fame mufcles in fneezing, cough-
ing, and in the liiccup ; — The increaf-
ed motion of the organs of relpiration
in the fit of an afthma; — The copious
fecretion of tears and the Jailva, when
Simulating fubftances ai'e applied to
the eyes, or taken into the mouth ;
and the uncommon flux of humours to
every part that is irritated. — All thele,
and man)' more, are the efforts of na-
ture to free the body of fomething hurt-
ful ; and are lb many mftances of that
principle of felf-prefervation fo confpi-
cuous in all animals. Thele motions,
therefore, cannot, in my opinion, be re-r
ferred to any connexion or communi-
cation among the nerves, but to the
brain itfelf, and to that fentient being
which animates our whole frame, and
which endeavours, at all times, to free
the
of the Nerves. 73
the body of whatever occaflons pain or
uneaiinefs.
Indeed, when thele efforts are unable
to expel the offending caitfe, as in great
inflammations of the ftomach, or when
a large flone is lodged in the kidneys
or bladder, they often become hurtful,
and increafe the pain they were intend-
ed to remove. Nay, as m many other
inflances, the befl things may, by ex-
cefs, become the worft : fo this endea-
voiu* to free the body, or any of its
parts, from what is noxious, is fbme-
times fo flrong and impetuous, as to
have fatal confequences. But, in gene-
ral, this principle of prefervation is
highly ufeful^ fince without it we fliould
often cherifli, within oiu* bodies, fuch
caufes as would iboner or later end ir^
pur ruin.
Nor can we confider the mind as
^fting either ignorantly or perverfely,
when it fometim^s excites fuch motions
in the body as increafe its own pain,
and,
74 Q/' ^^'^ Sympathy
and, in the end, prove more hurtful
than beneficial ; for thefe motions do
not proceed, as the followers of Stahl
have imagined, from any rational views
in the mind, or a confcioufnefs that the
Avelfare of the body demands them, but
are an immediate confequence of the
difagi'eeable perception which excites it
into acTion *.
20, There are various inftances of
fympathy, which feem to be chiefly oc-
eaiioned by the vicinity of the parts f.
Of
* See this point further illuurated in aii Eflay on the vi-
lz\ and other involuntary motions of animals, edit. ii.
•3*5— 3-1- an^ 3+3 343-
* Parts may fuffer fro.n vicinity, although their nerves
have no particular fympathy with one another. Thus,
pain caufes inflammation, nbt only in the vefTels immedi-
ately affefted, but alfo in thofe contiguous to them. Fur-
ther, any conliderable obftru6lion, though attended with
little or no inflammation, may, in feme cafes, occafion
fympathetic aircflions in the neighbouring parts, by chan-
ging the diftribution of the blood through the veflels of
thofe part?.
When one of the fingers is inflamed, in confequence of
a wound below the nail, or feme acrid matter lodged there;
the hand, and foraetimes the arm, may become fwelled and
i;iflamed, not only by means of the pain, which occafions
a
of the Nerves. 75
Of this kind is, perhaps, the confent be-
tween the neck of the bladder and ex-
tremity of the rediini ; whence a violent
tcneffmis and flrangury mutually excite
each other. — The vomiting occafioned
by an inflammation of the liver ; — The
pain, fwelhng, and inflam.mation of the
hand and arm, from 2. paron^jchia ; — The
increafed fenlibility of the retina, from
an inflammation of the conjundiva or cor-
ned',- — The pain andfwelling of the face
from the toothach, and the pain in the
ear from an inflammation of the back
part of the fauces ; — The flipprellion of
urine from an inflammation of the in-
teftines or mefentery, or from a fevere
nephritic paroxyfm in either kidney; —
The lympathy between the larynx and
pharynx, and feveral others, may be, in
a great meailire, owing to the fame
cauie.
To
a greater derivation of fluids to the vefiels of trie finger and
Jiand, but alfo from a kind of inflammation being propaga-
ted up the arm along the coats of the nerves, which are di-
ftributed to the fingers.
76 0/* //;^ Sy MP ATH Y
To this head, alfo, may be referred,
thofe fympathies which are fometimes
occafioned by hard tumours prelTing
upon, or irritating the nerves that are
contiguous to them. Thus, a hard
{\velling on one fide of the neck, has
occafioned an uneafy fenfation near the
end of the radius y a Uttle above the
wrifl : and the fwelhng and drawing up
of the teflicle, from a flone defcending
tlirough the ureter y is probably owing to
an irritation of the nerves of the tefli-
cle, where they run along the pfoas muf^
cle, over which the ureter paflcs. But
it may be proper to obferve, that the
heavinefs of the eyes, and flecpinefs af-
ter a full meal, drinking largely of
ftrong liquors, or a dofe of opiuniy which
have been afcribed to the compreffion of
the third pair of nerves, by the diflenfion
of a branch of the carotid artery, which
pafles over them near then' origin, are
owing folely to the change produced in
the nerves of the flomach ; whence the
fenfibility
of the Nerves. 77
fenfibility of the whole iyflem is impair-
ed.
May not the complaints of the flo-
mach and bowels, from a fuppreffion of
the menfes, and foon after conception, be
owing not only to a particular fympa-
thy between their nerves, but partly al-
io to the change made in the quantity
of the blood thrown upon theie parts,
by the obftru6lion of the uterine veflels?
And does not the fudden relief, obtain-
ed by a fmall evacuation of blood from
the hsemorrhoidal veins, fhew, that ma-
ny diforders may be either occafioned,
or cured, by a Irnall change made in the
diflribution of the blood to the diffe-
rent parts of the body ?
The pain in the head, fbmetimes the
eonfequence of wearing ftrait flioes, is,
perhaps, rather to be afcribed to a
greater determination of blood to the
vefTels of the pericranium, than to any
particular fympathy between the nerves
of that part and the feet. And the ef-
fea
78 Of the S Y xM P A T H Y
fe6l of linapifms applied to the foles, in.
leflening a deliriiimy is chiefly owing to
the pain they excite; which, by afFed:-
ing the whole nervous fyflem, lelTens
the perception of that irritation in the
brain, or its membranes, which is the
cauie of the delirium: and hence it is
that finapilms, applied to the hams, or
other feniible parts, have produced the
fame effed:s, as when laid to the feet.
22. Lastly, in morbid cafes, we
meet with a variety of anomalous fym-
pathies, ^\'hich we can neither explain
from the vicinity of the parts, the
connexion or communication between
their nerves, nor from that general ten-
dency to the welfare and prefervation
of the body, which is i^o obfervable in
many lympathetic motions, that take
place in a found as well as morbid flate.
Of this kind, are the purging from
fmelling to a cathartic medicine ; That
pungent fenfation felt on the top of the
left llioulder-blade, when a pimple a lit-
tle
of the Nerves. 79
tie beloAV the out fide of the right knee
was Icratched *; That burning pain,
which, upon making water, has been felt
in the foles of the feet by a perfon affeft-
ed with an ulcer in the bladder ; the
J'paJ'mns cyniais from a wound in the foot,
and the locking of the jaws after an am-
putation. Thus, Avhat reafon can be gi-
ven, why, fometimes, after cutting off an
arm or leg, thole mufcles which raife
the lower jaw fliould be affected with a
fl[3afiii, rather than any other mufcles?
I fhall allow, that Ibme fymptom of this
kind might be expected from the irrita-
tion of the nerves of the flump, or from
Ibme acrid humour abforbed by the vef-
fels of the fore, and carried to the brain ;
but in either cafe, why do the temporal
and mafleter mufcles only fliffer ?
I THINK it moft probable, that the a-
nomalous fympathies above mentioned,
and many others, whofe caufe appears
equally obfcure, proceed from that ge-
neral
* See Hale\ Statical EiTays, vol. ii. p. 6c.
t
80 Of the Sympathy
neral fympathy which prevails tlirough
the whole nervous fyflem ; and which,
in certain cafes, in confequence of the
uncommon weaknefs or delicacy of a
particular organ, makes it fuffer, altho'
the other parts of the body are not fen-
Hbly afFed:ed. The following cafes, com-
pared together will ferve to illuftrate
this.
A MIDDLE aged woman, Avho had
fprain'd her right foot and ancle, fome
weeks after, not only complained of a
pain and flifFnefs in thefe parts, but alfb
felt, though in a much lefs degree, a ten-
fion and forenefs over her whole body.
— On the other hand, a girl of nine
years, as often as one of her feet was
extended, fo as to bring it nearly to a
right line with the leg, and coniequent-
ly greatly to flretch its ligaments and
tendons, was inftantly feized with a moil
violent convulfive cough, which conti-
nued without intermifTion, as long as
the foot v/as kept in that pofition.
In
of r/> Nerves. 8r
In the former cafe, it will readily be
allowed, that the ftifthefs and forenefs
felt through the whole body, proceeded
from that general fympathy which ob-
tains between all its parts by the medi-
ation of the brain, which> however,
would not have produced hich an effecft,
but for the pecidiar delicay of the ner-
vous fyilem in that patient i
In the latter cafe, tJie convulfive
cough, occalioned by extending the
foot, could not proceed from any par-
ticular fympathy between this part and
the lungs, in confequence of any
connodon or communication between
their nerves, llnce the nerves of many
other parts have an equal or greater
connexion with thole which ferve the
feet. This convullive cough, therefore,-
mufl be afcribed to a peculiar delicacy
or uncommon fenlibility of the lungs ;
whence, in confequence of that general
fympathy which prevails thro' the whole
nervous fyflem, they v/ere affciled with
F a
Sz Of the Sympathy
a difagreeable fenfation, as often as the
ligaments and tendons of the ancle and
foot were overflretched ; which, how-
ever, produced no uneafinefs nor fym-
pathetic motion in the other parts of the
body, becaufe they were endued with
no inch morbid delicacy or uncommon
fenfibility.
Asa fiirther proof of this, I knew a
woman poffefled of a moft delicate fto-
mach, who, when this organ was more
than ufually indifpofed, was apt to fall
a retching as often as flie made the ne-
ceflary effort to pafs water ; and I have
had fever al patients affe(fl:ed, in confe-
quence of a virulent goiiorrhoca, with a
gleet and a tendernels, and Ibme degree
of forenefs in the urethra^ who, as often
as they drank two or three glalles of
wine, immediately felt an uncommon
uneafinefs in that part. This extraor-
dinary lympathy, however, between the
ftomach and urethra, ceafed as foon as
the latter became quite found.
Since
Gf the Nerves. 83
Since we oblerve that only thole,
whofe nervous fyflem is remarkably de-
licate, are afFcfled with general and
violent convulfive motions or i|)afms
from the paffions of the mind, difor-
ders in the prirms i)U^ and other cau-
fes ; have we not reafon to conclude,
when, in conlequence of an irritation of
any one part, an uncommon fympathe-
tic motion is produced in a diilant or-
gan, with which it has lefs connexion,
either by the nerves or blood-veilels,
than with many other parts which are
noways diiturbed ; that llich fympathe-
tic motion is owing to a peculiar deli-
cacy or mobility of that organ ; and
that, were the other moving organs of
the body equally delicate and fenfible,
univerlal, or at leaft more general con-
vulfions or fpafms would have been the
confequence ?
But, fuppollng we could neither ex-
plain fatisfa^torily, nor even conje(fl:ure
with probability concerning the caufe
F 2 of
84 0/ the Sympathy, 6-^\
of many uncommon and anomalous
fympathies, it would be no more tharl
what happens to us every day in our in-
quiries into the more abflrufe opera-
tions of nature. In every part, even
of the inanimate world, we find inex-
plicable difficulties ; what wonder then,
if, in the human body, a fyftem fo cu-
rious, fo fubtile and compounded, we
fliould meet with many appearances
wliich we cannot at all account for ?
The farther we puili our inquiries into
nature, the more fhall Ave be convinced
of our ignorance, and how fmall a por-
tion is known of the works of the Great
Creator !
Scarcely do lue guefs aright at the things
that are upon earth, and with labour do we
find the things that are before us **
CHAP.
* Wi/dom, chap. ix. fver. 16.
[ 85 ]
CHAP. II.
Of Nervous, Hypochondriac,
and Hysteric DifordcrSy in general,
'TpHE nerves, like the other parts of
the body are liable to various dif-
eafes, which may arife from a fault ei-
ther in their coats, then' medullary fub-
ftance, or in the brain and Ij^inal mar-
row, from which they all proceed.
The coats of the nerves may be ob-
flrufted, or inflamed, comprefTed by hard
fwellings, or irritated by acrid humours.
With regard to their medullary fub-
flance ; if a lingle nervous filament, ex-
clufive of the membranes flirrounding
it, be an extremely fmall canal, we may
conceive it, according to the different
ftatcs of the body, to be endued with
different
86 _ 0/ Nervous
different degrees of fii'mners or laxity,
whence the action of the nerves may
perhaps be conilderably affected.
This nervous canal may likewife be
obftrucled, tho' fuch obllrucflion is ra-
ther more lilcely to arife from fome ex-
ternal caiiie, than from any fwelling
in the medullary fubftance of which its
fides confifts, or from the vifcidity of
the fluid it contains. In the fmall ar-
terial veilels, obftruclions may often
happen from a fpafm ; but altlio' the
nerves cc^mmunicate a power of motion
to other parts, yet it does not appear that
they themfelves have any motion.
If the medullary part of the nerves
be fimple and not made of veflels, like
the other parts of the body, it can nei-
ther be liable to obftruclions nor inflam-
mations, but may fuffer greatly from
the irritation of acrid fubftances.
With refpecl to that fluid Avhich
the nerves are fuppofed to contain, as
we are wholly ignorant of its nature,
both
Disorders in general. 87
both in a Ibund and morbid flate, we
can never know, when the diieales of
the nerves arile from a fault in this fluid,
aitho' their action muil be coniiderably
affected whenever it is vitiated.
When the brain or ipinal marrow
is obftruc^led, comprefled, irritated, or
otherwife difealed, the nerves will fuifer
almoft equally, as if they themfelves were
primarily affected.
It would be of little life to infift fur-
ther on thofe faults, in the brain or
nerves, which may produce difeafes, iince
the llibtility of thefe parts makes it of-
ten impoffible for us, either before or
after death, to difcover, precifely, from
what caule fuch difeafes proceed ; nor
have we any ligns to diflinguiili, from
one another, thofe morbid fymptoms,
which may arife from a fault in the
coats, the medullary fubftance, or the
fluid of the nerves. But how much
foever we may be in the dark about the
immediate caufes of the difeafes of the
nerves.
88 Of Nervous
nerves, yet their eiFecls may all be re^
cluced to Ibme change in that fenfibility
or moving power, which the nerves
communicate to the different parts of
the body.
The fentient power of the nerves
may be either too acute, obtufe, depra^
ved, or wholly wanting ; and that pow^
er in them, which is necefPary for mvif-
cular motion, may be either weakened,
or quite deftroyed.
1, (,?) When the feeling of the nerves
is too acute ; difagreeable or painful
fenfations, and violent or irregular mo-
tions will be excited in the body, by the
application of fuch fubflances to the
nerves of the diifcrent organs, as in a
more hcaltiiy and firmer ftate, \\'ould
either occaiion lefs unealinels and dif^
turbance, or none at all. In Rich a con-
dition . of the nervous iyftem, the paf-
iions of the mind, ei'rors in diet, and
changes of heat and cold, or of the
weight and humidity of the atmolphere,
will
Disorders in general. 89
v.iU be apt to produce morbid fym-
ptoms ; fo that there ^^411 be no firm or
Ions: continued flate of health, but al-
moll a conftant lliccellion of greater or
lefs complaints.
(h) On the other hand, when either
the whole nerves, or a part of them, are
deprived of a proper degree of fenfibi-
lity, altho' the body in general, will
then be lefs apt to be affe<^ed by the
caules above mentioned ; yet, as fome of
its organs will not be fufficiently u'rita-
ted by the Jiimnli defigned by nature to
excite them into aclion, the a(^ion of
thofe parts will be imperfect. Thus,
when the nerves of the inteftines are
lefs difpofed than ufual to be affecl:ed
by then* natural y?w/?///, the irritation of
the aliments, air and bile, will only bq
able to raife a languid periftaltic motion,
and therefore the perlbn will become
coftive. WJien the fenfibility of
the retina is impaired, objects are feen
lefs diftin6tly ; and when the audito-
ry
^o 0/^Nervols
ry nen^es lofe fome part of their ex-
quiiite fenfibility, the ear cannot accu-
rately diftinguiih the various mufical
founds.
(r) When the feehng of the nerves
in any of the organs of the body, be-
comes unnatural or depraved, the moffc
difagreeable fenfations and alarming
fymptoms are fbmetimcs raifed by the
application of fuch flibilances, as in a
found ftate would produce no manner
of diilurbance : And hence we may un-
derftand the fm-prifing effe^ls of certain
fmcUs, aliments and medicines on many
delicate people.
This uncommon or depraved feelino;
-I- o
of the nerves does not always conlift in
a more acute fenfibility ; for water Avill
raife violent convulfions in a h'^drophobia,
whilft the fauces and (rfophagiis are not at
all aiFected in that manner by folid food ;
and a fmall quantity of honey will fome-
times occaflon more violent gripes, than
many of the flronger piu*gatives.
{d) When
Disorders in general, c^ i
[d) When any of the nerves lofe
their power of feeling entirely, the or-
gans, or parts to which they are diflri-
buted, become quite infenfible. When
the whole nerves of the organs of fenfe
and voluntary motion are thus affedled,
whilfl the heart and mufcles of relpira-
tion continue to ad:, we call the difeafe
an apoplexy.
2. {a) A GREATER degree of that;
j)o%yer in the nerves, which is neceflary
for motion, can only give more force
and fteadinefs to the mufcles, when they
all pofTefs it in an equal degree ; the in-
creafe, therefore, of this power is hard-
ly to be accounted a diftemper : It is ne-
ver exerted, except in confequence of
an effort of the will, of fome affection
of the mind, or of the a£lion of fome
Jlimiikts on the brain or nerves ; to the
two laft of which, are to be afcribed all
the depraved and irregular motions ob-
ferved in the body, and not to any real
depravation of the nervous power itfelf,
which
92 0/ Ner vo u s
which feems only to occallon dileaies,
when it is either weakened, or wholly
deftroyed. Thus a tetanus or unnilial
Ipafmodic contraction of any miifcle, is
not ovv'ing to an increafe of that power
in its nerves, which is necelfary for mul-
ciilar motion, but to an extraordinaiy
exertion of it, in confequence of fome
uncommon irritation or affection of the
brain and nerves.
{b) A DIMINUTION of the moving
pwcr of tiie nerves, produces a debility
of the whole body.
(c) A TOTAL want of this power ^
occafions either a partial or univerfal
palfy, according as only a few of the
nerves or the whole fyflem is affected.
When any of the qiufcles are deprived
of the nervous influence^ they are not on--
ly rendered paralytic, but foon after be-
come fmaller ; hecaufe the circulation of
the fluids cannot be carried on, as ufual,
tlirougli the very fmall vefFels when they
rire deppvcd of the nervous power *.
But
* See above, chap. i. Nq. 8.
Disorders i:i gmcraL <) ^
But here it vv'ill be proper to ob-
lerve, that, as there is fcarce any part
of the body without nerves, and very
few altogether without feeling, the
nerves mnil not only fuffer, when they
themfelves, or the brain and fpinal
marrow are primarily afFei^ed, but alio
when the other parts are difeafed: and
hence the difficulty, perhaps the impof-
fibility, of fixing a certain criterion, by
which nervous diforders may be diflin-
ffuiflied from all others*
All difeafes may, in Ibme fenfe, be
called affections o^ the nervous lyftem,
becauie, in almofh every difeafe, the
nerves are more or lefs hurt ; and, in
confequence of this, various fenfations,
motions, and changes, are produced in
the body. — However, thofe diforders
may, peculiarly, deferve the name of
NERVOUS, which, on account of an un-
uHial delicacy, or unnatural (late of the
nerves, are produced by caules, which,
in people of a found conjflitution, would
either
94 ^f Nervous
either have no fuch eiFecls, or at lead in
a much lefs degree.
To iUuftrate this by a few examples.
— We do not call the toothach a ner-
vous dileafe, becaufe the nerves of the
teeth are greatly pained ; . but if, from
a particular delicacy of conftitution, the
patient is, by this pain, thrown into
convulfions and faintings, we call theie
fymptoms nervous, — An obflruc^ion in
the coats of the ftomach, or other hypo-
chondriac vifccray is not, ftri(^ly fpeak-
ing, a nervous difeafe ; but if the nerves
of thefe parts are fo changed from their
natural ftate, that low fpirits, melancho-
ly, or madnefs, are the confequence of
this obflrud:ion, then thele fymptoms
delerve the name gf nervous. — Again,
although the fever excited by the pain-
ful inflammation of the finger in -Sl paro-
jiychiaj and the fever and Vomiting occa-
fioned by a nephritis ^ arife from the fym-
pathy of the nerves, yet flich fyjnptoms
are N not commonly accounted nervous
diforders.
Disorders in general, ^5
diforders, becaufe they do not indicate
any particular unfound flate of the
nerves, and happen, in Ibme degree, to
eveiy one ill of a paronychia or nephritis ;
but if convulfions or faintings are add-
ed, then thefe laft fymptoms, being the
eifeAs of an uncommon delicacy of the
nervous fyftem, may be juftly called
nervous. — In like manner, the convul-
fions fometimes preceding the erup-
tion of the fmall-pox deferve this name,
becaule they only feize thofe whofe ner-
vous fyflem is ealily moved, while the
quick pulfe, and other feverifli fymp-
toms, though excited by the variolous
matter afting'as a ftimidns on the nerves,
are not reckoned nervous. — To con-
clude, even a gntta Jereita, from a tumor
preiling upon the optic nerve, is not, in
our fenfe, fo much a nervous difeafe, as
that dimnefs of fight which 4s fome-
times occafioned by a diforder of the
ftomach; for the caufe now mentioned
will produce the gntta ferena in every
perfon
(^6 0/ N E R V o u s
perfon equally; whereas tliis dimneib
will only happen to fuch as have a pe-
culiar delicacy of nerves.
In treating, therefore, of nervous dis-
orders, I fliall confine myfelf chiefly to
thofe complamts which proceed, in a
great meailire, from a weak or unnatu-
ral conflitution of the nerves; and of
tliis kind, I prefunie, are moll of thofe
iymptoms Avhich phyiicians have com-
monly diftingui filed by the names of fta-
ndcnt, fpafmodic, hypochondriac or hyjieric.
As the iagacious Sydenham has juftly
obferved, that the fliapes of Proteus, or
the colours of the chanidleon are not more
numerous and inconiiiiiei. . , than the va-
riations of the hypochondriac and hy-
fleric difeafe *"; fo thofe morbid fymp-
toms which have been commonly cal-
led nervous, are fo many, fo various,
and fo ii'regular, tliat it would be ex-
tremely hard, either rightly to defcribe,
or fully to enumerate them. They imi-
tate
* Sydankam. oper. ^/i/?. ad D. Cole,
Disorders in general. ^7
tate the iymptoms of almoft all other
difeafes ; and, indeed, there are few
chronic diftempers with wliich they are
not more or Icis blended or intermixed.
Hence it is, that the late celebrated Dr.
Mead fays of the hypochondriac afiec-
tion, non uriam ftdem bahet, Jed morbus toti^
jis corporis eft *. I fiiail not, therefore, un-
dertake to give a full or exa6t defcrip-
tion of thele diforders, nor pretend to
exhibit a complete liil of all the morbid
fymptoms, which have been commonly
reckoned of the nervous, hypochon-
driac, orhyileric kind; butfliall content
myfelf with mentioning the following,
as being the moil common and remark-
able.
Wind in the flomach and inteflincs,
heart-burning, four bclchings, fqueam-
iflmefs, and vomiting of a watery fluff,
tough phlegm, or a black liquor like
the grounds of coffee ; want of appetite
and indigeflion, or an uncommon cra-
G ving
*' Monita et prtecept. med. cap. xvii.
98 0/ Ner vou s
ving for food and quick digeftion; a
debility, faintnefs, and fenfe of great
emptinefs about the llomach, when hun-
giy ; a ftrong defire for rare or uncom-
mon forts of food, or for things that
can afford no nourifliment ; a vilible
^veiling or inflation of the ftomach, e-
ipecially after eating ; fometimes a fe-
vere pain with cramps in it ; an oppref-
fion about the pviscordia ; an unealy,
though not painful, fenfation abovit the
flomach, attended with low ipirits, anxi-
ety, and fometimes great timidity;
flrong pulfations within the belly ;
fpafms in the bowels, and diflenfions of
certain portions of them ; violent cholic
pains ; a grumbling noife from wind
paffing through the inteflines ; the bo-
dy fometimes too lax, oftener bound;
pains in the back and belly, refembling
thofe of the nephritic kind; a fenfe of
irritation and heat in the neck of the
bladders and urethra^ with a frequent de-
fire
Disorders in generaL o o
fire to make water ; a great difcharge of
limpid urine; at other times a frequent
i]3itting.
Sudden fluilies of heat over the whole
body, fliiverings, a fenfe of cold in
certain parts, as if water was poured
on them, at other times an unufual
glow ; flying pains in the arms and
limbs ; a troublefome pain in the back,
and between the flioulders ; pains, at-
tended with a hot feniation, fliifting
often from the fides or back to the in-
terior parts of the abdomen; cramps, or
convulfive motions of the mufcles, or of
a few of their fibres ; fiidden ftartings
of the legs and arms ; almoll confi;ant
involuntary motions of the mufcles of
the neck and head, or arms and legs ;
a general convulfion affed:ing, at once,
the flomach, bowels, throat, legs, arms,
and, indeed, aimoil the whole members
of the body, in which the patient ftrug-
gles as in a violent epileptic fit ; long
G 2 faintings.
100 (y-NERVOUS
faintings, in fome cafes, following one
another, after fliort intervals.
Palpitations or trembling of the
heart; the piilfe very variable, frequent-
ly natiu-al, fometimes iincommonl)' flow,
and other times quick, oftener fmall
than full, and, on certain occafions, irre-
gular or intermitting; a dry cough with
difficulty of breathing, or a conftric-
tion of the lungs, fometimes rctiu-ning
periodically ; yawning, the hiccup, fre-
quent ilghings, and a fenfe of fuifoca-
tion, as if from a ball or lump in the
throat ; fits of crying, and convullive
laughing. Altho' in the day-time the
patients are generally pretty cool, and
the pulfe fometimes (lower than natural,
yet in the night, efpecially in time of
ileep, hot fluflies often fpread over al-
moft the whole body, the pulfe becomes
quicker and flronger, and a faintneis,
or fome degree of ficknefs at ftomach is
felt.
Disorders in general, \ i o i
A GIDDINESS, efpeclally after riiing
up hafliiy ; pains in the head, fomc
times returning periodically; a vio-
lent pain in a linall part of the head,
not larger than a ftiilling, as if a nail
was driven into it ; a finging in the ears;
a dimnefs of fight, and appearance of a
thick niift, without any viliblc fault in
the eyes. Objects are fometimes i^etn
double, and unufual fmells are percei-
ved ; obftinatc Avatchings, attended
fometimes witli an uneafinefs, which is
not to be defcribed, but which is lef-
fened by getting out of bed ; diflurbed
fleep, frightful dreams, the night-mare;
fometimes a drowfinefs, and too great
inclination to fleep ; fear, peeviflmefs,
ladnels, defpair, at other times high fpi-
rits; wandering thoughts, impaired me-
mory, ridiculous fancies; ftrange per-
Hiafions of their labouring under difea-
fes of which they are quite free ; and
imagining their complaints to be as dan-
gerous as they find them troublefome;
.thev
10 2 Of Nek w ov s
they are often angry with thofe who
would convince them of their miflake.
Patients, after having been long
afflicled with nian^v^ of thefe fymptoms,
(for all of them never happen to any one
perfon) fometimes fall into melancholy,
madnefs, the black jaundice, a dropfy,
tympany, pbthifis pulmonalis, palfy, apo-
plexy, or fomc other fatal diftemper.
Those patients who are liable to the
above complaints, fome of v/hich delerve
the name o^ nervous much better than o-
thers, may be diltingiiifiied into tln-ee
dalles.
I. Such as, though ufually in good
liealth, are vet. on account of an un-
common delicacy of their nervous fy-
llcm, apt to be often affected with vio-
lent tremors, palpitations, faintings
and convulfive lits, from fear, grief, lur-
prize, or other palhons ; and from w^hat-
ever greatly h'ritates or dilagreeably af-
feels any of the more fenfible parts of
the body.
2. Such
Disorders in general, 103
2. Such as, belldes being liable to
the above diforders from the fame
cauies, are almofl always more or lefs
troubled with indigeflion, flatulence in
the flomach and bowels, a lump in the
throat, the cla'viu /jyjiericusy giddinefs, fly-
ing pains in the head, and a fenfe'of
cold in its back part, frequent fighings,
palpitations, inquietude, fits of faliva-
tion, or pale urine, <<!:)X.
3. Such as, froni a lefs delicate feel-
ing, or mobihty of their nervous fyilem
in general, are fcarce ever affedled with
violent palpitations, fain tings or con-
\ailiive motions, from fear, grief, flir-
prife, or other palTions ; but, on ac-
count of a difordered ftate of the nerves
of the flomach and bowels, are feldom
free from complaints of indigeflion,
belching, flatulence, w^ant of appetite, or
too great craving, coflivenefs, or loofe-
nefs, flufliings, giddinefs, oppreffion or
faintnefs about the pr^cordia, low fpirits,
difagreeable
IQ4 0/' Ne R VQU S.
diiagreeable thoughts, watching or dii^
-tiirbed fleep, t^v.
The complaints of the iirll of the
above clafles may be called fimply ner-
voiu ; thoLc of the fecond, in compli-
ance with ciiflom, may be faid to be
}?yftericy and thofe of the third, hypochon-
diiac.
The hypochondriac and hyileric dif-
eafes are generally conladered by phy-
iicians as the fame ; only in women,
fiich diforders have got the name of
hyfterlCy from the antient opinion of their
leat being folely in the womb ; while
in men, they v/ere called h'jpocbondriaCy
upon the fuppoiition, that in them they
proceeded from fome fau^t in thofe vif^
cera which ly under the cartilages of the
ribs.
The learned Hoffman, difTenting from
moft of the later writers, affirms that
the hypochondriac and hyfleric are dif-
ferent dheafes, whether we regard their
fyrnptoms.
Disorders in general , 105
iymptoms, caufes, or terniination * :
But we cannot agree to this opinion, a<5
their fyniptoms areof fb flniilar a nature,
and as the hypochondriac difeafe is not
more unlike the hyfteric, than this laft
is often unhke to itfelf. It is true that in
women, hylleric lymptoms occur more
frequently, and are often much more
flidden and violent, than the hypochon-
driac in men ; but this circumftance,
which is only a confequence of the more
delicate frame, fedentary life, and par-
ticular condition of the womb in wo-
men, by no means fliews the two dif-
eafes to be, ftriftly fpeaking, different.
Nor does it appear more reafonable to
pronounce the hyfteric diforder of a dif-
ferent kind from the hypochondriac;
becaufe the former may have its feat fre-
quently in the uterus, and the latter in
the alimentary canal, than it would be
to diftingui/li the hypochondriac com-
plaints into as many different difeafes
as
* SjJ^efn. med. torn. ni.p. 4. cat, v. § v. et vi.
io6 O/^Nervous
as the caufes from which they may ariie ;
or to divide hyfteric fits, as they are
called, in women, into nervous, ftoma-
chic and hyfteric, becaufe they often
proceed from violent affedions of the
mind, or a difordered ftate ot the iiot
mach, as well as from a fault in the
iiterus.
But further, it is to be obferved that
in women, the fymptoms commonly cal-
led hyfteric, are lefs frequently owing
to the unfound ftate of the womb, than
to faults fomewhere elfe in the body;
for virgins are often free of fuch com-
plaints, while married women, and even
thofe who bear children with eafy la-
bours, are fometimes aftii^led with
them. Add to this, that women who
are regular, and have no ailment about
the uterus, do not always efcape the
hyfteric difeafe; while thofe who labour
under fchirrous tumours and other difor-
ders of that part, are often not affected,
at
Disorders in general, 107
at lead, with its worfl fymptoms. Laft-
\y, in thofe, who have long and greatly
fufFcred by this malady, the womb, af-
ter death, has frequently been obferved
to be found.
Upon the whole therefore, the fymp-
toms of the hyfteric difeafe in women
feem only to diiter from thofe of the
hypochondriac in men, in lb far as the
former, fometimes, proceed from the
iitcnuy and are, on account of the more
delicate frame of the fex, more frequent
and often more violent, than the lymp^
toms of the hypochondriac affed:ion in
juen.
But whether thefe two diftempers be
conlidered as the fame or diftincl, fince
the fymptoms of both are £0 much a-
kin, we fliall coniider them under the
general character of Nervous; and be-
gin with inquiring into the caufes from
which they moft commonly proceed.
The antient phyficians, with feveral
of the moderns, have agreed in placing
the
io8 0/ Nervous
the foie, or, at leaft, the chief feat of the
hyfleric difeafe, in the womb ; but, with
regard to the parts affedled in the hy-
pochondriac, the opinions ha^ e been
various and contradictory.
Many authors have afcribed this dis-
order in men, to obflructions in the
Ipleen, liver and mefentery. — Righmorc,
to a vitiated conftitution of the flo-
mach *. — TVilliSy to an indiipoiition of
the brain and nerves, or to a fault of
the fj^irits.- — EtmuUcry who confounds
the hypochondriac difeale, v/hen in a
higher degree, with the fcur\y, has
Avrltten a diiPertation to prove that its
ieat is not in the fpleen, but in the in-
teftines, cfpeciaily in that part of the
colon y wliich lies in the left hypocliondre,
in which the excrements often ftagnate,
and where much wind is pent upt- —
S-^denham afcribes the fame diftemper to
an
* Exercitaf tones de pa£lone hyjler, et affisclion. hyfochondr.
\ Oper. /. 1S20.
Disorders in general, i o ^
<in ataxy or confufion of the ipirits *. —
MandeviUey to a dilbrdered chylification,
and a deficiency or paucity of the ipi-
rits t« — Junckerns makes the caiifa proxima
of the hypochondriac affeftion to confifl
in an obilruvn:ed motion of the blood in
the "oena portarum and vifcera connefted
with it X — Bocrhaave derives it from an
atrabiliary humour lodging in the pan-
creas , Ipleen, flomach, and neighbouring
organs II . — H.off'man from a perverted pe-
rillaltic motion of the ftomach and in-
teflines **. And laftly, Dr Chc\nc is of
opinion that all great nervous diforders
proceed from fome glandular obftrucfcion
in the ftomach, bowels, liver, fpleen,
mefentery or other organs of the lower
belly tt.
But
• Epiji. ad D. Cok.
t A Treatife of the hypochondriac and hyileric pafTion^,
dialogues i. and ii.
X Junckeri Coufped. Medicinal p. iS6.
II Jphorifm.de cognofcend. morh. % 1098.
** Syjlem. Med. torn. \n. part. iii. cap. v.
ff Englifh Malady, partii. chap. \ii,
no ^f Nervous
But altho' it is not to be doubted,
that the hypochondriac and hyfteric
aiFed:ions often proceed from a morbid
flate of the ahmentary canal, uterus, or
other vifccra of the abdomen, yet as there
are feveral of their lymptoms, which feem
independent of any cUforder in thoie
parts ; and as there has often no trace of
thofe difeafes appeared, after death, in
any of the abdominal organs, it feems
highly probable, they, may frequently
arife from fome lefs viiible fault in the
body.
We fliall therefore proceed to inquire
into the mod common caufes of thofe
nervous, hypochondriac or hyfteric
lymptoms above mentioned, treating
firft of fuch caufes as render the body
more liable to thefe diforders ; fe-
condly, of thofe, which, meeting with
the former, actually produce them.
The firft have been called the predifpo-
fing caufes; the fecond the occafional
caufes.
CHAP.
[ III ]
'CHAP. III.
Of the Predifpofing Causes 0/ Nervous
Disorders.
THESE may be reduced to two,
viz.
LA TOO great delicacy and fenlibi-
lity of the whole nervous fyftem.
II. An uncommon weaknefs, or a de-
praved or unnatural feeling, in fome of
the organs of the body.
I. A TOO great delicacy and fenfibi-
lity of the whole nervous fyftem, may
be either natviral, that is, an original
defed: in the conftitution, or produced
by fuch difeafes or irregularity in li-
ving, as weaken the whole body, efpe-
cially the nerves. Long or repeated
fevers.
112 Of the Causes
fevers, profufe haemorrhages, great fa^
tigue, excellive or long condnued grief,
luxurious living and want of exercife,
may increafe or even bring on fuch a
delicate ftate of the nervous fyllem.
As the whole animal frame is contri-
ved with the greateilwifdom, fo we can-
not but admire, in particular, how the
nerves, tho' all are endued with the ge-
neral lenfe of feeling, have yet in differ-
ent organs, certain fenfations, quite dif-
ferent from each other ; and are per-
fecl:ly well adapted to thofe things,
which are deligned by nature to be
appUed to them. Tlius, for example,
as pure air gives no uneafmefs to the
nerves of the wind-pipe, and is refrefti-
ing to thofe of the lungs ; fo to a cra-
ving ftomach wholefom food is highly
o-rateful : but air collected in the flo-
mach feidom fails to produce a difa-
greeable fenfation, and not only folid
food, but even the mildeft liquids, fal-
ling by accident into the v,'ind-pipe,
bring
o/ Nervous Disorders. 113
bring on violent fits of coughing, which
do not ceafe till the fenfe of irritation is
lefTenecI. — ^In like manner, warm blood,
which does not affect the heart or vai^
cular fyftem, with any difagreeable fen-
fation, 'occafions, in the ftomach, faint-
nefs, hea^'y ficknefs and vomiting. —
The nerves of the nofe, tongue and fto-
mach, are all endowed with ienfations
of different kinds ; whence fome fub-
ftances very ungrateful to the palate,
are often agreeable to the ftomach. Se-
veral flibftances, which hurt the eyes,
give no uneafinefs to the alimentary ca-
nal; and, on the other hand, antimo-
nial wine, or an infufion of ipecacuanha
in water, which neither irritate much the
tongue or other fenfible parts, affedl the
ftomach fo difagreeably as to occafion
violent vomiting.
But further, as the nerves, in many
of oiu' organs, have very different feel-
ings ; fo, in different people, or even in
the fame perfon at different times, the
H feeling
X 1 4 ^f ^'-^^ Causes
feeling of the fame nerves varies confi-
derably, and is more or lefs acute or
blunt, and fometimes unnatural or de-
praved. And hence it is, that the very
fame things applied to the fame nerves,
or organs, have very different effefts, ac-
cording to the conftitution of the per-
fons, or then* date of health at the time.
In fome, tlie feelings, perceptions,
and pafiions, are naturally dull, (low, and
di ill cult to be roufed ; in others, they
are very quick and eafily excited, on
account of a greater delicacy and fenfi-
bility of the brain and nerves.
All children, when compared with
adults, have their nervous fyflem very
fenfible and eafily moved, and are in
this refpecl fomething like thofe grown
people, who are mod fubjecl to the high-
eil nervous Ox* hyfleric fymptoms : And
hence it is, that children are fo liable to
convulfive fits from the pain of teething,
from worms, acrid humours in their
ilo.macli or bowels, and other caufes,
which.
o/' Nervous Disorders. 115
whicli, in people of a more advanced
age, and lefs fenlible nerves, would pro-
duce no fuch effects »
A DELICATE or cafily irritable ner-
vous fyflem, niuft expofe a perfon to va-
rious ailments, from caules, affecting ei-
ther the body or mind, too flight to make
any remarkable impreliion upon thole
of firmer and lefs fenfible nerves. Thus,
any accident occafioning fudden fur-
prife, will, in many delicate people, pro-
duce ftrong palpitations of the heart,
and fometimes fainting with convul-
fions. — I have known fome, even men,
whofe nervous fyftem was fo delicate and
moveable, that a vomit, a fmart purge,
or the pain raifed by a blifter, would
throw them into convulfive fits. Nay,
there was lately a paralytic patient in
the Royal Infirmary here, who felt a re-
markable uneafinefs thro' his whole bo-
dy, when it was charged with the elec-
trical fluid, by means of a wire held in
liis hand, altho* there was no fliock given
H % him.
1 1 6 Of the Cavses
him, nor any fparks draAvn from him. — -
We are told of a Lady, who, upon hear-
ing the found of a bell, or any loud
noife, would fall into fits of fwooning,
which were fcarce to be diflinguiflied
from death ^ : And I have feen the pain
of the toothach throw a young woman,
of weak nerves, into convulfions and in-
fenfibility, which continued for fevcral
hours, and returned, upon the pain be-
coming again more acute t*
Some
* Boy'e^s ufefulnefs of exp. Philofophy, part ii. p. 248.
■J The following cafe, communicated to me by Mr.
James Sfcnce furgeon in Dunkeld, is a remarkable inftance
of the many violent and uncommon fymptoms, which may
arife from a fmall caufe, in perfons of a very delicate ner-
vous fyftem.
An unmarried woman, of 23 years of age, immediately
after having been ftung in the neck by a bee, felt a Iharp
pain, with a violent itching in that part, and over the
whole head and f.Kc, which, together with her arms, felt
uiff and fwelled. In a few minutes, the pain fpread to her
throat, and then to her Itcmach, occafioning a great anxiety
and difficulty of refpirat'.on. At this time, a large dram of
malt fpirits was given her, which, the' it was immediately
vomited up again, relieved the pain for a little : But, foon
after, it was felt violently in the lower belly, and was ioU
lowed bv a Icofe ftool. She complained novy of an un-
conainoi^
of Nervous Disorders. iiy
Some women, from a too great deji-
cacy or lenfibility of the nervous fyflem,
are, after conception, fo much affecled
with a heat and uneafy fenfation in their
back, colick-pains, and other fymptoms,
as to be in hazard of mifcarriage. In
fuch cafes, when the danger neither a-
riles from too much blood, nor too great
a laxity of the uterine veflels, but, mere-
ly, from an uncommon weaknels and
delicacy of the nerves, bleeding will do
harm^ and aftringent and cooling me-
dicines will prove ineifectual, whilfl lau-
danum given from time to time, in pro-
per
common heat in her face and head, and of a great faintnefs :
Her pulfe was fmall and irregular, her tongue and throat
dry, her extremities cold, and the whole body aiFedted
with a tremor. After taking a draught of warm water,
and having the part that was Hung, rubbed with warm oil
of olives, fhe was put to bed, and found confiderable re-
lief from flannel-cloths, wrung out of a hot decotftion of
fome emollient herbs, applied to the abdomen and feet.
After this, a draught with fome of the elixir paregoriaim^
foon produced a profufe fweat, and freed her of the pain,
inclination to vomit, and other fymptoms. Next day her
fkin being hot, and her pulfe full, a new fweat was pro-
cured by a draught with y^. minder, znd /al. 'vol ammon.
and, before the evening, Ihe was net of every complaint.
ii8 Of the Causes
per dofes, will produce the beft effecfis :
For, by lefTening the too great fenfibility
of the nervous fyftem, it not only quiets
all the uneafy fenfations, but calms the
mind itfelf, and renders it lefs liable to
be ruffled by flight caufes.
Women, in whom the nervoujs fy-
ftem is generally more moveable than in
men, are more fubjeft to nervous com-
plaints, and have them in a higher de-
gree. On the other hand, old people,
in whom the nerves have become lefs
fenfible, are little afflicfled with thofe
diforders ; nay. Dr. Cheyie has obfer-
ved, that an advanced age fometimes
proves a cure.
Lastly, altho' the variolous matter in
the blood, by its Jlwmlus, frequently pro-
duces in children, convulfions before
the eruption ; yet, in grown people,
whofe nerves are lefs delicate, this fym-
ptom, rarely, if ever, happens. On the
other hand, people whofe folids are lefs
firm, and their nerves more delicate and
eaflly
I
of Nervous Disorders. li^
ealily afFecled, altlio' ilibject to many
Gomplaints, yet are feldom attacked with
ardent fevers or violent infiammator}'"
difeafes ; which feems to be chiefly ow-
ing to the weak (tate of their blood and
veflels.
To the dilFerent fen (ibility of the
nerves in general, or, at lead, of the
heart, is owing, in a great meaiure, the
Variety of the quickneis of the pidie in
healthy people. A late phyfician of this
place told me of one of his patients,
v/hofe pulfe, in a healthy ftate, did not
beat above 38 or 40 times in a minute :
And I know a young woman, whofe na-
tural pulfe, when fitting, is rarely under
1 20, yet has no complaint, and feems
to enjoy good health : Near nhie years
ago, when I attended her in a fever^
her pulfe beat upwards of igo in a
minute ; and {i\G was, at that time, trou-
bled with the greateil ftartings and tre-
mors I had ever feen : Nay, fo very ir- '
ritable was her heart, that, after the fe-*
. vet*
I20 Of the Causes
ver vv^as much abated, and when, in a
horizontal pofture, her pulfe beat under
140, by only fitting up in her bed for
a little while, it became fo quick, that,
with difficulty, I could count it ; but,
after repeated trials, found it to be near-
ly 220 in a minute.
Is not the quicknefs of the pulfe, in
children, chiefly owing to the greater
fenlibihty of their heai't ? and does not
the pulfe generally grow flower with
age, becauie the heart becomes lefs fen-
iible, and, in a very advanced age, per-
haps, in fome degree, callous? Laftly, is
not the pulle, c£tcris paribus y quicker in
fmall than in large animals, chiefly be-
caufe the nerves are endued with a great-
er degree of fenlibility in the former,
than in the latter *?
Since, as we have obferved, the
nerves, in the different organs, are en-
dued with various kinds of feeling, and
are
* The flownefs of the pulfe in larger animals, is, no
doubt, partly owing to the ventricles of their heart, on
account of their greater capacity, requiring a longer time
for the performance of their feveral motions.
of Nervous Disorders. 121
are very differently afFe(^ed by the fame
things, will not morbid humours in the
blood be more apt to produce difeafes in
thofe parts, whofe nerves are mofl flrong-
ly afFecled by them, than in others
which flifFer lefs ? And may not this be,
partly, the reafbn why, in certain dif-
eafes, fome parts of the body are much
more commonly affected than others ?
And w^hy, in fome epidemics, the eyes,
nofe, or fauces; and, in others, the breafl
or inteftines are mofl apt to fuifer ? This
alfo may, partly, be the caufe why thofe
organs, which have fliffered by fome
former difeafes, are mofl liable to be at-
tacked, when the body is feized with
any new diforder ; for this does not
feem to be owing, yo/Jy, to the weaknefs
of the vefFels, but alfb to their being
more eafily irritated by any acrimony
in the blood, or by its increafed force.
Further, it may be proper to take no-
tice here, that the different operations
of various medicines are not fo mvich
owing
Ii2r Of the Cavses
owing to their powers, either of dilTol-
ving the blood, or changing it in other
relpecls, as to the particular nature of
the nerves of the different organs, dif-
poilng them to be very differently af-
fected by the fame kind of flimulating
fubflances.
Thus cathartic medicines applied to
the belly of children, in the form of a
plaifter, do not fenfibly increafe the fe-
cretion from the liver, or from the fall-
vary or lachrymal glands ; but they fb
affecl; the nerves of the inteflines, as to
occalion a greater flux of humours from
their veffels, and accelerate the periflal-
tic motion, and fo bring on a purging:
And this does not feem to be owing, fo
much, to the finer parts of thofe medi-
cines, which enter the blood, and may-
be conveyed with it to the bowels, a(5l-
ing immediately on their nerves or fmall
veiTels, as to a particular fympathy be-
tween the nerves diflributed to the te-
guments of the abdomen and thofe of the
inteflines }
' o/' Nervous Disorders. 123
inteflines; otherwife an aloetic plalfter
applied to the back or the head, fliould
open the body as much, as when laid
to the belly. — Nitre, which proves of-
ten highly diuretic, does not feem to
afFecl: the fecretions of the other glands
remarkably. — The finer parts of cantha-
rides entering the blood by the applica-
tion of blifters, rarely produce vomiting
or purging, or difagreeably aftecl any
part, except the urinary pafTages, Vv^here
the nerves are fo formed, as, by the a-
crimony of the flies, to be more irritated,
than thofe of the other organs. Nor
can the ftrangury, occafioned by cantha-
rides y be owing, as fbme have thought,
to their particles not pading freely tln^o*
the vellels of the kidneys and bladder,
fince the vellels of the brain are much
fmaller than thcfc, and fmce the kidneys
are not near fo much affected by them,
as the neck of the bladder. — Does not
mercury, when mixed with the blood,
generally increafe the fecretion of the
faliva
X
124 Q/' ^^'^ Causes
faliva, much more than that of any o-
ther humour, becaufe the fmall vefTels
of the falivai-y glands are more ftrongly
affe^led by its pecuUar Jlimulus, than
thofe of any other fecretoiy organ ? — -
Laftly, does it not appear, from what has
been faid, that the virtue of a medicine,
which is fpecifically to promote the fe-
cretion of the bile, fcvicu, urine, or the
faliva, muft conlifl in its being peculi-
arly fitted for flimulating, and confe-
quently increafing the vibratory motions
of the fmall fecreting velTels of the li-
ver, kidneys, teflicles, or falivaiy glands,
more than thofe of the other parts ? And
do not fuch medicines alone, if any fuch
there be, deferve, in a ilrict fenie, the
name of Emenagogue, which not on-
ly tend, by their general flimulating
or attenuating power, to promote the
menftrual evacuation, but ahb, by their
particular quality, are fitted to ftimulate
the nerves and veflels of the womb more
than any other ?
But,
of Nervous Disorders. 125
But, to return from this digrcffion;
II. Besides a too great fenfibility
of the nervous fyflem hi general, there
is often an uncommon weaknefs or de-
licacy, or an unnatural or depraved feel-
ing in various parts of the body, which
expofes certain peribns to violent, and
fometimes very extraordinary affections,
from caufes which would fcarce pro-
duce any difturbance in people of a
found conftitution.
Thus, feveral delicate women, who
could eafily bear the flronger fmell of
tobacco, have been thrown into fits by
muik, ambergreafe, or a pale rofe, which,
to mofl people, are either grateful, or,
at lead, not difagreeable. The fmell
of cheefe has, almofl always, occafion-
ed a bleeding of the nofe in fome *.
Mr. Boyle tells of a Nobleman, who
v/as apt to faint aAvay when taniy was
brought near him ; and there lately
lived, in this country, a Lady, who
was aifecFled with a general uneafinefs,
as
* Kaau Boerhaave impet. faciens, § ^09.
126 Of the Causes
as often - as there v/as any fclleiy in
in the room where flie fat. The fight
of a cat, nay, even the invifible effluvia
from that animal, have occafioned an-
xiety, faintnefs and fweating *. I had,
-\ feveral years fince, a patient, who was
alvv^ays affected with an itching and un-
eafinefs over her whole body, when flie
either fwallov/ed nutmeg, or applied it
externally. There have been fome who
were ready to faint when they finelled
to cinnamon : and Mr. Bo)le mentions
a Lady, who had fuch an antipathy to
honey, that a little of it, put mto a
poultice, without her knowledge, and
laid to a fliglit wound, tlirew lier into
great diforder, which continued until
tliat application was removed f* — 1 knew
-L a woman, who, foon after conception,
always contracted an averfion to fnuif,
and did not recover her tafte for it, un-
til fometime after her delivery : And it
is well known, that, in time of preg-
nancy,
* Kaatt Boerhawve Impet. faciens, ^ 409-
f Ufefulnefs of experimental philof. part ii. p. 260.
-f
of Nervous Disorders. 127
nancy, the nerves of the flomach are fo
much changed, that mofl women are
then troubled with a natifeUy vomiting, or
depraved appetite. Laftly, certain per-
fons, in confequence of an uncommon
delicacy, or unnatural fenfibility of the
nerves "which terminate in the bronchia^
or veficles of the lungs, are apt to fuf-
fer an afthmatic fit from the effluvia of
particular fub fiances, which produce no
ilich eife(ft; on thofe whole pulmonary
jierves are differently diipofed.
But there is no organ of the body,
the unnatural ftate of whole nerves is
fo frequently the caufe of nervous, hy-
pochondriac and hyfteric diforders, as
the alimentary canal, efpecially the fto-
mach.
An uncommon delicacy of the nerves
of the flomach and inteflines, which may
be either, in a great me^-fure, natiu-al,
or brought on by difeafes, improper ali-
ment, irregular living, exceflive grief,
$)r other caufes, is to be diflinguifhed
fron^
I 28 Of ^^^^ CaU SES
from that acute feeling, or increaled
fenfibility, which is the confequence of
an inflammation, or of an aphthous flate
of thefe parts, iince m thefe laft cafes e-
very acrid fubflance gives them pain ;
whereas, in the former, many infipid
and fcemingly innocent aliments, pro-
duce great uneafineis in the ftomach
and bowels, while volatile fpirits, flrong
wine, brandy, and ipiceries, are not
only inolfeniive, but often neceflary for
allaying thofe diforders, which are pro^
duced in the firfl paffages, by fiich cau-
fes as would fcarce give any diflurbance
in a found flate.
Further, this morbid or delicate
flate of the flomach and bowels, does
not condfl folely in their weaknefs, but
chiefly in tlie uncommon difpofition of
their nerves, which have a feeling very
different from what is natural. As a
proof of this, we obferve, that in fuch a
flate of the alimentary canal, the appe-
tite is often not only good, but beef and
mutton,
of Nervous Disorders. 129
mutton, even when falted and dried,
will be more eafily digefted, and give
lefs difturbance, tiian many vegetables,
which in healthy peribns fit much light-
er on the ftomach *.
It is furprifing, how much the con-
dition of the ftomach and inteftines,
and the diipofition of their nerves, will
vary, even in the fame perfons, at differ-
ent times.
I Thus
• It is a miftake to think, as fome have done, that ve-
getable food in general, is worfe to digeft than animal.
The contrary feems to be demonftrated by Walaus''^ expe-
riments on dogs ; from which it appears, that bread and
herbs are much fooner digefted than butcher meat, even by
thefe animals which are naturally carnivorous j the for-
mer rt^maining in the ftomach only four or five hours, and
the latter feven or eight. Vid. Epiji. tie mot. chyl, et fang, ad
Thorn. Bartholin. Agreeably to this, people whofe ftomach
and inteftines are quite found, find themfelves lighter, and
much fooner hungry after a dinner of white bread, herbs,
roots, or ripe fruit, than one of beef, mutton, or pork.
It is not owing, therefore, to their being moj-e difficult to
digeft, or their remaining longer in the ftomach, that ma-
ny vegetable aliments give fuch difturbance to fome deli-
cate people, but to their affefting difagreeably the nerves
of the alimentary canal. For the fame reafon it is, that
roafted meat agrees better with them than broth or boil-
ed meat, and old cheefe than new preffed curds.
130 Of the Cau SES
Thus cabbage, onions, leeks and o-
ther vegetables, will lie long on the fto^
mach, and occafion flatulence and looie
ftools in many, who formerly found no
fiich inconvenience from them; and
the fame thing is true of honey and o-
ther aliments : nay, Mr. Boylc tells us of
a perfon, who was more violently vo-
mited by coffee than crocus mctallonim, or
other ftrong emetics ; and was made
iick even by the fmell of this liquor, as
he pafTed by a coffee-houfe, although
formerly he had ufed to drink it with-
out feeling any difagreeable effects *. In
fome people the ftate of the nerves of
the ftomach is fo very uncommon, that
laudanum f inftead of relieving, will excite
vomiting, and occafion violent cramps
in that organ : nay, there have been per-
fons with wliom pills of opium always dis-
agreed when newly made ; but occafion-
ed no difturbance after being kept ibme
weeks.
That
* Ufefulnefs of Exp. Philof. part ii. p. 260.
o/' Nervous Disorders. 131
That many of thofe complaints,
v/hich have been commonly called ner-
vous, proceed, in a great meaflire, from
a particular y unnatui'al, or depraved fen-
fibility of the nerves of the alimenta-
ry canal, appears evidently from this,
that altho', in many cafes, the ftomach
and inteftines are much diieafed, yet
the patients are not affe^^led with any
remarkable nervous or hypochondriac
fymptoms, while others are greatly trou-
bled with thefe complaints who have a
good appetite, a quick digeftion, and no
tough phlegm, or other noxious humour
in their ftomach. Add to this, altho'
cliildren, on account of the great fenfibili-
ty of their nerves, are liable to convullive
diforders and other nervous complaints ;
yet they are rarely affe<R:ed with the hy-
pochondriac diieaie, becaufe the nerves
of their ftomach and inteftines have not
that unnatural or depraved feeling which
is common in this malady ; and which,
when it Ls, on certain occalions, much
I 2 increafed
132 Of the Causes
increafed by fome acrid matter in the
blood falling on them, becomes not only
the predilpofing caule, but conftitutes
the hypochondriac difeafe itfelf, and
gives rife to mofl of its fymptoms.
In aweakly and delicate, or an unna-
tural ftate of the llomach and bowels,
improper aliments, excefs in eating or
drinking, wind, fliarp humours, and
fbrong paflions, fuch as grief, anger and
the like, will occafion much more vio-
lent fymptoms, than in perfons whofe
alimentary canal is firm and found. — :
Thus, a draught of cold water, will in-
ftantly affed: fome very delicate wo-
men with a violent pain and cramp in
their ftomach ; and the fight of one vo-
miting, or of certain difagreeable ali-
ments, or medicines, will produce a nau-
fcay and even vomiting, in perfons whole
flomachs are eafily moved. Nay, in fome
cafes, fo very delicate is the ftate of
the flomach, that turning the body
haftily in bed, or raifing one's felf, will
iiii mediately
of Nervous Disorders. 133
immediately occafion a faintnefs, giddi-
nefs, a general weaknefs, and fometimes
an inclination to vomit. This lafl fym-
ptom has been remarked by S^jdenham^
in hylleric women ; and I have had fe-
veral patients in continued fevers, who,
together with an uncommon debility
and faintnefs, were, upon the frnalleft
motion in their bed, feized with a naii-
fea and retching to vomit.
Further, a delicate flate of the firfl
paflages, or an unnatural fenfibility of
then* nerves, not only difpofes people to
many complaints in thefe parts, but the
whole nervous iyftem is thereby render-
ed more moveable, and liable to be af-
fetl:ed by the flighteft caufes. — Thus, I
have known fome women of a delicate
frame, in whom, from an obftrudlion or
irregularity of the menftrua,t\\e nerves of
the ftomach had acquired fuch an uncom-
mon fenfibility, that, after eating free-
ly of any folid meat, they were not only
feized with a pain and ficknefs at the
ftomach,
134 Of the Cav SES
ftomach, and a fenfe of ftifFnefs and rigi-
dity in the trunk of the body, but fonie-
times aifo with faintings, attended with
a quick trembling pulfe, and fmall con-
vulfions of the mufcles of the legs and
arms. — A woman of a delicate conftitu-
tion, who v/as attacked with a quotidian
intermittent, feven weeks after cliild-
bearing;, as often as (he fwallowed fome
magnefia alba, felt immediately a kind of
quivering motion propagated through
her whole body. The fame perfon, as
often as (he took a draught of lime-wa-
ter, obfen^ed the palms of her hands,
which before were foft and moift, be-
come at once di*y and hard. It was re-
markable, that neither crabs eyes, nor
chalk, occaiioned any fuch uneafy feel-
ing as the magnefia did.
When my ftomach and bowels have
been out of order, and affected with an
uneafy fenfation from wind, I have not
only been fenfible of a general debility
and flatnels of Ipirits, but the unexpect-
ed
of Nervous Disorders. i^^
ed opening of a door, or any llich tri-
flins: unforefeen accident, would inftant-
ly occaflon an odd fenfation about my
heart, extending itleli' from thence to
my head and arms, and, in a lefTer de-
gree, to the inferior parts of my body.
At other times, when my ilomach is in
a firmer ftate, I have no fuch feelings,
or at leaft in a very fmall degree, from
caufes which might be thought more
apt to produce them.
From what has been faid, we may
fee, that faintings, tremors, palpitations
of the heart, convulfive motions, and
great fearfulnefs, may be often owing
more to the infirm ftate of the firft paf-
fages, than to any fault either in the
brain or heart. But it would be un-
neceflary to infift farther on this head,
as the powers which the alimentary ca-
nal, when its nerves are difagreeably af-
fected, muft have in producing difor-
ders in the moft diftant parts of the bo-
dy, cannot be doubted of by thofe who
attend
13^ Of the Causes
attend to that wonderful and widely ex-
tended fympathy which obtains between
it and almoft the whole fyftem *. What
has been faid may be fufficient to lliew,
how much a delicate or unnatm-al Hate
of the nerves of the alimentary canal
muft dilpofe people to nervous, hypo-
chondriac, and hyfleric complaints. But
further, wlien, through the fault of the
ftomach and inteftines, the digeftion is
imperfe(fi:ly carried on, the ill prepared
chyle may lay a fomidation in the blood
for exciting a variety of nervous fym-
ptoms, as will afterwards more fully ap-
pear.
Since the flronger or weaker effefts
of emetics and cathartics muft depend,
entirely, on the different conftitution
of the nerves of the prinid; vias, and the
quantity of mucus defending them, it is
eafy to fee that the dofes of thofe medi-
cines can neither be certainly determined
-by the ages nor iizes of the patients, nor
* See above chapter i. No. 1 1.
c)/' Nervous Disorders. 137
by the quantity of blood in their \e£-
lels.
It is owing alone to the different
fenlibility whicli the nerves of the ali-
mentary canal, in different perfons,
have of various Jlimiiliy that the feveral
vomiting and purging medicines have
flich different effects. — That the ftrongefl
emetics icarce move Ibme people, while,
in others, the mildefl are apt to have
too great an operation. — That a few
grains of rhubarb fhall purge and gripe
one patient feverely, and a drachm of
the fame medicine have no fenlible ef-
fect on another. — That a drachm and a
half of foluble Tartar fhall prove a
ftronger purgative to fbme, than four
ounces of facred tin^lure. — That child-
ren are often harder to purge than fome
adults'*. — That worms, tough phlegm
and
* It is here to be obferved that in children, frequently,
and alio fometimes In adults, vomiting and purging medicines
have much lefs effeft than might be expefted, confidering
the delicacy of their nerves, on account of the ftomach and
inteftines
rg8 Of the Causes
and other noxious humours, lodging in
the ftomach and bowels, produce very
diiFerent effects in different perfbns;
and that the bark, which generally
makes the body coftive, occafions gripes
and purging in fome. And is it not to
be afcribed chiefly, if not folelyy to the
different conftitution of the nerves in
different animals, that what is highly
noxious to fome, proves wholefome food
to others ? Thus the cicuta aquatica,
which is eat by goats without any
harmf, is a deadly poifon to men and
other animals.
Wherein confifl the various kinds
and degrees of fenfibility which the
nerves of the alimentary canal and other
organs polTefs, Ave no more know, than
we do their peculiar ftrufture, or how
they come to be endued with fenfation
at all: but that the particular fenfibili-
ty
intellines being lined either with a great deal of natural
mucus, or morbid flime.
t Sv^encke dijfertat. de c'lciit. aq^uat. Ge/neru
.of Nervous Disorders. 139
ty of the nerves of the gullet, flomach
and inteflines is often greatly changed
by difeafes, even when the nervous fy-
ftem in general is not much altered, we
know from experience *. Nor is there,
perhaps, to be found a ftronger inflance
of this than in the hydro^phohia confequent
on the bite of a mad dog ; where the
pureft water excites fuch convviliive mo-
tions of the gullet, flomach, diaphragm
and abdominal mufcles, that, after a
few attempts to fwallow it, the fight of
any fluid, and efpecially if it touches
the patient's lips, will inllantly affecl him
w4th horror, and throw him into violent
convulfions and vomiting. In fome
cafes
• Since it is probable that the nerves are partly nourifh-
ed by the fluids diftributed to that produftion of the pia
tnater which furrounds their medullar)' fuhltance ; it is eafy
to fee that the nerves of a particular organ may have their
fenfibility increafed, diminifhed or otherwife changed by
fluids that are improper, or of an acrid nature, being fent
to tkem ; when, in the mean time, the brain and nervous
fyltem, in general, may be found, and fufFer in no other
way, but by fympathy with that organ whofe nerves are
morbidly afFefted.
1^6 Of the Causes
cafes (altiio* thefe more rarely happen)
the nerves aHb of the intelHnes become
fo far depraved in their feeling, that li-
quors can no more be admitted by in-
jeftion into the great guts, than into
the ftomach by deglutition. Nay, it
fliould feem that, fometimes, not only
the nerves of the alimentary canal are
flrangely altered in this difeafe, but al-
fo thofe of the face, and perhaps of the
whole fiirface of the body, lince we are
told of hydrophobic patients, who could
not even bear a blaft of cool air *.
How tliis change is produced in the
nerves of the fii'fl palTages or other parts
in the Jy^drophohia, or in what it con-
lifts, is, perhaps, one of thofe difficulties
which phyficians may defpair of being
ever able to explain. One tiling, how-
ever, is certain, that, in men as well as
dogs, who have died of that difeaie, the
gullet and ftomach have been often
found
* Philof. Tranfadl. abridged, vol. v. p. 366, and Ad.
Acad. Moguntin. torn, i. J>, ^J^\.
of Nervous Disorders. 141
found free of any vifible inflammation ;
whence the difeafe muil hav€ had its feat
either in the nerves themfelves, or in vef-
lels frnaller than thofe which carry red
blood. But whatever may be the
change made by this diftemper on the
nerves of the ahmentary canal, or in
what manner foever the canine poifbii
produces this change, we know that if,
from any caufe, the nerves of the fauces,
gullet and ftomach fliould acquire a fen-
iibihty, fomething ilmilar to that Avhich
the nerves of the larynx and trachea are
naturally endued with, the moft violent
convulfive motions of thofe parts, and
retchings to vomit would enfue, upon
attempting to fwallow even the mildeft
liquors. In this, however, the fenfibir
lity of the fauces and gullet, in the bj-
drophohiay differs from that of the larynx
and trachea in a natural flate, that thefe
lafl: parts fuffer flill more from folidg
^han liquors of a rnild natiu'e ; whereas
142 Of the Cal'ses, 6^c,
the former are difagreeably afFed^ed by-
liquids alone.
But to return. — As a too great fen^
libility of the nervous lyftem in general,
or an unnatural delicacy of the llomach
and inteftines or other organs in parti-
cular, do not, commonly, of thenifelves
produce thofe various fymptoms which
go by the name of nervous, hypochon-
driac and hyfleric, I come next to in-
quu'e into thofe feveral occafional cau-
fes, which, meeting with the predhpo-
fing ones above mentioned, may bring
on this numerous train of difeafes.
CHAP.
[ 143 ]
CHAP. IV.
Of the occafional Caiifes of Nervous,
Hypochondriac, and Hyste-
ric Diforders,
'nr^HESE are either to be found in
the blood, or they have their leat
in fome particular organ of the body.
The former I fhall call general, the lat-
ter, particular occafional caufes.
The general occafional caufes may
be reduced to three, viz,
I. Some morbid matter bred in the
blood.
n. The diminution or retention of
fome accuilomed evacuation.
HI. The want of a fuflicient quan-
tity of blood, or of blood of a proper
denfityo
L The
144 Of the Causes
I. Something bred in the blood,
and not carried off by any of the excre-
tories, difagreeably affe^li ng the nerves,
as often as it comes into contact with
them ; or forming obilru(ftions in the
fmall vefTels, and producing different
fymptoms, according to the parts it at-
tacks.
That many of the fymptoms com-
monly called nervous, hjpocbondriacy or
byjleric, are frequently owing to ibme
noxious matter in the blood, affecting, at
different times, different parts of the bo-
dy, I have been fully convinced by ma-
ny cafes which have occurred in my
pracftice, but fliall only mention two,
AvJiich feem to prove this point fufEci-
ently.
I, A BOY, often years of age, of a
very feniible nervous f)."ftem, who, in
December IJ^J, had been feized with
a palpitation of his heart, fell from his
Horfe about the beginning of January.
From this time the palpitation left him ;
but.
of Nervous Disorders. 145
but, in a few clays after, he was attack-
e'd with a violent headach, returning
Ibmetiiues once a day, at other times on-
ly every 3d or 4th day. Dming the fit,
his pvilfe became fmaller and quicker,
and often intermitted ; his feet were
cold, but, by the violence of the pain,
a plentiful fweat broke out and relie-
ved him. As thefe headachs continued
to increafe, the patient loll his flomach
and fiefli, and looked pale. By the ufe,
chiefly, of an electuary of the bark and
valerian, in lefs than three weeks the
pain in the head abated greatly ; but his
appetite grew worfe, and he often com-
plained of a nanfea, Thefe fymptoms,
however, were all removed, in four or
five days, by fome warai ftomachic and
cordial medicines ; but were fucceeded
by an intolerable pain a-crofs the mid-
dle of his belly, which, in the fpace of
eight days, returned five or fix times,
and not only affed:ed his pulfe, as the
headach had done, but, fometimes, oc-
K cafioned
146 Of the Cavses
cafioncd a difficulty and pain in making-
water. This pain no fooner left liis bel-
ly, than the headach returned with
greater violence than ever, fo that the
boy would faint in Tome of the worft pa-
roxyfms. It had no certain periods,
coming fbmetimes twice a-day, fome-
times only once in two days, and was
attended with a fenie of fuffocation
from wind, and a lump in his throat.
He was eafieft in the night when he flept
or lay quiet, but any confiderable mo-
tion of his body alwavs raifed his head-
ach. Before the fits, he was obferved
to be uncommonly lively, and diipoied
to laugh. On the 21ft of February, at
two in the afternoon, he was feized with
fits of involuntary laughter, between
which he complained of a llrange fmeU,
and of pins pricking his nofe ; he talk-
ed incoherently, ftared in an odd man-
ner, and Ills complexion changed to a
livid colour ; immediately after, he was
feized with convullions, and then fell
into
of Nervous Disorders. 147
into a faintingfit, which laded near half
an hour. Wiien his pulfe, breathing,
and ienfes returned, he complained of
a great coldnefs and pain in the back
part of his head, and vomited his din-
ner, with fome tough phlegm. At this
time his appetite w^as good, and after-
wards it became greater than it ufed to
be in perfect health.
On the 9th o^ March, fome purulent
matter was difcharged from his right no-
flril, and much about the fame time, a
fmall quantity more came from the right
ear ; after w hich he had fcarce any vio-
lent fits of the headach, but a continued,
tho' lefs fevere, pain in die back-part of
the head ; which being greatly increa-
ied by motion, he lay conflantly a-bed,
and moflly on his back. Altho' he had
a confiderable thirft, and drank plenti-
fully ; yet, during the whole month of
March, he did not make above fix oun-
ces of water in tw^enty-four hom's, and
iweated none.
K 2 About
148 Of the Causes
About the beginning of ApriU the
complaints of his head were fo much a-
bated, that he covild bear fitting up in
a chair ; he began to make water more
plentifully, and, when any thing ruffled
him, voided great quantities of quite
limpid lu'ine. During the month of
Mrzy he continued to grow better; and,
before the end of Jiimy he had perfect-
ly recovered.
In February ly^f)^ he began to com-
plain of a conflant headach, which, tho'
worfe at times, yet was never fo violent
as the year before, nor alfedied his pulfe
or ftomach : But now, he frequently faw
objefts double. In the beginning of
March, fome purulent matter came from
one of his noflrils, and foon after the
headach abated, but he loft his appetite,
and was attacked with a pain in the left
ilde of his belly, between the fhort ribs
and OS iliiimy confined to a fpace little lar-
ger than the breadth of a fliilling. This
pain was often fo fevere, as to make him
readv
of Nervous Disorders. 14^
ready to faint : fometimes it fliifted, and
then he was feized with fatiguing fits of
involuntary laughter. His head was al-
ways eafy when the pain in his belly v/as
worft. In the funimer he recovered his
health as the year before ; and next win-
ter complained little or nothing of his
head, but, for fome months, had a wea k-
nefs and painful feeling in Ms left eye,
when expofed to the leaft light. As
there was no inflammation in this eye,
the pain feemed to be owing to too great
a fenfibility of the retina.
2. An unmarried Avoman, aged be-
tween 25 and 30, had an irregular ague
in Aiigufl and September 1757, of which
no lymptoms remained in OBoher^ except
a fweating every other day, if file lay
long in bed. This flie prevented by
getting up before breakfall ; but, in
eight or ten days after, file was feized
with a tightnefs in her breaft, which oc-
cafioned a cough, but without expedlo-
ration. This oppreilion at her breaft,
with
150 Of the Cavses
with the cough increaliiig, altho* the
pulfe was good, I thought it proper to
make her lole eight ounces of blood ;
but neither this evacuation, nor a bh-
fter afterwards apphed to her back, gave
any rehef. She ufed a mixture with the
acetum fcillitkum, was vomited, purged
with facred tinchirc, took camphire, ca-
ftor, afa fostida and laudanum, with very
little benefit : At laft, about the begin-
ning of November, a mufk julep taken
for a forDiight, aimoft quite freed her
of her diforder.
After having continued during the
winter in pretty good health, fhe began,
in April, to complain of pains in her
legs and knees, but moftly in her body,
Altho' her pulfe was not altered, yet
twelve ounces of blood were taken a-
way, which had a thin iizy fkin of a
blueifh colour. Some days after the
pain in her lides, ftomach, ftermm and
back increafed, fhe was much troubled
with wind in the firft palFages, and made
very
of Nervous Disorders. 151
very little water. The fenfe of fufFoca-
tion and dry cough, which (lie had in
October, returned, and Die was feized,
efpecially in the evenings, with liich
violent catchings or convulfive motions
of her legs, thighs, and almoil her
whole body, as not only to (hake the
bed, but the room in which flie lay. At
this time, flie was vomited, bliftered on
the back, and took draughts o^ fp. Mm-
derer. with Jal, vol. ammon, but without
any advantage. By the ufe, however,
of bolufes of camphire and mufk, with
fmall dofes o^ laudanum at bed-tune, ilie
got pretty free of the catchings ; and
tlie tightneis and dry cough were alfo
ieflened; but the pains in her fides, bow-
els and legs continued as bad as ever.
On the 7th of Ma^ flie complained of a
pain and fwelling in one of her arm-pits,
which daily increafed ; and her pulfe,
which had generally beat only between
60 and 70 times in a minute, now ex-
ceeded 100, • She lofl ten ounces of blood,
which
152 Of the Causes
which was very fizy; emollient fomen-
tations and fiippurating poultices were
applied to the arm-pit ; notwithftanding
which, the pain increafed to fuch a de-
gree, that (he was obliged to take every
night a large dofe of laudanum to procure
reft. From the time this fwellingand pain
began under her arm, the fenfe of fuffo-
cation, the cough, the other pains and
catchings abated, and left her intirely,
about the 20th of A/^y, after the tumor
had broke and difcharged fome bloody
matter. During both illnefles, flie con-
tinued perfecftly regular.
From thefe two cafes it appears, that
various fymptoms of the nervous kind,
mav be owins; to fome morbid matter in
the blood, occafioning different com-
plaints, according to the parts upon
wliich it falls, even when there is no rea-
fon to fufpeft any obflrud:ion in the vif-
cera of the abdomen^ or fault in the uterus.
In the firft cafe, it is not eafy to fay,
what gave rife to the difeafe \ but, in the
fecond.
I
of Nervo.us Disorders. 153
fecond, an agucifli diforder imprudent-
ly checked, leaving a taint in the blood,
produced a fenfe of fufrocation, the dry
cough, pains in various parts of the bo-
dy, and fpafmodic contradlions of the
mufcles ; which complaints were never
intireiy cured till fome noxious matter
I was difcharged by the flippuration of
a gland in the arm-pit. Nor can it
appear Itrange, that fo fmall an evacu-
ation Uiould purify the blood, and re-
lieve the patient, when, in the plague it-
felf, a proper fuppuration of one of the
glands of the neck, arm-pit, or groin,
will prove a perfed: crifis.
As a further proof, that complaints
of the nerv^ous or hyfleric kind often
proceed from Ibme morbid humour in
the blood, I have frequently feen them
relieved by an itching between the
toes, red puftles appearing on the bread
and belly, or fome other cutaneous e-
ruption.
That
1 54 Of the Causes
That taint or morbid matter in the
blood, which occafions many fymptoms
of the nervous kind, may proceed from
very different canfes; fuch as, improper
food, a fcorbutic * or fcrophulous ha-
bit, fevers Avhich have had imperfect
crffeSy or other difeafes not fully cured,
elpecially the cutaneous diibrders ;
when the morbid matter, inftead of be-
ing thrown off by the {k\n, is reallumed
into the blood, and depoflted on fome
of the internal parts. But by far the
mofl frequent taint in the blood affect-
ing the nerves, is an arthritic matter,
falling at different times on different
paits of the body.
Araeteus has long ago taken no-
tice, that, in fome, the gout wanders
through
* By fcorbutic is not iiere meant, that fault in the blocd
which produces the true fcurv y, to which people who live
3t fea and in marOiy places are fo fubjecl, but that humour
which has been common'v-, though improperly, called
'coibutic, and which, when it is carried to the (kin, in-
ilead of livid blotches, produces dry, fcurfy eruption?,
fcabsj tetters. trV. and, when in a high degree, the lepra
(ii-jTccruf/:,
of Nervous Disorders. 155
tlii'ongh the whole' body * ; the truth
of which obfervation has been confirm-
ed by later writers t> and Avould have
been more carefully attended to by
phyficians, if thofe fymptoms which a-
rofe only from an imperfe(^ gout, had
not been, for the moft part, either llur-
red over, under the ipecious name of
nervous, without any particular inquiry
into then* real caufe, or confidered
merely
* De eaujis et fignh morhorum^ lib. xi. cap. xii.
■\ " Enimvero ufu medico vel parum exercitatos, hoc
" latere nequit ; archritide (praecipue frigida, inerti, lan-
*' guida ; maxima vero omnium ea fupprefTa, retufaque)
'• aegrotantes, interdum humeri, peftoris, dcrfi, lumbo-
•' rum, aliarumque in ambitu corporis partium dolore
*' vago tanquam rheumatico ; faepe etiam capitis afFedli-
*' bus, more prorfus hyfcerico; alias, aliis in corpora malis,
** quafi fcorbuticis urgeri ; fepiffime vero valetudine du-
•' bia, et in tempus diuturnum incerta, et neutra efle.
" Qui quidem eorum flatus ac conditiones, fenfu remiffiori
*' et leniori gradu morbofas natales fuos arthritico miaf-
'' mati, coeco, in corpus fubrepenti, et eo loci clam agenti,
" fe debere, ultro videntur agnofcere : quinetiam ali-
*' quando, multos poft annos, dubium hunc in modum
*' actos ; tandem apparente paroxyfmo arthritidis ideoneo,
•• de iftoriun origine et natura malorum arthritica, omnis
*' fublata dubitatio eft." Mufgra'vc de arthrittde anomalqy
fap. xix. p. 316,
I §6 Of the Causes
merely as the efFecls of the hypochon-
driac or hyfleric diieafe, or of the fcur-
vy ; elpecially in fuch as, having never
had a regular fit of the gout, were not
fiiipe^led of any arthritic humour.
Were it neceflary, many cafes might
be produced to (hew, that nervous, hy-
pochondriac, and hyfleric complaints
are often owing to an imperfed: gout
wandering through the body; but I
ihall only mention the two following.
I. A GENTLEMAN aged §8, tempe-
rate, and fubjecl to no diftemper, except
a rheum.atifm, of which, for fome years,
he had frequent returns in his loins,
in Augufl 1 752, after a fevere fit of this
kind had fuddenly left him, was feized
with a great depreffion of fpirits, often
attended with a ficknefs at flomach,
and a particular fenfation about the
epigaftric region, which he could not
well defcribe. In leis than two months,
by proper medicines and exercife, he
i^ot free of thoie complaints ; but had
not
of Nervous Disorders. 157
not long enjoyed good health, when he
began to feel, frequently, a flight palpi-
tation of his heart, which was attended
with an intermiffion of his pulfe. This
was fucceeded by the lumbago^ during
w^hicli he found his appetite and fpirits
better than at other times, and indeed
as good as in his beft health. After-
wards, he had frequent returns of the
diforder about his flomach, with low
fpirits, and a naiifea^ efpecially in the
morning ; and complained fometimes of
a difficulty of breathing, but without
any cough or fpitting. This perfon,
who never had had the gout, nor fu-
Ipedled it, being told, that all his com-
plaints were owing to an arthritic mat-
ter wandering through his body, feem-
ed furprifed at firft, but was foon af-
ter convinced, by a flight pain and in-
flammation, M^iich feized one of his
great toes ; and, during the few days it
lafled, relieved him of his lownefs of fpi-
rits, and complaints of his fliomach. He
was
15^ Of the Causes
was for ieveral years, both before and
after tliis fit of tlie gout, afFefted, at
times, with a fmall running from the
urethra, and a pain in the left groin,
wliich fonietimes attacked the teflicle of
that fide. Thefe fyniptoms I confider-
ed, as well as the others, to be purely
arthritic, fince he had never in his life
had any venereal infection.
Tea, coffee, and all flatulent ali-
ments, hurt this patient. Flefli-meats,
old cheefe, vvinc, porter, and bitters
with the bark, fteel, and exercifc, efpe-
cially riding, did him mod fervice.
2. A GENTLEMAN aged 40, generally
healthy, who, from June 1752, had been
troubled with pains in his heels, and
fometimes in the middle of his left foot,
in the endof Mr?y 1755, about i^GWQn in
the morning, awaked Vvdth an unuflial
fenfation in his breafl, and a faintnefs,
but without any ficknefs at his ftomach,
or fwimming in his head : his puUe wa^
flirprifingly irregular and intermitting.
Twelve
of Nervous Disorders. 159
Tv/elve ounces of blood were taken
from him of a natural appearance, he
Iwallovved fome warm wine and water,
fp. corn. ccrv. tind. caflor and a folu-
tion of afa footida, but without any re-
markable effe<^.
Upon getting up, and walking thro'
the room, he found himfelf quite free
of a pain, which, for fome months, he
had felt in the middle of his left foot.
About ten, he began to make pale urine,
and, in five hours, voided five Engliili
pints of it, altho' what he had drunk,
during this time, did not amount to half
that quantity. About noon, partly to
abate this immoderate difcharge, and
partly to lefTen the too great irritability
of the heart by bracing the vifcera of
the lower belly, he girded himfelf very
tight with a broad belt, and, in three or
four minutes after, the languor, and
that unufual lenfation within his breafl
ceafed at once, and his pulle became
regular and natural. Next day he began
to
t6o Of the Causes
to be troubled with wind in his ftomach
and bov/els, v/hich did not occaiion any
(liai-p pain, but a diiagreeable fenfation
and great lov/nefs of fpirits.
After thefe fymptoms had continu-
ed by fits for four or live d^tys, he rode
out fome miles for exercife, and retui'n-
ed home, entirely free from his com-
plaints ; only, by being expofed to a cold
eaft wind, he got a fwelling, and a fmall
degree of inflammation in one of his
tonfils. Having fupped as ufual, he
went to bed, and, after a fliort fleep,
waked quite free of the inflammation in
the throat, but with a great faintneis,
attended with a very quick and fmall
pulfe. A glafs or two of claret, and a
bit of bread, removed this faintneis for
the time ; and, upon its retiu'n, it was
cured by the fame remedy. For fome
weeks after, he was much troubled with
flatulencies in his flomach and bowels,
with low fi)irits fonietimes, though in a
much lefs degree than before, and did
not
of Nervous Disorders. i6i
not entii^ely recover his health and
itrength in leveral months. The pain
in his heels, which he had felt little du-
ring moft of this time, returned and
continued pretty conftant till the end of
Augufl 1 757, when he had a flight fit of
the gout, with a fwelling and inflamma-
tion in his right heel. Since that pe-
riod, as well as before it, he has been
often troubled with a giddinefs, and fly-
ing pains in his head, arms, and hands,
frequent pains in his heels, and wind in
the prim£ vi^e.
These cafes need no comment. The
fymptoms with which the patients wxre
affecled, mufl have proceeded from an
irregular gout, the matter of which,
inftead of going to the extremities, wan-
dered through the body. The flomach
complaints could not be owing to any
tough phlegm, or other crudities ; for
the laft perfon had never, in his life,
thrown up, by a vomit, any thing of
this kind ; and the other, who took fe-
L veral
1 62 Of the Causes
veral vomits during his illnefs, never
appeared to have much of a foul fto-
mach ; nay, though he was often oppref-
fed ^vith a heavy licknefs and a naiifca
in the night and morning; yet he grew
eafy before dinner, and then eat with
as good an appetite and digeftion, as in
his befl health.
From what has been laid, it may ap-
pear, that fome morbid matter in the
blood, either arthritic or of another kind,
may be often the cauie of nervous com-
plaints. When this matter is carried
fmoothly along with the blood, without
forming obftruftions in any of the vef-
fels, or irritating the nerves, it gives little
trouble. When it remains fixed in the
extremities, or the mufcular parts of the
trunk of the body, it will only occafion
acliing pains of the goutifh or rheuma-
tic kind: but when it is depofited on
fiich of the vifcera as are very fenfible,
or by fympathy are apt, ftrongly, to af-
fect almofl the whole body, it may pro-
duce
of Nervous Disorders. 163
duce the moft of thofe iymptoms which
have been commonly called nervous,
hypochondriac, or hyfteric *. This mat-
ter may, in general, act either by its viP
cidity in obilrud;ing the fmaller veflels,
and thereby ftretching too much their
feniible fibres and nervous filaments, or
by its acrimony in difagreeably afFed:-
ing the extremities of thoie nerves which
it touches t*
It is to be obferved, however, that
the kind and violence of the fymptoms
occafioned by this morbific matter ^ will
not only be different according to the
parts which it affecfts, but in proportion
L 2 to
* See above, p. 97, i^c6
f It is probable, that the morbid matter in the blood,
producing nervous complaints, generally proves hurtful by
its acrimony, and but rarely by its vifcidity : at leaft we
know, that in the fmall pox, meafles, and continued fe-
vers, an acrimony in the blood, by ilimulating the brain
and nerves, frequently produces a. delirium, tr^morSy twitch-
ings, convulfions, and other nervous fymptoms ; and the
.horror febrilis, or fhuddering upon the attack of a fever, is
rather owing to a fpafmodic contraftion of the fmall veflels,
than an obftrudlion of them from vifcid blood.
164 Of the Causes
to the greater or lefler natural delicacy
or fenfibility of the patient's nerves.
Hence it feems to be, that men of
otherways hale and ftrong conftitutions,
and fome robufl women, are liable to a
regular gout, and but little to nervous
complaints. Their firmer fibres and lefs
delicate nerves do not predifpofe them
to the latter, and the fh-ength of their
digeilive organs, and vafcular fyftem,
enables them to tlnrow off the arthritic
matter on the extremities, by which
means the body is cleared of it.
Men of a middle conftitution, be-
tween the delicate and ftrong, are, from
tliis morbid matter, affefted with pains
of the cold rheumatic kind, and various
nervous lymptoms in a lefler degree;
and fome times alfo Avith a fit of the true
gout. But in them, this diftemper is
not commonly fo compleately formed,
as to clear the habit of the artliritic mat-
ter, at leaft for any confiderable time ;
for foon after the imperfect fit of the
gout.
q/' Nervous Disorders. 165
gout, their old complaints begin to re-
turn.
On the other hand, women of a more
delicate habit, and men of weak fibres
and very fenfible nerves, have more
rarely any diforder like the true gout;
either, becaufe in fuch conflitutions the
arthritic matter is imperfectly formed ;
or, what is more probable, becaufe the
vital organs are unable to throw it off
upon the joints and extremities. Hence
this morbid caufe in the blood, inftead
of being depofited on the apoueiirofh,
tendons, ligaments, and membranes of
the feet, hands, or other joints, falls
upon different parts of the body, and
produces fymptoms almofl as differ-
ent as are the parts which it attacks.
Such, for inftance, are the flying pains,
fpafmodic contractions, and fudden fen-
fations of heat and cold in the mufcles
and exterior parts of the body. — A want
of appetite, or too great craving and
faintnefs, a naiijca or vomiting, flatulent
fwellings.
1 66 Of the Cav sEs
Avelllngs, horborygmi, watching, low ipi-
rits, cramps, convulfions, and violent
pains in the flomach and bowels. — An
increaied fecretion offallva, from an ir-
ritation of the veffels of the falivary
glands. — The globus hyjieriais in the gul-
let. — A Ipafmodic ajihma in the lungs. —
Palpitations and irregular motions in
the heart. — An excelfive flow of pale u-
rinc, or fbmetimes nephritic pains in the
kidneys. — A hemicrania, the claims hyjle-
7-icuSy or lliooting pains in the head. —
Belides thefe, I have feen many other
fymptoms, occalioned by an imperfect
or an u'regular gout, fuch as a delirmn
and mania, an inflammation in one of
the tonlils, a troublefome djfuria ; a vio-
lent itching between the toes ; a fevere
pain about the c anil ago enfiformis, return-
in'^twice or thrice a-day, elpecially upon
any ftrong affedion of the mind or ef-
fort of the body, and fometimes attend-
ed with a painful fenlation in the middle
of each arm ; a fenfe of a burning heat
over
of Nervous Disorders. 167
over the whole lurface of the body, ex-
cept the legs, while, in the mean time,
the £kin was icarce fenllbly hotter than
in a flate of health, and the pulfe was
under 80 in a minute. In one patient,
I met with a flight, but frequently re-
turning gonorrhcea, from a gouty humour
falling on the nerves or velTels of the tt-
rethra; and, in another, an uneafy itch-
ing of the fcrotiim, I have feen three cafes
of a fliarp pain in the tefticles from the
fame caufe. In one of thefe there was a
confiderable fwelling along with the
pain, both which went off upon the gout
coming into both the feet.
All tliis is confirmed by obferving,
that perfons who have been but little
troubled before with thofe fymptoms,
commonly called nervous, upon the rheu-
matic or rather gouty pains leaving
their feet, hands, or loins, have been
feized with an irregular intermitting
pulfe, giddinefs, faintnefs, difficulty in
breathing, naufca and vomiting, iiatu-
Jence in the flomach and bowels, de-
prefllon
r68 Of the Causes
preflion of fpirits, and other fymptoms
of the like kind *.
Such complaints, if the patient has
never had the gout, are generally called
nervous; but, if he has been lubject to it,
are readily enough afcribed to the ar-
thritic matter leaving the extremities,
and fixing upon the head, or vifcera of
the thorax or belly.
This difference, however, may be
obferved, that the fymptoms arifing
from the retroceffion of the true gout,
are
* As the arthritic matter affeif^ing the nerves of the fto-
mach, net cnly occafions the fymptoms now mentioned,
but fo:netimes extraordinary languors, an univcrfal debi-
lity, anxiety, and faintings ; it is noways improbable, that
the fudden death of fevera!, fubjed to a wandering gout,
may have been fometimcs owing to its afTcding the nerves
of the Itomach at once, and in fo ftrong a manner, as not
only to occafion fainting, but a total fufpenfion of the mo-
tion of the heart : and this will appear ftill more probable
by obferving, that fuch perfons have often, immediate'y
before their death, complained of a fliarp pain or ficknefs
or other unufual fenfation in their ftomach. In fuch cafes,
the caufe of the death will be, in vain, fought for in the
heart, lungs, brain, or, Indeed, in any other part of the
body ; for the arthritic matter affedling the ftomach is too
fubtile to be feen, altho' aftive enough to dcftfoy.
of Nervous Disorders. 16?^
are generally more violent, than thofe
which are occafioned by a rheumatic or
imperfed: arthritic humour wandering
through the body.
Upon the whole, it may appear that
one very frequent occafional caufe of
many nervous, hypochondriac and hy-
ileric fymptoms, is fome acrid matter in
the blood, commonly no other than the
arthritic humour, the caufe likewiie of
the chronic rheumatifm and true sfout *.
It
* It may be objefled, that nervous and hyfteric com-
plaints cannot be owing to any noxious matter in the blood
or finer fluids, fince violent pains and other fymptoms of
this kind, are obferved to fhift fo fuddenly from one place
to another, that we can fcarcely conceive this to be owlno-
to the tranflation of any morbid matter. But altho' here,
as well as on many other occafions, we are obliged to own
our ignorance, yet we have no more reafon to deny that
nervous, fpafmodic or hyfteric difoiders are owing to fome
acrid humcur irritating the nerves of the parts afFefted, or
of fome other parts, with which they have a remarkable
fympathy, than that the gout or rheumatifm proceed from
fuch a caufe, becaufe they often move fuddenly from one
place to another, efpecially upon the imprudent application
of topical remedies. When the gout leaves the head or
Itomach, and immediately feizes the feet ; is the arthri-
tic matter, which afFefted the veffels of the former parts,
inft^tly
1 70 Of the Causes
It may be proper to oblerve, that,
altho* a gouty humour in the blood
may be much oftener the caufe of
nervous fymptoms in men than in wo-
men; yet, in the latter, many com-
plaints of this kind do certainly flow
from that fource. Of this I could re-
late many inflances which have occiu'-
red in my practice; but, that I may not
be tedious, I lliall only mention one.
A Lady aged 60, of a delicate conftitu-
tion,
inftantly carried to the latter? Or, is It not more reafonable
to fuppofe, that the gouty matter, which abounds in the
blood or finer fluids, as foon as it falls particularly on the
feet, by exciting a great pain there, leflens or deflroys the
diforder in the ftomach or head ; and, perhaps, by remo-
ving fome fpafmodic contradtion in their very fmall veffels,
allows the gouty matter, that was fixed in them, to pafs
through, and mix itfelf with the general mafs of fluids ?
It is, further, to be obferved, that many fymptoms of the
nervous or hyfteric kind feem to be owing not to any acrid
matter immediately irritating tlie parts which fufFer, but
cnly afFeding the ftcmach and intellines ; whence, by means
of their remarkable fympathy with moft other parts of the
body, a variety of fymptoms are occafioned, which either
increafe or abate, or Ihift from place to place, according
as the nerves of the firll paflages are varioufly affi^fted.
o/ Nervous Disorders. 171
tion, and who had been often liable to
complaints in her llomach, upon her
becoming free from flight rheumatic
pains, which fhe ufed to feel in her
arms, began to beaffetled with an a-
verlion to food, a heavy ficknefs, and
fometimes a vomiting ; an acute, or burn-
ing pain in her flomach, fometimes fliift-
ing from it to her bowels ; flatulence,
belching, palpitations, and, on fbme oc-
cafions, a fenfe of faintnefs at the fto-
inach, or a difficulty of breathing : Af-
ter being affected with thefe various
lymptoms, which fucceeded one ano-
ther, without any regularity, for three or
four weeks, or longer, they generally
abated, and fometimes went quite off,
upon fiiarp pains coming into the thighs,
legs, and feet, which lafl not only felt
hot, but were often fwelled. I fhall
only add, that, as in thofe women, who
were quite regular as to the monthly e-
vacuation, or long paft that time of life
when it naturally ceafes, I have found
hyfteric
lyz Of the Ck\]ST.s
byilerlc complaints to be owing very of^
ten to a rheuinatic or gouty hunioiir af-
fefting them differently at diiterent
times ; fb the mofl attentive obfervation
has convinced me, that, by far, the mofl
Irequent caufe of the hypochondriac dil-
eaie in men is no other, than a humour
of the fame kind affecting chiefly the
nerves of the ftomach and bowels, which
from an original weaknefs had been
more expofed to its attacks, than the
other parts of the body. This humour,
in thofe of a melancholic temperament,
befides other fymptoms, generally occa-
fions watching, timidity, a great deprel-
fion of fpirits, and Ibmetimes very un-
eafy diftra6ting thoughts. In others, of a
different conllitution, the fame caufe
produces a variety of complaints in the
flomach and bowels, and other parts of
the body, with much lefs watching, and
v/ithout any great degree of low i^^irits.
The arthritic matter may be bred,
cither in confequence of fome hereditary
defed
(^/Nervous Disorders. 173
defed in the conftitutlon, or from high
living ; whereby the ftomach and bow-
els are £0 weakned, or loaded with rich,
heavy, or hot aliments, as to convey
very improper chyle into the blood.
Physicians have widely differed a-
bont the natnre of that humour which
is the caufe of the gout, fome making it
tartareous or acid / others urinous or
alkaline. But, fenlible how vain all fuch
difquilitions are, I fhall not attempt to
define the nature of that noxious mat-
ter in the blood, fo often the caufe of
nervous, hypochondriac, and hyfteric
diforders, further than as I have alrea-
dy endeavoured to fliew, that it is mofl
commonly of the arthritic kind : And I
fhall now add, that it may be fometimes
a fcorbutic or fcrophulous taint, or fome
other fault, in confequence of other
difeafes imperfectly cured. Indeed,
there is no reafon to believe, that, what-
ever is hurtful to the human body, mufl
be either acid or alkaline, or of fome
other
174 V ^^'^ Causes
other known fpecies of acrimony. What
is the acrimony of ipecacuanha, antimo-
nial wine, oi fcmen hpfcyamiy opium, rhus,
mytifolia Monfpeliaca, and of the roots of
the cictita aqtiatica ? Moil of thefe fub-
ilances fhew no remarkable fliarpnefs or
pungency to the tafle ; and yet, when
received into the ftomach, they quickly
occafion either ficknefs and vomiting,
raving, or infenfibility, epileptic fits, or
even death. What peculiar acrimony
have the effluvia of mufli, ambergreafe,
or a pale rofe, which tlirow fome delicate
women into hylleric fits ? In like man-
ner, with regard to that morbid matter
in the blood, the caufe of fo many ner-
vous complaints, and even of the gout ;
all we know is, that it is apt to ftick in
the iiualler vefTels ; that it difagreeably
affeclis the nerves as often as it falls upon
them, and thereby occafions various
lymptoms, more or lefs violent, accord-
ing to the fenfibility of the parts affect-
ed, and the confiitution of the patient :
But
of Nervous Disorders. 175
But in what manner, or by means of
what particular kind of acrimony, it pro-
duces thele efl^e^s, we are yet entire-
ly ignorant, and, indeed, likely to con-
tinue fo.
11. A SECOND occalional caufe exci-
ting nervous diforders, may be the re-
tention of fome accuftomed evacuation,
fuch as the mmfes or haemorrhoids.
The naufeay vomiting, depraved ap-
petite, faintings, and other complaints
to which many women are liable for
fome months after conception, fliew that
a change of the circulation in the
womb, an obflruclion and diflenfion of
its veflels, or whatever irritates the ute-
rine nerves, may produce many of thole
fymptoms commonly called nervous or
hyfleric. The fame remark may be
made upon the various diforders whick
happen upon the fupprellion, diminu-
tion or u'regularity of the menfes, and
at that time of life when this evacuation
ceafes. 'Tis true thefe complaints are
much
IjG Of the Cavses
much lefs remarkable in fome than in
others : Thus, while many are only af-
fec^hed with a naiifeay want of appetite,
flatulence in the flomach and bowels, a
cough, difficulty in breathing, headach,
or flying pains through the body ; there
are others, Avho, belides feveral of thefe
fymptoms in a higher degree, are alio
fubjedl to uncommon haemorrhages,
faintings, and violent hyfleric convul-
fions, on account of a greater delicacy
and mobility of their nervous lyftem.
An obftruclion or fuppreflion of the
menfes may produce nervous or hyfleric
diforders, either from the lympathy of
the womb with the other parts, from a
redundancy of blood, or from the re-
tention of fomething hurtful to the
nerves.
r That many parts of the body may
be affefted through the confent of then*
nerves with thofe of the womb, will
not appear improbable, after what has
been faid of the remarkable fympathy
that
■of Nervous Disorders. 177
that takes place between the various
parts of the body*. But it may be
proper to obferve, that when the men-
fes are obflrui^ed, the ftomach gene-
rally fufters firft, and, by means of its
confint with almoft every part of the bo-
dy, gives rife to many of the complaints
which follow. Thus the hy fieri c con-
vullions and other violent fymptoms,
which are fometimes occafioned by a Rid-
den ftoppage of the menfes, do not feem to
proceed immediately from the uterus^ but
commonly from the ftomach and bowels,
whofe nerves are firft affe^led either by
their fympathy with thofe of the womb,
or by the blood which fliould have been
difcharged by this organ, being partly
turned upon the alimentary canal. For,
2. Alt ho' it is probable that the
menftrual evacuations is not owing to a
general plethora, or increafe of the mafs
of blood at the end of every month, but
to the particular ftru<n:ure of the womb,
M yet
* See above chapter i. No. j i, {o).
178 Of the Cavses
yet as the body, after being long ac-
cuflomed to any regular evacuation,
feldom fails to fufFer from a ftoppage
of it, fo it is not to be doubted, that in
women, and efpecially in the more fan-
guine, fome degree of a plethora may be
often the confequence of a flipprellion
of the menfes. Agreeably to this, we
obferve, that bleeding is often the beft
remedy for the complaints incident to
women at that time of life when their
couries leave them.
3. If we confider that, by means of
the other excretory organs, fome hu-
mour is thrown off, which, if retained,
would prove noxious to the body, it
will not appear altogether improbable
that the menftrual evacuation, when
fupprefled, may become hurtful by its
quaUty as well as quantity: And this
feems to be confirmed, by thofe un-
common haemorrhages from the eyes,
ears, ends of the fingers and other
parts, upon the total fuppreffion of the
menfes ;
of Nervous Disorders. 17^
menfes; for fuch haemorrhages cannot be
owing to a general plethora occafioning
too great a diftenfion of the whole val-
cular fyftem : Were this the cafe, the vef-
fels of the lungs, and other internal
parts muft burfl before any blood could
pafs by the pores of the fkin. When
one runs fail, or walks up a fleep hill,
the force of the blood is much more in-
creafed than it can be from any plethora,
that may be fuppofed to happen to wo-
men who are obflrucfced ; and yet we
never find that violent exercife makes
the blood iflue from the points of the
fingers or the pores o^xht meatus audito-
riiis, altho' it fbmetimes occafions an
haemorrhage from the lungs. Further,
if a general plethora were the caufe of
thofe uncommon haemorrhages which
happen in confequence of a fuppreflion
of the menfesy bleeding would always
prevent them, which, however, it fel-
dom does. An inftance of this I had
many years fince in a patient, who,, tho'
M 2 file
f
-f
180 Of the Causes
fhe had loft by the lancet about forty
ounces of blood, in the {pace of a
month, yet continued to have a Imall
haemorrhage from the left ear, once
in twelve or fourteen days. Another
cafe, no lefs remarkable, was that of a
woman aged 34, who, near fix weeks
after bearing her fecond child, to which
fhe gave flick, was feized with a pain
in the middle of her fore-arm ftriking
down to the middle finger of the left
hand. Next day, flie felt a pain in the
point of that finger, where there had
been for two or three days a red fpot,
from which there ifllied about four
ounces of blood. At the diftance of
24 hours, fhe loft near an ounce of blood
in the fame manner ; and notwith-
ftanding flie was blooded once and
again, yet for fome days, almoft at the
fame hour, this haemorrhage returned,
but always in fmaller quantity. In this
woman, the lochia had ftopt foon after
delivery.
If
of Nervous Disorders. i8i
If thefe periodical evacuations of
blood cannot, then, be accounted for
from a general ■plethora, is it not prob-
able that when the mmjh are ftopt, fome-
thing hurtful may be retained, which
falling on certain parts, in people whole
nervous fyftem is eafily afterted, may
throw the fmall vefTels of thofe parts into
Hich violent alternate contra(5lions, as to
force the red blood, inftead of the tliin-
ner fluids, through their dilated ori-
fices ? When, in this manner, the of-
fending matter is moftly evacuated, the
extraordinary motions of the fmall vef-
fels, and confequently the flux of blood
from them, will ceaie *.
In like manner, thofe various other
(complaints, confequent on the obflruc-
tion of the menfes, may be often owing to
the quality of what is retained, which
loon
* See above chap. I. No. 17. Alfo Phyfiologlcal EfTays,
edit. ii. p. 35, ^c. where I have endeavoured to fhew, by
a variety of fafts, that the fmall veflels, when afFefted with
any unufual y?/«»/«r, are agitated with uncommon con-
tradlion*.
i82 Of the Cavses
fooii becoming acrid, difagreeably affe^ls
the nerves of thofe pai'ts upon which
it falls.
What has been faid of obftriifted
menfcs as the caufe of nerv^ous diforders,
may be, in a great meafure, applied to
the flippredion of the haemorrhoids, in
Inch as have been accuftomed to them :
And it may not be amifs, when treating
of the fupprelllon of the jncnfes and hae-
morrhoids, to add the difcharges of iA
lues, fetons, or other old fores fliddenly
dried up, as producing fimilar effects.
Further, fince cold feet, or cold and
moiflure in general, by flopping the per-
fpiration, is obferved to increafe nervous
diforders, is it not probable that fome
acrid matter may be then retained,
which, by falling on the ftomach and
other internal parts, fometimes gives
rife to nervous, as well as other morbid
fymptoms? Hence we find, that, during
the dry warm weather in our climate,
and the dry and temperate weather of
hotter
of Nervous Disorders. 183
hotter countries, the nervous, hyfteric
and hypochondriac complaints are lels
frequent than lat other times.
III. A TH I RD general occalional caufe
of nervous diibrders may be, the want
of a fufficient quantity of blood, or of
blood of a proper denlity : And hence
it is, that an immoderate flux of the
menfesy lochia and haemorrhoids, or any
other great haemorrhage, will often oc-
cafion violent fymptoms of this kind.
Hippocrates has obferved, that convul-
fions may arife from inanitiouy as well as
repletion : And as the flrength and firm-
nefs of the whole body depend upon
proper fluids, and a due quantity of
them, may not very irregular and flrange
diforders happen from a want of blood,
or from a too watery ftate of it, efpe-
cially in thofe whofe nervous fyftem is
very delicate and eafily aifefted ? For
when there does not remain in the vef-
fels a quantity of blood fufficient for car-
rying on the feveral functions in a pro-
per
1 84 Of the Causes
per manner, the regular circulation of
all the fluids mufl be diflurbed, and the
diflribution or exertion of the nervous
7noving power will become irregular.
But, in whatever way great lofs of
blood may give rife to nervous difeafes,
we are fo certain of the fa(fl:, from ex-
perience, that perhaps the following ca-
fes, in proof of it, may be thought fii-
perfluous.
I . A Y o u N G'gentleman of feventeen,
complaining of a pain in his right fide
after a fall from his horfe, was blooded
-\' very largely. Some days after, he felt
a coldnefs in his ftomach, which was
foon fucceded by fits of violent pain and
fpafms in that part, fometimes lafting
twenty minutes, or half an hour at a
time. Thefe fymptoms returned after
no regular intervals, but generally twice
or oftener in 24 hours ; and gradually
increafed to fuch a height, that the pa-
tient was obliged to be held down in
his bed by two or three people, in or-
der
I
of Nervous Disorders. 185
der to prevent his tearing his hair, and
doing himfelf other mifcliief. The pain
and cramps were ahvays preceded with
afenfation of coldnefs intheflomach, and
frequently went off in an inftant. Gin-
ger with hot brandy felt cold in the fto-
mach at the acceflion of the fit. After the
patient had fuffered in this manner for
three weeks, the diforder gradually a-
bated ; and, by uUng a few ftomachic
medicines, a proper diet and exercife,
he perfectly recovered.
On another occafion, after lofins: a
good deal of blood, he was attacked
with the fame fymptoms, but in a much
lefs violent degree.
2. A GENTLEMAN between 40 and
50, for thefe thirteen years paft, has fel- -k
dom been much blooded, or fweated,
and lived low for a few days in order
to get rid of a cold, rheumatifm, or o-
ther cafual diforder, without making a
great quantity of pale water, efpecially
in the night, which has, fometimes, con-
tinued
I S6 Of the .Cavses
tinued for two or three weeks, and has
not been flopt without ufing large quan-
tities of the bark, riding, and other re-
medies.
3. A Gentlewoman, in whom the
menfes flow too plentifully, is frequent-
4- ly troubled with a gnawmg pain and
fbmetimes a flatulent diilenfion of her
ftomach when flie is not with child; but
during the time of pregnancy, flie is
generally free of any fuch complaints.
4. In the Philofopliical Tranfaclions
No. 174 we have a remarkable cafe by
Dr Cole, of a Lady fubjed: to hyflerics,
who after being much reduced by an
-f uncommon lofs of blood in cliild-bear-
ing, was for a long time affefted with
violent periodic convulfions, accompani-
ed with a great flux of limpid urine, re-
turning every fourth or fifth day at a
certain hour.
Under this head of general occafio-
nal caufes, may alfo be comprehended
watching, great fatigue and exceflive ve-
nery.
of Nervous Disorders. 187
nery; all of which not only tend to
break the conflitution, and difpofe the
body to nervous difeafes, but alio to
create them, elpecially in fuch as are
already prediipofed to them.
Having thus far treated of the gene-
ral occafional caufes, we fliall proceed
next to mention the chief of thofe oc-
cafional caufes which we call particuldr,
from their having their feat in certain
parts of the body.
CHAP,
1^8 Of the Causes
CHAP. V.
Of the particular occafional Caifes of ^ZK-^
vous, Hypochondriac, andYLY"
§ T E R I c Diforders,
'"F^HESE may be reduced to the fix,
-■- following, viz,
I. Wind :>. . n
/in the Itomach
n. Atouffh phleo;m> , ,
^ & ^ ^ r and bowels.
HI. Worms J
IV. Aliments improper in then- quan-
tity or quality.
V. Scirrhous or other obftru6lions in
the vifcera of the lower belly.
VI. Violent affections of the mind.
I. Wind
of Nervous Disorders. 189
I. Wind in the flomach and intel^
tines, though of itfelf a very common
fymptom in nervous diforders, yet de-
ferves a place among their occafional
caufes, as giving rife to many unealy
fenfations. Altho' all our food abovmds
more or lefs with air, yet, in the time of
digeftion, it is feldom feparated in iiich
a quantity, as to give any trouble, un-
lefs when the flomach and bowels are
weak, or when their nerves are endued
with an uncommon fenfibility : But in
fuch circumilances, the complaints it
occafions, are various, fuch as want of
appetite, naiij'ca, faintnefs, low-fpirits,
watching, fwelling of the flomach and
bowels, violent pains in them, tight-
nefs, and oppreflion about the p-gcordia^
difficult breatliing, a fenfation of a
weight in the flomach, belching, the^/<7-
his hyfiericuSy giddinefs, fliooting pains in
the head, (^c. Nay, I have frequently
felt, in myfelf, a plain connexion be-
tween wind in the prima vU and pains
in
190 Of the Causes
• in my legs and feet ; and the uneafy
fenfation, fometimes, as it were, coming
and going between thefe parts.
The manner in which wind pro-
duces fo many and fiich various com-
plaints, may be underflood from its
diflending the ftomach and inteftines,
and thereby occafioning Ipafms in thofe
parts, or otherwife difagreeably afFe<5t-
ing their nerves, which have fo great a
fympathy with the other parts of the
body*.
However,
* See above, chap. i. No. 11.
Some have imagined, that the flatulence produced in
the ftomach and bowels, pafTes freely by means of the ab-
forbent veins into the blood, with which it circulates thro'
the body, and produces a variety of fymptoms, fuch as
Ihooting pains in the head, the cla^'us hyfiericus, or flying
pains in the arms, legs, and other parts, palpitations of
the heart, a fluttering motion of fome of the fibres of the
voluntary mufcles, and puiFy fwellings below the fkin. At
other times, when thefe complaints ceafe, and the firft paf-
fages fuffer more from wind, they fuppofe, that the flatu-
lence finds a ready way from the blood into the ftomach
and inteftines by their pores or exhaling arteries. This opi-
nion, however, is ill founded ; for experiments made on
animals newly dead fliiew, that neither the ftomach nor
inteftines
of Nervous Disorders. I91
However, it may be proper to ob-
ferve, that the effects of whid in the"
iirfh paflages are not only various in dif-
ferent perfons, but in the fame perfon
at different times. In people whofe fto-
mach and bowels are in a found ftatCj
if
Inteftlnes, nor even the peritonaeum which is much thinner,
are pervious to elaftic air ; and we know, from other ex-
periments, that capillary tubes, or abforbent vcfTels,
do not attradl elaftic air as they do watery fluids ; nay,
fmall portions of air, when they get into fnch tubes, pre-
vent their attra(fiing any more of other fluids.
In hypochondriac and hyfleric patients, I have cbfer-
ved little fwellings or elevations of the fkin, of a pale co-
lour, and of different fliapes. Thefe, in a few minutes,
acquired their full flze, and after half an hour, or more,
would quickly vanifli. In hyfleric women alfo, we meet
with foft puffy fwellings below theficin, which, becaufe of
their fudden rifing and difappearance, have, by fome, been
afcribed to wind fliifting from one part of the cellular mem-
brane to another. But this is no ways probable ; and
both thefe pufiy fwellings, and thofe riflngs of the fldn,
feem to be owing to the fame caufe, ^oiz. an increafed al-
ternate motion of the fmall arteries of the parts, occafioned
by an uncommon irritation of them, or their nerves ;
whence there muft happen an effufion of a ferous or lym-
phatic fluid in the fpaces of the tella celulc/a, or in the
interftices of the fl<in, which, as foon as the extraordinary
motion of the fmall vefl'els ceafes, will be quickly abforb-
ed ; and confequently thofe fwellings will difappear.
19^ Of the CavsK6
if wind happens to be colle<fled, it may
create fome uneafinefs, but does not
quicken their pulfe, or afFe<a them with
that dilagreeable fenfation, anxiety a-
bout the prtecordiay or depreifion of fpi-
. rits, fo often its confequences in thofe
whofe alimentary canal is endued with
a more delicate feeling. Nay, the fame
perfons are, at different times, very dif-
ferently affected by wind, juft as the
nerves of the ftomach and inteflines
happen to be more or lefs fenfible, or
their feeling more or lefs different from
what it is in a natural flate. Thus,
when an ai'thritic or rheumatic humour
in the blood is turned upon thofe vi-
fceva, the wind produces a much more
uneafy fenfation than at other times.
Further, the great diflenfion of the
inteflines, and fometimes alfb of the fto-
mach in a tympany, without thole un-
eafy complaints that attend wind in
hypochondriac or hyfleric cafes, fliews,
that unlefs there be a particular indif-
pofition
of Nervous Disorders. 193
polition of the nerves of thefe organs,
flatulence alone will not give very re-
markable diflurbance.
II. A tough phlegm in the flomach
and inteftines.
Patients generally imagine, tliat
this is produced by their food, which
they believe is all turned into phlegm :
But they are miftaken ; for while the
flomach remains dilbrdered, be the ali-
ments ever fo little of a glutinous na-
ture, this fub fiance will be continually
generated.
In the alimentary canal, befides the
fine exhaling arteries, which furnilli the
gaftric and intellinal lymph, there are
many fmall glands, which fecrete a li-
quor of a more glutinous nature. In
a found flate, this mucus is in no greater
quantity than necefTary to defend the
delicate nerves of thofe parts from the
heat, cold, acrimony, or attrition of the
food ; but when the fecreting vellels
have lofl their tone, or are affe£led with
N an
1^4 ^f ^^^ Causes
an unnatural jiimuhtSy not only the mu-
cous glands, but alfo the exhaling arte-
ries may throw out, in a greater quanti-
ty, a vilcid fluid, which, by lying fome
time, may acquire ftill a greater degree
of cohefion.
When much phlegm is collected iii
the ftomach and inteflines, their nerves
are rendered left lenfible of the Jlinmlus
of the aliments, their abforbent vefTels
are partly obftrufted, and the gaftric
and inteftinal lymph are more Iparingly
fecreted, or, at lead, become more vif-
cid. Hence, the digeftion and abforp-
tion of the finer parts of the food, are,
in a great meafiire, prevented ; whilft
this phlegm, by difagreeably affecting
the nerves of the alimentary canal, efpe-
cially when they are in a delicate ftate,
occafions want of appetite, fometimes
an unnatural craving for food, a naitfca^
flatulence, gripes and loofenefs, cold
and hot fits, a quick pulfe, weaknels,
faintings, lownefs of ipirits, fleepinefs,
fighing.
of Nervous Disorders. 1^5
fighiiig, coiivulUve motions *, and gid-
dinefs. Nay, I have had fome patients
who, from a viicid phelgm in their flo-
mach, were afFerted with a flight deli-
riwHy and had their eyes like thofe of
people in liquor.
Nor will it appear flrange, thatfo ma-
ny and fuch different fymptoms fliould
proceed from a diibrder in the ftomach
and bowels only, if we attend to that
lympathy which I have fo often men-
tioned as taking place between them
and the other parts of the body.
III. Worms in the firft paflages, e-
fpecially in children, are frequently the
caufe of nervous fymptoms, flich as great
craving for food, inflations of the ali-
mentary canal, hiccup, vomiting, dry
N 2 cough,
* A Girl of 14, who had been troubled with t\ie chorea
Sancli Viti, was feized with the meafles. A few days after
her recovery, fhe had a return of her former diflemper,
which, after it had continued near a fortnight with little
abatement, notwithftanding the ufe of feveral medicines,
was entirely removed in a few days, by a natural locfenefs,
by which fhe voided a great deal of fiimy ftufF. It may be
worth remarking, that, during the continuance of this
convulfive difcrder, her appetite was much greater than
ulual.
196 Of the Causes
cough, difficult breathing, lighing, irre-
gularities of the puUe, palpitations, tre-
mors, convullions, epileptic fits, drowfi-
nefs, raving, infenfibility, e^r.
Worms produce mofl of thefe fym-
toms, by preventing the proper dige-
ftion of the food, or by irritating, with
their frequent motions or biting, the
fenlible nerves of the flomach or bow-
els, whence every other part may be af-
fedled by fympathy.
Several of the above fyniptx)ms
may alfo be occafioned by acrid humours
in the prm£ vi£ ; as will appear by the
following cafe.
A Boy of 14, on the 12th of J aimary
1757, was feized with a pain in his
head and belly, and foon after became
delirious, and made no anRvcr when
fpoke to. When awake, he fometimes
cried out in a wild manner, as if com-
plaining, or praying to be freed from
his trouble ; but his words had general-
ly little connexion. He flept well, had
a
of Nervous Disorders. 197
a fharp appetite, was not coftive, and
his piiile was full and flow, but fome-
"what irregular. Thefe fymptonis con-
tinued 'till the I 6th of January y when I
faw him firft, and ordered ^e'vcn ounces
of blood to be taken away, a blifter be-
tween his (lioulders, and a clyfter. On
the 17th no better: the blifter had oc-
cafioned a ftrangury. On the 1 8th, took-
a bolus of calomel and rhubarb, but
foon vomited it up again. On the 19th,
fwallowed five grains of calomel at bed-
time, and next morning had three
ftools, after which he became much more
fenfible, but ftill complained of his head:
2ift, had a natural ftool, in which were
two finall worms of the afcarides kind.
Upon this he was ordered piihis ftanni^
and another dofe of calomel and rhubarb,
which brought away a great deal of
flime, but no worms. On the 25th, he
was free of all his complaints.
This patient, m Jtdy 1758, having
had a return of thelymptoms above men-
tioned ;
198 Of the Causes
tioned ; he was blooded without any be-
nefit, but was greatly relieved by a dofe
of rhubarb and calomel, and entirely
cm*ed by a repetition of it, altho' no
worms were found in his ftools. At
this time, as well as in his former ill-
nefs, he had a greater appetite than
ufual, elpecially when the difeafe began
to yield.
IV. Aliments improper in their
quantity or quality.
The mofl wholefbme food, in too
great a quantity, opprefTes the ftomach
and bowels, is not properly digefted,
but becomes either acid or putrid, and
generates much wind ; whence the
nerves of thofe parts being difagreeably
affed:ed, a variety of complaints are pro-
duced.
On the other hand, the want of a
due quantity of aliments occafions faint-
nefs and wind, and, in time, fo much
weakens the ftomach and bowels, as to
render them unfit either to receive, or
to
of Nervous Disorders. 199
to digeft what is neceflary for fupport-
ing the body.
But altho* food be taken with nei-
ther too full nor too iparing a hand,
yet its quality may difpoie it to produce
nervous diforders. Thus high feafon-
ed and heavy meats, flrong fauces and
wines, will not only, by degrees, ener-
vate the tone of the ftomach, and pre-
vent or dellroy the natural feeling of its
nerves, but will corrupt the blood, per
haps breed the arthritic matter ^ and bring
on a difeafed Hate of the whole body.
On the contrary, a watery and flatulent
diet, by difagreeably affecting the nerves
of the firll paflages, generating a great
deal of wind, and not affording proper
nourifliment, will be the caufe of many
ailments.
It is, however, to be obfervcd, that
aliments, either hurtful in their nature
or quantity, will chiefly produce nervous
fymptoms in thofe, who, from the pe-
culiar
200 Of the Causes
culiar ftate of their alimentary canal, are
moll liable to iuch diforders.
Thus, v/ind or crudities in t\iG pri-
m£ vi<je, occafioned by diet, will often
give na great uneafinefs to thofe of firm
nerves, and whofe ftomach and bowels
are ftrong ; but in more delicate peo-
ple, on accoimt of the particular fenfi-
bility of thefe organs, fiich caufes will
either excite painful fpafins, or other
difagre cable feniations, attended with
lownefs of fpirits.
I have obferved above, that in fbme
the ftomach becomes fo very delicate,
that even a fudden change of pO'
fture will be apt to occafion a naufea or
vomiting: and there are others, who,
when their ftomach is empty, efpecially
after a late error in diet, feel an uneafy
craving, faintnefs, and giddinefs, which
fymptoms are almoft as certainly relie-
ved by a little folid food, or a glafs of
wine, as pain is by opium. To this
faintnefs and difagreeable fenfation in
the
o/ Nervous Disorders. 201
the ftomach, ^^hen empty, tliofe are
mofl: liable, avIio, belides a particular
vv eaknefs of that organ, carry an arthri-
tic matter in their blood frequently af-
fecting it.
V. Scirrhous, or other obflrudlions
in the ftomach, inteflines, liver, fpleen,
pancreas, mefentery, uterus^ and ovariUy
often produce iymptoms of the hypo-
chondriac or hyfteric kind ; fuch as want
of appetite, naufea^ cramps in the flo-
mach, vomiting, fometimes of a black
or bloody coloured matter, flatulence
and crudities in the firft paflages, hecl.ig
heats, cold fweats, low ipirits, and other
complaints, more or lefs violent, ac-
cording as the patient's nerves are more
or lefs delicate.
Such obftructions in the ftomach
and bowels, feem to occafion many of
the above effedls, by liindering the free
circulation of the fluids through thele
parts, by affeifling their nerves with an
uneafy fenfation, and by preventing di-
gcftion,
2-02 Of the Causes
geftion. — In the liver and fpleen, by
impeding the fecretion of bile, and, by
their weight, occalioning a difagreeable
lenfation, not only in thefe, but the
neighbouring parts by f^'mpathy *. — In
the mefentery, by preventing the fur-
ther preparation of the chyle, and its
courfe towards the thoracic d\\^. — In
the titei'iis and ovarian by diHurbing the
fimftions of thefe parts, and by confent
aifecling the flomach and bowels. Fur-
ther, hard fwellings in tlie titenis or other
abdominal vlfcera, by irritating fuch
nerves as are contiguous to them, more
at one time than another, may give rife
to fpafinodic contractions of the inte-
ftines in fome parts, and iiatulent diften-
lions of them in others, and may fb af-
fect the whole nervous fyftem, as to oc-
cafion
* Iv: the bodies of thofe who have died of the hypo-
chondriac difeafe, the meferaic, and other veins which
meet to form the t-ena portanm, have been often found
wreatly diftended with blood. But this diftenfion of thofe
vein?, if any thing preternatural, was probably only a
confequence of fome oburuclion in the liver, aod not to he
reckoned, as it lias been by fome authors, the caufe of
■ha: difiemnc:.
o/'Nervous Disorders. 203
cafloii hyfleric faintings and convul-
fions.
As obftruclions in the ftomach, liver,
ii'c, may be often the caufe of low fpi-
rits, fo, on the other hand, melancholy,
or long continued grief, frequently gives
rife to hypochondriac and hyfleric com-
plaints, and fometimes to obilruclions in
thole vifcera. For fuch a ftate of the mind
not only diforders the nerves of the
ftomach, liver, and bowels, and occa-
iions a want of appetite and digeftion,
with its various confequences ; but by
means of the agency of thole nerves, it
may alfo produce in fome of the fmall
veilels of thefe vifcera^ fiich a fixed fpaf^
modic contraction, as to lay the founda-.
tion of an irrefolvable obflruclion ; in
much the fame manner as a fudden
fright has given rife to a fcirrhtis, and af-.
terwards a cancer in the breafl. Fur-
ther, the flow interrupted breathing,
and the fedentary life of thofe who are
much affected with grief, will make the
fluids
204 ^f the Causes
fluids more apt to ftagnate, and confe-
qucntly to form obftrud:ions iu the fmall
velTels of the hypochondriac vifcera,
I. A Gentleman aged 60, who had
been above three years fubjecl to cramps
and pains in his ftomach, want of ap-
petite, belching, fits of ficknefs and vo-
miting, began, in fpring 1748, to throw
up a dark-coloured liquor like coffee-
grounds, and to void the fame by flool.
In the end of Afril 1749, ^^^ vomited a
greater quantity of this black fluff than
ever, and foon after he threw up about
an Enghfh quart of blood, moflly clot-
ted, which reduced him lb low, that he
never recovered his liefla or colour.
Throughout the flimmer, he continued
in a declining way, being much oppreff-
ed with belching, ficknefs at Itomach,
and frequent retchings to vomit, tho*
rarely bringing up any thing, but a
tough phlegm, till the beginning of Or-
toha\ v»-hen, after licavy ficknefs, he vo-
mited a great deal of bbckifh coloured
fluff
of Nekvous Disorders. 205
fluff* one morning, and in the evening a
confiderable quantity of clotted blood.
On the 15th of this month, about eleven
in the forenoon, after retching to vo-
mit, he complained fuddenly of a fharp
pain below the falie ribs of his left fide :
immediately after, his pulfe began to
fink, and he died at tv^^o.
This body being opened, the coats
of the ftomach were found thick and
fcirrhous in feveral parts, efpecially a-
bout its left orifice. In thofe morbid
parts feveral fmall ulcerations and
chops were obferved, and near the bot-
tom of the ftomach a hole as broad as
a fliilling. This part, which had been
thinner than the reft of the ftomach,
feems to have given way on the
morning before the patient died, and
the laceration was probably the caufe
of that fliarp pain he complained of in
his left fide. There was nothing in the
ftomach, as all its contents had been
emptied into the cavity of the abdomen.
It
206 Of the CaU S ES
It can hardly be doubted that the
black-coloured liquor, which this pati-
ent frequently vomited, as well as the
clotted blood, came from the veflels of
thofe fcirrhous parts of the flomach, in
which the fmall ulcerations and chops
were obferved. The blood that ovizes
flowly into the flomach from very fmall
veflels, may lie for a confiderable time
before it is thrown up, and acquire a
dark brown, or blackifli colour; but
when it flows in greater quantity, and
from larger veflels, it is vomited up,
either partly coagulated, or quite fluid,
if it has remained only a very little
time m the flomach.
It may be proper to obferve, that
the black as well as bloody vomitings,
were probably increafecl, if not fli'ft oc-
cafloned by the frequent emetics which
the patient had taken to remove the
flcknefs, want of appetite, and other
complaints of his flomach : and un-
doubtedly whenever there is a confirm-
ed
cf Nervous Disorders. 207
ed fcirrhus in the (lomach, ftrong vo-
mits mud incrcafe, exalperate, or in-
flame it, and probably break fome of the
veflels leading to the tumor. In fiicli
cafes, therefore, inllead of ipecacuanha
and antimonials, the patient fliould ufe
nothing but warm water, or a decoc-
tion of camomile-flowers, which will be
fiifficient to relieve the ftomach when
foul, without occafioning fuch violent
convulfive contraclions in it, as the
ftronger emities do.
2. A MAIDEN Gentlewoman about 30,
in September iJS5i hegan to complain of
w^ant of appetite, and wind in her fto-
mach, and loft her flefii and ftrength.
From the beginning of March following
her pulfe became quicker than natural,
and file then began to bring up every
thing file fwallowed, two or three hours
after ; and feldom went to ftool v> ithout
a clyfter. V/hen her flomach was empty
of vi6luals, flie threw up tough phlegm,
which, a few days before her death, was
mixed
2oS Of the Causes
mixed with fome blackifli matter. She
never complained of any acute pain,
but only of an uneafineis and tightnefs
about the ftomach. Her bowels were
much diftended with wind, wliich gave
her a great deal of trouble ; and the air
fliifting frequently from one place to
another, produced confiderable fwel-
lings, which could be ealily felt outward-
ly. After trying various medicines, to
little purpofe, fhe died about the end of
Ma).
Upon opening her body, the colo;t was
obferved to be much contracted in fe-
veral places, and, in the right fide, to
adhere to the peritoneum ; but the chief
caufe of her complaints and death, ap-
peared to be a fcirrhous tumour, which
Ipread over the whole pylorus y and a fmail
part of the ftomach adjoining to it. The
fides of the pylorus conflfted of a firm
cartilaginous flibftancc, near an inch
thick, and the paflage was fo ftraitened,
as fcarcely to admit a quill. On the in-
fide
of Nervous Disorders. 20^
fide of the j^y/on/i were found fome fmall
chops and inequalities, from which, as
I hnagine, a cdnfiderable part of the
phkgm which (lie vomited might come*
Be that as it will, it is fcarce to be
doubted, that the black coloured fluff
was furniflied by the mouths of the
fmall blood-vellels in thofe ruptured
parts of the pylorus. If thele veflels had
been larger, this matter would have had
more of a dark brown, or reddifli colour;
or the blood itfelf, either fluid or clot-
ted, would have fbmetimes appeared.
At no rate could this matter come from
the liver, for that part was found ; nor,
fuppofing it otherways, could any thing
have eafily pafTed from the duodemmi in-
to the ftomach, on account of the ffrait-
nefs of the pylorus,
o 4. A Female child, which, from its
birth, had been afflided with wind,
gripes, and violent convulfions, died at
the age of five months, after many re-
medies had been ufed unfiiccefs fully.
O Nothing
21 o Of the Cau ses
Nothing preternatural was difcovered
upon diiledlion, except a portion of the
colon, about five inches in length, quite
fcirrhous.
4|. A Gentlewoman, who had born
feveral children, and had been general-
ly healthy, in the 59 th year of her age,
ten years after the Jiienfes had left her,
began to complain of pains in her back,
groins and belly, above the os pubis , the
violence of which brought on the fliior
,alhiis, and frequently a difcharge of
blood from the vagina. Thefe pains
lafted uiually five or fix hours, and re-
turned every day nearly at the fame
time. During the fit, fhe had always
this haemoi'rhage, but at other times
the wliite flux only.
Notwithstanding the ufe of fe-
veral medicines for twelve or fourteen
months, her complaints were increafed;
the pains, which now began in her legs
and thighs, and rofe to the lower parts
of her belly, returned regularly every
morning
of Nervous Disorders. 211
morning at ten, and were fo acute, that
fbe cried out almofh the whole time they
lafted; nor had fhe now any perfed: in-
tervals of eafe. During the paroxyihi,
her pulfe was fmall and quick, and her
body cold, altho* all over in a fweat.
Her pains were always mofl fevere and
lading when fhe was coflive, which hap-
pened often. The matter difcharged
from the vagina had no ofFenfive fmell.
She was much troubled with wind in
her ftom^ch and bowels. While the fit
lafted, fhe never made any water, but
fpit a great deal more than ufual. By
the continuance of her difeafe, flie gra-
dually wafted away* and at laft died.
As I was only confulted for this per-
fon at a diftance, I never learned whe-
ther her body was opened or not ; but
I think there can be little doubt, that
almoft all her complaints, and particu-
larly the fliarp periodic pains in the hy-
pogaftric region, were owing to a
O 2 fchirrus
'zii of tbc Causes
fcirrluis in the t/iirus beginning to turn
cancerous.
VI. Vi o L ENT affocTions of the mind.
Nothing produces more liiddcn or
lurprizing changes in tlie body,tlian vio-
lent aftecHons of the mind, whether tliefe
be excited by external objects, or by the
exercife of tlie internal fenfes. Tlius
dolefid, or moving ftories, horrible or
unexpected lights*, great grief, luiger,
terror and other pallions, frequently oc-
calion the molt fuddcn and >iolent
nervous Amptoms. Tlie fh*ong im-
prellions made in fiich cafes on the brain
aiid ner^ es, often tlirow the perfon into
hylleric fits, either of the con\iillive or
fainting kind. — Long continued grief
and anxiety of mind weaken the tone
of the ftomach, deflroy the appetite
digeilion,
* I: is faid, that the great Lord Veruuzm was wont to
faint, when he faw an eclipfe of the fun : and we are told
of a Lady, who, upon looking through a telefcope at the
comet of 1681, was llruck with fuch terror, that fhe died
in a few days. FicdUk. chjcrvat. hied. lib. iii. ohfew.
xxiii.
of Nervous Disorders. 213
digeftion, occafion thirft, a white tongue,
flatulence, and other complaints *. —
Great fear produces paleneft of the
countenaiice, an univerfal debility and
fhaking, palpitations of the heart, anxie-
ty about the breaft, quick breathing,
and a looienefs, or a large difcharge of
limpid urine. — By fbdden terror, deli-
cate women or children have been not
only thrown into fainting and convul-
iions, but rendered fubject, all their life-
time, to epileptic fits. — Anger quickens
the pulfe and refpiration, and increafes
the force of the heart : Hence it has
been immediately followed by an un-
common excretion of the faliva, by bi-
lious vomitings t, bleeding at the nip-
ples t, and a rupture of fuch veflels as
were
• " Qui laborant animi pathemate, pctiffimcm corripi
" folenc morbia ventricxili, ut inter caetera oblervavi in
** moerentibas, qui conqaeruntur priaio de languore ven-
triculi, mox inappetentia, oris amaritie, lid circa horis
matutina'', craditatibus, flatibus et tenSonibui hvpochon-
driorum." Baglivii opera, Ofia, p. 565.
t Pechlin. lib. iii. obfervat. xzv.
X Stalpart. Vender Wi«U cent. i. obf. Lxxiv-
214 Of the Cav SEs
were lately cicatrized. In women, it
frequently occalions fpafmodic contrac-
tions in the bowels, and a flatulent or
hylleric cholic. — Some of the more vio-
lent paflions have, all at once, occafion-
ed a kind of tetanus, or catalepiy; fo
that the perfon has appeared liker a
flatue than any thing alive ; nay, exr
cellive fear, grief, joy and flianie have
been fometimes followed by fudden
death.
Bonetiis has recorded the cafe of a
Lady, who, among other hyfteric fymp-
toms, owing to grief and difappoint-
ments, was feized with frequent faint-
ing fits, which fometimes laded half an
hour* : And, feveral years ago, I had a
patient, who, upon the unexpected death
of her hufband, fell into fuch fits, gene-
rally holding her from five to fifteen
minutes. In thefe faintings fhe lay like
a dead perfon, without any apparent
breathing, or motion of the breafl ; only,
when
f Se^ukkret. anatom. lib, ii. § xxxiii, oh/, ix.
of Nervous Disorders. 215
when a candle was held near her mouth,
the flame was obferved to move a little.
Her pulfe, however, was fcarce changed,
only fomewhat flower and feebler than
uiiial. She came out of thefe faintings
with fighings and crying, and general-
ly relapfed into them in little more than
a quarter of an hour. In this way, flie
continued for two days.
Baglivius mentions a young man of
Dalmatia, v/ho, from looking at a perfon
in an epileptic fit, was himfelf affecled
in the fame manner * : And it has fre-
quently happened, in the Royal Infir-
maiy here, that women have been feized
Avith hylleric fits from feeing others at-
tacked with them. But one of the mofl
remarkable inftances of this kind, hap-
pened in the Poor's-houfe at Haerkm, in
the time of the learned Dr Boerhaave,
and is recorded by his nephew in the
following manner,
" In
* Praxis Medica, cap. xiv. § il. See alfo Natttr. curiof^
1730, /. 30?.
21 6 Of the Causes
*' In domo, qua pauperes ex cleemo-
fynis publlce aluntiir, in civitate Harle-
menfiy perterrita puella incidit in mor-
biim nervorum convulfivum, certis pa-
roxyfniis reducem : Adftantiuni et ad-
juvantium in earn intenta itidem corri-
pitur eodeni morbo, poftridie altera,
deinde tertia, quarta, imo fere omnes,
tarn pueri quam puellae : Status, mifer-
rinius! Corripitur hie, corripitur ilia,
imo fere omnes eodem tempore, dum
unum alter a{|)icit, proflernuntur. Me-
dici iblertes fruftra adhibent, quae dic-
tat ars, faluberrima antiepileptica me-
dicamina. Confugitur tandem ad Bo-
erhaavium^ qui mifertus infelicis paupe-
rum Ibrtis, petiit Harlemum^ et dum rem
examinat, invadente in unum paroxyf-
ino, vidit convelli plures fi^ecie epilep-
iiae. Datis incafflmi optimis remediis
a medicis iapientibus, et ad imaginati-
onem ex uno in alterum tradufto mor-
bo, rite perpenfis, han-c avertendo, cre-
didit, poITe curam obtineri, et obtinuit.
Scilicet
of Nervous Disorders. 217
Scilicet praemonitis ephoris, praefenti-
biis omnibus, juifit per cameram difpo-
ni fornaces portatiles, prunis arclentibus
inftru6las, atque iis imponi ferreos ha-
miilos, acl certain figurani adaptatos,
turn ita niandavit ; quia omnia fruftra
forent, ie aliud nelcire remedium,
quam, ut qui primus puer foret vel
puella, infauilo morbi paroxyfmo arri-
peretur, locus quidam nudati brachii
candente ferro ad os ulque inureretur ;
utque gravitate pollebat dicendi, per-
territi omnes ad crudele remedium,
dum inftare fentiunt paroxyfmum, om-
ni mentis intentione, et metu dolorifi-
cae inuftionis, eidem refiftunt fortioris
oblatione ideae: et certe quantum va-
leat hie ab objeclo animae intentae re-
vulfio, docet epilepfia diverfimode cura-
ta, ut quidem ipfe terror eandem luftu-
lerit, febris epidemic a, quartana, ptya-
lifmus, matrimonium, virga *,"
There
* Abr. Kaau Boerhaax-e impet. faciem Hippocrati diJlum,
§ 406.
21 8 Of the Causes
There is a difeafe very common in
the Iflaiid of Zetlandy which is known
there by the name of the convulfrje fits.
It begins with a violent palpitation of
the heart ; foon after which, the patients
fall to the ground, imlefs they are fup-
ported ; their arms and legs are alter-
nately con trailed and relaxed; and, in
fome cafes, their joints become lb rigid
that they cannot be bent. Their re-
fpiration feems to be difficult, and they
cry terribly while the fit lafts, which is
generally lels than a quarter of an hour ;
altho' in fome rare cafes, it has conti-
nued above an hour. Tliis diforder
feldom attacks married women ; but
young women, and even girls of twelve
or ten years of age, are liable to it.
Some boys and two young men in the
ifland liave been alio ailbcfed with it.
in the cliurch or other public meetings,
as ibon as any one is feized, all fuch as
have been formerly fubjeft to tlie dif-
temper are attacked Vvklt it, which of-
ten^
o/ Nervous Disorders, 219
ten occafions great difturbance ; and
fonie, who never had thefe fits, will be
afFe(^ed, upon feeing or even hearing
the noife of fuch as are feized with
them.
This difeafe does not fecm to im-
pair die health of the patients ; for the
young women fubjecl to it are general-
ly as ilrong, and, in other refpecls, as
healthy as any in the Ifland.
We have feen above *, that there is
a remarkable fympathy, by means of the
nerves, between the various parts of the
body ; and now it appears that there is
a Hill more wonderful fympathy be-
tween the nervous fyflems of different
perfons, whence various motions and
morbid fymptoms are often transferred,
from one to another, without any cor-
poreal contacl: or infection.
In thefe cafes, the impreflion made
upon the mind or fenfor'mm commune by
feeing others in a difordered flate,
raifes, by means of the nerves, liich mo-
tions
* See chap, i, Tso. lo and u.
220 Of the Causes
tions or changes in certain parts of the
body as to produce fimilar afFecftions in
them: And hence it is, that the fight
only of a perfon vomiting has often
excited the fame action in others; that
fore eyes become fometimes infectious;
that yawning is propagated from one
perfon through a whole company, and
that convulfive diforders are caught by
looking on thoie who are aiFed:ed with
them. Now, altho' we cannot explain
how different impreflions made on the
fenforium commune fliould occafion, by
means of the nerves, thofe various chan-
ges in the body; yet that the nerves are
really capable of producing very Hidden
changes in the circulation and diftribu-
tion of the fluids, when the mind is
varioufly affecled, we have full proof
in that rednefs of the face which accom-
panies afcnic of Ihamc, that increafed flux
of the falha which happens to a hungry
perfon upon the fight of grateful food,
and tliat plentiful diichargc of tears
wliich
of Nervous Disorders. iit
which is often produced by piteous ob-
]eSis or tragical ftories.
Thus far we know, from certain ex-
perience, that, when the nervous fyfteni
is extremely delicate, a fmall impreilion
on anv of the or2;ans of fenfe v/ili often
throw the whole body into diforder.
For example, I have knovv^n people of
■weak nerves, fubjecl; to wind in their
ftomach, and a fwimming of their head,
who, by looking into a miri'oir that was
kept conftantly moving before them,
became i^o giddy, as to be in hazard of
falling. Others upon the fudden open-
ing of a, door, or any other unexpected
noife, have been liable to be feized
with convulfions. Nay, there have been
fome, Avhofe brain and organs of fenfe
were fo iiifceptible of imprellions, that
they could fcarce abflain from imitating
every motion and gefture they faw per-
formed by others *.
On
* Philofophical Tranfaft. abrljg. vol. iii. p. 8.
222 . Of the Causes
On the other hand, it is to be obfer-
ved, that flroiig nervous fymptoms are
feldom occalloned by fear, terror, grief,
the force of imagination, or any Hidden
imprellion on the organs of fenfe, in
perfons whofe nerves are firm and lefs
fenfible ; but, when the contrary is the
cafe, the caufes above mentioned will
often produce the mofl flidden and vio-
lent hyfleric fits, or convulfive difor-
ders, wdthout any fault in the womb,
alimentary canal, or other parts of the
body.
To conclude our obfervations on the
caufes of nervous difeafes, it may be
proper to take notice, that altho' it ap-
pears from the clifledlions of thofe who
have died of them, that the ftomach
and inteflines, liver, fpleen, omentum^
melentery, or uterus, have frequently
been found obftrucled, fcn*rhous, or o-
therwife unfound, yet as in many other
cafes of the fame dilbrders, no fuch
morbid appearances have been obferved
in
of Nervous Disorders. 223
in the body after death ; it follo'vvs, that
thele fymptoms may frequently proceed
from caufes, which, ehiding our fenfes,
are not to be difcovered by diilec^ion.
Nay, obftrudlions, fchirriy and other
diforders of the infceraj obferved in
thofe who have died after long differ-
ing from nervous ailments, feem, Ibme-
times to have been the confequences of
a long flate of bad health, rather than
the caufes of it : Particularly, by the fre-
quent attacks of that arthritic or other
morbid matter which is often the cauie
of thefe diforders; and, by the pains
and fpafms attending them, fome ob-
ftruftions may at length be formed in
the fmall veflels of the itomach or
neighbouring parts ; to which every new
return adds a little, juft as new inflam-
mations of the cornea always increaie
Ipecks on that membrane.
CHAP.
224 Of the mojl remarkable
CHAP. VI.
Ohfervations on fome of t1)e mojl remarkable
S-^mptoms of the Nervous, Hypo-
chondriac, and Hysteri c kind.
I. A N uncommon fenfe of cold or
•^ ^ heat in different parts of the
body, fometimes fuddenly fucceeding
each other.
The natural heat of animal bodies is
owing to the regular and uninterrupt-
ed circulation of the fluids. As this
degree of heat, however, is nearly the
fame in every part that is defended from
the external cold, and is what we are
accuftomed to, we are, commonly, no
more confcious of it, than of the beat-
ing of the heart, or of the alternate con-
traction
Nervous Symptoms. 225
traclion of the inteflines. But as of-
ten as there is a more rapid motion
of the fluids through the whole body, or
only in the fmaller veilels of fbme part,
we feel a greater heat, than the natu-
ral. In like manner, a fenfation of cold
proceeds from a diminiflied circulation
or a ftagnation of the fluids in the
fmaller veiTels.
In hypochondriac and hyfteric cafes,
a quicker or flower motion of the fluids,
and confequently an unufual fenfation
of heat or cold in the vefl^els of the
head, back, arms, legs and other parts,
may arife either from the vefl^els them-
felves, or their fluids. From the vef-
fels, — when thefe, from fome fault or
irritation of the nervous fyftem, or from
fympathy between their nerves and
thofe of the fl:omach, or fome other ve-
ry fenfible part, are either thrown into
an unufual alternate motion, or aifeft-
ed with a continued fpafmodic fl:rid;ure.
From the fluids, — when, by their acri
P mony
22 6 Of the juoji remarkable
mony or vlicid quality, the very fmall
veflels are either excited into uncommon
vibratory contractions*, or become in
a great meafure obftrucled.
It is obfervable, that in thofe parts
of the body, in which patients com-
plain of an unufual lieat or cold, v/e
can, often, neither by our feeling, nor
the thermometer, difcover a greater
or leis degree of heat than in the neigh-
bouring parts, where there is no ilich
fenfation. This may be owing to the
heat or cold, in fuch cafes, being felt
below the fkin and memhrana adipoja,
viz, in the mufcles : Or, perhaps, a vio-
lent alternate motion excited in the
very fmall vefFels, by fome acrid fluid,
may give a fallacious ]^Gn£Q of heat to
the perfon, Vvhen there is really no
greater degree of it, as far as can be
difcovered
* That acrid humours and afFetTiions of the brain and
nerves may excite a violent alternate motion in the fmall
vCiTels, or affccl them with a continued fprfiii or tctauus,
we hav2 fhcwn above chap. i. No. 17.
Nervous Symptoms. 227
difcovered by the thermometer. In
like manner, the ftagnation of fome vif^
cid humom' in the lame veiTels may
produce a ihnCe of cold, altho' the real
heat is little, if at all diminillied. 'Tis
true, that in bludiing the increafed mo-
tion of the fluids through the vellels of
the face is accompanied with a glow;
but it is to be confidered that the in-
creafed motion here, is in the veflels of
the Ikin, and fuch alfo as carry red
blood, which leems more apt to acquire
heat by friftion or agitation, than the
thinner fluids.
The fenle of cold and fliiverino; in
the beginning of mofl: fevers and in-
flammations, feems not to be owing, as
fome have imagined, to vifcid fluids
fl:agnating in the fmall cutaneous vefl^els,
but to a Ipafmodic contracflion of thefe
vefl^els, in confequence of that irritation
which the nervous lyfl:em fuffers from
the febrile ftirnidiu, or the beginning in-
flammation. Hovi^ever, altho' all fevers
P 2 proceed
22 8 Of the mojl remarkable
proceed from irritation, and confe-.
quently from an aiFetlion of the nerves,
and many fevers of the low kind have
had the name of nervous pecitliarly be-
ftov/ed on them; yet a regular intermit-
tent feems to deierve that appellation
better than, ahnofl any other fpecies of
fever ; for its paroxfyms, like thofe of
the epilepfy, or other convuliive difor-
ders, are owing, not fo much to any
fixed obllruclion in the vafcular iyftem,
or general acrimony, or vifcidity of
the mafs of fluids, as to an irritation or
affeflion of the nerves of fome particu-
lar part, fuch as the flomach or in-
teflines; Vv hence the v/hole fy (lem fuffers
by fympathy, and a fliuddering is pro-
duced, which is Ricceeded by a hot fit
and fv/eating, that, for the time, removes
the caufe of the difcafe. And as an
intermittent agrees ^vith epileptic and
other convuliive diforders as to its
caufe ; fo its returning paroxyfms, like
theirs, may be often prevented or weak-
ened
Nervous Symptoms. 229
ened, by raifing, a fliort time before the
approach of the fit, an acute pahi or a-
ny great commotion in the body.
II. Pains in different parts of the
body, fuddenly moving from one place
to another.
These pains are fomething a-ldn to
thofe of the rheumatic kind, but gene-
rally have their feat in the fkin, mem-
branes, and mufcles, and not in the liga-
ments and joints. Their fhifting fudden-
ly, and their feeming fometimes to have
a connexion with the flatulent complaints
of the ftomach, has induced fbme phy-
ficians, as well as the patient, to afcribe
them to the motion of air between the
fkin and muicles, from one part of the
body to another. But their true caufe
feems to be, either fbme vifcid or acrid
matter fiatking for a fliort time in the
fmall veflels of certain parts, and irrita-
ting them, or fpafmodic contractions of
thefe vefTels from a f}aiipathy betv/eeii
their
230 Of the mofi remarkable
their nerves and thofe of the flomach
and inteftmes, or fome other very fen-
fible part *.
From the fame caufes affeftms: the
velTels or nerves of the pericranium, or
other parts of the head, proceed flying
pains in this part, and the claviis hyfte-
ricus, which Syicnham, who imagined the
hyfteric difeafe to proceed from a con-
fufion of the animal fpirits, afcribed to
the whole fpirits of the body being con-
tracted into a fmall part of the head,
and producing much the fame fenfa-
tion, as if a nail were driven into it t*
That thofe pains in the head often
proceed from a fympathy with the flo-
mach, is rendered probable by the vio-
lent vomiting which fometimes accom-
panies the claviis hyjlericus, and by obfer-
ving, that people much troubled with
wind
* It is obfervable, that Diodes Caryftius mentions, a-
mong the figns of diforders of the belly, pains flying
through the body, without any apparent caufe. Vid. Epiji.
ad Regem Antigonum.
* Sydenhami Oper. EpiJi. ad D. Cole.
Nervous Symptoms. 231
wind ill their llomach, and flying pains
in dieir licad, are not fo often aiTecled
with thefe pains, when they are free
from the flatulence*
III. Hysteric faintings, and convul-
fions.
Many hyfleric women are liable to
be ieized v/ith faintings, during which
they lie as in a deep fleep ; only their
refj^iration is fo low as Icarce to be per-
ceived. Others, along with faintings of
this kind, are affected with catchings
and ftrono; conviilfions.
These fits come on differently in dif-
ferent patients ; in fome, a coldnefs, at-
tended with a fenfe of fliffnefs^ is firft
perceived in the legs, or in the trunk of
the body ; after this, a yav/ning and
flretching of their arms ; a lownefs of
fpirits, with an opprcilion about the
prc-cordia ; the flomach, or fome part of
the inteftines, is diflcnded with wind ;
tliey often feel, as it were, a ball in then*
throat J
232 Of the moft remarkable
throat ; their breathing becomes quick ;
the heart flutters, or is affected with a
ftrong palpitation ; a giddinefs, a noile
in the ears, and a lofs of fight, as well as
of the other fenfes, fuccced, together
with convulfive motions of the extremi-
ties and other parts of the body.
Fits of tliis kind may be owing to
various caufes ; fuch as,
I . An irritation of the nerves of the
ftomach or inteflines, from wind, acrid
humours, or other caufes, whence the
whole fyflem is often brought into con-
fent. Nor can it admit of any doubt,
that hyfleric fits frequently proceed
from tliis caufe, fince the patients are
often fenfible of their beginning with
an uneafy fenfation in thofe parts.
2. A SUDDEN flippreliion of the menfes
often gives rife to hyfleric fits : And in
fome a fatal apoplexy, attended with a
violent fpafm of the mufcles of the glot-
tis^ has been the confequence of the
menflrual
Nervous Symptoms. 233
menftrual evacuation being fuddenly
ftopt; as in the following cafe.
An unmarried woman, aged 20, of a
delicate habit, having expofed herfelfto
cold at the return of the monthly peri-
od, was, next morning at four, fuddenly
feized with ^Jiupor, and a difficulty in
fpeaking, and moving any of her limbs.
She was foon after blooded, and a bli-
fter was applied between her flioulders.
At eight, w^hen I iirft faw her, flie could
neither fpeak nor fwallow, but was trou-
bled Avith a hiccup: Her face was pale,
her fkin cold, altho' her pulfe and
breathing were natural. About half an
hour after ten, (lie began to breathe
with labour, and with a fnorting noife.
This flruggle, however, eipecialiy in ex-
piration, did not arife from any fault
in the lungs or mufcles of refpiration,
but from a fpafm of thofe mufcles of the
larynx which fliut the glottis; and it came
by fits, which continued three or four
minutes, and fometimes more. In the
intervals,
-34 V ^^^^ ^^ft rcmdrkabld
intervals, which were fomewhat longef
than the accellions, fhe breathed pretty
eafily. The oleum fuccini held to the nole,
leflened at firfl the ipafmodic contrac-
tion of the glottis y and made her breathe
eafier. She was blooded again, and had
a purging clyfler. About eleven, the
fore-part of her neck around the laryiXy
and under the flerno-maftokl mufcles,
was much Avelled, as if the cellular
membrane had been diflended with
air. A poultice of theriaca and camphire
applied to this fwelling, feemed to leflen
the violence of the fits of difficult refpi-
ration. In the afternoon, her pulfe be-
coming quick and full, and her fkin hot,
file was blooded a third time; but not-
withftanding this and other remedies,
fhe died that night at ten ; eighteen
hours after flie Avas firfl: taken ill.
3. Avery acute pain in any of the
more fenfible parts of the body, or vio-
lent affections of the mind, as terror,
grief, anger, or difappointments, will
fometimes
Nervous Symptoms. 235
fometimes lb llrongly afFecl the whole
nervous fyftem, as to bring on hyfteriq
fahitings, with convulfions, altho' the
body be in every relpe^l: healthful and
found, bating the too great delicacy or
fenfibility of the brain and nerves.
IV. A Catalepfij and tetanus.
Of all the nervous or fpafrnodic difor-
ders, there is none more fiirprifing than
the catalepjis or fliipor vigilans, as it is cal-
led by Fernelius *. In this the patient
becomes either wholly, or in agreatmea-
fiire, infenfible of Avhat is doing about
him, and remains exacl:lv in the fame
pofture in which he wasfirftfeized. Hi^
joints are fometimes fo ftifF, that they
can fcarcely be bent, or, if they are, they
remain in whatever fituation they are
placed. The pulfe is often low and ir-
regvilar. This difeafe may be ov, Ing to
fome violent affeftion of the mind difor-
dering
* Patholog, lib. v. cap. ii.
236 Of the mojl remarkable
dering the brain and nerves, or to fome
acrid matter affedling them, either by
its immediate contact, or by fympathy
with the flomach, inteftines, uterus, or
fome very fenfible parts. To the lame
general caufes are Ukeways to be afcrib-
ed the emprojlhotomis and opifthotonus, and
tetanus. And here ^^'e mufl reft ; for to
endeavour to explain more particularly,
either how the paftions, or an irritation
of the brain or other fenfible parts,
brings on alternate convullions or fixed
fpafms of the mufcles, would be to no
pui'pofe, till we are better acquainted
with the ftruchii'e of thefe organs, and
with that caiife Avhich immediately pro-
duces their contraftion ; points which
will, probably, for ever elude our re-
fearches. All we know, is, that what-
ever irritates, or difagreeably aiTe^ls the
brain, nerves, or any of the more fen-
fible parts, occafions continued fpafms
or convulfive motions, either in the
pai'ts themfelves, if mufcular, or in thofe
with
Nervous SymptoxMs. 237
with which they have any coniiderable
fympathy ; and that, when the nervous
fyflem is delicate, or the irritation great,
ahiiofl the whole mufcles will be fomer
times agitated with alternate contrac-
tions, or aiFe(fi;ed with a tetanus or gene-
ral rigidity.
V. Wind in the flomach and bowels.
All our aliments, efpecially thofe of
the vegetable kind, abound with an*. In
the time of digeftion, part of this air is
feparated, and produces that flatulence
or wind in the flomach and bowels with
which many people are greatly trou-
bled. But altho' flatulence arifes from
our aliments, fome of wliich produce it
more than others, yet ftrong and health-
ful people are feldom troubled with
wind, unlefs they either over-load their
flomach too much, or fwallow liquors
that are in a fermenting ftate, and con-
fequentiy full of elaflic air. Wliile,
therefore, the matter of flatulence pro-
ceeds
238 Of the tnoft remarkable
ceeds from our aliments, die caufe
which makes air feparate from them in
fuch quantity, as to occalion uneafy
complaints in the prinice vhrj is, almoft
always, a fault there ; for when, on ac-
count of a weaknefs of die ftomach
and bovv'eis, or an unnatural flate of
their nerves, the digcrtion does not go
on properly, not only more liatulence
is produced, but lefs of it returns again
to a fixed flate. Farther, when, tliro'
the weaknefs of the coats of the flo-
mach and inteilines, the prefRire upon
its contents is conliderably diminillied,
the air emitted by the aliments in di-
o:eftion, will not only be in 2:reater
quantity, but will expand itielf more
than in people of ftronger organs. A-
grceably to this, it is obferved, that dogs
are much troubled with wind and borho-
rygmi, after tying the eight pair of nerves,
Vv'hich ^^wd man;', branches to the ali-
IJlcn^^!ry canal.
Air
Nervous Symptoms. 239
Air in the ftomach being often hin-
dered from riling, by a flight fpafm of
the cardia, or lower part of the gullet,
either occafions an inflation of that or-
gan, with other uneafy fymptoms, or
pafTes into the inteflines ; where, joined
to more that is generated there, it di-
ftends them in fome places, and confe-
quently occafions a contracFlion in o-
thcrs. Hence pain; and when the fpafm
gives way, the air rufliing through a
narrow paflage of fome of the bowels,
makes a rumbling noife : But when the
fpafm in any part of the inteflines, efpe-
ciaily the colony is greater, or lafls long-
er than ufual, the air is more and more
rarefied by the heat of the body, whence
their coats being over-ftretched, great
pain is occafioned, which is often at^
tended with a vomiting. This is what
is commonly called 2i flatulent or hyfteric
colic. In fome cafes, certain parts of
the alimentary canal are affected with
filch a fixed fpafmodic contratflion, that
fcarce
240 Of the mojl remarkable
fcarce any air pafles either upward or
downward; and more being daily ge-
nerated, the ftomach and bowels become
at lengtii greatly diftended, or a tympa-
ny is produced. In this difeafe, I have,
ieveral times, obferved the fwelling of
the belly fall greatly, and the difeafe go
almofl quite off, while in the mean time
very little wind was difcharged. This
fliews, when the alimentaiy canal re-
turns to a found flate, that not only lefs
air is generated from the food, but what
has been produced, may be moflly de-
llroyed or reduced to a more fixed con-
dition.
VI. A* GREAT craving for food.
This may be owing to fome humoiu-
in the cavity of the flomach ftimulating
its nerves, or to thofe nerves being fo
changed, that they are almofl always
affecled with that fenfation we call hun-
ger, unlefs when food is newly taken
into the flomach.
Doctor
Nervous Symptoms. 241
Doctor Lovjer has obferved, that
hypochondriac and hylleric people, are
often troubled with an uncommon
hunger or fames canina ; and while this
lafls, they are almoft quite free of other
complaints ; but that their uiual ail-
ments return with their natural ap-
petite. In other cafes, however, the
morbid matter aiFe(R:ing the nerves of
the ftomach in hypochondriac and hy-
fleric patients, fometimes occafions a
want of appetite and naufea. In like
manner, the true gout, when turned
upon the ftomach, according to the
different fenlibility of the nerves of that
organ, or its being more or lefs fixed
upon thefe nerves, produces very diffe-
rent effects; fuch as, an oppreflion, a
languor, flatulence, want of appetite,
and a ^Qw^e of coldnfefs in the ftomach,
or a violent pain with cramps and vo-
miting.
The malacia and pica, common to
women with child, and to girls aifedted
Q^ with
242 Of the mojl remarkable
with the chlorofis, proceed either from
Uii acid or ibme other acrid humour in
the ftomach, or from its nerves being fo
changed by the flate of pregnancy, as
to produce a longhig for certain foods,
and other fubllances, which, in thefe
cafes, are generally moft grateful to the
tafte, as well as apt to remedy the dis-
order of the ftomach.
VII. A Black vomitinq;.
Alt ho' not a few of the moderns,
following the opinion of the antient
Phylicians, have fuppofed the hypochon-
driac difeafe to be owing to an atrabili-
ary humom* produced in the ftomach,
liver, or fpleen, yet, in many hypo-
chondriac patients, there is no fuch hu-
mour ; and where it is obferved, it is
only a fymptom or confequence of that
difeafe, but not its original caufe.
Patients who have been long af-
fiicled with violent pains and cramps,
or other diforders in their ftomach, of-
ten
Nervous Symptoms. 243
ten throw up fbme dark coloured fluff,
which is commonly nothing but blood
that has loft its colour ; lor altlio'
when blood is poured into the cavity of
the ftomach in a large quantity, it is
foon vomited either in its fluid ftate, or
coagulated; yet, v^^hen it ouzes flowly
from the fmaller veflels, it lofes its red
colour by long lying, and when thrown
up, refembies the coffee-grounds. This
kind of black vomiting is generally
owing to fbme of the following cauies,
viz,
1. Violent pain or cramps in the
flomach ; the lii'fl of which may great-
ly increafe the motion of the fluids in
the fmall veifels, and the laft may fqueeze
the globules of blood through the ori-
fices of the fmall arteries, deiigned for
conveying the'gaflric lymph, only, in-
to the cavity of the flomach.
2. Scirrhous tumors in the flo-
mach beginning to ulcerate, or a rup-
(^ 2 tiire
244 Of the mojl remarkable
tnre of Ibme of the fmall vefTels leading
to them *.
3- A
* Further, fcirrhous tamors in the ftomach, byobftrvift-
ingf in a great meafure, the courfe of the blood through the
indurated part, may occafion a more copious influx of this
fluid into the neighbouring veflels ; whence the orifices of
fome of the exhaling arteries in the villous coat of the fto-
mach, may be fo dilated as to allow globules of red blood
to efcape with the thinner humours. This fuppofition is
rendered, at baft, not improbable by the following inftance
of bloody urine, occafioned by the womb prefling upon
the neighbouring parts in time of pregnancy.
A Gentlewoman, aged 19, began, in the fourth month of
her firft pregnancy, to make bloody urine, which continued
till within fifteen days of her time. This conftant difcharge,
tho' weakening, yet was not attended with a quick puHl-,
nor any pain in the back or belly. After being deliver-
ed, fhe recovered and enjoyed perfedl health, 'till about
three or four months after flie had conceived again, when
the bloody urine returned and continued, as formerly, till
a fortnight before file was brought to bed. In her third
pregnancy, flie was afFefted in the fame manner, only flie was
much troubled with collivenefs, which increafed the other
diforder ; and after this delivery, before flie fell with child
againy flie had foraetimes returns of the bloody urine.
During her fourth pregnancy, which happened in the 25th
year of her age, the fame fymptom returned, but her lofs
of blood was now greater and more confl:ant than ever, fo
that fhe complained of gre:;t weaknefs, of a giddinefs and
lofs of appetite ; her pulfe was quick and fmall, and for
■ above a month together, flie had quotidian feverifli pa-
roxyfms, generally of ten or twelve hours continuance.
About the middle of the ninth month, her water returncd
to
Nervous Symptoms. 245
3 . A fupprelTion of the menfes or hae-
■morrhoids, whence the blood that ufed
to be evacuated by the uterus or reBum is
turned upon the flomach, and partly dif-
charged by fome of its exhaling arteries.
I HAVE known fome hyfleric patients
affed;ed with levere pains and fpafms in
their bowels who did not vomit any
black fluff, but often paffed it by ftool.
In this cafe, the black purging was ow^-
ing to red blood making its way, in
fmall quantity, into the cavity of the
inteftines ;
to the natural colour; but after lying in and recovering
flowly, in fix or feven weeks ihe grew as ill as ever. Her
blood was now become fo thin, that when fhe happened to
cut her finger, it would fcarcely tinge lin?n.
This difeafe, to which this perfon feems to have been
predifpofed by a laxity of the vefTels of the kidneys, was
moft probably owing to the preffure of the womb on the
iliac arteries, by which means the blood was thrown with
greater force upon the emulgents ; for, if the caufe^of this
haemorrhage had been merely the fupprefllon of the menfes,
it ought to have appeared much fooner than the fourth
month. But however that may be, the patient found great
beneStfrom the tinfture of rofes, the bark with elixir of vi-
triol, a ftrengthening plaifter, and a diet confifting chiefly
of mucilaginous fubftances, gellies and the lighter flefn
meats, with a little claret.
2±6t Of the mojl refnarkable
inteftines; for that this atrabiliary hu-
mour, as it has been called, did not
come from the liver, I was convinced,
by obferving, that fuch patients aspafled
it by ftool, frequently vomited up, at
the fame time, bile of a natural colour.
However, as hypochondriac and hyfte-
ric patients fometimes throw up a dark
green bilious humotu', there may be,
perhaps, a few cafes, in which a black-
ifli liquor coming from the liver or gall-
bladder, may pais from the duodenum in-
to the ftomach, and be afterwards dii-
charged by vomiting.
yill. A SUDDEN and' great flux of
Dale urine.
i.
This is reckoned by Sydenham the
pathognomic fign of the hypochon-
driac and hyfleric difeafe "'^. It has been
afcribed by Hoffman to a fpafm of the
fphindcr of the bladder t; and by Dr.
Cheyne
* Epji. ad D. Cole.
\ Syftem. Med. torn. iv. part. iii. cap. vi. § xvi.
Nervous Symptoms. 247
Chejne to an obflruclion of the perfpira-
tion *; but without fufficieiit reafon.
The real proximate caufe of this
fymptom is always the lame, viz. an in-
creafed motion, together with fome
degree of conftrid:ion of the fccre-
tory veflels of the kidneys ; the firft
augments the quantity, and the fecond
occahons the pale colour of the water:
Altho', it mull be owned, that this
colour is, principally, owing to the
quicknefs of the fecretion of the u-
rine and of its palTage through the
bladder, before the finer parts are ab-
forbed, and it has had time to acquh'e
the common fmell and tafle, as well as
coloiu' of that fluid.
The caufes of fuch an increafed mo-
tion of the fecretory veflels of the Idd-
neys may be reduced to the following ;
I. Sudden or violent affe^^tions of the
mmd. Thus people of a delicate frame
and very moveable nerves will, foon af-
ter a fright, anger or vexation, make
great.
• Engliih Malady, part ii. chap. ix.
248 Of the moji remarkable
great quantities of pale water. The
whole nervous iyftem being in fuch
cafes violently agitated, the fecretory
veflels of the kidneys are tlirown into
ftronger and quicker alternate contrac-
tions than ufual, and fo make a larger
fecretion of urine. Add to this, that
as the perfpiration is generally checked
by diforders of the mind, the watery
parts of the blood, will be turned more
upon the kidneys.
2. An increafed motion of the renal
veflels is often owing to fympathy. Thus
as pain in the kidneys produces a naiifea
and vomiting, fb a difagreeable fenlation
in the ftomach and bowels, from wind,
crudities or other caufes, frequently af-
fedls the veflels of the kidneys with flich
an increafed alternate motion, as greatly
to quicken the fecretion of urine. Fur-
ther, when the body is thrown into a
general diforder, which happens in
hyflieric fits, the nerves of the kidneys
are
Nervous Symptoms. 249
are afFecled as well as others ; and if the
renal veflels are weaker or more irritable
than thofe of the other glands, the
fluids, which are put into violent mo-
tion, will run off this way in the form
of pale water. If the inteftines are par-
ticularly weak, the perfon will be feized
with a purging.
In children breeding teeth, the irri-
tation of the nerves of the gums, fome-
times, affecls the kidneys by confmty
fo as to occafion a confiderable difcharge
of tirine of this kind.
3. Since Sydenham has oblerved, that
the hyfteric difeafe will often feize the
kidne)'s, and occafion a pain, like that
of a nephritic paroxylm *, may not that
noxious matter in the blood wliich is
often the caufe of nervous diforders, be
thrown, fometimes, in llich a manner
on thofe parts, as, tho' not to produce
pain, yet fo to flimulate their fecretory
vefTels,
* Epiji. ad D. Cole,
^5^ Q/' ^^-^ ^^^ft remarkable
veflels, as greatly to iiicreafe the quan-
tity of the urine ? Nor is this more
furpriiing, than that the fame, matter
affecting the nerves of the flomach
ihould produce, at diiferent times, very
different complaints. I have met with
feveral inftances of a great and long-
continued flux of urine from an arthri-
tic humour turned on the kidneys.
Further, lince a floppage of ui-ine,
with a pain at the neck of the bladder,
will, in fuch patients, fometimes pro-
ceed from the morbid matter producing
a Ipafm there ; may not a diminifhed fe-
cretion of urine, withovit any pain in
the bladder or tirethray be owing, in
fome cafes, to a fpalinodic contraction
of the ureters, or fecretory vefKls of the
kidneys ?
I fiAVE had patients, who, after a
Y long fever, or fome other tedious and
Vv^eakening didemper, made a great
quantity of pale water in the night,
but in the day-time no more, fometimes
lefs.
Nervous Symptoms. 251
lefs, than ufual, and of a natural colour.
This increafed fecretion did not gene-
rally begin at any certian hour in the
evening, but foon after going to bed ;
and in the morning, after getting up,
it gradually abated. Nay, a Gentle- -h
man who had been in ufe, for ten or
twelve days, to make from four to fix
Englifli pints of pale water in the night,
finding himlelf greatly weakened there-
by, refolved to try what getting out of
bed would do ; and accordingly, at two
in the morning, after having that night
paffed about a pint and a half of urine
at twice, he rofe and fat up for two
hours, and then was able to make but
about half a gill. After this he went
to bed again, and, in two hours more,
made near three quarters of a pint of
pale water. This experiment was repeat-
ed fome nights after with the fame event.
Those who are troubled with this
flux of limpid urine in the night, find
themfelves ftronger, cooler, and in the
befl
152 Of the mojl remarkable
beft fpirits in the evening, at wliich
time their pulfe is floweft; but foon af-
ter going to bed, their pulfe becomes
quicker, they grow warmer, and begin
to make water in great quantity ; They
are not refreflied with fleep, and, in the
morning, they feel thirfty and languid,
and have a quicker pulfe than at other
times.
This excefs of pale tu^ine, tho* mofl
incident to people of weak nerves, yet,
to diflinguifli it from the true hyfteric
^rofluvium, may be called hectical or
colliquative, as coming in the place of
thofe night-fweats, which often exhauft
fuch ^s have had their velTels weakened,
and their blood impoveriflied by fome
difeafe. When the veflels of the kidneys
are relaxed, and yield too eafily, or are
too irritable, the fever raifed in die
night, by the heat of the bed, will na-
turally tlu'ow off the humour by them,
rather than by the pores of the /kin:
But, in the day-time, the whole body,
and
Nervous Symptoms. 253
and the loins in particular, being kept
cooler, the blood will be lefs rarefied,
and will move with lefs force, whence
the dilatation, or increafed alternate mo-
tion of the renal veiTels will abate, and
confeqiiently the urine will be feparated
in much lefs quantity.
An increafed fecretion of the falivUf
is, like the copious limpid urine, owing
to an unuflial motion of the vefFels of
the falivary glands : And it may be ob-
ferved, that in patients whofe falivary
veflels are weakefl and mofl Lrritable, a
falivation will oftener happen, while, in
thofe whofe kidneys are mofl apt to be
affecT:ed by any diforder in the body, a
flux of pale water will be more fre-
quent.
IX. A NERVOUS atrophy.
A marafmus, or fcnfible wafling of the
body, not attended with flveatings, any
confiderable increafe of the excretions
by urine or flool, a quick pulfe or fe-
verifh
254 ^f ^^^^ ^'^^ft remarkable
verifli heat, may deferve the name of
nervous : Not that I would be thought
by this to iiilinuate, that fuch a difeafe
proceeds from, a diminifhed fecretion of
the animal f|)irits, or from their vitiat-
ed quality. The fluid of the nerves does
not feem to be that nutritious juice, by
means of which the daily wafte of the
body is repaired * ; and we know too
little of its properties, to make it the
foundation of our reafoning on the na-
ture or cure of difeaies. But this kind
of atrophy, tho' not, perhaps, owing
to any fault in the fpirits, or even in the
brain or nervous fyftem in general, may
yet deferve the name of nervous, as it
feems, frequently, to proceed from an
unnatural or morbid ftate of the nerves
of the ftomach and inteflines.
The influence of the floniach In the
animal oeconomy, is greater than is, per-
haps, generally imagined : It not only
contributes to the digeftion of the ali-
ment,
* See ubove, chap. i. No. 9.
Nervous Symptoms. 255
merit, but the whole fyilem is either
invigorated, or alfecled with a languor,
according to the different difpofition of
its nerves. By proper food the nerves
of the ftomach are gratefully ftimulated,
and the whole body is thence enlivened
and ftrengthened ; fo that, befides its
nfe for nutrition, food in the ftomach
becomes, on account of its ftimulus^ al-
together neceflary in fome delicate ner-
vous people, for keeping up the ftrength
of the body, and the due exercife of all
its fun(ffcions : And hence it is, that ilich
perfons become often faintiili as foon as
the greateft part of the food has pafTed
into the inteftines ; — that ftrong broths,
tho' they may aiford as much, or more
nourifliment than fome kinds of folid
meat, yet do not ladsfy the ftomach, at
leaft for any conliderable time, or en-
able us to endure much labour; and
that^ according to the different diipofi-
tion of the nerves of the ftomach, dif-
ferent
2§6 Of the mojl remarkable
ferent aliments will be moft grateful to
it, and moft invigorating to the body*
We know, that an unnatural flate of
the nerves of the ftoniach may either pro-
duce a craving or an averlion to food;
that low fpirits and melancholy often
proceed from that caufe ; nor is it to be
doubted, that when the nerves of the
flomach are, from certain caufes, affe(fi:-
ed in a manner fomewhat different, an
indifference for food, a weak digeftion, a
languor and coldnefs, a flow pulfe, and
wafting, may be the confeqviences *.
The morbid affeftion of the nerves
of the flomach, by fympathy, impah's
the
* Long continued grief, and other paffions, too great
application of mind, a gouty humour, or the morbid mat-
ter of feme difeafe imperfeftly cured, remaining in the bo-
dy, and thrown upon the flomach, as vve!l as other caufes,
may bring on fuch a ftate of the nerves of that organ, efpe-
cidly in thofe whofe nervous f)'ftem and alimentary canal
are naturally too delicate and fenfible. I had fome time
fince a patient fubjed to fits of the gout at the diftance of
feveral years, who, after labouring under fuch an atrophy
as r am now treating of, for eight or ten months, and ufing
various medicines with no great benefit, was cured by a
return of the gout to one of his great toes.
Nervous Symptoms. 257
the vigour and energy of the whole fy-
ftem; whence the motion of the heart
and circulation of the blood will be-
come flower and moi'e languid, the bo-
dy will be deprived of its natural heat,
and be affected with a general weaknefs.
The patient decays daily, tho' exliauft-
ed by no excefllve evacuations, becaufe
his food is not converted into good
chyle; and the nutritious fluid in the
blood, either does not poflefs its ufual
properties, or, on account of the lan-
guid manner in wjiich all the operations
of the body go on, is not applied to the
fever al parts, in fuch a way as to repair
the wafte they daily fiiffer. Further,
the watching or want of refrefliing refl,
and low fpirits or melancholy, which
generally accompany this difeafe, may
contribute to prevent the proper nutri-
tion of the body.
This atrophy is generally attended
with great coftivenefs, and fometimes
with belchings, and other figns of flatu-
R lence
25^ ^f ^^^^ ^^^^ft remarkable
lence in the alimentaiy canal. In fomc
cafes, the urine does not exceed the na-
tural quantity, there is no thirfl, and
the tongue is clean. In others, the dis-
charge by urine conies at length to be
confiderably increafed, a drought pre-
vails, and the patient decays faller.
The pulfe often differs little from
what it is in health, except that it beats
with lefs force. In fome, it has a fmall
degree of quicknefs ; and in others, it
becomes a good deal flower than is na-
tural.
After a nervous atrophy has conti-
nued long, and reduced the patient
much, obilru^lions, fometimes, begin to
be formed in the lungs, either from the
languid circulation, or the fault of the
fluids ; a dry cough comes on, the pulfe
grows quick, and ahec^lic fever is kind-
led, which, together with the original
difeafe in the ftomach, increaies the de-
cay, and haflens the patient's fate.
Some-
Nervous Symptoms. 259
Sometimes tliis difeafe, after it has
brought the patient very low, vv^ill take
a fudden turn, without any apparent
caule. The patient, who had little in-
clination to eat, will get an uncommon
craving and quick digeftion, even of fo-
lid food, which ufed to lie remarkably
heavy on liis Itomach : His pu Ife will be-
come quicker than natural, and his fkin
warm ; his veins, which were contract-
ed, will appear fwelled with blood; from
being low fpirited, he will become
chearful, and daily grow ftronger and
plumper * : All which effecfls feem to
proceed, in a great meafure, if not fble-
ly, from fome change in the nerves of
the ftomach and bowels.
In other cafes, this diforder goes off
as flowly as it came on, and the patient
does not recover fully, 'till after a long
time.
R 2 X. A
* See a cafe of this kind, in a young lad of 14, defcrib-
ed under No. xiii. of this chapter.
26o Of the mofi remarkable
X. A NERVOUS or fpafmodic ajlhma.
Every difficulty of breathing, which
is owing to a fpafm of the bronchial vef-
fels, or veficles of the lungs, may, in a
large fenfe, be called a nervous or ipaf-
modic ajlhma; but as in moft afthmatic
ailments, where the lungs are obftrud:-
ed, or loaded with phlegm, there is ge-
nerally more or lefs of a fpafmodic con-
traction excited in the air-vefTels of the
lungs ; I ihould chufe to define a fpaf-
modic afih7na to be that ipecies of diffi-
cult breathing, which is not owing to
any obftrudlion in the lungs, or load of
humours compreffmg their veiFels, but
to an uncommon contraction of their
bronchial tubes and veficles, whereby
they do not yield, as ufual, to the pref-
fure of the air in infpiration.
The prediipofing caufe of this diieafe,
is a particular weaknefs and delicacy, or
fenfibility of the pulmonary vefiels and
nerves, which renders the mufculo-ten-
dineous
Nervous Symptoms. 261
diaeous membrane comiefting the an-
nular cartilages of the bronchia liable to
be alfe&d with a fpafmodic contradlion
from fuchoccafional caufes, as in a found
ftate of the lungs would not produce
this effedl.
These caufes may be reduced to the
following.
1. Any acrid or noxious matter in
the blood, whether of the arthritic, rheu-
matic, or fome other kind, thrown on
the lungs, and irritating their nerves.
As a proof of this, I have known a per-
fon, affected with a fit of the fpafmodic
ajihma, fliddenly relieved by a gouty pain
in his great toe, and become worfe after
a day or two, when this pain went off.
2. Sympathy with the ftomach.
When the nerves of this organ are dif^
agreeably affected by wind, phlegm, or
crudities, the lungs, if they are more
than ufually irritable, often fuffer by
fympathy, and are feized with a fpafm.
Further, when the flomach is much dif^
tended
262 Of the mofi remarkable
tended by wind, it may, by prefling
upon the diaphragm, increafe an aflh-
matic fit.
3. As hyfteric fits and fpafinodic co-
lics are often occafioned by violent af-
fections of the mind; fo I have known
Ridden fear bring on an afthmatic pa-
roxyfm, in a woman who was fubjed: to
frequent attacks of this difeafe.
4. A SUDDEN diminution of the per-
jfpiration or contraction of the cutane-
ous velFcls from cold, may, by turn-
ing the humours in too great quantity
upon the lungs, occafion a fit. The
cold affecting the cutaneous nerves,
may alfo, by fympathy, produce fome
kind of fpafm in the air-vefi[els of the
lungs.
5. Too great lofs of blood will, in
thofe Vv'ho have very delicate or irritable
lungs, be fometimes apt to produce
aflhmatic fits, rather than other nervous
:^'mptom3 *,
6. Some
* See an inllance cf this in Dr. Banfs treatife on the
three digeftions and difcharges of the human body, p. 291,
Nervous Symptoms. 263
6. Some fixed ob{lru(fl:ioii in the
lungs, which, at all times, makes the
breathing fomewhat lefs free than in
perfed: health, efpecially if any conlicler-
able exerciie is ufed, and which, when
fome of the above-mentioned caufes
concur, produces an adhmatic fit, which,
indeed, ftriclly ipeaking, is of the mix-
ed kind. And here it may be proper
to obferve, that among the many pati-
ents liable to periodical fits of the ajlhma^
there are but very few who have not
fome obflrucfbion, or other obftacle con-
flantly remaining in their lungs ; fo
that a true nervous or fpafmodic aj}b?}m,
without any other fault in the lungs,
than an uncommon dehcacy, or irrita-
bility of their nerves, is a difeafe which
we feldom meet with ; and, on this ac-
count, I have fubjoined the following
cafe.
A GIRL, healthful, well made, and 0/
a feemingly good conftitution, began,
at the age of feven, to complain of a pain
at
264 or i^^^ ^^^ft rsriiarkabk
at the lower part of the fternum. This
pam, which returned at no certain in-
tervals, became gradually more fevere
during the fpace of near two years ; af-
ter which, in place of it, the patient be-
gan to be affected, at times, with a dif-
ficulty of breathing, which returned fre-
quently, without obferving any certain
periods ; as a week, a fortnight, or a
month, would fometimes interveen be-
tween the fits. She was generally feiz-
ed with the fits all at once ; and after
breathing with the utmoft difficulty for
half an hour, fometimes more than an
hour, (he would, of a fudden, become
perfectly well, and fall a-dancing imme-
diately after with her companions. It
was obfervable, that this girl had no
complaint of her flomach, no cough,
nor other apparent fault in her lungs ;
nor did flie ufually expectorate phlegm
when the fit went off; and, except in
time of the aflhmatic paroxyfm, breath-
ed with the fame eafe as any perfon in
perfe(fl
Nervous SyxMptoms. 265
perfedl health. After having been lub-
jedl to returns of this fpafinodic afthma
for above two years, fhe died of a con-
tinued fever, in which her head was
greatly affected.
Was this diflemper owing to fome
morbid matter in the blood, which firft
affed:ed the parts about the Jlenmm, or,
perhaps, the mediajlinum, with a painful
ienfation, and afterwards falling on the
lungs, and irritating then- nerves, occa-
fioned a Ipafm, or true cramp of their
aereal vefTels ? I fliall only add, that fits
of the fpafmodic afthma are fometimes
preceded by a great difcharge of pale
urine; fo that the patients can foretell
them a day or two before they are at-
tacked,
XI. A Nervous cough.
A COUGH may be called nervous, when
it does not proceed from any plilegm,
obftruclion or other irritating caufe in
the lungs themfelves, but from fympa-
thy
+
z66 Of the mofi remarkable
thy with fome other part whofe nerves
ai'e difagreeably afFeifbed. Of this kind
is that dry cough wiiich is occalioned
by worms, or by teething in children*
A cough with very unufual fymptoms,
has alfo been owing to water in the pe-
ricardiwn, and other dilbrders of the
heart, when the huigs thenifelves ap-
peared to be found. But inftead of
making any further oblervations on this
{iibje(ft,; I fliall give a particular account
of a very extraordinai^y cough of the
true nervous or f) mpathetic kind.
A GIRL aged eight, in January 1760,
was feized with a dry cough, which
continued for two or three months, not-
withfianding feveral remedies that were
iifed to remove it. In Odobcr following,
the cough returned v»dth as much vio-
lence as before, and vvith this difference
only, that it v/as rather more fevere
when (lie fat up than when ilie lay in
bed. Altho' her fldn was cool, her
pulfc fcarce quicker than ufual, fome
blood
Nervous Symptoms. 267
blood was taken away, and a vomit
was given, but without any good ef-
feft.. Upon a fuipicion that this cough
might be owing to worms in the fto-
mach or inteflines, flie took fome pow-
der of tin, and two dofes of rhubarb
with calomel. The cough ceafed in
eight or ten days after ufing thefe me-
dicines, altho' no worms were brought
away by them.
Towards the en d of December 1760,
this girl, after having been in good
health for fix or feven weeks, was again
feized with a dry cough, for wliich fhe
was tvv^ice blooded without any advan-
tage ; but file found fome relief, for a
few days, by a blifber applied to her
back.
About the middle of Jamiar'j, the
cough became more conftant and fpvere
when fhe fat up, but never afFe<fl:ed
her when flie lay in bed. On the tliird
o? February i when I was called, I found
the following fymptoms,
Wh I l e
268 Of the mojl remarkable
Wh I l e flie lay in bed, fhe had no
cough, no difficulty in breathing, nor
any pain Ox- unealinefs in her bread ;
her fkin was cool, her tongue moifl
and clean, her appetite good ; and fhe
was as chearful as iifual. Her pulfe
beat, then, about c^o times in a minute;
it was of a moderate ftrength, but a lit-
tle irregular. When flie fat up in bed,
her pulfe became quicker by ten or
twelve ftrokes in a minute, but fhe flill
was free from the cough and every o-
ther complaint ; and in tliis pofture fhe
continued mofl part of the day. When
fhe flood either on the bed, or on the
floor, or when fhe fat on the bedfide or
on a chair, fhe was immediately feized
with the cough, which continued with-
out intermiihon, *till flie lay down a-
gain. The cough was dry and convul-
five, for fhe could* not reflrain it for one
moment ; it was attended v/ith a pain
in the fiernu?n, about an inch or more
above the xiphoid cartilage, which pain
fhe
Nervous SyxMptoms. 26^
fhe never felt in any degree, when fhe
lay down or fat up in her bed.
When fhe flood on her feet, her pulfe
became very fmall and irregular, and
beat at the rate of 200 times in a mi-
nute.
At different times, in the months of
February and March^ I frequently repeat-
ed the following experiments with a
view to diicover more of the nature
and caufe of this uncommon coi/gh,
1. When Ihe lay on her back, a-
crofs the bed, Avith her legs hanging o-
ver it, fhe was free from the cough, but
was immediately troubled with it when
file fat up.
2. Wh en fhe fat up in the bed, or fat
on the floor, with her thighs and legs
in a horizontal poilure, flie coughed
none.
3. When flie fat in the bed, and
drew up both her legs as clofe as fhe
could to her thighs, fhe was then at-
tacked
1'jo Of the 7120JI remarkable
tacked with the cough, and with the
pain in her breaft.
4. When ftie fat in her bed on the
bolfler and pillow, with her thighs and
legs inclining a little downwards, flie
had no cough.
5. When llie kneeled down, either
on the floor or in the bed, with her bo-
dy erecl, flie was immediately feized
with. the cough, and the pain in her
breaft.
6. When flie lay on her back, with
her head and flioulders as low or a little
lower than her body, flie coughed with-
out intermiflion, as flie did alio in an
erect poftnre.
7. In a prone pofture, with her head as
lo\v or lower than her body, flie cough-
ed inceflantly, and was like to be iuffo-
cated ; but as loon as her face was a little
raifcd and fupported on the bolfter or
pillow, the cough ceafed.
The cough, the pain in her breaft,
and iQw^Q of fuffocation, were greater,
and
Nervous Symptoms. 271
and her pvdfe was fmaller, quicker, and
more irregular, when her head was low,
than when (lie flood upright ; but lying
low on her face feemed to give her fliii
greater uneafineis than lying low on her
back.
8. She lay on either fide with eafe,
and without coughing, unlefs when her
head was as low or lower than her bo-
dy.
^. When flie fat or flood with her
feet in Avarin water, fhe had neither any
difficulty in breathing, nor inclination
to cough, nor pain in her breafl; but
file coughed without intermiilion the
moment her feet were taken out of the
Avater.
When fhe fat with her feet in the
warm water, her pulfe beat i 20 times
in a minute ; and, when flanding in it,
between 130 and 140 times. When flie
flept out of the water, and flood on
the floor, the cough infcantly returned,
and her pulfe rofe to 200 in a minute.
10. When
2yz Of the moji remarkable
10. When the heat of the water was'
reduced (by pouring fome cold water
flowly into it) from above loo degrees
of Farenheit^s fcale, to about 70, the
cough returned with its ufual violence ;
and altho' fhe fat in a chair, her pulfe
rofe from about 120 to near 190, and
turned fmall and irregular. After this,
upon gradually adding boiling water, fb
as to raiie the heat of the bath to 88 or
90 degrees, the cough flopt, and her
pulfe became fuller, much flower and
more regular.
I r . When flie coughed the moft vio-
lently, if her foles were only madp to
touch the warm water, flie grew imme-
diately eafy, and continued fo, altho'
her feet were not wholly immerfed.
12. When one of her feet was taken
out of the bath, the cough was not pre-
vented, by increaling the quantity of
warm water, fo as to make it not only
cover the other foot, but alfo a good
part of the leg.
13. After
Nervous Symptoms. 273
13. After her feet had been, for
fome minutes, m water heated to about
114 degrees, one of them was taken out
of it, and, that inflant, the cough re-
turned with its ufual violence; not-
withflanding, that foot and ancle con-
tinued, for fbme time, to be warmer than
the body naturally is, or than was ne-
ceflary to prevent coughing upon put-
ting the foot into the warm water.
14. When one of her legs was taken
out of the water (warmed to about (^6
degrees) and wrapt in a dry or vv^et
piece of flannel whofe heat was at leaft
114 degrees, flie coughed as ullial, but
was relieved as foon as her foot was a-
gain put into the warm water.
1 5. Wh en her feet were covered with
dry fand, heated to above no degrees,
flie coughed with the fame violence llie
ufed to do on the floor. Nor was the
cough, either when (lie fat or flood,
prevented by the flannel wrung out of
hot water, and applied round her feet
S and
274 ^f ^^■'^ ^^^^fi remarkable
and legs ; altho* an equal or a greater
degree of heat, was, by this means,
communicated to thefe parts, than by
the pedihroium.
1 6. When her hands were dipt in
warm water fhe continued as free from
the cough, as when her feet were bath-
ed. But a bottle filled with hot water
and held between her hands, had no
fuch efFe^.
17. When one of her feet was taken
out of the bath, altho' the hand of that
or the other fide was put into water of
an equal or a greater heat, fhe coughed
without intermiflion, but as foon as
both hands were dipt in the warm wa-
ter, file coughed no more.
1 8. I MADE her breathe over the fleam
of hot water, when one of her feet was
taken out of the pedlhroiimi ; but this did
not prevent the cough.
19. When fhe lay with her head as
low or lower than her body (No. 6. and
7.) warm water then applied to her
hands
Nervous Symptoms. ^y^
hands or feet had no efFed; in prevent-
ing or lelTening the cough ; but in eve-
ry other pofture it kept her quite eafy.
20. If one or both hands were dipt
in cold vi^ater, fhe was prefently feized
with the cough, and with the pain in
her bread, whether fhe lay in bed, or
fat with her feet in warm water. The
fame thing happened when her palrns
were applied to a quart bottle of cold
water; with this difference, that the cold
water inftantly raifed her cough, where-
as the cold bottle took two or thi'ee fe-
conds before it could produce that ef-
feift. The cough was alfo raifed by ap-
plying a bottle full of cold water to her
ftomach.
21 . Wh EN fhe lay with her legs hang-
ing over the bed-fide (No. i.) fhe be-
san to coui^h as foon as her foles touch-
ed fome cold water.
2 2. The putting her hands in cold
water, when fhe lay in bed, not only
excited the cough, but raifed her pulfe
S 2 from
276 Of the mojl remarkable
from about ^o to above 180 flrokes in
a minute.
These experiments were often re-
peated between the 3d o^ February and
the 8th of March; but fome time after
this, I found the following difference
with refped: to fome of the above men-
tioned lymptoms.
23. On the ifl and 4th o^ April y when
fhe lay acrofs the bed with her head
llipported by a pillow, and her legs
hanging over (No. i.) flie was imme-
diately attacked with the cough, and
lier pulfe turned fo fmall and quick,
that I could not exacT:ly count it ; but I
was fore it did not beat lefs than 18 or
20 times in five feconds (No. 9.). Upon
railing her legs, lb as to bring them to
a horizontal pollure, the cough imme-
diately ceafed, and her pulfe in a mi-
nute after beat only ten times in five fe-
conds. As foon as her legs were al-
lowed to hang down again, the cough
returned with its ufaal violence.
24. y^pril
Nervous Symptoms. 277
24. April 4th, upon putting one of
her hands into cold water when a-bed,
file was feized with the cough, and her
pulfe became very fmall, and beat at
lead 20 times in five feconds. (No. 22.)
Of late, flie felt more uneafinefs and
pain in her breafl, with a greater fenle
of fuffocation, when flie was feized with
the cough, either upon a change of
pofture, or putting her hands into cold
water. And her pulfe which ufed to
be about 90 when flie lay in bed, was
now at 96 in a minute : but her fldn
continued cool, flie had no thirft, and
her appetite was good.
It will be proper to add, that fhe has
had no expectoration from the beginning.
From the above fafls it appears,
[a) That an ere(^ poflure does not
excite the cough, unlefs either the legs
or thighs be much bent or in a de-
pending or perpendicular fituation. See
No. I, 2, 3, 4 and 5 above.
[b) That
278 Of the moji remarkable
(b) That a depending fltuation of
the legs did not, at firjfl:, occafion the
cough, unlefs when the body was ereS:;
but afterwards, that poflure of the legs
had this efFed: altho' the body lay hori-
zontal. No. I and 23. Her pulfe al-
fo became a great deal quicker in this
attitude than it had formerly been, ei-
ther when file fat up, or when fhe flood ;
whence it would feem that the caufe of
the difeafe had been gradually increa-
fing from the 3d of February to the jfl
o^ April. No. 9, 10, 23 and 24.
[c) That when the head and flioul-
ders are as low or lower than the body,
the cough is flill more fevere than
when fhe flood upright. No. 7.
(J) From the experiments already
related, I was ready to imagine that the
cough might be owing to fome tumor
or other fixed caufe in the breaft, which,
in certain poflures, fo ftrongly irritated
that part of the lungs which it touch-
ed, as to occafion a conflant convul-
five
Nervous SymptOiMs. 279
five motion of the mufcles of refpii^a-
tion ; but the following experiment,
which I frequently repeated, foon diffi-
pated this theoretical illulion.
When my patient lay in bed, upon
extending one of her feet, fo as to bring
it nearly to a right line with the leg,
fhe coughed violently, and her pulfe
role from 94 in a minute to 1 8 in five
feconds : But when her hands were ei-
ther flrongly bent inwards or extended
outwards, or when flie pulled ftrongly,
or raifed a conllderable weight with
them, no coughing enfued.
When the cough was raifed by
ftretching her feet, warm water applied
to her hands immediately put a (top
to it.
From this experiment, as w^ell as
No. 23. it may appear, that this extra-
ordinary cough did not depend on any
fixed obflrudlion or tumor within the
thorax irritating the lungs in certain po-
ftures. But, in this patient, the nerves
of
28o Of the mojl remarkable
of the lungs feem to have been endued
with an uncommon degree of fenfibi-
lity, and to have had a peculiar fympa-
thy with the legs and feet ; whence as
often as they were in a depending fitu-
ation, or the nerves, tendons, and liga-
ments at the ancles, Avere ftretched, an
uneafy fenfation Avas felt in the lungs,
which occafioned an inceflant cough.
Altho' the fympathy betAveen the lungs
and the other parts, appears to have
bcenlefs remarkable, yet the fliockAvhich
their nerves llifFered from cold Avater,
(No. 20 and 21.) Avas fo ftrongly felt
in the lungs, as to occaiion a pain in
the breaft, together Avith the cough.
When the head and flioulders Avere
loAver than the body, the cough Avas
more fevere than in any other fituation,
probably, becaufe in that poflure the
refpiration is lefs free, and the blood
Avould pafs Avith more difficulty thro'
the lungs.
((?) Warm
Nervous Symptoms. 281
(e) Warm water did not, by its pref-
fure on the nerves or blood-vefTels of the
feet, prevent the cough, becaufe it was
excited by cold water, whofe weight is
greater. Neither did the pedihivium pro-
duce this effed: by its heat alone, or e-
ven by its heat and moifture; for fand
or wet flannel of an equal or greater de-
gree of heat applied to the feet, did not
prevent the cough. No. 15. and 16.
(/) As the effedis of the pediluviwn
cannot be deduced from its rarefying
the blood by its heat, neither can they
be owing to any derivation of this fluid
towards the inferior extremities, be-
caufe warm water, whether it was ap-
plied to the hands or the feet, liad the
fame influence in flopping the cough ;
and as foon as the foles of her feet
touched the water, the cough ceafed.
No. I 6. and 11.
[g] It remains, therefore, that warm
water, by its particular ad:ion on the
extremities of the nerves to which it is
applied.
282 Of the moji remarkahU
applied, renders the whole fyflem lefs
fenfible of any irritation ; whence the
too delicate lungs would be lefs afFe6l-
ed in confequence of their fympathy
with the inferior extremities [d). How-
ever, when the patient lay with her
head lower than her body, the warm
water did not then prevent the cough ;
becaufe, in that pofition, the irritation
in the lungs was too great to be whoUy
removed by the anodyie power of the
warm water : And, for the fame reafon,
it feems to have been, that the pedilwohim
did - not prevent the pain within her
bread and the cough, wliich were rai-
fed by dipping her hands in cold water.
No. 6. 7. 19. and 20.
(/;) It appears from the above expe-
riments, that warm water affecls our
nerves very differently, not only from
a dry heat, but alfo from warm fleams,
or cloths dipt in hot vrater ; a fact which
feems not to have been known, or, at
leaft, not fufficiently attended to, and
wliich.
Nervous Symptoms. 283
which, perhaps, may afford feme iifeful
hints in practice. No. 14. and 15.
(/) Si N CE warm water, applied to the
nerves, has a fiiperior anodyne efFe6l,
not only to fubilances that are warm
and dry, but even to warm fleams or
vapour ; it is eafy to fee, how clyfters of
warm water may give relief in pains of
the bowels and other abdominal vifceray
altho' they do not communicate more
heat to the great guts than they pof-
fefTed before.
{k) Lastly, the effects of the warm
water in this cafe appe^tr the more re-
markable, as a pill, conlifting of half a
grain of opium, and three grains of afa
footida, given every evening and morn-
ing, for feveral days, had not the lead
effect in either preventing or leflening
the cough.
Between the 20th of January and
the 25th oi March y a variety of remedies
v/ere prefcribed for this patient, with-
out any advantage, viz. vomits, blifters
and
284 ^f ^^^^ ^f^'^ft rejnarkahle
and an ifTue between the fhoiilders, the
bark, powder of tin, rhubarb with ca-
lomel, -^WXs o^ opium With afa f(Etida, bo-
lufes of theriaca, with camphire and
valerian .
Towards the end o^ March, I put
her on a courfe of pills made of the ex-
trad: of hemlock, which flie continued
for two months. About the middle of
Mfzy file began to have lefs pain in her
breaft, and lefs lenfe of fuifo cation and
coughing, when flie fat up out of bed,
or Avalked through the room. Upon
the 2 2d o^ May, thefe complaints left
her altogether ; and on the 28th of that
month, the cough was neither raifed by
Handing nor walking, nor when her
head was laid lower than her body : Alfo
cold water applied to her hands, had
now no effect in exciting the cough or
pain in her breaft. On the 30th of
iA/jv, after walking a little abroad, the
cough returned for a day or two. Up-
on tlie 3d of?// 7^', after having made a
journey
Nervous Symptoms. 285
journey of about ten Englilli miles in a
chaife, the cough attacked her with as
great violence as ever. Being now ful-
ly convinced, that this ailment was not
OAving to any fixed obftrud:ion in the
lungs, but to an uncommon delicacy or
fenfibility in their nerves, I ordered for
her, pills of extract of gentian and lima"
tiira martis, which flie took twice a day
for about ten weeks. Towards the end
of y?//y, the violence of the cough began
to abate, and for the firft eight or ten
days oi Aiignjl, (lie was feldom troubled
with it. On the loth o^ Aiiguft^ it re-
turned and continued to the 2d of
September, when it left her entirely. In
the month of 'November following, flie
had a flight attack of the cough and un-
eafinefs in her breafl ; which fymptoms
returned, for one day, vn September 1762,
fince which flie has been very rarely af-
fefted with them in any coniiderable
degree. It was obierved, tliat the re-
turns of her cough after September lyGi,
were
286 Of the mojl remarkable
were always owing to her ufing exer-
cile too freely.
XII. Pal p I TAT I ONs of the heart.
1 . In thofe whofe nervous fyftem is
eafily moved, any fudden and ftrong
pailion, but efpccially fear, will produce
palpitations, and an irregular motion of
the heart, by rendering it more irri-
table, and, at the fame time, by forcing
upon it the venous blood in greater
quantity than ufual *.
2. The regular motion of the heart
may be alfo difturbed by its fympathy
with the ftomach, when this organ is
difordered, by wind, noxious humours,
worms, or other caufes ; — by the flippreP
iion of fome habitual evacuation ; — by
fome acrid matter in the blood falling
on
• Fear or furprize feems to occafion a fudden contrac-
tion of the right finu: 'venofus, and, perhaps, alfo of the
adjoining trunks of the n.e>ia cava ; for I frequently feci,
upon any furprize, a fudden contraflion about my heart,
while the veins in my hands and fingers feel as if the)'
were diftended with blood.
Nervous Symptoms. 287
on the heart itfelf*; — by mflammations
or obftru(!l:ions in it or the pericardmmy
and by polypi or oiTiiied valves ; for thefe
caufes either render the heart more ir-
ritable than in a natural ftate, or difhirb
the free motion of the blood through
the great velTels adjoining to it.
XIII. The pulfe often varying in
quicknefs, ftrength, and fulnefs, not
only in different patients, but in the
fame at different times.
To account for thefe variations of the
pulfe, it will be fliiiicient to mention,
briefly, the general califes of a flrong
and weak, hard and foft, quick and
flow pulfe.
I. As a ftrong pulfe is ov/ing to the
ventricles of the heart expelling with a
confiderable force, that quantity of
blood which they can contain ; fo a
weak pulfe may proceed from a debili-
ty
* I have often feen palpitations, which, as far as I could
judge, were owing fol>;ly to an arthritic humour affecting
the heart.
288 Of the mo/l remarkable
ty of the ventricles, whence a proper
impulfe is not given to that fluid ; or it
may be owing to a too great irritability
■whereby the ventricles contrail before
they are fufficiently filled ; or to the
want of a free circLilation of the blood
through the lungs, whence it returns
in too fmall a fir earn to the heart.
2. A HARD pulfe is owing either to a
too great denfity of the blood, or to
an obftru6lion, or, oftener, a fpafinodic
contraction of the vafcular fyflem, par-
ticularly the capillary arteries ; in which
cafe the blood palfing with difficulty
into the veins, the arteries mufl feel
tenfe and hard *.
This pulfe often occurs in pleurifies,
and other inflammatory dLfeafes. It is
to be obferved, however, that in inflam-
mations of liich parts as are veiy {en-
fible,
* I have known fome people, whofe pulfe, in a natural
ftate, was harder than that of moft others in the greateft
inflan.rnatory difeafes. Is it not probable, that in fuch,
the coats of the arterial fyflera were more tenfe, and the
paflage from the arteries into the veins ftraiter than ufual ?
Nervous SymptoiMs. 289
iible, and have a remarkable fympathy
with the heart, while the pain produces a
kind of fpafmodic contraction of the ar-
terial fyftem, it often renders the heart
fo irritable, that, though the pulfe feels
fomewhat hard, yet it is very fmall ; be-
caufe the ventricles contract before they
are fiifficiently filled with the returning
blood : And this is frequently the cafe in
inflammations of the ftomach, bowels,
and uterus *. On the other hand, when
the lungs or liver are inflamed, the
pulfe is generally fofter and fuller, be-
caufe thefe parts have but little painful
feeling; and therefore the vafcular iy-
flem is feldom affefted with any fpafm.
It is, however, to be obferved, that an
inflammation of the external membrane
of the liver or lungs, is attended with
confiderable pain, and a hard pulfe as
in a pleurify.
3. A too foft pulfe is owing either
to a laxity of the whole vefTels, and par-
T tlcularly
* Phyfiologica! EHays, edit. ii. p. 6G.
290 Of the mojl remarkable
ticularly of the capillary arteries, or to
a thinneis or watery ftate of the bloody
which palTes into the veins and fecrdr
tory veilels fo eafily, that it can exert'
little of its force in dilating the arte-
ries.
A SOFT pulfe is more common than
a hard one, in thofe patients who are
flibjecl to nervous or hy fieri c com-
plaints ; becaule, too thin blood and a
laxity of the vafcular fyftem are more
common in fuch, than denfe blood and
a too great tenfion or ij^afmodic con-
tracftion of the arteries, which occafion
a hard pulfe.
4. A PULSE quicker than natural muft
be owing to one or more of the follow-
ing caufes, "jiz, an increafe of the ftimu-
lating quaUty of the blood, its quicker
return to the heart, or a greater degree
of fenlibility, and confequently a great-
er aptitude for motion in the heart.
(^) The flimulating quality of the
blood is increafed, by its becominq; too
denle
Nervous Symptoms. • 291
denfe or fizy, — by external heat, — by
frefli chyle, flich efpecially as is prepa-
red from annual food, or acrid and heat-
ing aliments ; and by the mixture of
any noxious humours bred in the body,
or of malignant or poifonous effluvia re-
ceived from the air.
(b) Th e blood is made to return in
greater quantity to the heart by all
kinds of exercife, fuddeu fear, and
other flrong pallions.
(c) The fenfibiiity, and confequently
the irritability of the heart * is increa-
fed, by various affections of the mind,
or whatever increafes the general fenfi-
biiity of the nervous fyflem, — by fympa-
thy with the other parts, efpecially the
ftomach and inteflines, when thefe are
pained, or affected with a difagreeable
ienfation, — by an arthritic, fcorbutic,
T 2 or
* See Phyfiological EfTays, edit. ii. p. 185, &c. and
p. 252, Arc. and Edinburgh Phyfical Efiky , vol, ii. art. xx.
p. 310, &c. where it is proved, from undoubted experi-
ments and obfervations, that the irritability- of the mufcles
of animals depends on their fenfibiiity.
292 Of the mofl remarkahk
or fbme other morbid humour thrown
upon the heart; and by obftru(ftions
and inflammations in any part of the
body, but eipecially in the lungs, peri-
cardiiun^ or in the heart itfelf.
5. A PULSE flower than natural muft
be owing either to a diminution of the
flimulating quality of the blood, its flow-
er return to the heart, or a lefs degree
of fenfibility, or aptitude for motion in
that organ.
(^) The flimulating quality of the
bload is lefTened by external cold, — by
too weak or too fpare diet; and by the
blood being not of a proper denfity, but
poor and watery from a weaknefs of
the vafcular lyftem. Hence, after great
evacuations, the pulfe not only often
becomes low, but very flow. I have
feen, in patients recovering from fe-
vers, or in women, ten or twelve days
after child-bearing, the pulfe fall under
fifty flrokes in a minute, and rife after-
wards to about feventy,its natural ftand-
ard,.
Nervous Symptoms. 2^3
ard, when the patients were flronger,
and their vefTels fuller. In flich cafes,
befides die poornefs of the blood, and
the want of a fufficient quantity of it, a
general languor and debility of the
whole body, probably concurred to
niake the pulfe fo very flow.
(b) The return of the blood to the
heart becomes flower when the body is
at reft, efpecially in a horizontal pofture,
and when the mind is not difturbed by
pallions.
(c) The fenllbility and irritability of
the heart are leffened by age, deep fleep,
and every medicine or diftemper that
impairs the general fenfibility of the
brain and nervous fyftem, as opmn, a
lethargy, coma, apoplexy, 6^f. Further,
as the heart is often rendered more ir-
ritable by its confent with the ftoniacli
and bowels, when thefe parts are difi-
greeably affected by wind, the arthritic
matter, or other caufes ; fo its irritabi-
lity feems, in fome cafes, to be leffened
by
294 ^f ^^^^ ^^^^ft remarkable
by its fympathy with thefe parts, when
their nerves are affected in a different
manner *. Thus, worms or vifcid
phlegm in the ftomach and bowels, or
a violent pain of the fpafmodic kind af-
fecting them, will fometimes make the
pulfe much flower than natural, as well
as irregular: And long continued grief,
melancholy, or low fpirits, by impair-
ing the vigour of the whole nervous as
well as vafcular fyflem, may render the
pulfe flower than in its natural flate,
unlefs fome morbid caufe quickens the
motion of the heart.
From what has been faid, of the cau-
fes of the quicknefs, flownefs, flrength,
and fiilnefs of the pulfe, it will eafily
appear, why, in nervous, hypochon-
driac, and hyfleric dlforders, the pulfe
is often fo different, not only in various
perfons, but in the fame perfon at dif-
ferent times. I fliall, therefore, only
add
* *' yence -^ pleramque fatis fano corpore, fi fco-
*' machus infirmus eft, fubeunt et cjuiefcunt." Cc//n: de
Medici r.a, lib, iii. cap. 6.
Nervous Symptoms. 295
add a few inftances of the effect of thofe
ailments in making the pulfe quicker
or flower than uiual.
(i) A LADY aged 38, who had loft a
great deal of blood in child^bed, on the
eighteenth day after her delivery, at fix
in the morning, was feized with a fliarp
pain above the os pubisy darting towards
the anus. This pain Ibmetimes extend-
ed upwards, and then over to the right
fide in the direction of the colon, Not-
Vvdthflanding her having taken twenty-
five drops of laudanum, flie complained
of a naiifea and inclination to vomit a-
bout half an hour paft feven, and before
two in the afternoon, (lie vomited fix or
{^Y^n times. About eleven in the fore-
noon, having got a clyfter with afa foo-
tida, (lie had tv/o ftools, and palTcd a
great deal of wind. Her pulfe, which,
when file was taken ill, beat 60 times
in a minute, about feven in the morn-
ing began to grow quicker, and, before
two in the afternoon, rofe to 130, but
became
296- Of the mojl remarkable
became feebler and fmaller in proper- \
tion to its quicknefs. At this time, as
fcarce any tiling would ftay on her fto-
mach, fhe got a broth clyfter, with 40
drops of laudanum in it : After wliich ftie
lay quiet for two hours, and her pulfe
came down to 120. From four in the
afternoon to ten, flie took every hour
fome panada, with a little claret and
cinnamon, by which her pulfe was re-
duced to 100 in a minute, and began
to be fuller. After this, as the com-
plaints in her ftomach and bowels de-
creafed, her pulfe returned to its natu-
ral ftrcngth and flowneis.
A Q,uiCK pulfe, as in the above cafe,
is carefully to be diftinguiflied from a
quick pulfe occafloned by an inflamma-
tion, or a common fever. In the former
it is foft, and neither full, hard, nor
contrafted ; it becomes fmaller as it in-
creafes in quicknefs; nor is it common-
ly attended with any great heat or
thirft ; but the furefl mark is, that it be-
comes
Nervous Symptoms. 297
comes flower upon eating a little flefli-
meat, drinking a glafs of claret, or u*
ling caftor and opium \ all which are
hurtful when the pulfe is quickened by
inflammation, and, for the moft part, in
fevers 'till their decline.
However, it may be proper to ob-
ferve that a quick pulfe, occafioned by
pain from fpafms or wind in the fto-
mach or bowels, may, efpecially in ilich
as are plethoric, upon continuing long,
change its nature, and, from being
merely nervous or ipafhiodic, become, at
laft, inflammatory; that is the conie-
quence of an inflammation produced in
the part affefted with pain.
(2) An unmarried Lady, between 30
and 40, was feized with a ievere pain in
her lower belly, andhad been ill of it near
two days before I was called. I found
her pulfe at 70 ftrokes in a minute, and
of a natural foftnefs. I ordered her,
at bed-time, 25 drops of laudaiiwn with
as many grains of rhubarb. She was
eafy
298 Of the moft remarkable
eaiy tlirough the night, but next morn-
ing, when the effects of the laudarium
were over, and the rhubarb had begun
to operate, her pains returned with
greater violence, and flie had two ftools. j
About noon, the pains increafed, and
then her pulfe, which in the mornmg
had been juft as the day before, became
fmaller and flower, fo that at two in the
afternoon it was not above 56 in a mi-
nute. At that time, fhe complained of
a lownefs, and a coldnefs through her
whole body. I dired;ed her to take
fome panada with wine and nutmeg,
and ordered a clyfter with fifty drops of
laudanum in it. This foon removed the
pain and reftored the pulfe to its natu-
ral fulnefs and quicknefs ; the coldnefs
went of}', and her fkin grew rather
warmer tlian ulual.
In thefe two cafes, we fee, from the
fame general cauie, viz. a fliarp pain in
the bowels, oppofite effects, a quick
pulfe in the firfb, and a flov/ one in the
focond ;
Nervous Symptoms. 299
fecond ; and by the fame medicine and
diet, viz, iaudammi, panada and wine,
we find the pulfe made flower and fuller
in the one, and quicker and fuller in
the other. What might be the reafbn
of fuch a difference is hard to fay : Was
it owing to the different kind ofjiimulie
affefting the nerves of the bowels, or
rather to the different conftitution of
thefe two patients ?
An acute pain in any part generally
brings on an inflammation, and quickens
the pulfe, but in people fubje^l: to ner-
vous or hyfleric complaints, a violent
pain ill one fide of the head, in the flo-
mach or inteflines, often renders the
pulfe flower and more languid.
When pain produces inflammation,
it not only excites the veffels of the part
into flronger and more frequent alter-
nate contrad;ions than ufual; but the
heart and whole arterial fyftem are, by
fympathy, rendered more irritable. On
the contrary, when an irritation or pain
in
300 Of the mojl remarkable
in any part occafions a fpafm or conti-
nued contraCiHon of its veflels, no in-
flammation is produced in it ; and the
heart and vafcular fyflem, being, by
fympathy, alfo commonly affected with
fome degree of fpafm, perform their al-
ternate motions with lefs freedom and
readinefs ; whence the pulfe becomes
flow, fmall, and fometimes irregular,
and the whole body feels cold.
Does then the difference between
pain, with or without inflammation,
confifl in the vefFels of the part affecT:ed
being agitated, in the former cafe, with
an uncommon alternate contraction,
and in the latter with a continued
ipafin ?
When, in delicate people, we meet
with pain producing a quick but foft
and feeble pulfe, and vvithout any con-
llderable increafe of the heat of the
body, we may fiippofe either, that al-
tho' the veflels of the pained part be af-
fe^led with a fpafm, yet the he^rt does
not
NeIivous Symptoms. 30^
not fliffer in this way, but is only ren-
dered more iiritable by the pain ; or
that notwithftanding thofe velTels may
be agitated with a greater alternate mo-
tion than ulual, yet, on account of the
weak ftate of the blood or laxity of the
folids, fcarce any degree of inflamma-
tion is produced.
(3.) A Gentleman betwixt 30 and
40, who, for feveral years, had been
much troubled with flatulent com-
plaints, was, after an error in diet,
feized with a pain about the middle of
the abdomeriy and ftriking into his back,
which foon became fo intolerable, that,
after having vomited up feveral dofes
of laudanwjz, and got clyllers to no pur-
pofe, he was obliged to have recom-fe
to the ft^miaipium for relief. His pulfe,
which in a natural (late beat about 64
times in a minute, was, by the violence
of the pain, reduced to 44 flrokes in
that time, and was, befides, fmall, feeble
and often iiTegular. The warm bath
not
$02 Of the moft remarkable
not only relieved the pain in the bow-
els alnloft inftantaneoully, but alfo ren-
dered his pulfe full, foft and regular,
-tho' feme what quicker than it uied to be i
when he was in health. Sometime af-
ter he came out of the warm bath the
pains returned with conliderable vio-
lence, and his pulfe alfo became; flow,
fmall and irregular ; but upon having
recourfe to it again, he was immedi-
ately made eafy, and the pulfe returned
nearly to its natural ftate.
(4.) A YOUTH of fifteen, of a ftrong
make and feemingly healthy conftitu-
tion, had, for fome time, been fubjecl,
once in fix or eight v/eeks, to a violent
pain in his belly, with an apprehenlibn
of immediate danger. During the
time he was mofl troubled with thefe
colic pains, his pulfe commonly beat
only fifty times in a minute ; but as
foon as, by the ufe of laxadves, and aro-
matic bitters, he had got free of this
complaint, it returned to its natural
quicknefs,
Nervous Symptoms. 303
quicknefs, wliich was about 80 flrokes
in that time.
(5) Another lad of 14, of a thin
and delicate habit, and of quick and
lively feelings, whofe pulfe, in health,
ufed to be between 70 and 80 in a mi-
nute, about the beginning ofjwte 1 y§y,
was oblerved to be low-fpirited and
thoughtful, to lofe his appetite, and
have a bad digeftion. Altho' he fell a-
way daily, yet he had no night-fweats,
no extraordinary difcharge of urine,
and was coftive. His tongue v/as clean,
his fkin cooler than natural, and, when
in bed, his pulfe beat only 43 times in
a minute ; nay, about the middle of
July, when reduced almoft to fkin and
bone, his pulfe, in a horizontal pofture,
did not exceed 39. About the end of
Align ft, his diflemper took a fudden'turn ;
he then began to have fuch a craving
for food, with aquick digeftion, that lie
grew faint, unlefs he eat almofl every two
hours; he had two or three llools a-day ;
his
304 Of the mo ft. remarkable
his piilfe beat from 9610110; his fkiii
-was warm ; and his veins, which fcarce
could be feen before, became now tur-
gid with blood. The flrong apprehen-
fions he formerly had of dying left him,
he was fure he fhould recover ; and ac-
cordingly, by the middle of OBobcr, he
was plumper than ever he had been be-
fore. Towards the end of November, his
appetite became moderate, and his pulfe
gradually returned to its natural flate.
It was obfervable, that the pulie was
flowed towards the evening, and gene-
rally of a proper ftrength and fulnels.
Since, with all my attention, I nei-
ther could difcover the caufe of this pa-
tient's firft complaints, nor of the fiid-
den and contrary turn which they took
afterwards, I fliall not pretend to rea-
fon on his cafe ; but I thought it de-
ferved to be mentioned, as a good
inflance of a nervous atrophy, and of
the efteci of fuch diforders In making
the
Nervous Symptoms. 305
the pulfe much flower, than ever it has
been obferved in a natural ft ate.
XIV. Periodical Headachs.
These either affect almoft the whole
head, efpecially the fore-part, or only one
fide of it ; fometimes no more than one
of the eyes, with part of the fore-head
and temple of the fame fide. — They ge-
nerally return once a-day, nearly at the
fame hour, and as regularly as the fit of
a quotidian ague. — In fome cafes, they
are attended with a vifible fwelling not
only of the eye affected, but alfo of that
fide of the fore-head. Sometimes the
eye feems to fink within its orbit : at
other times, nothing can be obferved
but that the eyes want their ufual luflre,
and look as if the perfon had watched
long, or drunk too much.
The moft common caufes of periodic
headachs in thofe who are fubjed to
nervous difordcrs, are,
I. Sympathy with the flomach, by
which the nerves chiefly of the fore-part
U of
3 ©6 Of the moft remarkable
of the head fufFer ; and the fiiiall vef^
fels to which they are diftribiited, are
either afFecled with a continued fpafm,
or agitated with uncommon alternate
contraclions and relaxations ; in con-
fequence of which the patient feels a
pain, flraitnefs, fulnefs and pulfation
about the fore-head and temples.
2. A VISCID or acrid humour ob-
flrudiing or irritating the linall vellels of
the pericranium^ mufcles of the head, or
(hira mater, and confequently affe^ling the
nerves of thofe parts with a painful fen-
fation. This may be often no other than
a rheumatic, gouty, or fcorbutic humour
falling chiefly on the head.
3. A PARTICULAR wcakncis, delica-
cy and fenfibility of the nerves of thofe
parts of the head ; whence, from Hidden
changes of weather, errors in diet, fa-
tigue of body, llrong pallions, intenle
application of mind, ilippreflion of ordi-
nary evacuations, or even from (lighter
Cviufes, thefe nerves being eafily fuicep-
tible
Nervous Symptoms. 307
tible of pain, the fmall veilels to which
they are diftributed, become affected ei-
ther with violent alternate contractions
and relaxations, or a fixed fpafm. This
feems to be confirmed by obferving,
that women liable to tliefe periodic
headachs fufFer mofl feverely about the
menftrual periods ; at which time it is
well known, that ifTues and other fores
become generally more painful and in-
flamed, as being more irritable and ea-
iily affected than the other parts. In
any general indifpofition, thofe parts,
which are leafl firm and found, fuffer
moft.
How thefe headachs fliould return
every day, or fometimes once in tvvo
clays, is a hard queflion. We know,
that intermitting fevers obferve very re-
gular periods : And I have feen epilep-
tic patients have fits once or twice every
day, or once in two days, almoft pre-
cifely at the fame hour. Hyftcric con-
vulflons, and other difeafes, have alfo
U 2 been
3o8 Of the mofl remarkable
been obferved fometimes to be regulan- j
ly periodical.
Does the morbid matter in fuch
cafes, after being diflodged by the viof
lence of the paroxyfm, require a cer-
tain time, before it is again collected or
depofited on the parts affecfled, in fuch
a quantity, as is fuflicient to produce a
new fit ? Such is the obfcurity of nature
in many of her operations, that we
meet, ahnoft every where, with appear-
ances, of which we' are unable to give
any fatisfadlory explanation. However,
both in natural philofophy and medi-
cine, it is often fuificient, at leaft for the
purpofes of life, to know the certainty
of fome particular fb^nomenay altho' we
cannot account for them. Sitficit ft quid
fiat ijitclliganms, etiajnfi quomodo quidqtie fiat
igiioremus . Cic er o .
XV, A GIDDINESS.
This may proceed from fome of the
caufes which have been mentioned a-
bove.
Nervous Symptoms. 309
bove, as producing periodic headachs,
eipecially when they afFe6l the anterior
part of the brain or dura mater.
Many people of a delicate, nervous,
and vafcvilar fyftem, after (looping and
fuddenly raiflng their head, are apt to
be feized with a vertigo^ which is fbme-
times accompanied with a faintneis. In
this cafe, the vefFels of the brain being
too weak, feem to yield more than ufu-
al to the weight of the blood, when the
head is inclined ; and afterwards, when
it is fuddenly raifed, and the blood at
once defcends towards die heart, thofe
vefTels do not contrad: fad enough, fo as
to accommodate themfelves to the quan-
tity of blood remaining in them: At the
fame time the brain, on account of its
too great feniibility, is more affeded
than ufual, by any fudden change in tlie
motion of the fluids through its vefTels.
It feems to be owing to an uncom-
mon delicacy and fenfibility of the re-
tinHf and indeed of the whole nervous
fyftem,
3IO Of the mojl remarkable
fyftem, that fome people become fo gid-
dy as to be in hazard of falling, if they
look ftedfaftly into a glafs that is kept
-conftantly moving before them, or at
any obje<ft that is turned fwiftly round.
XVI. A DIMNESS of fight, without
any vifible fault in the eyes.
This fometimes proceeds from the
ftomach *; in which cale the patients
are only affecled with it, at particular
times, when that organ is out of order,
and, by fympathy, affedis the retina, op-
tic nerves, or that part of the brain
from which they take their rife. I know
a Lady much troubled with a fournefs
hi her ftomach, who, when this increa-
fes to a greater degree than ufual, lees
every thing indiftin6lly, as if a thick
fhioak or m]ft were before her eyes ; nor
does fhe get quite free of this, till, by
chalk, or crabs eyes, lime-water, nmgnc-
fa alba, vomits and bitters, fhe has de-
ftroyed,
* See Lommii Qhfer--vat. Med. lib. ii.
Nervous Symptoms. 311
ftroyed, in a great meafure, the acidity
in her ftomach.
I HAD fome years fince a patient of a
a very deUcate nervous fyflem, whole
eyes, when his ftomach was much trou-
bled with acidity and flatulence, were
fometimes rendered fo very fenfible,
that looking ftedfaftly on a crimfon co-
lour, or coming fuddenly from a bright
light into a dark room, or from this laft
into the fim-fhine, wovild occafion a
giddinefs and pain above his eyes, to-
gether with a dimnefs of fight, and a
bilious vomiting.
XVII. Low ipirits, melancholy and
a mania,
I. In cafes of an irregular gout, Avhen
the arthritic matter falls upon the fto-
mach and bowels, it frequently produ-
ces a naufea, flatulence, low Ipirits, and
other uneafy fymptoms. In ilich, wind
pent up in the ftomach or inteftines, oc-
cafions a difagreeable, though not pain-
ful.
312 Of the moft remarkable
fill, fenfation, attended with a faintnefs,
languor, and depreflion of mind. But
at other time^, when this arthritic mat-
ter has left thefe parts, we may obferve,
that a greater degree of flatulence, oc-
cafioned by errors in diet, will have no
fuch effed:. Low fpirits, therefore, in
hypochondriac and hyfleric cafes, may
be frequently owing to fome morbid
matter in the blood, flatulent and im-
proper aliments, or other caufes affedl-
ing the fliomach and bowels with a par-
ticular fenfation, which, though not
painful, neverthelefs is attended with
great dejed:ion of mind.
2. Low fpirits may be occafloned by
obftrucfbions in the hypochondriac vif-
ccra, viz. the fl:omach, liver, e^^. But as
obftru^lions often happen in thofe parts
without any remarkable dejection of
mind ; whenever they are attended with
this fymptom, it muft be owing, princi-
pally, to the nature of the obltrud:ing
matter.
Nervous Symptoms. 313
matter, or rather to a particular morbid
ftate of the nerves ofthoie vifcera*
3. A MANIA, and the higher degrees
of melancholy, may proceed from fome
noxious matter in the blood, carried
from the vifccra of the lower belly or o-
ther parts, where it was chiefly lodged,
to the brain. Of this I fliall give an
inflance or two, that fometime ago oc-
curred ivx my practice.
{a) A Gentlewoman upwards of 30,
who had been long troubled with wind
in her ftomach and bowels, indigeftion,
faintnefs, languor, palpitations, and
fudden fits of terror, with a pulfe gene-
rally quick, but variable, having been
for fome little time much freer of thefe
complaints than ufual, on the 24th of
Augufti became all at once deprived of
Jier reafon. During the nights and in
the mornings, flie talked incoherently,
but throughout the day, flie had fome
intervals of reafon. While flie conti-
nued in this way, her pulfe was better
than
314 Of the mojl remarkable
than ufual, and fhe was quite free of her
ordinaiy nervous fymptoms. She had
no fharp pain in her head, but com-
plained of an uneafy fenfation and great
confufion in it. Being coftive, fhe took
fome aloetic pills; but could not be
prevailed on to ufe any other medi-
cine. However, in a few days, fhe
grew much better, and by the 5 th
of September entirely recovered the ufe
of her reafon, but relapfed, in fome
degi'ee, into her old complaints of fla-
tulence, indigeflion, and palpitation.
(^) A Gentleman aged between fix-
ty and feventy, after having been for
fome years free of the gout, began to
have conftant complaints of his flomach
and bowels, and at laft was feized, all
at once, with a delirium, |^ which, by
the application of finapifms to his fbles,
went off in a few hours. In two days
the delirium returned, when, by blifler-
ing his legs, a pain came into one of
Ills great toes, upon which he recovered
his
Nervous SymptOxMs. 315
his ienfes entirely. In this manner the
gouty humour moved backwards and
forwards, between his head and feet,
for near two months, ^till at laft, being
more fixed in the brain, it brought on a
continued and violent madnefs, which
no remedy could leflen. In this ftate
he obllinately refufed almoft every kind
of food, and died in a few weeks.
4. Sudden terror, exceffive grief, or
other violent pailions of the mind, in
people whole nervous fyftem is very de-
licate, may affect the brain fb as to pro-
duce a continued mania or melancholy.
But in what manner the paflions, or the
morbid matter of nervous difeafes
change the ftate of the brain or cojiimon
fenforhim, and occafion flich diforders,
is entirely unknown.
XVIII. The inaibus^ or night-mare.
In this difeafe the patient, in time of
fleep, imagines he feels an uncommon
oppreffion or weight about iiis breaft
and
i
316 - Of the mojl remarkable
and ftomach, which he can, by no ef-
fort, fliake oiF; but groans, and fome-
times cries out, though, oftener, he at-
tempts to {peak in vain. He imagines
himfelf to be ftruggling with ftrong men
or devils, to be in a houfe on fire, or in
danger of being drowned in the fea or
fome river. In attempting to run away
from danger, or climb up a hill, he fan-
cies he falls back as much after every
ftep as he had advanced before. The
terror excited by the frightful ideas at-
tendingthe night -mare, fometimes occa-
fions a tingling of the ears, and a tremor
over the whole body.
This diforder has been commonly
fuppofed to proceed from a ftagnation
of the blood in the fumfes of the brain,
or in the veflels of the lungs ; or from
too great a quantity of blood being fent
to the head.
The horizontal poflure in time of
lleep, and the prelTure of the llomach
upon the aorta, in a fupine lituation,
have
Nervous Symptoms. 317
have been thought fufficient to occafion
a more than ufual diftenlion of the finu-
fes and other velTels of the brain ;
and the weight of the heart prefling on
the left auricle and large trunks of the
pulmonary veins, may, it is faid, pre-
vent the eafy return of the blood from
the lungs, and fo produce an oppref-
fion, and fenfe of weight and fliffocation
in the brealt*. But not to enter into
a particular examination of thefe opi-
nions, which are far from being fatis-
faclory, I fliall only obferve, that, if they
were true, fbme degree of the night-
mare ought to happen to every perfon
that lies on liis back, ef])ecially after
eating a full meal. Further, if a ho-
rizontal fltuation could overcharge the
brain with blood fo as to occafion the
incubiiSf how comes it that people, who
remain, for fome time, in an inverted
poflure, do not feel tliis difeafe begin-
ning to attack them? And why does a
(lighter
• See Dr. Bend's Eflay on the incubus, chapter ii.
3 1 8 Of the mojl remarkahk
flighter degree of the night-mare fbme-
times feize people who fleep m an ere(^
fituation in a chair * ? As the weight
of the ftomach, even when filled with
food, can have fcarce any efFed: upon the
motion of the blood in the aorta, fo the
preffure of the heart is by much too
fmall to be able, fenfibly, to retard the
motion of that fluid in the pulmonary
veins ; otherways people exhaufted by
tedious dileafes, who generally lie on
their back, woidd be conftantly affecfted
with the inathits.
We knov/, that certain medicines or
poifons, worms, and even corrupted
bile or other humours, by difagreeably
aftefting the nerves of the flomach, pro-
duce an opprefTion about the pracordia,
v/ild imaginations, frightful dreams, ra-
ving and infenfibility: And there is no
doubt, that low ipirits, melancholy,
and
* Something of this kind I have experienced myfelf,
not only after eating, but alfo before fupper, when my
ftomach was our of order, and troubled with wind.
Nervous Syimptoms. 31^
and diflurbecl fleep, often proceed from
a difordered flate of the ftomach. Is
it not probable, that the night-mare has
its feat chiefly in the fame organ? If
epileptic fits often proceed from the fto-
mach, why may not the inciihits, which
has been confidered by Galen as a noc-
turnal or flighter epilepfy, liave its feat
in that part ? People troubled with ner-
vous and hypochondriac ailments, and
who have delicate or flatulent ftomachs,
are more fubjed; than others to this dif^
order. — A heavy or flatulent flipper
greatly increafes the night-mare in thofe
who are predifpofed to it. — The {yvci.-
pathy of the ftomach with the head,
heart, lungs, and diaphragm, is fo re-
markable, that there can be no difficul-
ty in fuppofing the feveral fymptoms of
the inatbiis to arife from a difa2:reeable
affe(^ion of the nerves of that organ.
When my ftomach has been out of
order, and troubled with wind, I have
often perceived a flighter inciibus {^yl^
me
320 Of the mofi remarkable
me before I was fully afleep, the unea*
ilnefs of which would make me get up
fuddenly. As foon as I was quite a-
wake, I was generally feniible I had
been affected with a weight and un-
calinefs about my ftomach, attend-
ed with a faintnefs, and fome fort of
oppreflion or fuffocation about my
breaft, as if the circulation in my lungs
had been a good deal obflrud:ed. While
I fat up in bed, or lay awake, I felt no-
thing of thefe fymptoms, except, per-
haps, fome degree of uneaiinefs about
my ftomach; but when I was juft about
to fall afleep, they began to return a-
gain. In this way, I have often gone
on, for two hours or more, in the be-
ginning of the night. At laft, I found,
that a dram of brandy after the fii*ll at-
tack, kept me eafy the whole night.
This remedy has never failed to fiicceed
with me, the few times I have had oc
cafion to try it ; fo'r of late, fince my
flomach has been pretty found, I have
feldom
Nervous Symptoms. 321
feldom felt in my fleep any of thofe
uneafy fenfations which refemblc the
night-mare.
From what has been faid, it feems
probable, that in the incubus the flomach
is commonly the part primarily afFecled:
I fay commonl'j, becaufe fymptoms like
thofe of the night-mare may fometimcs
arife without any fault in the ftomach.
Thus, I have known aflhmatic patients,
whofe lungs w^ere much obftrucfled,
who, in time of ileep, were greatly op-
prefled with a fenfe of fuiFocation, and
diflm'bed with uneafy dreams : And Dr.
Lower mentions a patient, w^ho, though
he could fleep pretty eafily with his
head inclined forward, yet in the op-
pofite fituation, he was always foon a-
waked with horrid dreams and tremors ;
the caufe of w^hich appeared, after his
death, to have been a great quantity of
water in the ventricles of the brain.
The incubus is moft apt to ieize per-
ions when lying on their back; becaule
X ia
322 Of the moft remarkable
in this pofition, on account of die flo-
mach and other abdominal vifiera prefT-
ing more upon the diaplii'agm, we can-
not inlpii'e with the fame eafe, as when
we lit up, or lie on one fide. Further,
in that iituation .of the body, the food
feems to lie heavier on the ftomach, and
wind in it does not efcape fo readily by
the (sfophagns or pylorus as in an ereci
ftate, when thefe paffages are liighei*
than the other parts of the ftomach *.
We are only affecled with tlie night-
mare in time of fleep, becaufe the
fti'ange ideas excited in the mind, in
confequence of the difordered ftate of
the ftomach, are not tlien corrected by
tlie
* When I have been liable to be attacked with a fenfa-.
tion offaintnefs at my ftomach, I have found it always
vvorft when I lay on my back in the night-time, and be-
come better when I got out of bed, or fat up in it : And a
middle aged woman, who, in the morning, was frequently
fubjed to faintings, -found that fhe could prevent them fay
getting up as foon as flie perceived them about to come on.
Further, when the miliary eruption does not come out pro-
perly in women after child-bearing, they are often affefted
with a fenfe of faintnefs, and with an oppreflion in their
breathing, which fymptoms are commonly worfe when
they ly on their back, than when they fit up in bed.
Nehvous Symptoms. 323
the external fenfes, as when we are a-
wake * ; nor do we, by an mcreafed rC'
fph'ation, or other motions of the body,
endeavour to fliake off any beginning
uneafy fenfation about the flomach or
bread. The incubus generally feizes one
in his firft fleep, but feldom towards the
morning, becaufe at this time the flo-
mach is much lefs loaded with food,
than in the beginning of the night.
If the night-mare were owing to a
ftagnation of the blood in the lungs
from the weight of the heart, or in the
finufes and other veflels of the brain
from the horizontal pofture of the bo-
dy, it would become greater the longer
it continued, and would fcarce ever go
off Ipontaneoufly : But we know, that
this diieafe, after affecting people for
X 2 fometime,
* I had, fome years fince, a patient aftbi^ed with an
eryjipelas in his face, who, when awake, was free of any
confufion in his ideas ; but no fooner did he fiiut his eyes,
altho' not a-flecp, than his imagination began to be great-
ly diilurbed : He thought himfelf carried fwifily through
the air to diftant regions ; and fometimcs imagined his
head, arms, and legs, to be feparared from his body, and
to fly ofF different ways.
324 Of the mojl remarkable
fometime, often gradually ceafes, and
is fucceeded by rcfrefliing fleep ; for as
foon as the load of meat, or wind, or
other caufe difagreeably affecting the
nerves of the ftomach, is^ removed, the
oppreflion and weight on the bread,
wild imaginations, frightfnl dreams, ^r.
will vaniih, as all thefe proceed origi-
nally from the diforder of the ftomach.
It is worth while, however, ta obferve,
that as neither wind, tough phlegm,
nor crudities in the ftomach, will occa-
lion the fymptoms of the hypochon-
driac difeafe, unlefs the nerves of that
organ be indifpofed ; fo neither a hori-
zontal pofture, fleep, nor heavy flippers,
will produce the night-mare, at leaft in
any coniiderable degree, unlels the per-
fon be predilpofed to it from the parti-
cular condition of the nerves of his fto«
niach : And here I fliall juft remark,
that a plethora, as well as other caufes,
may fo affed: the nerv#of the ftomach
as to give rile to the incuhiis* Hence, a
fupprelHon
Nervous Symptoms. 325
ilippreflion of the menfes in women,
fometimes occalions this as well as o-
ther diforders of that organ. It mufl,
however, be acknowledged, that a pU-
thora^ by rendering the circulation thro'
the lungs lefs free, may help to pro-
duce, or at leafl increafe, the opprelfion
df the breaft in the night-mare : And
hence it is, perhaps, that young men,
who abound in blood, are often trou-
bled with this diforder.
It has been obferved above *, that
violent or long continued complaints of
the nervous, hypochondriac, or hyfle-
ric kind, fometimes terminate in an a-
poplexy, palfy, jaundice, dropfy, tympa-
ny, or phthifis. Now, from what has
been faid it will not appear ftrange,
that the brain and nerves may, by the
continuance or frequent repetition of
fuch fliocks, be fo weakened or diforder-
ed, that not only fatuity, a deep melan-
choly, or mania, but alio a paliy or an
apo-
* See p. 102.
326 Of the mojl remarkable
apoplexy, may enfue. Further, as ner-
vous diforders are often owing to ibme
morbid matter in the blood, when this
leaves the ftomach and inteftines, or o-
ther parts where it ufed chiefly to fix,
and is thrown, in a great meafure, on
the brain or origin of the nerves, it is
eafy to conceive, how a palfy or apo^-
plexy may be the confequence.
Again, flnce hypochondriac and hy-
fteric diforders, are fbmetimes occafion-
ed by obflrucflions in the abdominal
vifceray and often give rile to them ; and
as from a bad digeftion the chyle mufl
be ill prepared, it will appear why thofe
difcafes do fbmetimes terminate in the
jaundice or dropfy.
It has been obferved alfo, that pa-
tients much afflicted with thofe ailments
have at length fallen into a tympanites,
which may be thus accounted for. I
have fhown above, that the great pre-
difpoling caufe of nervous, hypochon-
driac, and hyfteric diforders, is a parti-
cular
Nervous Symptqms.O 527
cular weaknefs and delicacy, or uncom-
mon fenfibility of the ftomach and bow-
els ; whence, from fliglit caufes, they will
be often afFed:ed with fpafms. Now,
when the fpafmodic contrad:ions of the
alimentary canal do not continue long,
the wind that was pent up is allowed
to move fi*om one place to another, and
is at laft expelled either upwards or
downwards : But when the ftomach and
inteftines, by reafon of their weaknefs,
and fmall, but continued, fpafms, have
been inflated by flow degrees, the irrita-
tion occafioned by this dillenfion in-
creafes the fpafm fo much, that the air,
continually generated by the aliment in
time of digeftion, is moftly retained, or,
at leaft, is not difcharged in fuch a
quantity as to relieve the patient, or fen-
fibly todiminifli thefwelling of the belly.
Lastly, 9. pbthiJJs pidmonalis may alfo
be the confequence of nervous diforders,
when the morbid matter producing
them falls chiefly upon the lungs ; or
when
328 Of the 7noJl remarkable , &c.
when the vitiated chyle or blood forms
obflruclions in that organ.
And here it may be worth obferving,
that while the morbid matter producing
the hypochondriac difeafe, cliiefly af-
fe^ls the ftomach and bowels, the pa-
tients are always apprehenlive, and of-
ten greatly alarmed from any trifling
increafe or variation of their complaints,
as if they were in immediate danger of
dying ; but after this matter has left its
old feat, and, by fixing on the lungs,
has brought on an incurable phthifiSy
they generally ceafe to be apprehenlive
or fearful, and cherifh the hopes of life
to the laft. The reafon is, that when
the lungs are affected there are no fuch
uneafy feelings excited in the body,
nor fear and defpondency in the mind,
as when the flomach and inteftines flif-
fer, which are not only poflelled of a
much more delicate fenfibility than the
lungs, but have alfo a more remarkable
iympathy with the brain, and whole
nervous f^^llem.
CHAP.
[ 329 1
CHAP. VII.
Of the Cure of Nervous, Hypochon-
driac, ^z^i Hysteric Disorders.
ALTHO' it may be faid in general,
that thefe diforders are more
troublefome and lading than dangerous,
yet as they proceed from various caufes,
the danger, as well as the cure, muft be
often very different. Thus, when they
are owing to an original delicacy of the
whole nerves, or a debility of thofe be-
longing to the flomach and inteftines,
they feldom prove quickly fatal, but
fcarce ever admit of a thorough cure. — -
When they are occafioned by an arthri-
tic matter in the blood, their cure will
be almoll as diilicuit as that of a chro-
nic rheumatifm, or of the gout itfelf ;
and
330 Of the Cure of
and in fuch a cafe, perhaps, the befl that
can happen, is for the morbid matter
to throw itfelf off, by regular fits, m the
extremities. — When they arife from
too great or too Ihiall a flux of the
mmfa,. if the uterus can be reftored to a
found ftate, the nervous fymptoms will
vanifh of courfe. — When great and con-
firmed fcirrhous obftrucflionstin the ab-
dominal vfccra are the caufes of hypo-
chondriac or hyfleric complaints, they
are not only incurable, but likely to j
prove foon fatal. — When they proceed
from worms, phlegm in the flomach and
bowels, or violent affeiflions of the mind,
they maybe often, and fometimes fpeed-
ily cured. — Laftly, when intemperance
in eating or drinking has brought on
nervous ailments, they may be, almofi:
always, leUened, and fometimes cured,
by a proper diet, moderate exercife, and
a few medicines.
But however troiiblefomc and ob-
llinate neWous difordcrs often may be,
thcv
Nervous Disorders. 331
they have fome advantages attending
them ; for the weak ftate of the blood
and vafcular fyflem in many of thele
cafes, renders fuch patients much lefs
fubjed: to inflammatory difeafes, than
thole of a ftronger conftitution.
FrOiM the account I have given of
nervous, hypochondriac, or hyfteric diP
orders, it will appear, as has been al-
ready obferved, that their cure, far from
being the {ame, muft differ according
to the various caufes from which they
proceed : and that the numerous, warm,
aromatic, flimulating, and foetid medi-
cines, which have been called nervous,
or antihyfleric, however proper they
may be in fome cafes, are, neverthelefs,
hurtful in others.
In treating, therefore, of the cure of
thofe difeafes, I fliall not attempt to
lay down any general method to aniVver
in all cafes or circumftances, even for
the fame fymptoms ; but fliall endea-
vour to point out that particular treat-
ment.
332 Of the Cure of
ment, which feems befl fuited to the
cafe, according to the various caufes
from wliich it may arife.
But, before I proceed, it will be pro-
per to obferve, that as it is generally in
the power of medicine to relieve, it is
frequently beyond the art to eradicate
the diforders we now treat of; and
therefore it may be often of ufe to
intimate this to our patients, eii^eci-*
ally to fuch as have fortitude enough
to bear thofe evils, which can neither
be wholly prevented, nor fully cured ►
— It is further neceflary to acquaint
every patient, that without a long per-
feverance in a courfe of medicines, diet,
and cxercife, no great or lafting benefit
can be expecfled. To this purpofe is
the following pafTage oi Mont anus, which
equally deferves the attention of fuch
patients as are affected with ner-
vous ailments, and of the phyficians
who undertake their cm'e. *' In cura-
** tione hujus morbi (fciz. bypochondriaci)
** non^
«<
Nervous Disorders. 333
non licet prafiuire Umpis nienfu iinhiSy aut
** anniy ftciit in aliis contingat, fed oportet
" in toto vitds fu(S tempore curationi operam
** dare; interdtm czirationi, iitterdtim pnefer^
** vationi, attendendo,''*
The general intentions in the cure
of nervous diforders, may be reduced
to the two following, viz.
I. To lefTen or remove thofe predil^
pofing caufes in the body, which ren-
der it peculiarly liable to nervous ail-
ments.
II. To remove or correal the occafi-
onal caufes, which, efpecially in luch as
are prediipofed, produce the numerous
train of nervous, hypochondriac, or hy-
ileric fymptoms mentioned in the pre-
c ceding part of this work f*
I. The great predifpoflng caufe of
nervous diforders is, as I have fliown, a
too great delicacy or uncommon fenfi-
bility of the nerves in general, or of
thofe of the flomach and inteftines, or
other
* Confil. 230.
f See above, p. 98, CfV.
334 V ^^■'^ Ct^RE of
other organs in particular. If tliis
fault in the conftitution could be effec-
tually cured, we fliould always have it
in our power to leflen the violence of
nervous fymptoms from whatever caufe
they might arife, and to prevent moft
of thofe which proceed from fudden im-
preffions made on the mind. But when
the fault in the nervous fyftem, ali-
mentary canal, or other parts, is 0770;/-
nal, i, e, natm'al to the conftitution,
and not the confequence of fome difeafe
or irregularity in living, it does not
admit of a perfect cure : The utmoft
that can be done, is to lellen it.
The beft remedies to anfwer xhc frji
intention of cure, are either fuch as not
only ftrengthen the ftomach and bow-
els, but the whole body, or thofe which,
by their pecuhar a(5lion on the extre-
mities of thofe nerves to wliich they are
applied, lelFen, for a time, the too great
fendbility of the whole fyftem.
I. The
Nervous Disorders. 335
\. I. ^cTh,e remedies which have been
found by experience to communicate
greater ftrength to the body are,
(a) Bitters. Of thele, I moft com-
monly ufe the radix gentian£, fiimmitates
teittattrn fninoiisj and cortices ciurantiorum ;
the two former, as being lefs naiileous
and heating than many of the other bit-
ters; and the laft, partly on account
of its agreeable flavour. Thefe bitters
may be put into any of the ftronger
white wines ; but if die patient be trou-
bled with acidity in the firft paflagcs,
they ought to be infufed in brandy or
boiling water. The watery infufion
will be rendered more agreeable to ma-
ny ftomachs, by adding to each Engliih
pint of it three ounces of the aqua cinna-
momi fortisy or aqua arcsnatica of our Dif-
penfatory *.
The ftrength, as well as the dofc of
thefe bitters, muft be adapted to the
con-
* The officinal compofitions mentioned in thefe cbfer-
vations are always underflood to be thofe of the Edinburgh
Difpenfatory , unlefs the contrary is exprefTed.
336 Of the Cure of
conftitution and circumftances of the
patient. If they heat too much they
mufl be weakened, or taken along with
fome drops of the elixir of vitriol *.
When bitters lie heavy on the flomach,
and lefTen, inftead of mending, the ap-
petite, they ought to be omitted, and
the cure mufl be attempted by other
remedies.
{b) The Bark. This is more ftrength-
ening and lefs heating than any of the
bitters. It may be given either in fub-
ilance or decoction, or infufed in cold
or in boiling water, in lime-water, wine,
brandy or rum.
The bark in fubflance, frequently
difagrees with delicate ftomachs, and oc-
caiions ficknefs, gripes, and fometimes
a loofenefs. An infulion or decocflion
of it in water, efpecially, if fome grate-
ful aromatic, fuch as cinnamon or nut-
meg be added, is lefs apt to produce
thefe effects ; but when infufed in bran-
dy
* Mead 7r,onita medica, p. 109.
Nervous Disorders. 337
dy, with fome bitters or aromatics, it
will agree well with mofl people. The
bark in fubftance often fits lighter on
the ftomach, if a glafs of red port be
taken after every dofe of it; and the
gripes and purging, which it occafions
in fome, may be certainly prevented, by
adding, for a few days, the confeciio Ja-
■ponica to it; for after the ftomach and
bowels have been accuftomed to the ufe
of the bark, it generally occafions either
much lefs difturbance, or none at all.
For feveral years paft I have frequent-
ly joined the bark and bitters in the fol-
lowmg form.
R. Cort. Peruvian. Pulv. unc. iv.
Rad. Gentian.
Cort. Aurant. ana unc. i. fs. Mifce.
Infunde in fpir. vin. Gall. lib. iv. in balnea arena: per
dies vi. et cola.
Of this tindlure, I generally give one
table fpoonful, with four or five Ipoon-
fuls of water, every morning an hour
and a half before breakfaft, and be-
tween feven and eight in the evening.
Y I
338 Of the Cure of
I fometimes add to each pound of this
tinclure, an ounce or more of the fp,
lavend, cQmp, which improves its tafte,
and makes it fit better on fome flo-
machs.
I HAVE, myfelf, taken the above
tincffcure in the morning, for eight
months together, and with remarkable
advantage. For three or four years
before, I had been much troubled
Avith wind in my ftomach, a giddinefs,
and fometimes a faintnefs. I obferved
in the morning, foon after taking this
medicine, a grateful fenfation in my
flomach, accompanied with better Ipi-
rits, than I had at any time through
the day, or than I ever found from
drinking wine, even when I ufed it
freely. I have ordered this tincture to
many patients, v/ho have taken it for
two or three months running, and, af-
ter intermitting it for fome time, have
begun again. Moft of them have
found benefit, and tliofe moft, who ufed
it
Nervous Disorders. 33^
it longeft. The cafes were chiefly weak
and windy flomachs, with a general de-
licacy or debility of the nervous fy-
flem *.
When the ftomach and bowels do
not difagree with acids, twenty or thir-
Y 2 ty
* A married Lady aged 40, of a thin habit and delicate
nerves, had been complaining for fome years of a general
weaknefs and feeblenefs through her whole body, efpecial-
ly in her limbs, with a pain fometimes in her ftomach and
belly, which flie attributed to wind. 1 prefcribed for her
the tindure of the bark, &c. which fhe took once a-day
for near two years, intermitting now and then a week or
ten days. It had a moft fenfible efFeft in ftrengthening her,
and never failed to raife her fpirits. When, after inter-
mitting this medicine for a longer time than ufual, her old
complaints have begun to return in a lefs degree, a kv/
dofes of it, have, almoft always, put her to rights again.
Another married Lady aged between 30 and 40, of a deii-
cate nervous fyftem, and affedled with wind in her ftomach,
giddmefs, flying pains through her body, frequent fits of
loofenefs in a morning, feeblenefs and low fpirits, was, by
the ufe of the fame tinfture for near two years (inter-
mitting it now and then a month or more at a time) cured,
in a great meafure, of all her complaints, except that fhe
continued, fometimes, to be troubled with the pains, and
fomething of the low fpirits, though in a much iefs degree
than formerly.
Were it necefTary, I could add many other cafes in
ivhich the fame remedy has been remarkably ufeful.
340 Of the Cure cf
ty drops of the elixir of vitriol may
fometimes be taken with advantage in
each dofe of the tinfture. This elixir
taken twice a-day, in this or a larger
dofe, in fpring water alone, has often
good effecis in ftrengthening the fto-
mach and refloring a decayed appetite ;
and is generally an excellent cooler
when the flomach complaints are at-
tended with any degree of febrile heat,
a white tongue and a thirft.
Alt ho' the bark is preferable as a
ilrengthener to any of the bitters, yet
it does not wholly fuperfede their ule.
The bark alone will not fit fo well on
many ftomachs, as when it is joined
with an agreeable bitter; and I think
I have found more benefit, myfelf,
from the above tineS:ure, than from the
hark alone either in fubftance or de-
coftion. With regard to the fafety of
taking, for a long time, the bark, a-
gainfl wliich many have had great pre-
judices ; I can fay, that I do not recol-
lect
JNervous Disorders. 341
lecH: its proving hurtful in any cafe in
which I have ordered it, unlefs where
it happened to difagree with the pa-
tient's ftomach. About fourteen years
lince, I fwallowed, in iixteen days, near
four ounces of it in fvibllance, when I
laboured under a catarrhous cough,
without feeling any bad effei^s from
its allringent quality. In a tertian in-
termittent attended with a cough and
(pitting, after the ufe of vomits and
fome pectorals, I have prefcribed the
bark in the uflial quantity, without the
bread being any ways hurt by it. I
have had repeated experience of its
virtues in curing a hoarfenefs after the
meafles, unattended with a fever or
difficult breathing ; and in the chin-
cough, when given early, and before
any obftru£lions are formed in the
lungs, I have found it one of the befl
remedies. Laftly, The fuccefs of the
bark in refolvin^ indolent gjlandular
fwel-
+
34- ^f the Cure of
iwellings *, may fliew that it is not pofi
feiTed of any con fider able obflrud:ing
quality.
(r) Steel. There are few medicines
that fo remarkably ftrengthen the fto-
mach and bowels, and indeed the
whole body, as iron and its preparati-
ons. The aftringent quality of this
metal was not unknown to Diof cor ides ^
who recommends, for a weaknefs of the
itonlach and inteflines, water in which
a red-hot iron has been extinguifhed.
The fal mart is was in great efteem
with River ins 'y but Sydenham preferred
the filings of iron to all its prepara-
tions f.
The filings have been commonly
prefcribed from five to fifteen or twenty
grains ; but altho' this lafl quantity
^vill heat many people, yet fo different
are conftltutions, that fome will bear a
much greater dofe ; nay I know a
Gentleman,
* See Mu«!ical Inquiries and Obfervations, vol. i.
t Dijfsrt, epipl ad D. Cole.
Nervous Disorders. 343
Gentleman, who, for a weaknefs in his
ftomach and indigeftion, has taken eve-
ry day, for fome months together, about
230 grains of the filings of iron, divi-
ded into three dofes. It is obvious,
however, to obferve, that thefe filings
will ad: varioufly as they are finer or
coarfer, and according to the quantity
of an acid in the flomach and bowels.
They fometimes occafion, eipecially in
the more delicate conflitutions, a dilbr-
der in the firft pafTages ; in which cafe,
Sydenham has advifed a few drops of
laudanum to be taken with them at
bed-time ; but fifteen grains or a fcruple
of theriaca will have as good or a better
effect.
Those who cannot take the limatitra
jnartis will often bear Mynficbt^s tind:ure,
the chalybeate wine, and Pyrmont or
other fleel waters of a weaker nature.
I know a Lady whom fix or eight grains l.
of the filings of iron purge more flrong-
ly than an ordinary dofe of rhubarb,
and
344. Of the Cure of
and yet fifteen or twenty drops of the
t'mBura martis M^nfichti give her no dif-'
tiirbance.
I fometimes order this tind;ure, or
th6 mars faccharatuj, to be taken at the
fame time with the tin£hire of the bark
and bitters above mentioned ; but, com-
monly, I advife the chalybeates only
at thofe times, when the patients inter-
mit the bitters.
The chalybeate waters, altho' they
contain but a very fmall proportion of
iron, are often obferved to have re-
markable effed:s in ftrengthening the
body. Particularly, the waters of Bath
in Somerfetfoire have been of great ufe to
many, who, from a weak flate of the
Itomach and bowels, were affected with
low fpirits and other nervous com-
plaints.
It may be worth while to obferve,
that notwithftanding the remarkable
effects of chalybeates in many difeales,
yet thefe medicines, in a flate of fofu-
tion,
Nervous Disorders. 345
tion, or in a faline form, do not feem
to enter the blood ; for the late hige-
nious Dr JVrighty having made a dog,
who had fafted 36 hours, Rvallow a
pound of bread and milk, with which
he had mixed an ounce and a half of
fal martis diflblved in a fufficient quan-
tity of water and filtrated ; he opened
the dog an hour after, and colled:ed
from the thoracic duel: near half an
ounce of chyle, which did not fuffer
the leaft change of colour by dropping
into it a tincture of galls ; altho' this
fame chyle, after -^ of a grain of fal
martis was dilTolved in it, acquired a
deep purple colour from that tinc-
ture*.
If fal martis and other preparations
of iron do not enter the blood, it
is obvious, they mufc produce their
effedis /o/Jj by ftrengthening the flo-
mach and inteilines ; whence not only
the digeftion of the aliment will be bet-
ter
* See Philofophical Ttanniifl. for 1750, vol. l. part, ii.
P- 595-
34^ Of the Cure 0/
ter performed, but by means of that
remarkable fympathy which fubfifts be-
tween the alimentary canal and the
whole fyftem, a greater degree of vi-
gour will be communicated to every
part of the body : for there is nothing
more certain, than that we feel our-
felves either vigorous and healthful, or
feeble and fickly, as the nerves of the
flomach and bowels are in a found, or
an infirm flate.
Th e above medicines, (a^ b, c,J are
to be ufed not for days or weeks only,
but often for many months together,
otherwife no great or lading benefit is
to be expelled from them. In fome
cafes, it may be necellary not to omit
their ufe, wholly, for years ; for when
the caufe of any difeafe is deeply rooted
in the conflitution, thofe medicines
Avhich are proper for removing it, muft
be taken almofl like our diet, r)ot only
regularly, but for a very long time.
In
Nervous Disorders. 347
In fuch cafes, it may be beft to take
the bark and bitters chiefly in the win-
ter and Ipring-feafon, intermitting their
life now and then for a week or two ;
and in the fummer to drink either
fome of the chalybeate waters at the
wells, or a gill or more of the Pyrmont
or Hartfell-Spa * thrice a day on an
empty ftomach.
(d). The Cold BATH. Nothing per-
haps ftrengthens the nervous fyftem
more fenfibly, or gives a greater Qiring
to all the velTels, than cold bathing ;
for altho' the water only ad:s imme-
diately
* The Hartfell-Spa is a water which ifTues from a moun-
tain of that name near Moffat in North Britain. It has
a ftrong chalybeate together with an aluminous talie, is
mach faturated with iron, and feems alfo to contain an a-
luminous fait. It is deflitute of that fpirit obfervable in
the Pyrmont water and thofe of Spa near Liege, but retains
its virtues longer, and may be carried to a great dillance
without being fenfibly weakened. It is an excellent
ftrengthener, and has often been found ferviccable in wealc-
nefles of the ftomach and intellines with indigellion and
flatulence. For a more particular account of this water.
See Effays Phyfical and Literary, vol. i, and Philofoph.
Tranfaft. vol. l, part i.
34^^ Of the Cure of
diately pa the cutaneous nerves and
vefTels, yet its ftrengthening power is,
by fympathy, communicated to the in-
moft parts of the body. The cold
bath, like the former remedies, ought
to be long continued. The moft pro-
per feafons for it, are the fpring, fltm-
mer and autumn. It is enough, efpe-
cially for thofe of a (pare habit, to go
into the cold bath three or four times
a week ; but as it tends to make people
thinner, thofe who are too plump may
life it daily. When the ftomach, liver
or other vifcera are much obftruc^ed, or
otherwife very unfound, the cold bath
is improper, fince by turning the blood
with more force than ufual upon thefe
parts, it may increafe, inftead of lefFen-
ing the patient's complaints.
Many inftances might be given of
the good efFefts of cold bathing in
ilrengthening people of delicate confti-
tutioiis, and making them lefs fubje<5l
TO nervous ailments ; but as fo much
may
Nervous Disorders. 349
may be found to tliis purpofe in Sir
John Floyer^s hiflory of cold bathing, I
fhall only obferve, that I have known
it of great fervice to feveral women,
who, chiefly from a weaknefs of their
nervous fyftem, were very liable to fuf-
fer abortion ; and that a young Lady
whofe nerves feemed to have a very
great degree of fenfibility from the in-
tolerable pain which fhe felt from
blifters, and from the very uneafy fen-
fation, which was occafioned by every
red pimple that rofe on her face, found
more benefit from a long courfe, firft
of the cold bath, and afterwards of fea-
bathing, than ffom bark, bitters, chaly-
beate waters, and various other reme-
dies.
To prevent miftakes, it may be pro-
per to mention here, that while I re-
commend bitters, the bark, elixir of
vitriol, chalybeates and cold bathing,
as the beft ftrengtheners of a delicate
nervous fyftem, I do not mean that all
thefc
350 Of the Cure of
thefe are to be ufed, efpecially at once,
by the fame patient. In fome cafes,
the tincture of the bark with fome bit-
ters will be fufficient. In others, more
benefit may be found from fteel in fub-
ftance, or from the chalybeate waters ;
and fometimes cold bathing may fuc-
ceed, or at lead make the cure more
compleat, after internal flrengtheners
have in a good meafure failed. I fliall
only add, that when nervous com^
plaints, arifing principally from a deli-
cacy of the nervous fyftem, are attended
with a quick pulfe and a preternatural
heat, bitters and ileel are improper; but
an infulion of the bark in cold water,
with elixir of vitriol, will often prove
uieful.
(e) Air. As a cool and dry air
braces and imparts vigor to the whole
body, fo nothing tends more to relax
and weaken tlian hot air, elpccially
that which is rendered fo, by great
fii'es, or by ftoves in fmall rooms.
When
Nervous Disorders. 351
When the ftomach and bowels are
weak, the body ought to be well guard-
ed againft cold, efpecially in winter,
by wearing a thin flannel waiftcoat next
the fkin; for this will keep up an e-
qual perfpiration, and defend the ali-
mentary canal from many impreflions
it would be otherwife fiibjec^ to, upon
every fudden change from warm to
very cold weather.
(/) Aliment. The food ought to
be nourifhing, but of eafy digeftion,
and iuited to the ftomach of the pati-
ent. Fat meats and heavy fauces are
hurtful. All exccfs is to be avoided.
Valetudinarians ought never to eat
more at once than they can digeft with
eafe. Every time the ftomach is over-
loaded, its ftrength is impaired, and its
nerves are dilbrdered ; but when one
eats moderately, not only the ftomach,
but the v/hole body is invigorated and
repaired. Above all things heavy flip-
pers ought to be avoided, fince the fto-
mach
352 Of the Cure of
mach is more apt to be oppreiled with
tlie fame quantity of food, iii a horizon-
tal than in an ered: pofture ; and fince
the digeflion goes on flower in time of
deep, than when we are awake.
Wine in excefs enfeebles the body,
and impairs the faculties of the mind.
A few glafles in time of eating, or after
it, may be ufcful, but more will load a
weak flomach and retard digeflion.
The befl time to drmk a little wine, is
upon an empty ftomach ; for the liquor
being, in that cafe, lefs weakened and
more readily applie^i to the nerves
there, mufi: have the greater eifed: in
ftrengthening them. AVhen my flo-
mach has been Aveak, and when, after
havhig been indifpofed, I had hot
palms, was languid and apt to fweat
upon motion, I have often found my-
Iclf much better for a glafs of claret
and a bit of bread, an hour or more
before dinner ; in this cafe, the ^vine
cooled me, made my pulfe flower, and
Nervous Disorders. 353
gave me more fpirits and ftrength. I
have ordered claret in the fame way to
others, before dinner and between
feven and eight in the evening, with
advantage. When children are weakly,
have a tendency to the fcrophiday or are
inclined to the rickets ; or when they
have been much reduced by a fit of
teething, I find a little claret once or
twice a day, upon an empty flomach,
an excellent flrengthener and the befl
fticcedaneum to the bark, which many
children will not take.
These good effects of wine thus ufed,
leem not to have been altogether un-
known to Celfus, who tells us " Si qids
** vero Jlomacho labor at ^ non aqnam, fed vimim
** caliduniy bibere jejunus debet ^,^'
Wine in general, is preferable to
malt-liquor, as being lighter, lefs apt to
ferment, and lefs flatulent. For com-
mon drink, water alone, or with a little
wine, is the lighted and befl ; but when
Z the
* De medicina, lib. i . cap. viii.
354 or ^^^^ Cure of
the flomach and bowels ai'e troubled
with acidity, water mixed with a imall
proportion of rum or brandy is greatly
preferable to wine or malt-liquor.
LInder this head, it may not be im-
proper to obierve, that the frequency,
now-a-days, of ftomach complaints, and
nervous ailments, as they are common-
ly called, may be partly owing to the
too great \\£g of tea. I once imagined
tea to be in a great meafure unjuftly ac-
cufed ; and that it did not hurt the
ftomach more than an equal quantity
of warm water ; but experience has,
iince, taught me the contrary. Strong
tea di'iMik in any coniiderable quantity,
in a morning, eipecially if I eat little
bread with it, generally makes me faint-
er before dinner than if I had taken no
breakfaft at all ; at the fame time, it
quickens my pulfe, and often affe^ls m-e
with a kind of giddinefs. Thele bad
effecfs of tea are moft remarkable when
my ftomach is out of order.
(g)* Ex-
Nervous Disorders. 355
(g). Exercise. Exercife is of fuch
ule for ftrengthening the nervous fyf-
tem, that, without its alliftance, the moft
powerful medicines will prove often in-
effed:uaL Of all kinds, riding on horfe-
back has been juftly efteemed the beft :
It has been particularly extolled by
Sydenham in hypochondriac and hyfleric
dilbrders. It greatly promotes digeflion,
fanguification, the diftribution and fe-
cretion of all the fluids ; and ftrengthens
the whole body, as well as the flomach
and bowels. Riding is preferable to
walking, as it fliakes the body more and
fatigues it lefs. But it is proper to ob-
ferve, that any great exercife, elpeeially
riding on horfeback, after a full mealy
will diforder the ftomach, and retard
digeflion, inftead of promoting it.
The ingenious Dr Gilchriji oi Dumfries ^
has recommended failing, as a kind of
exercife well adapted to the cure of
nervous complaints arifing from a weak
ilate of the blood and alimentary canaiy
Z 2 ^n4
356 Of the Cure of
and has given fome inftances of its good
effects*. But as we find it very dif*
ficult to prevail with any patient in this
place to undertake a long lea-voyage,
I can fay little on this head from my
own experience. However, I have not
only been well informed, that a Gentle-
man, who had been long fubjecft to epi-
leptic fits at land, was never feized with
them wlien at fea ; but a young Gentle-
man, lately my patient, who had a very
delicate nervous f^ftem, and whole fto-
mach and inteflines were £0 uncom-
monly fenfible, that a fingle ftool, pro-
cured even by the elixir facrumy made
him faintifh ; and vomiting or purging
Avas almoft fure to bring on fainting
fits with flight convulfions : This
perfon, I fay, had his conftitution fo
changed while he was at fea, that altho'
dm'ing a voyage of four or five weeks,
he vomited much every day, and pur-
ged
• See his Treatife on the ufe of Sea voyages in me-
dicine.
Nervous Disorders. 357
ged frequently ; yet he had neither any
faintings, nor was fenlible of any par-
ticular weaknefs in his flomach or
bowels. After this voyage, he had no
return of thofe fits to wliich, for fome-
time before, he had been liable, till at
the diftance of eight months, when he
applied a blifler to the under part of
his breafl ; the pain of which, when
the plafler was taken off, occafioned
faintings with flight convulfions.
Friction of the legs, arms, trunk
of the body and ahdo^neii with a fielli-
brufli, with flannel or a coarfe linen
cloth, is a kind of exercife that ftrength-
ens, promotes the circulation, and is
particularly beneficial when the bowels
are weak.
Lying too long in bed will weaken
and relax, while early rifing, like gentle
exercife or cool air, will brace and in-
vigorate the body.
(h) Amusement. The mind ought
to be diverted and kept as eafy and
chearful
358 Of the Cure of
chearful as pofTible ; fince nothing hiirts^
more the nervous fyflem, and particu-
larly the concod;ive powers, than fear,
grief or anxiety.
2. But as the remedies ^^, b, c, d, e,
f g, hyj above mentioned, however pro-
per for mending a delicate flate of the
nerves in general, or of thofe of the
alimentary canal in particular, mufl
often be ufed a confiderable time before
they can produce any great effefts, it
becomes frequently necellary to have
recourfe to medicines of another na-
ture ; in order to palliate thole uneafy
fymptoms with which nervous and
hyfterical people are often afFecfled.
Th e principal remedies of tliis kind
are the following, viz.
(a) Such as weaken, during the
time of their operation, the fentient
power of the nerves, and confequently
lefTen thofe pains, irregular motions or
fpafms which arife from any unuflial
irritation. The chief of thefe is ap'mm,
which J
Nervous Disorders. 359
which, when applied in fufficient quan-
tity to the nerves of any fenfible pai't,
not only leflens their power of feeling,
but, by fynipathy, alio that of the whole
fyftem : By this quality, it often gives
fudden relief in many violent diforders
of the nervous and hy fieri c kind. It
is of great ufe in fixed fpafms, as well
as in alternate convulfions of the muf-
cles, and in pains not attended with
inflammation ; in a weaknefs, laflitude
and yawning, occafioned by too great
a flux of the menjh, in flatutent colics,
and fometimes in the true fpafmodic
ajlbma, where tliere is no obflru(n:ion in
the lungs nor phlegm opprelhng them.
When given, at bedtime, to the quan-
tity of a grain or a grain and a half,
along with a little afa foctida, I have
frequently feen it lefTen that reftlefTnefs,
and thofe hot flufliings and fick fits
which many hypochondriacal people
are liable to ; but after being ufcd for
fome time, it lofes this effed; in a great
ineafures
i
360 Of the Cv KE of
meafure, unlefs its dofe be increafed
from time to time. It is to be obfer-
ved, that if the patient be in any degree
plethoric, bleeding or other evacuations
ought to precede the liberal exhibition
of opium y for this will make its good
eifecfts more certain and conlpicuous,
and will prevent, in a great meafure,
any bad confequences that it might
otherwiie have.
',:Al71ho' opium is often proper for
quieting many nervous and hyfteric
fymptoms from whatever caufe they
may arife, yet it is peculiarly ufefiil,
when thofe fymptoms are principally
owing to an extraordinary delicacy of
the nervous fyftem.
But however ufeful, o/>/i;^//2 may be
in many cafes, yet we often meet with
patients who receive more hurt than
benefit from it. Some are affetled with
an uncommon faintnefs and languor
about the pr^cordiay or with flar tings ;
others with a ficknefs and vomiting, or
a
Nervous Disorders. 361
a violent pain with cramps in the fto-
mach, or an itching over the whole ^
body, elpecially about the eyes and
nofe. In fome few, it occafions a raving
and niadnefs. ,,riiji L .
Alt HO* opium i in many cafes, exhi-
larates, inftead of occailoning heavinefs
and fleep, yet it ought rarely to be gi-
ven to patients who are low^fpirited ;
for however it may relieve them for
the prefent, yet after its effects are over,
they generally become more depreiled
than before.
Opium given too largely, and too
long continued, leflens the fenfibility
and vigour of the whole nervous fyftem,
whence not only the flrength of the
body, but alfo the faculties of the mind
are confider ably. impaired.
But notwithftanding theie bad ef-
fefts of opium when too liberally ufed, I
have leldom feen any mifchief from it,
as a palliative, in diforders arifing from
a too great delicacy of the nerves,
where
362 Of the Cure 0/ «
where it was ordered with difcretion,
and given in fmall quantities at firft.
Nay, in this way, thofe who fufFer moft
from opium may be brought at length
-{- to bear it eaflly ; a remarkable inftance
of which, I lately had in a middle aged
Lady, whom fovir or five drops of laii-
daniimy taken by the mouth, affe<5led
with a violent pain and cramp in her
flomach ; and fixteen di'ops in a clyfter,
though it did not occafion thefe com-
plaints, made her dehrious for twelve
hours ; for this Lady, having after-
wards begun with one drop of laiida-
mmy gradually rofe to twenty-five ;
nay, fhe has fometimes taken that quan-
tity thi'ice a day, without feeling any
of its former bad effects. In cafes of
great ficknefs accompanied with a pain
in the flomach and frequent vomiting,
when the patient could not bear lauda-
num inwardly, I have ordered three
or four tea-fpoonfiils of it to be rubbed
hito tlie flomach and belly, afterwards
applying
Nervous Disorders. 363
applying to thefe parts a piece of flan-
nel moiftened with Hungary -water
made hot. The effect was, that all the
patient's complaints began to abate in
lefs than an hour after the application
of the laudanum, which I ordered to be
repeated at the diflance of fix or eight
hours, if it was neceflary.
There is one inconvenience which
feldom fails to attend the continued ule
of opiumy viz. coftivenefs, which is beft
remedied by takins: now and then an
aloetic pill, or fome other gentle pur-
gative. But in fome cafes of pains in
the ftomach and bowels with indio-ef-
tion, much flatulence and belching,
where laudanum, chiefly through its
binding quality, did not anfwer fo well,
I have found very good effects from
the extradiim hyofqami, given from a "v
grain and a half to three or four grains
at bedtime, and repeated in a lefs quan-
tity in the morning ; for altho' as an
anodyne, the powers of this extraci: are
much
364 Of the Cure of
much inferior to thofe of ophm't yet,
by its proving often laxative, it be-
comes preferable to it in feveral cafes.
(b) Such as, by afFecling the nerves
in an agreeable manner, and perhaps
relaxing them, leflen the ^Gn£e of pain,
and often put a flop to tremors, con-
vullions, fpafms and an uncommon agi-
tation of the nervous fyftem. Of this
kind are the warm Jcmicupium, pedilnvi-
nm^ and hot fomentations, which are
frequently ferviceable in cafes where
opiimi would be improper ; but as they
all tend to relax, they are only to be
ufed by delicate people, as palhatives
in urgent cafes.
(c) Such as, by their peculiar Jlimii-
///j, powerfully affecl the nerves, fo as
not only to render them lefs feniible of
the irritation ariflng from various mor-
bid caufes, but alfo to communicate to
them fome degree of vigour, at leail
for a fiiort time.
Of
Nervous Disorders. 365
Of this kind are camphire, caflor,
mufk and the f^tid gums. The firft
and moft remarkable efFedts of thefe
medicines are owing to their aflion
on the nerves of the ftomach ; but in
what particular manner they operate
on thefe nerves, we know not. They
do not feem, at leaft, moft of them,
to pofleis any real ftupifying or narcotic
quality, like opium and other medicines
of that clafs.
Camphire is very volatile and pene-
trating ; it promotes peripiration, and
frequently a6ls as an atilpafmodic ; it
fbmetimes procures fleep, in fevers at-
tended with raving, where opium would
prove hurtful ; and I have found it of
good ufe in rendering, more quiet and
compofed, fome maniac and melancho-
lic patients. ;,,
Camphire, given in large quantities
to different animals, produces fleep,
fometimes madnefs, a vomiting, pur-
ging, a flux of urine, the hiccup, epi-
leptic
$66 Of the Cure of
leptic convulfions and death*: and fe-
veral of thefe efFed:s are fo fudden, that
they muft proceed rather from the im-
mediate action of the camphire on the
nerves of the ftomach, than from its be-
ing mixed with the blood.
Physicians have differed widely in
their opinions concerning the nature of
campliire ; fome having efleemed it hot
and others of a refrigerating nature ;
but
* Commentar. Somnieftf. torn. \v. p. 199, {fff.
The following cafe was, fometime fince, communicated
CO me by a friend.
A Gentleman defirotfs of knowing what efFefts a large
dofe of camphire would have, fwallowed half a dram of it
ciffolved in a little oil of olives, and very foon after percei-
ved an uncommon but not difagreeable glow of heat in his
ilomach.- After having walked abroad for half aft hour,
upon looking at a news-paper, he found himfelf quite in-
capable to underitand what he read, his head being crowd-
ed with a great many confufed ideas. He now began to
ftageer when he walked ; and, fometime after, a dark
cloud feeming to come over his eyes, and feeling other
fymptoms which made him apprehend an apopledlic attack,
he went to a neighbouring apothecary, with a view to get
fome blood taken away ; but upon going into the open
air, all thefe fymptoms began to abate, and, in a few hours,
he found himfelf in his ufual health, without the affiftance
of any remedy.
Nervous Disorders. 367
but as it is not my purpofe to enter
deeply into this difpute, I fhall only ob-
ferve, that altho', in fome cafes, a glais
of claret or port, or even a dram of
brandy, will render the pulfe flower and
the body cooler j and, in catarrhous fe-
vers, baftard peripneumonies, pleurifies
and anginas, blifters often leflen the
quicknefs of the pulfe remarkably ; ne-
verthelefs, wine, brandy, and blifters,
are, in their own nature, not coohng, but
heating : In like manner, camphire, as
its effed:s in the mouth, and on the fkin
and the eyes, fhew, is naturally heating;
but fometimes it may cool, by lefFening
or removing fome diforder in the body
w^hich increafed its heat and quickened
the pulfe. I have known, in many
cafes, a confiderable ienCe of heat raifed
in the ftomach, by a bolus of fix or fe-
ven grains of camphire well mixed with
a fcruple of conferve of rofes. Howe-
ver, altho' I cannot agree witli thofe
who think camphire a cooling medi-
cine.
-t
368 Of the Cure of
cine, yet I do not look upon it to be fa
heating as fome have imagined. Perhaps
camphire may excite a lefs degree of
heat in the ftomach than in the mouth,
or even than when applied to the fkin;
for we know that the fame flimvilating
fubflances afFeft the nerves of the fto-
mach and of thefe parts very differ-
ently.
Castor. I cannot help thinking
the virtues of tliis medicine, in nervous
diforders, are lefs than many have ima-
gined. When given from twelve to
twenty grains, it fometimes procures
reft, not, as I imagine, by any true nai*-
cotic quality like opium, but by leflening
that uneafy fenfation in the ftomach
from wind, \vhicli is often the caufe of
v/atching : and indeed, caftor feems to
have the beft effecls on thofe patients,
whofe complaints are in a great mea-
fure flatulent. In fome cafes, I have
thought laiulamim had a better effecl:
when it was joined Avith cafior either in
fubftance
Nervous Disorders. 369
flibflance or in tinclure. A Gentle-
woman aged upwards of forty, much
troubled with flatulence and low fpirits,
was often feized, when flie lay to fleep,
with a fenle of faint nefs about her fto-
mach, which obliged her to fit up, and
often prevented her from getting reft
moft of the night. Twenty drops of
laudajtum made her drowfy, but did not
remove the faintnefs ; this, however,
was effecfted by adding to it a tea-
Ipoonful or two of the tin[i. cajiorei com-
pofita.
Musk, is lefs heating than cajlor, and
may be given in cafes, where neither
it nor opmn are proper. Altho' the
fmell of mufk is olfenlive to many, yet
I have fcarce ever found it difagree
with the ftomach. It is chiefly uieful
in xhc fubfultus tendinum in fevers, in the
hiccup, cramps in the ftomach, and
other fpafmodic diforders. I have tried
it in the chin-cough and the true fpaf-
modic aJ}J?ma, but it was given in too
A a jinall
370 Of the Cure of
fmall clofes to determine, with certainty,
as to its virtue in thefe difeafes. Two
or thi'ee grains of mufk well rubbed
with a little fligar, and mixed with half
a table fpoonful of mint-water, will
fomctimes flop the vomiting occalloned
by teething in children. The good
effed:s of mufk are frequently lefs con-
fpicuous from its being not genuine, or
taken in too fmall dofes. Rinxerius men-
tions it as having, in his time, been
given with fuccefs to the quantity of
thirteen grains in a hyfteric fit ; and
now it is common to order it in this,
or a larger dofe, three or four times a*-
day.
Asa foetida, is the flrongefl of the
foetid gums, and almofl the only one
that I have been in ufe to prefcribe
internally in nervous or hyfleric cafes.
It has good effects in flatulent diforders,
and fpafms of the alimentary canal, and
in aflhmatic fits that are either owing
to ^vmd in the flomach or increafed by
it.
Nervous Disorders. 371
it. In cafes, where fiidden relief is
wanted, it ought to be given diffoh ed
in fbme of the fimple waters. I have
often given, with advantage, pills of
aja fmtiday p, iii. aloes and Jal mart, ana
/>. i. to patients who, along with a cof-
tivenefs, were troubled v/ith flatulent
pains working up from their bowels to
then* flomach, and producing ficknefs
and vomiting. Theie pills were taken
every night, or once in two nights, in
fuch quantity as to keep the body
gently open. Afa footida, like cajior, fome-
times procvires fleep ; it gives relief in
fits of lownels, efpecially when difTolved
in fpu'its, or joined with the volatile
falts ; but a too frequent repetition of
filch warm medicines hurts the flomach
at lafl.
When nervous or hyfleric com-
plaints are attended with a quick pulfe
and a feverifh heat, the foetid gum.s,
camphire and cafior^ on account o
their heating quality, ought to be given
A a 2 very
c
372 Of the Cure of
very fparingly, or not at all. They are
much better adapted to cafes where
the pulfe is low and flow. As we do
not know the particular manner in
which each of them operates on the
nerves, fo we cannot tell, before trial,
in what conflitutions they will, feveral-
ly, be moft fuccefsful. Frequently, one
of them will anfwer where another has
failed : nay, fuch is the uncommon dif^
pofition of the nerves of the ftomach in
fome cafes, that a table fpoonful of the
f }\\icG of lemons, unmixed with any
thing, has proved always a certain cure
for a palpitation of the heart, after
many of the medicines called antihyfteric
iiad been tried in vain : and agreeably
to this, we are told by Riveriiis, that a
draught, or a clyfter of vinegar and
water, has often given immediate relief
in a hyfleric fit*.
It is to be remarked, that die feveral
medicines mentioned under this head,
* Praxis medicay lib. XV. cap. vi.
Nervous Disorders. 373
(2. (ly hf c,) are chiefly ferviceable as
palliatives, for lefleniiig or removing
the prefent pain or other complaints
in nervous and hyfleric cafes, but not
for giving any durable flrength to the
body or lirmnefs to the nerves, upon
wliich depends the radical cure. How-
ever, when thofe diforders do not pro-
ceed fo much from a general debility
of the nervous fyftem, as from a mor-
bid or vinnatural ftate of the nerves
of the flomach or fome other part,
long continued palliation may fome-
times make a cure ; for wliile the pal-
liative remedies lefTen the bad efFed;s of
this diforder of the nerves, nature,
cither by herfelf, or with their afTiftance,
at length expels or fiibdues the morbid
caule. Thus obflinate headachs, as well
as feveral other complaints commonly
reputed of the nervous kind, have been
cured, after other remedies had failed,
by the long continued ufe of opium, as
will appear from the following cafes,
wliich
374 ^f ^^^^ Cure of
which were communicated to me by a
friend.
N. N. AGED 28, healthy and ftrong,
after a fea-voyage of three months, du-
ring which he was alraoft conftantly
fick at the ftomach, but never vomited,
was much expofed to cold in a long
journey he made by land. At this time,
fomething happened which greatly vex-
ed him, and foon after, he began to be
affected with a fixed pain in his fore-
head, which increafing by degrees, at
laft fpread over his whole head. I faw
him firft, about two years after the head-
ach began, at which time he complain-
ed of a conflant pain, attended with a
v/eight and heavinefs, in his head ; he
had befides fiiarp flying pains in diffe-
rent parts of it, as if a nail had been
driven into them. At certain times
the hcadach increafed greatly, and was
attended with a quick pulfe. He fre-
quently pafled great quantities of pale
water, ^ipecially in ^'iolent fits of the
headach.
Nervous Disorders. 375
T:ieadach. His fleep was difturbed with
frightful dreams, out of which he would
often awake with great opprellioii and
terror. He was generally low-fpkited,
fufpicious and peevifli, tho' on fome oc-
Gallons, he was uncommonly chearful.
The leaft contradi(flion threw him into
a fit of melancholy. He felt a tenfion
about liis eyes, elpecially when his head
was much pained. There was fcarce
any lecretion of mucus from his nofe ;
and fo moveable was his nervous fyftem,
that if he retained his water too long,
or hurt his nofe ever fo little, by haftily
bringing away from it fome of the hard-
ened miicus^ he never failed to have an
increafe of his headach. He was liable
to fits of iickn^fs at his flomach, and of-
ten threw up a clear watery humour
without tafte or fmell. He was gene-
rally coftive and his pulfe good, except
when attacked with the violent fits of
pain in his head, wliich nothing was fo
apt to bring on, as any intenfe thought
or
376 Of the Cv KE of
or long-continued application of mind.
Invohmtaria penis crcdione^ cum feminis pie-
rumqtie emijfione, tarn die qiiam noBu f<epe ten-
tatus fuit.
For three years after I had firft feen
him in this condition, he continued un-
der the care of fome phyficians of cha-
racter in Ital'jy who, having prefcribed
for him a variety of medicines without
any advantage, gave him up as incu-
rable. Upon this I told him one reme-
dy ftill remained, which might be of
fervice, viz. opium ; and as he readily a-
greed to my advice, I began with giving
him half a grain every night at bed-time.
I alfo difTolved two drams of ftrained
opium in four ounces of fpirit of wine,
and ordered him to rub a little of this
on thofe parts of his head which were
mofl pained. The dofe of opiton at bed-
time, was gradually increafed to a grain
and a half, and fometimes he took a
grain twice a-day. He had not ufed
the o-hium a month, when he became
fenfibly
Nervous Disorders. 377
fenfibly better, and in eight or ten
months found himfelf free of all his
moft troublefome complaints. After this
he began to leflen the dofe of the opiums
and to take it only once in two nights,
and fometimes feldomer. Only, when,
from vexation or any other caufe, he
was threatened with a fit of the head-
ach, he immediately had recourfe to
the opium in a larger quantity. He was
adviied to ule daily exercife, and to keep
his mind as eafy and chearful as pollible.
At fii'ft he drank a few glafTes of wine
at his meals ; but, after he had taken
the ophim for fome time, he found that a
lingie glafs of wine heated him, and
made his headach worfe ; on which
account he confined himfelf to water a-
lone. The third year after he began
to ufe the opium, he was fb free of his
complaints, that, during the fpace of
twelve months, he did not take above
three dofes of it.
It
378 Of the Cure of
It may be worth while to remark,
that this patient was fo fenflble of any
change of weather, tliat, by a general
feehng of weaknefs and inactivity, and
of pains in his joints, he could have told,
in the morning before he got out of bed,
that the weather was moid and rainy,
©r the winds eafterly or foutherly.
M. N, An unmarried woman aged
30, after confiderable vexation of mind,
began to be feized in much the fame man-
ner with the above patient, and had ta-
ken medicines for five years to little pur-
pofe. The chief fymptoms were a con-
ftant and fever e pain over her whole
head, cfpecially the back-part, a fliffnefs
in the mufcles of the neck, great pain
and loofenfs of her teeth ; diflurbed
fleep, frightful dreams, low fpirits, ilia-
kings and trembhngs of her whole bo-
dy, cold and hot fits by turns, fiurtiings
in her face, flatulence and fwelling in
her ftomach with frequent belchings, iu-
aitivity, lofs of appetite, flying pains
through
Nervous Disorders. 37^
through her body, and inability to ap-
ply with attention to any thing ferious.
In fummer 1759, flie began to take the
opium in the fame way with the former
patient. In three weeks flie found
herfelf fomewhat eafier, and after fix
weeks was much better in every refJ3ecl.
Her headach was moftly gone, her teeth
were free of pain, and firm, her fleep
much lefs difturbed, and the ffufhings
and fhakings in a great meafure re-
moved. For about two weeks after
fhe began to take the ophpn, flie was
troubled with gripes, which however
went off after being longer ufed to this
remedy. A folution of opium in fpirit of
wine was often applied to her head and
neck, and always gave her eafe. •
II. With regard to the fecond in-
tention of cure, which was to correct or
remove the occafional caufes, which, e-
fpecially in fuch as are predifpofed, give
rife to all the nervous, hypochondriac
and hyfleric fymptoms ; as thefe caufes
are
38o Of the Cure of
are various, the medicines muft be often
different : nay, what is proper in one
cafe, may be hm^tful in another.
The occafional caufes were diflin-
guiflied before into the general and
particular.
The general caufes were,
1. SoxME morbid matter bred in the
blood.
2. The diminution or fuppreffion of
fbme habitual evacuation.
3. The want of a fufficient quantity
of blood.
. ,.^ , The particular caufes were,
I.. Wind *) • t_ n i
/ in the Itomach
2. Tough phlegm > , , ,
\ and bowels.
3. Worms j
4. Aliments improper in then' na-
ture or quantity.
5. Obstructions, frequently of the
fcirrhous kind, in the abdominal vif-
ccra.
6. Sudden
Nervous Disorders. 381
6. Sudden and violent afFedlions of
the mind.
In order therefore to treat diflindlly
of the fecond intention of cure, it will
be neceflary to mention particularly
the different remedies, which are moft
likely to lefFen or remove thefe feveral
caufes.
I. Some morbid matter in the blood.
(rt) As we are often ignorant of the
nature of that matter in the blood,
which is the caufe of nervous diforders,
fo we mufl be often at a lofs how to
corredl or expel it. When I fufpe(fl it
to be of that kind which produces the
arthritis vaga, from knowing the family-
diftemper of the patient, his conftitu-
tion and manner of life, or his being
much troubled with flying pains in his
head, arms or limbs, I rely moft upon
a proper diet and exercife, with the
tinchire of the bark and bitters men-
tioned under the firft intention of cure,
in order to prevent the generation of
this
382 Of the Cure of
this 'matter ; or gradually to fubdue and
carry it off, when ah'eady generated.
But Hippofing the bark and bitters had
no power to deftroy the arthritic matter
in the blood, which feems mofl pro-
bably to be the cafe, yet by ftrengthen-
ing the flomach and bowels, they may
not only retard the generation of more,
but prevent, in a great meafure, an
attack upon thefe parts ; which are ob-
ferved to fuifer moft, when, from any
caufe, they have been much weakened,
or otherwife put out of order.
The reputation which bitters have
had in gouty cafes, among the antient
as well as fome of the modern Phyfl-
cians, led me to think, that a well cho-
fen medicine of this kind might be
very ufeful in nervous, hypochondriac
or hyfteric complaints from an arthritic
matter in the blood : And altho', in
patients in the decline of life, the tinc-
ture of the bark and bitters has often
failed me, yet in thofe who were under
forty
Nervous Disorders. 383
forty or fifty, I have found it do more
fervice than any other remedy.
When the patients are liable to fits
of the true gout, I increafe the propor*
tion of the rad, gentian, and cort» aurant*
in the tincture, adding at the fame time
fome nutmeg or ginger, eipecially if
the ftomach be cold and flatulent. In
this cafe alfo, the tindlure may be taken
to the quantity of two table-fpoonfuls
twice a-day.
I HAVE known an indigeflion and
flatulence, with a pain and flcknefs at
the ftomach from the gout, greatly re-
lieved, after other medicines had failed,
by drinking, thrice a-day, fix ounces
of a ftrong decodlion of feveral of the
common bitters* in water: And a
Gentleman of my acquaintance, who
had been much troubled, for fifteen
years, with a pain in his fl:omach, has
been cured by chewing two drams of
the
Vi%. Rad, gentian, calctm. aromat. cort. aurant, fumtnit,
ah/ynth. centaur, min. card, benedicl. withy'va. cat-v.
384 Of the Cure of
the roots of gentian daily. This kept
his body open, and increafed his appe-
tite ; it began to give him eafe in a few
days ; and when, upon omitting it,
the pain returned in a lefTer degree, it
was quickly removed by having re-
courfe to the gentian again.
A milk diet which, fometimes, has
proved a radical cure for the goutf,
has been commended by Sydenham in
certain hyfleric cafes, after other medi-
cines have failed J. I can fay little of
its eifecfls in either cafe from my own
experience. We meet with few patients
who will confine themfelves to this diet,
and, in feveral cafes, it is improper to
advife it. About eighteen years ago,
I had a patient aged 48, who, on ac-
count of an ulcer in his lungs, reftricled
himfelf for many months to a diet of
milk and vegetables alone, and after he
got free of that diieafe, continued to
live
^ Celfus de medidna, lib. v. cap. xxiv;
X DiJJkrt. Epiji. ad D. Cole.
Nervous Disorders. 385
live in this way for feveral years. This
perfbn, who was of a very full habit>
and had been formerly attacked once
a-year, at lead, with the gout, remained
free from this diftemper for feven or
eight years, that is, till fome years after
he had returned to the ufe of flefli
meats and fermented liquors.
Lime-water is faid to have been
drunk fucceisfully by feveral gouty pa-
tients*. I have only had one who
gave it a decilive trial. This perfon
was aged about fifty, and had for fe-
veral years been fubjecl every winter
to a fmart fit of the gout. In February
or March IJ5S) he began to drink daily
an Englifli quart of lime-water, living at
the fame time very temperately. Be-
fore the end of the fii'ft year, he had a
very flight attack of the gout ; about
the end of the fee on d year, he had ra-
ther lefs of this difeafe ; but after he
B b had
* See AlJion\ DifTertation on quicklime and lime-water,
part iii.
386 Of the Cuke of
had continued drinking the lime-water
conftantly for near three years, he was
feized with a fevere and long continued
fit of the gout, in both his hands and
both his feet. This patient obferved,
tliat the hme-water when drunk warm,
mended the ftate of his ftomach, when
it was difordered before the coming on
of a fit of the gout, and he thought it
had a good effect, in driving this difeaie
to the extremities. The lime-water
agreed perfectly well with liim, and
mended his appetite.
From this cafe it may be fairly con-
cluded, that lime-water does not radi-
cally cure the gout or deftroy the arthri-
tic matter in the blood, altho', by
flrengthening the ftomach and inteftines
imd preventing acidity in them, it may
render the attacks of this difeafe lefs
frequent, and in fome perfbns, perhaps,
lefs fevere*.
When
* It may be proper to mention, that a patient of Dr
Clerk'sy Phyncian to the Royal Infirmary here, who ufed to
have
Nervous Disorders. 387
When lime-v/ater is drunk for the
cure of nervous complaints from an
imperfect gout, it ought to be taken to
the quantity of at leaft an EngUfli quart
daily ; as, at firil, it is fometimes apt \
to occafion an uncaly heat in the fto-
mach, a Httle fweet milk may be added
to it ; but afterwards it is better to
drink it alone. In the winter-feafon,
and when the ftomach is more difor^
dered than ufual, the lime-water ought
to be drunk nearly blood- warm.
Soap has been propofed by the late
Doctor John Cierk, a Phyfician of diilin-
guifhed character in this place, as the
B b 2 proper
have a fevere and long continued fit of the gout once in
two years, has been kept free of this difeafe for near three
years paft, by drinking off, at once, an Englifh quart of
lijne-water, every forenoon about eleven o'clock- The
lime-water taken in this way, always purges him twice
or thrice about three o'clock in the afrernoon. But as
this perfon is of a very full habit of body, it is probable
that the lime-water has proved ufeful to him rather by that
daily evacuation which it occaficns by ftool, than by any
virtue it pofTefTes of deftroying the arthritic matter in the
blood.
388 Of the Cure of
proper folvent of the arthritic matter
in the blood*. It has fometimes been
of life in old rheumatifms, and may be
properly taken along with the lime-
water, as it prevents coftivenefs and
deftroys acidities in the flomach and
bowels.
As fome perfons fubjecl to the true
gout, have found great benefit from
drinking, twice a-day, about a gill and
a half of a ftrong infufion of tanfy in
boiling water, it is probable the fame
medicine might be ufeful in thofe com-
plaints which arife from an imperfecH:
gout afferting the flomach and other
parts. But of this I can fay nothing
certain from my own experience, not
having had any patient who gave the
tanfy a fair trial.
Issues and perpetual bliflers have
been often of ufe in headachs, and in
tlie fciatic or chronic rheumatifm affec-
ting
* See Dr Pringle's Obfervat, on the difeafes of the army,
part ii'. chap. 2. edit. i.
Nervous Disord-ers. 389
ting one leg ; but I have not found them
do much fervice in nervous or hypo-
chondriac complaints from an arthritic
humour.
(/>) I have obferved above, that com-
plaints of th« nervous kind fometimes
proceed from that kind of humour in
the blood which is commonly, but im-
properly, called fcorbutic ; and which,
when it is thrown out on the flcin, ap-
pears in the form of tettars, fcurfy
erruptions or the lepra gracoriim. In this
cafe, we mufl endeavour to drive the
morbid humour outwards to the fkin,
by vomits, warm ftomachics and fudo-
rifics ; after which the radical cure
mud be attempted by mild mercurials
and the purging mineral-waters.
The method which I have always
found fuccefsful, at leaft in flighter
cafes, is to give twelve grains of tlie pi-
luU athiopic(j£ every night at bedtime, and
every other morning a dram or a dram
gild a half of polychreil fait diffolved in
an
39© Of the Cure of
an Engli/h pint of water*. The fait,
befides, otherwife contributing to the
cure, opens the body, and prevents the
pills from raifing a falivation, which
they are fometimes apt to do. Thefc
medicines arc to be ufed till the fcurfy
or leprous erruptions quite difappear.
When the obftinacy of the difeafe re-
quires it, I give the pills both morning
and evening.
Alt ho' the true fcurv^ is a difeaie
rarely obferved, except in thofe who
live at fea or in marfliy places, yet we
frequently meet with patients, who have
fome degree of a fcorbutic taint in their
blood, as appears from their fpungy
gums, a lalfitude and other complaints.
I have had feveral patients of this con-
flitution, who were deeply affedled with
the hypochondriac difeafe ; their chief
lymptoms were low Ipirits or melan-
choly, watching, flatulence, frequent
Ipitting
* In place of this folutlon of the Polychrefl fait, I have
fometimes ordered fea-water to be drunk.
Nervous Disorders. 391
Ipitting of the faliva, a bad digeflion,
flying pains, a tightnefs about the />r«e-
cordiay a dark colour and troubled look.
I have never fucc ceded in curing any
of thofe patients ; but a long courfe of
the tincture of the bark and bitters with
elixir of vitriol, and daily exerciie,
feemed to agree better with them than
any thing elfe. When they are coftive,
I order, once in two or three days, as
much foluble tartar as is neceflary to
open them gently.
{c) When nervous fymptoms are oc-
cafioned by fome morbid matter re-
maining in the blood, in confequence
of fome former difeafe imperfeftly cu-
red ; we muft have recourfe to fucli
remedies as are beft fuited to the nature
of that difeafe or the circumftances of
the patient.
That humour which produces the
rafli or miliary erruption, when it falls
on the internal parts, inftead of being
thrown out upon the fkin, generally
occafions
3 9 - Of the Cure of
occafions a great depreflion of fpirits,
anxiety and faintnefs, pale-water and
watching, and fometimes raving and
convuliions. In this cafe, I have found
mofh advantage from the warm pedilu-
vium, or warm fomentations applied to
the feet and legs, from bliflers, wine,
whey and bolufes of camphire, fafron
and fait of hartfliorn. When in the
miliary fever, the patients are much
opprelfed at the ftomach and complain
of a difficulty of breathing, a gentle
vomit of ipecacuanha, or of an infufion
of camomile, often gives relief.
The warm pediluvimn and fomenta-
tions often procure fleep, and give
fome immediate eafe to the patient ;
they likewife contribute to promote the
niihary erruption, by removing that
tenfion or fpafmodic contraction of the
cutaneous veflels which frequently re-
tards it. Where the patients are in any
degree plethoric, bleeding will often,
not only give fome prefent relief, but,
by
Nervous Disorders. 393
by relaxing the vafcular fyftem, will alfo
contribute to the expullion of the mor->-
bid matter by the fkin.
2. When nervous hypochondriac or
hyfteric fymptoms proceed from a di-
minution of fome habitual evacuation ;
that evacuation is to be promoted b}/
the proper remedies.
(a) When the menfes are obftrufted,
we mull endeavour to recal them, and,
till that can be done, the mofh troubler
fome fymptoms are to be palliated.
There are few cafes in which we are
oftener difappointed than in bringing
back the monthly evacuation, after it
has been long fupprefled ; and the me-
dicines proper in one cafe, may prove
ineifet^ual or even hurtful in another.
When the want of good blood is the
caufe why the menfes do not flow, the
befl remedies are the bark, bitters and
Heel, together with a nourifliing diet,
and exercife. After the patient has, by
^hefe means, got more and better blood.
394 Of the Cuke of
it ought to be determined to the uterus
by frequent dofes of tiuBiira facra, and
by making the patient iit every evening
over the fleams of warm water.
If a plethora or a too great abundance
of blood prevents the iiux of the mcnfes^
bleeding, efpecially in the foot or at the |
ancle, and gentle purges, will prove
moft efFedaial.
When the thicknefs or vifcidity of
the blood hinders it from making its
way through the uterine vefTels, fre-
quent vomits, and the pihiU mercmiales
laxanteSy or gentle purges with calomel,
will anfwer bed.
Lastly, when the fuppreffion of the
merfes has been owing to a fpafmodic
contraction of the uterine veifels, in
confeqiience of cold, fome violent paf-
fion, or other caiifes, the chief remedies
are the warm femicupiiim and pedihroiwn,
oily draughts, and pills of aloes, afa
frtida, extract of black hellebore and
faffron. A clyiler of vv'arm v/ater with
tliirty
Nervous Disorders. 395
thirty or forty drops of laudanum may be
given, in the evening, about the time
the menfes fliould return.
Obstinate obflrud:ions of the
monthly evacuation in women, have
fometimes been cured by eledi'ifying
them, and drawing the iparks chiefly
from their thighs. But Dr Clerk informs
me, tliat he has obferved this remedy
to iiicceed bed in thofe whole puile w^as
fhiall and languid.
Some young women, about the time
of the return of the menfeSy are apt to
be feized with violent pains in then*
back and belly, vvith faintings, raving,
and fometimes convulfions. In fuch
caies, the warm Jhnicupmm is of great
life ; but as, often, tliis cannot be
readily got, I have generally ordered
with Ibccefs, a clyfler of warm water
with fifty drops of Lmdanum, and a flan-
nel bag with the emollient herbs to be
wrung out of hot water, and applied to
the abdomen. When the patient has
been
39^ Of t])£ Cure of
been coftive, a laxative clyfler with afa
fastida muft be given to procure a ftool,
before the anodyne one is injected.
In the intervals between the returns
of the menfs, in order to render the pa-
tient lefs liable to the above mentioned
complaints, I have advifed with good
efFecl, the frequent ufe of the warm
pediluviiim^ fome dofes of the piluU rtifi,
and thofe oily draughts, which, in this
cafe, were much commended by Sir
David Hamilton^ ; and which I have alio
found of good ufe in pains of the
bowels, in thofe whom the meufes had
left.
I have fometimes met with immarried
women, who were liable to be attacked
with faintings and convulfive fits, after
every period of the menfes was over ;
which feemed to be owing to this eva-
cuation being lefs copious than ufiial.
Ill a cafe of this kind, the following re^
medics
* D: Praxci rrgulis, cop. iii.
Nervous Disorders. 397
medies ufed for two or three months
proved luccefsful.
R, Aloes focotrin.
Afa foetid.
Extraft. hellebor. nigr.
fal. Mart.
croc. Angl. ana drach. i.
Elix. proprietat. q. f. ut. f. pil. gr. iv.
Quarum capiat v. vel vi. alternis noftibus.
R. Rad. Gentian.
calam. aromat. ana unc. i.
Summit, centaur, min. drach. vi,
Flor. anthos, drach. ii.
M. f. materialia infundenda, per hor. vi. in aqu. bul-
lient. lib. iv. colatur. Adde
Tinft. Cort, Peruvian, unc. x. Mifce.
Cape unc. iii. bis in die.
Along with theie medicines the pe-
dihrjiimi was ufed every night at bed-
time.
When, in the decline of hfe, the ;/z^;z-
fes ceaie, various nervous or hyfleric
lymptoms appear, which are generally
leflened, and fometimes removed, by
frequent fmall bleedings, gentle ftoma-
chic purges and ifllies.
{b) If the haemorrhoidal flux is want-
ing in thofe who have been accuflomed
to
398 Of the Cure of
to it, we mufl endeavour to recal it by
emollient fomentations, and aloetic me-
dicines. When thefe or other remedies
prove inefFeclual, Hoffman has advifed
leeches to be applied near the anus once
a month.
{c) When old ulcers, or fores too
quickly dried up, have given occafion
to nervous diforders, purgatives, and e-
Ipecially ifRies or a feton, will be moil
fliccefsful in carrying off that humour
which diflurbs the body.
{^d) Wh en pimples or other enniptions
on the face have been fuddenly repel-
led by improper applications, violent
headachs, giddinefs, ficknefs at ftomach,
palpitations and other nervous fymp-
toms have been, fometimes, the conle-
quence. In fuch cafes, if the morbid
humour cannot be brought back to the
face, \\Q muft try to carry it off by per-
petual bliflers or ilfues' in the head or
neck, and by mercurial purges.
When
Nervous Disorders. 3^^
3. When nervous or hyfteric com-
plaints are occafionedby a wantof blood,
in confequence of an immoderate flux of
the haemorrhoids, menfes or lochia; the
cure confifts in reflraining thefe evacu-
ations, and filling the velTels by means
of fuch aliments as are light and nou-
rifliing, but not heating. In the mean
time, the violence of the fymptoms mufl
be abated by anodynes and wine, or
other cordial medicines. A horizontal
poflure is here of confiderable ufe.
The medicines which I have found
moft iuccefsful in reftraining an immo-
derate flux of the merifcs are the tindura
rojamm, terra Japonic a, alom, opium, and
elixir of vitriol.
I HAVE fometimes given the alom
mixed Vvith terra Japonic a as in the pulvis
Jljpticns ; bvit of late, I have prefcribed
it more frequently, in the following
form, as being lefs difagreeable to the
ftomach.
R. Laft. recent. buUient. lib. i.
Alum, rup. pulverat. drach. i. .id drach, i. fs. Mifce ut
£at
400 Of the Cure of
fiat coagulum, et fero colato. Adde
Sacchari albi unc. i.
Cape uric. iii. quaterin die.
If the alom-whey occafions a fournels
in the ftomach with a cardialgia, a fcruple
of crab's eyes or prepared oifter-fliells
twice or thrice a-day will be ufeful. In
one cale, the alom-whey leflened a pro-
flttviiim menfmm after the patient had ta-
ken, for fome time, forty drops of the
tincliira antipthifica thrice a-day, without
any |benefit. The fame medicine alfo
cured a flttor albiu of feveral years {land-
ing-
I HAVE not obferved remarkable ef-
fects from the bark, in flopping hae-
morrhages. After an immoderate flux
of the menjes had refifled that medicine
taken in fubflance for near a fortnight,
I have feen it yield in two or three days
to fuch a mixture as the following,
R. Aqu. menth. unc. vi.
cinnamom, f. v. unc. ii.
Confeft. Japon. drach. vi.
Syr. limon. unc. ii. Mifce.
Cape cochl, ii. 4ta vel 6ta quaque hora.
To
Nervous Disorders. 401
To remedy the coftivenels v/hich this
mixture generally occalions, it becomes
neceflary once in two or three days, to
order either feme rhubarb or a laxative
clyfter.
Th e bark, which is more remarkable
for its flrengthening than aftringent
quality, feems to be lefs adapted for
flopping hsemorrhages, than for reito-
ring ftrength to thole who have been
reduced by them. However, it is often
very proper, not only to give the bark
after the flux of blood is lelTened, but
alfo, at the fame time, with fome of the
ilronger aftringents.
Wh EN a profiuvmni maifmniy or a flood-
ing after abortion, is attended with,
or preceded by an acute pain, not in-
flammatory, in tlie lower part of the
back or belly, and returns ^vith greater
violence, as often as the pain returns or
increafcs, opiinr. ^vill prove a more effec-
tual remedy than any of theaftringenta,
as happened in the following cafe.
C c Mrs
402 Of the Cure of
Mrs D , aged between 30 and 40,
having gone abroad too foon, after an
abortion in the fourth month of her
pregnancy, was feized with a violent
pain in her back and the lower part of
her belly, which retm'ned once in
eighteen or twenty hours, and w^as al-
ways attended with an exceflive flood-
ing, which abated when the pain left
lier. Having been called, after flie had
uled feveral aftringent and ftrengthen-
ing medicines with very little advan-
tage, I ordered a clyfter of fix ounces
of an infufion of dryed red rofes in
boiling water with fifty drops of lauda-
num, to be given every night at bed-
time, and once in two days a laxative
clyfter in the morning, if it fhould be
neceflary. After the firft anodyne
clyfter, flie had httle either of the pain
or flooding, and after the third,
was quite cured of both thefe com-
plaints.
Liulovictis
Nervous Disorders. 403
Ltidoviais Sept alius ^, and after him,
^ir David Ha?nihon'\, has commended a
ftrong decodlion of bitter orange-lkins,
as a moil effectual remedy in a profluviimi
menfium ; and I have been informed by
an able Phyfician, that he has prefcribed
it once and again with fuccefs in the
following manner :
R. Cort. aurant. Sevil. recent, integr. vli.
Coque ex aqu. fontan. lib. iii. ad lib. ii.
Colaturas adde facchar. alb. unc. i.
Elix. vitriol gut. Ix.
Cape cochl. vi. tertia quaque hora.
I HAVE known the f.iior alhus cured,
in a great meafure, by a courfe of fea-
bathing, after many powerful medicines
had been tried in vain. The fame re-
medy in the intervals of a projiiivium
mcnfmm has contributed much to lefTen
that flux ; and a Lady aged between
40 and 50, a patient of mine, who was
fo much diftrefled with the bleeding
piles, that (lie rarely went to ftool with-
C c 2 out
* See Animadverf. med. lib. vii. art. 144.
+ Ds Praxeos repulh, cap, iii.
404 0/ the Cure of
out loling a great deal of blood, found
more benefit from fea-beathing than
any thing elfe. It not only leiTened
the difcharge of blood from the hemor-
rhoidal vefTels, but foon gave her a bet-
ter appetite, more flrength and a frefher
colour.
And thus much may ferve for the
cure of the general occafional caufes of
nervous, hypochondriac and hyfleric
diforders, I come next to mention the
method for leffening or removing their
particular caufes, -jiz.
I, Wind in the flomach and bowels.
As this proceeds either from a debili-
ty or fpafmodic affed:ion of the alimen-
tary canal, or from improper aliments ;
the remedies for performing the radical
cure may be found under the firfl in-
tention of cure above* and below, un-
der No. 4, where the treatment of ner-
vous complaints, ariling from errors in
diet,
* See above, pag. 3 34, IS'V,
Nervous Disorders. 405
diet, is laid down. Tlie medicines pro-
per for giving immediate relief for the
uneafy fenfations occafioned by flatu-
lence, will be mentioned afterwards,
when I come to treat of the cure of
fome of the principal lymptoms of the
nervous or hyfteric kind.
2. Tough phlegm bred in the flo-
mach and inteflines.
The cure of this phlegm is often te-
dious and difficult, and in many cafes
can by no means be obtained : For,
altho' by repeated vomits we may clear
the ftomach of the prefent load, yet
unlels that organ is fufliciently flrengtli-
cned and its fecretory vefTels reftored
to a found ftate, more phlegm will be
continually produced. Wherefore, be-
iides frequent vomits, we mufl have re-
courfe to the bark, bitters, chalybeates,
animal food and exercife, efpeclally ri-
ding or faiUng*. Repeated dofes of the
ti flu-urn
* Si'vero pituita ftomachus Impletiir, utilis navigatio.
Cel/uj de medicina, lib. iv. cap. v.
4o6 Of the Cure of
tinBura rhabarhari amara or elixir facrum,
are not only ufeful for ftrengthening
the ftomach and bowels, but for carry-
ing down and evacuating part of the
phlegm that diforders them. I have
fometimes thought that the emplaflriim
ftomachicum applied to the epigaftric re-
gion was of life.
Those avIio are apt to breed much
phlegm in their ftomach, generally find
it neceflhry to take a vomit once in ten
days or a fortnight, and fometimes of-
tener. When a vomit of ipecacuanha is
taken, either an infufion of horfe-radifti
fhould be drunk, or a little brandy or
powder of muftard fliould be added to
each draught of the Avarm water ; for
theie, by their warm fimiihis, tend to
invigorate the ftomach, at the fame
time that the phlegm oppreiling it is
evacuated.
As lime-water diftblyes ichtyocolla and
other glutinous ftibftances, I thought it
might be worth while to try what effecl
it
Nervous Disorders. 407
it would have on the tough phlegm
bred in the ftomach. With this view,
I poured three gills of lime-water on a
gill of that phlegm newly vomited up,
and mixed them well together : at firft,
the phlegm feemed to be rendered fome-
what thicker by the lime-water ; but
after {landing five or fix hours, it was
quite difTolved. After this, one of my
patients, at my defire, mixed one part
of very tough phlegm, brought up from
his ftomach by a vomit in the evening,
with two parts of lime-water ; and upon
examining this mixture next morning,
he found the phlegm had wholly loft
its tenacity. This Gentleman, at the
fame time, mixed fome of the phlegm
with common water ; but after ftanding
24 hours, it retained its tenacity in a
great meafure, altho* it was rendered
thinner by the mixture of the water.
When lime-water is ufed with a
view to the cure of phlegm in the fto-
jnach, it fliould be drunk to the quan-
tity
4o8 Of the Cure of
tity of near an Englifti pint, every
morning upon an empty ftomach, and
nothino: fliould be taken for two hours
after. An hour and a half before din-
ner and as long before fupper, half a
pint fliould be alfo drunk.
Further, as often as an emetic is
ufed, the patient, fome time after its o-
peration is over, fliould lirft of all take a
drauglit of lime-water, which in this
cafe, will ad: more flrongly m diflblving
any phlegm that may remain in the
ftomach, as well as in bracing its relax-
ed pores and veilels.
When together with a tough phlegm
tliere is a confiderable degree of acidity
in the ftomach, I have known good effects
from ten grains of the fal ahfyntbii or fait
of tartar given twice a-day. When the
ilomach is quite free of acidity, the e-
iixir of vitriol may be of ufe to ftrength-
en its vefTels, altho' it has no effect: in
dilFolving the phlegm.
3. Worms
Nervous Disorders. 409
3. Worms in the flomach and intell
tines.
In this cafe, ^vhile we palliate the
niofl troublefome fymptoms, we miift
endeavour to deflroy the worms by flich
anthelmintic medicines as may feem
befl adapted to the particular ftate of
the patient. I fliall only add on this
head, that in fome cafes, I have ihen
good elfe^ls from au infullon of the root
of the Indian-pink * ; but this remedy is
certainly much lefs efficacious here than
in South Carolina, and feems to lofe a great
deal of its virtue by being long kept.
I HAVE ordered, with good fuccels,
to fome grown perfons, fix drams or an
ounce of Spanip foap daily. It deftroys
the afcarides as well as the round and
fiat worms. Lime-water has been much
commended as an anthelmintic, but it
will fcarcely be of any ufe, except whcr^
the worms are lodged in the llomach or
high up in the inteftines ; for, if they
remain
* EfTays phyfical and literary, vol. i.
41 o Of the Cure of
remain in the ileum or the inferior part
of the jejunum, the Hme-water will be
moflly all abforbed before it can reach
them.
4. Aliments noxious from their
quality or quantity.
When nervous, hypochondriac or
hyfleric diforders are owing to tliis
caufe, or increafed by it, a proper re-
gulation of diet is the principal remedy.
[a) If, by a long habit of eating too
little, the concoftive powers are much
weakened, the patient muft, by flow de-
grees, increafe the quantity of his ali-
ment.
If, on the other hand, his complaints
have been occafioned by excefs in eat-
ing and drinking, he muft gradually
leflen the quantity, till he has reduced
jiimfelf within the bounds of ftricH: tem-
perance ; that is, he muft never eat fb
much at dinner as to make himfelf, foon
jifter, unfit to go about any bufincfs, or
apply
Nervous Disorders. 411
apply himfelf to any ftudy ; and he
muft make light fuppers, or none at
all, if he does not find his dinner di-
gefled.
I HAVE known fome people much af-
fiicled Avith the gout, while they lived
too fully, who being afterwards redu-
ced, by neceflity, to a ipare diet, got
quite free of that diftemper : And in-
deed when nervous ailments have been
owing to high living or an arthritic
matter in the blood, abftinence, or ra-
ther moderation in eating or drink-
ing, is of the greateft confequence in
the cure.
(b) With regard to the quality of
the food, the patients ought to abflain
from all heavy and fat meats, from
whatever they find hard of digeflion, and
from all flatulent aliments.
If the ftomach and bowels have been
hurt by a flatulent diet ; greens, roots,
fruits, and whatever is apt to breed
much wind, ought to be avoided; and
the
41 ^ Of the C V isi z of
the patient fliould live chiefly on bread,
rice and flefli-meats, with a few glalles
of wine of a good body and age, ai:^d
not apt to turn four.
If heavy meats, rich fauces, and the
too free ufe of wine or other ftrong li-
quors have hurt the flomach and bow-
els ; the patient ought gradually to re-
duce himfelf to a fmall quantity of
wine, and eat only the lighter animal
fubftances plainly drefTed, and fuch ve-
getables as are lead flatulent. In this
cafe, a diet of milk and vegetables alone
mayfometimes be of great fer vice, which,
however, muft not be gone into all at
once, but very gradually : And it is fur-
ther to be obferved, that while feme,
who had been accuflomed to animal
food and wine, liave found great bene-
fit by abflaining from them, without
loiing much ftrcngth, or any ipirits;
there have been others of a different
conftitution, who could not bear the
V. ant of fuch n diet, and vvhen wholly
confined
Nervous Disorders. 4I3
confined to milk and vegetables, were
not only troubled with faintnefs and low-
nefs of {pirits, but with great flatulence
and othei* diforders of the primes via :
From which it may appear, how far
fome have erred in recommending,
without fufficient reflri^lion, a diet of
this kind in the greateft part of nervous
diforders.
It may be obferved, that many peo-
ple who have weak or windy ilomachs,
elpecially fuch as are liable to the gout,
find not only vegetables, but milk to a-
gree befl with them, when they take,
at the fame time, fome pepper or other
fpicery : And I have known fome per-
fons fiibjecl to violent attacks of the
gout in their ftomach, who have been
much the better for fwallovving, every
morning, twelve or fixteen corns of
white pepper, with the water-gruel
which they took for breakfail.
That abftinence from wine and
flefli meats, and a diet wholly of milk
and
414 Of the Cure of
and vegetables, dues not prevent ner-
vous ailments, we have a ftrong proof
in the poorer fort of the country people
of North Britain, who, though they
live on milk, whey, barley, peafe and
oat-meal, with coleworts, potatoes and
other vegetables, without almofl any
animal food or fermented liquors, are
neverthelefs remarkably flibjecl to pains
in their ftomach and bowels, flatidence
and other complaints of the hypochon-
driac or hyfleric kind conned:ed with it.
Nay, however much a milk and ve-
getable diet may be of uie in fome
cafes, to leflen or remove fuch difbrders
as have been the confequence of high
living, yet, in general, it is certain that
a diet of this kind is more apt to pro-
duce flatulence in the iirft paiTages and
all the troublefome iymptoms depend-
ing upon it, than a diet conlifting partly
of vegetable and partly of animal food.
Nay, even milk itfeif, which holds a
kind of middle place between vegetable
and
Nervous Disorders. 415
and animal fubftances, has been ob-
ferved by Hippocrates^ to be hurtful to
thofe who are much fubjed: to wind in
dieir bowels*.
Because a mixture of flefli-meats
with vegetable fubftances and water,
kept in a heat equal to that of the hu-
man body, has been obferved to fer-
ment fooner and much more brifklv
than thofe vegetables and Avater alone,
fome have concluded that vegetable and
animal aliments together will produce
more flatulence in the pr'nna vm, than
vegetables alone : But it ought to be
confldered that the digejiion of the ali-
ments is very different from that cliange
which happens to them in a chymical
vefTel, and that as the production of
flatulence in the llomach and bowels, is
chiefly owing to a weaknefs of thefe
parts, a difordered ftate of their nerves,
or f]iafmodic contraclious In them ; a
certain proportion of animal food,
by
* Aphor. feci. v. N" 64,
41 6 Of the Cure 0/
by invigorating the alimentary canal,
gratefully affecting its nerves, and ren-
dering it lefs liable to irregular motions
and fpafms, may occallon lefs flatulence
in time of digeftion, than would hap-
pen from vegetables alone.
Wh en nervous complaints are owing
to an arthritic matter, a diet of milk
and vegetables, if the ftomach can bear
it, may, by deflroying, or rather not
furnifliing frefli fupplies of that matter,
effefl a cure. But where the ftomach,
from its weaknefs, or the peculiar dil^
polition of its nerves, cannot bear the
greateft part of vegetable aliments, fuch
a diet would be extremely improper ;
^vhilft the lighter animal food, in liich
quantity as can be ealily digelled, will
not only nourifli and ftrengthen the
body more, but will aft as an anodyne
in preventing or allaying many com-
plaints of the ftomach and bowels.
Upon tlie whole, no conftant rule
can be oiven as to the kinds of food ;
for
Nervous Disorders. 417
"for while a diet chiefly of fiedi meats
anlwers well with Ibme, others live beft
on milk and vegetables, either alone or
with a fmall proportion of animal food.
In like manner, with regard to liquor,
fome cannot do without wine, while
water alone, or water with a little
brandy or rum, agrees bell: with others.
Eveiy valetudinary perfon ought, there-
fore, to keep by thofe kinds of meat
and drink, which he finds by experi-
ence to be moll agreeable and lightefc
to his llomach. But whatever aliments
may be ufed, moderation lliould be
conflantly obferved, as people are ge-
nerally lefs hurt by the quality, than by
the quantity of what they eat and drink.
(<:) When the llomach and intefdnes
have been much hurt by high living,
or weakened by flatulent food, befldes
a proper diet, the bark, bitters, chaly-
beates and exercife* will be often ne-
ceHary for giving new ftrengtii to the
D d alimentary
* See the firft intention of cure, p. •», 3 j, l^c. above (^) {k)
41 8 Of the Cure of
alimentaiy canal. Gentle vomits and
ftomachic purges may alfo be of ufe to
cleanfe the firft pafTages and promote
the natm-al fecretions there.
5. Indolent obflruftions, chiefly of
the fcirrhous kind, in fome of the abdo-
minal vifeera.
Obstructions of the indolent kind
have their feat either in the fecretory
tubes of the glands, or in otlier velTels
fmaller than thofe which carry red
blood, in the glandular follicles, or in
the Ipaces of the tela cellulofa, in which
there is depolited, by the exhaling arte-
ries, a fluid which foon becomes too
thick to be taken up by the abforbent
veins, and is daily increafed by the
addition of new matter of the fame
kind. In fome cafes, the vefFels of the
obflrucled part are fo changed from
their original ftate, as to feparate, from
the^blood, fluids which, by flagnating
in
Nervous Disorders. 41^
in the follicles or cellular Ipaces, acquire
a cartilaginous nature.
It is generally difficult to difcover
when nervous * or hypochondriac com-
plaints are owing to fcirrhous or other
indolent fwellings in the coats of the
ftomach and inteflines, or in the other
abdominal vifcera, unlefs when the tu*
mours can be felt, which is often not
the cafe. But when I meet (efpecially
in women after the mcnfcs have left
the m) with complaints of want of appe-
tite, indigeftion, vomiting, flatulence,
and pains in the belly which have con-
tinued long, without any confiderable
intervals of eafe, and inftead of yielding
to medicines, become worfe ; I fufped;
fome fixed obftrud:ion in the flomach,
inteftines or neighbouring parts, efpe-
cially if the patient has a quick pulfe,
without any confiderable heat or thirft.
When hypochondriac or hyfteric ail-
ments are owing to indolent obftruc-
tions, we mud endeavour to refolve
D d 3 them
420 0/' the Cure of ^
them by degrees, and, in the mean time^
palliate the moil: troublefome fymptoms
occalioned by them.
(a) There are few remedies of great-
er ferviee in obftrucftions of the indo-
lent and cold kind than gentle friction.
It not only promotes the circulation
tlirough the fmall vefTels, but tends to
attenuate, and increale the abforption
of the matter flagnating in the follicles,
or extravafated in the fpaces of the cel-
lular niembrane of the obitrud:ed part.
I have had inflances of incyfted tumors
cm'ed by long continued fricfion alone.
One was on the upper eye-lid, about
tlie lize of a common cherry and of the
fteatomatous kind. Another was fitu-
ated in the memhrana adipofa on the left
lide of the abdomen ; it was bigger than
one's fifl:, pretty foft, and felt like the
ileatomas or atheromas. It was treated
with nothing but friction of the part
twice a-day with oleum cajupboratum. For
the firfl four months it did not feem
to
Nervous Disorders. 421
to yield, but foon after it began to lef-
ieii and went off very fafl. The fniall
tumour on tlie eye-lid was rubbed only
■with xhe. faliva.
(h) Warm fomentations are of great
ufe ; they not only relax the veflels and
attenuate the obflructing matter, but
by their warmth promotes the circula-
tion of the fluids through the obftrucled
part. They will, often, either relblve
ind-olent fwellings, or bring them to a
iiippiu'ation, when internal medicines,
without their alliftance, Avould do little.
They ought to be applied every morn-
ing and evening for near two hours,
but fliould not be fo hot as to be in
hazard of inflaming the fkin or making
it too tender. I generally ufe flannel-
cloths wrung out of hot water alone ;
and fometimes, in place of this, a hot
clecoclion of wormwood and camomUe
flowers or of the tops of hemlock, add-
ing to it a httle vinegar.
It
4^2 Of the Cure of
It is obvious, that when obftruftions
are deep feated in the abdomen, neither
fri^lions nor fomentations will have
fuch remarkable efFefts as when they
lie in the tunica cellulofa immediately be-
low the fkin.
[c) Gentle vomits and purges* fre-
quently repeated, are particularly ufeful
in beginning indolent obllruiftions of
the abdominal vifcera. But when an
obftru6lion in the flomach is fo far con-
firmed as to be irrefolveable, vomits,
elpecially of the ftronger land, may
prove hurtful by irritating the infard:ed
part, or even burfling fbme of its vef-
ielsf* And here it may be remarked,
that many of thofe hot and acrid medi-
cines commonly prefcribed in nervous
diibrders, muft be likewiie improper in
this cafe, fince by their flimulating
quality,
* I look upon the good efFefts of fca-watcr in glandular
fwellings to be chiefly owing to its purging quality. When
it does not prove laxative, but makes the patient thirfty an^
hot, no good is to be expeded from it.
•{• oee above, p. 206.
Nervous Disorders, 423
quality, they will be more apt to inflaine
and exalperate, than to lefTen or refolve
any fcirrhous obftrucflion.
(d) With regard to thofe internal
medicines Commonly called deobflruent,
they can have little or no effect, when
the obftrudling matter is accumulated
in the fpaces of the tela celluiofa, and
are, therefore, chiefly ufeful in thofe
obftrud:ions whofe feat is in the follicles
of the glands, or in the fmall veiTels
themfelves.
The internal deobflruent medicines
which I have ufed with mofl advantage,
are the tartanis fohihilisy fal pol'jchrefttis^
mercury and foap.
I GIVE the foluble tartar from drach.
i. fs. to drach. iii. or half an ounce, and
the polychreft fait from fcrup. ii. to
drach. i. fs, diflblved in an Englifli pint
of water, which is to be drunk, at three
or four draughts, every morning for
two months or longer.
I
424 Of the Cure of
I COMMONLY prefer! be mercury as a
deobflrucnt, either in the form of the
pilulae merciiriales laxantes, or of the folu-
tion of the corrofive fiiblimate. To
prevent thefe medicines from running
too much to the mouth, I give the pills
only once in two or three days, and
when the folution is ufed, I order a
gentle purgative once in four or five
days.
In glandular fwelhngs of the neck,
of the flrumous rather than the true
fcirrhous kind, I have \^qqi\ nothing
lucceed £0 well as a courie of the bark,
in fubilance or decoc^fion, for leveral
months ; giving at the fame time, eveiy
fourth or fifth night, fuch a dofe of
calomel and rhubarb, or of the pihiU
merciiriales laxantes, as may purge the
patient twice or thrice next morning.
Nor have I found thefe medicines lefs
efficacious, when together with indo-
lent Iwellings and a fcrofulous habit,
there
Nervous Disorders. 425
there was a confiderable degree of fe-
ver ; as in the following cafe.
A CHILD aged feven, of a lax and
fcrofulous habit, in March, began to be
affed:ed with hard fwellings on her left
wrifl and one of her legs, and with a
foft edematous fwelling of her feet
and hands ; at the fame time, her
tongne was foul, her pulfe quick, and
her fldn hotter than natural. In June
following, when I was flrll called, all
thefe fymptoms were increafed, flie was
much emaciated, and her pulfe beat a-
bove 130 times in a minute. As file
had ufed many other remedies without
advantage, after a vomit and a gentle
purge, I prefcribed a decoction of the
bark, with Ibme fpirit of vitriol, to be
taken, four times a-day, in the quanti-
ty of two or three table-ipoonfuls ; and
once in five or fix days a dofe of rhu-
barb with calomel. In lefs than four
weeks after flae began this courfe, her
pulfe
426 Of t1?e Cure of
pulfe became flower, her fkin cooler,
and her appetite better, and at the end
of two months flie was almoft quite free
of all her complaints.
Wh En glandular fwellings lie immedi-
ately under the fkin, the mercurial oint-
ment rubbed into the part, or a ftrong
mercvu'lal plafter applied to it, has fome-
times made a cure. — A Gentleman, a-
ged 21, had one of the conglobate
glands on the left fide of his neck fwel-
led from cold. This fwelling, which
was without j>ain, increafed gradually,
fo that at the end of three months, it
had acquired the fize of a hen's G^g, cut
longitudinally through the middle. Af-
ter he had ufed, for fix weeks, mercu-
rial purges, fomentations, and the com-
mon difcutient plaflcrs to no purpofe,
the emplajlrum fiiercin iak cum triplice mer-
curio was applied to the part. In two
or three days after, he began to falivate,
and for a week continued to fmt at the
rate ^\ ^.w Englifh ^'inK a-c«ay. After this,
the
Nervous Disorders. 427
the {pitting decreafed gradually, and
left the tumour reduced to one-third of
the fize it had before. The warm wea-
ther of fummer, which foon followed,
carried off what the mercurial plafter
had left unrefolved.
Among the deobflruent medicines
Spanijh foap deferves a principal place.
Obftinate glandular fwelHngs havelbme-
times yielded to it after mercury had
been tried in vain, as will appear from
one of the following cafes. It fhould
be given, daily, from half an ounce to
an ounce or more, if the patient's flo-
mach can bear £0 much.
I. A. M. UPWARDS of 20, applied to
me in April 1752 for a Avelling in the
epigaflric region, a little below the
cartildgo enfiformis. This tumour was
near as large as one's hft, and felt hard,
but without pain : It was evidently un del"
the mufcles and peritonmm, and as it
fliifted its place upon the patient's turn-
ing from one fide to the other, I con-
jeftured
428 Of the C u R E 0/
Je£liired its feat to be in the oynentum, e-
ipecially as it was attended with no diC-
order in the ftomach or bowels.
I ADVISED him to let warm water
fall from a confiderable height upon the
fwelling ; to cover it, all day, with a
piece of flannel, to nfe the pikiU feilitic^,
and drink with them, at leafl, an En^
glijh quart of cow-whey daily. Some-
time after, he got pills of gum, ammon.
galban. and aloesy but without any bene-
fit ; for the tumour became larger, and
^vhen he fat to write, which his bufinefs
often obliged him to do, he fuffered
much uneafinefs from that pofture. On
this account, I fent him to the country
in the end of J«/)', and advifed him to
Iwallow, e\ ery day, from half an ounce
to a Avhole ounce of Spaiiijh foap, and
continue the whey. Towards the end
of October he returned to town with the
tumour fenfibly diminiflied, and by go-
iii'^ on with the fbap 'till about tlie hc-
ginnjng.of j<:w///2;v, it was fcarcely to be
felt.
Nervous Disorders. 429
felt. He then left off all medicine, and
has beenever fince in good health, with-
out any fenfible fwelling or hardnefs a-
bout the part firft affected.
2. A Gentleman aged 33, after ha-
ving been fubjet^t, for fome years, to
rheumatic pains, obferved, in March
I J 52, an indolent glandular fwelling,
neither foft, nor yet of the hardeft kind,
on the right fide of his neck, immedi-
ately above the clavicle. In the Au-
tumn following, having expofed him-
felf to cold and wet, on a journey, this
fwelling became, foon after, conlider-
ably larger. He then lofl fome blood,
which was very lizy ; and in November
he ufed fome warm difcutient fomenta-
tions and the mercurial laxative pills.
Theie laft, which he took, once in two
days, for about three weeks, made him
fpit gently, but did not cUminlfh the
tumour. About a fortnight after he
had difcontinued the pills, he began to
take three drachms of foap daily, and
foon
4^0 Of the Cure of
foon doubled that quantity. Ill three
weeks, the fwelhng being fenfibly di-
minifhed, he was encouraged to con-
tinue this medicine ; but, about the
middle of faniiar), having catched cold,
he was feized with a diarrhcca^ and obli-
ged to omit the Ibap for above a fort-
night. In Fehmar-jy foon after the diar-
rhooa left him, he began to be troubled
with a violent itching over his whole
fkin, efpecially when in bed, and tliis
fymptom increafing, towards the end
of this month, he was advifed once
more to difcontinue the foap. At this
time the tumour was reduced, at leall:,
one half fince the middle of December*
On account of the increafe of this
itching and other complaints, he never
returned to the foap ; but after trying
a variety of other medicines, and the
air of different climates, in vain, he died
in Aiiguft 1754.
Since people affected with the ftone,
often take foap to a greater quantity
than
Nervous Disorders. 431
than this patient did, without any com-
plaint of itching, I think this fymptom
cannot be juflly afcribed to that medi-
cine ; efpecially as the patient had no-
thing of it for the firil: five weeks he
ufed the foap, and as it came on after
a diarrhcoa occafioned by cold. Nei-
ther can I think the fwelling in his neck
was critical, and that the itching and o-
ther bad fymptoms were owing to the
matter in it being dilFolved by the foap
and carried into the blood ; becaufe, in
March 1752, when this tumour began,
the patient had no particular com-
plaints, and in November, when it was
become fo large as to be broader, though
not fo thick as one's lift, his health was
bad and his blood fizy.
Alt ho' I have prefcribed foap in Ic-
veral other cafes without the lame fnc-
cefs, yet as many glandular fwellings
are altogther incurable, foap, if it fliould
be found to anfwer in two cafes out of
ten.
'432 Of the Cure of
ten, ought to be efleemed a valuable
medicine.
If it fliall be objected to the virtues
of Ibap as a relblvent, that fcirrhous
tumours, >vhen cut out of the body, are
not difTolved by being immerfed in a
fohition of it in water ; I anfwer, that
foap, in diflblving urinary concretions,
acts hke other chymical menfiriia; but
in refolving obllrud:ed glands, it muft
be alliiled by the motion communicated
to the fluids by the heart and arteries,
which it may probably flimulate into
ftronger contractions, and thus, as well
as by its refolving quality, contribute
to the cure. But further, I do not i-
magine that Ibap will ever dillblve a
lYue fchirnu either in the body or out of
it ; I only exped: that it will fometimes
remove glandular obftructions that are
lefs confirmed and of a fofter kind.
Qu ICKSILVER and its preparations,
altho* among the moil powerful deob-
flruents, if they fail of refolving hard
fwellines.
Nervous Disorders. 433
fwellings, are apt to irritate and inflame
them. This efFedl has been generally
afcribed to the weight of the mercu-
rial medicines, but without Hifficient
reafon ; for when ten grains of calomel
have raifed and kept up a falivation,
in fome perfons, for two or three weeks
Together, and when a flight Ipitting has
been occafioned by a grain and a half
of corrofive fublimate, diiTolved in fpi-
rits and taken in four days, it is plain
that the addition of weight to the mafs
of blood, in thefe cafes, muft have been
fo frnall, that no fenfible change in the
circulation could have been produceti
by it.
Soap has not only this advantage over
mercury, that it may be ufcd in mod
cafes, without irritating and inflaming,
and confequcntly without any hazard
of changing a fcirrhous fwelling into a
carcinomatous one, but it does not melt
down the fluids and reduce the flrength
like mercurials.
E e Soap
434 ^f ^^■'^ Cure of
Soap feems to a61; cliiefly by its de-
tergent quality, and perhaps, in fomc
cafes, as a true difTolvent. Every one
knows the property of a folution of foap
for cleaning the fkin : And if a patient
fwallows an ounce of foap daily, his
blood will in time become fo faponace-
ous, that whilft it cuxulates through the
half obftrucl:ed vefTels of a Rvelled gland,
it may infenfibly clear away and carry
along with it, that vifcid matter, which,
by adhering to the infide of theie vef-
fels, in a great mealure filled up their
cavity.
Of late, the extract of the ciatta has
been much extolled as a deobftruent * ;
but aitho* I have tried it, as well as the
powder of hemlock, in feveral hard
fwellings, fbme of which were external
and others lituated ^vithin the abdomen,
I have only £Gen it do fervice in tw^o
cafes, one of whicli was a large fcirrhous
fwelling in the left breaft, and the other
a hardened gland in the neck. The
latter
* See Dr Storck't three treatlfes on the virtues of the cicuta.
Nervous Di-sorders. 435
latter was removed by the extradl of the
ciciua in eight months ; and the former,
by the continued ufe, either of this me-
dicine, or of the powder of hemlock,
has not only been kept from increafing
for thefe four years paft, but is now re-
duced to one third of the bulk it once
had.
[e) In attempting the cure of ob-
ftruclions in the vifiera, belides fome of
the remedies above mentioned, it will
be proper to order a diet confifting
of the leall flatulent vegetables, weak
broths and the lighter meats. Ripe
fruits, if they do not offend the flomach
and bowels by their flatulence, may be
ufefiil on account of their faponaceous
or refolving quality ; as alio, goat or
cow-whey, efpecially in the beginning
of Summer, when it is mofl impreg-
nated with the virtue of the grafs and
other herbs. The patient's drink ought
to be rather tepid than cold, and the
beft is either water alone, <jr mixed with
E e 2 a
43^ Gf the Cure of
a little Rhenifli, or fome other light
white-wine.
(/) Exercise, elpecially richng, is
exceeding iifeful, not only to prevent,
but to remove beginning obflriiftions.
And here it may be proper to obferve,
that as thofe Avho lead a fedentary life,
eipeciaily the ftudious, (who in reading
and writing lit fo much with their body
bent forward,) ai'e moft fubjeft to hypo-
chondriac diforders and obftrudlions ;
it would be of great confequence for
fuch, to allot fome part of the day for
exercife, or if that cannot be done, at
leafl, to read or write moflly Handing ;
in which poflure the abdominal vifcera
are much lefs comprelFed than in the
other.
[g) In coniiderable obftriKftions of
the vificra, if the patient be of a full
habit, the cure ought to begin with
bleeding, which by emptying the vefTels,
may not only tend to leflen the obflruc-
tion, but alfiil the at^ion of the deob-
llruent medicines.
(/;) Whilst
Nervous Disorders. 437
(/;) Whilst by the ufe of fome of
the above remedies, we aim at a radi-
cal cure, we muft not ncgleft to palliate
the fymptoms which fo often attend
thefe obftrud:ions. This is to be done,
chiefly, by opiates, and by the lefs
heating carminatives and nervovis medi-
cines. But of this more hereafter.
6. Violent affe(5lions of the mind.
When nervous or hyfleric diforders
arife from this caufe, the cure confilts,
(a) In avoiding all difagreeable and
fliocking fights, and every occafion that
may be apt to excite violent pallions, or
commotions of the nervous lyftem.
(Z') In ftrengthening the nerves, fo
that the mind may be lefs apt to be
ftrongly affecfted either by impreilions
from external objed:s, or by fuch ideas
as arife purely from reflexion ; the
belt medicines for this purpofe are the
bark, bitters, fteel, the cold bath, and
exercife with proper aliment ; concern-
438 Of the Cure of
ing all which, fee the firft intention of
cure*.
{c) Nervous diforders occalioned
by ftrong impredions on the mind, are
often prevented, leiTened or cured by
exciting other fenfations or pallions of
a fuperior force. Of this we had a re-
markable inflance in the cure perform-
ed by Boerhaave, on the boys and girls in
the poor's-houfe at Haerk?n'\. — Epileptic
fits have been cured by whipping if. —
Convulfions from the toothach are re-
moved by blifters, — vomiting has been
ftopt by putting the hands fuddenly in
cold water ; and a common hiccup is
inftantly cured, by whatever excites
fm-prize, or ftrongly engages the atten-
tion.
(d) Ner-
* Pag. 344, iffc. above,
t See above, p. 217.
X Kaau Boerhaave, impet. faciens Hippocrat. diet. § 406.
In t\\&HiJloire de I' Jcademie Royale d^s Sciences 1 75 2, there
is an account of a girl, who was cured of epileptic fits
arifing from melancholy, by firing a gun at her bedfide,
juft as fhe was coining out of one of the paroxyfms.
Nervous Disorders. 439
(i) Nervous or hyfleric afFedlions
from a concealed or difappointed paf-
fion are better cured by the fruition of
the obje(fl* ; or if this cannot be ob-
tained, by proper diet, amufements and
by opiates, efpecially at bed-time, for
compofing the mind and procuring
fleep, than by the whole clafs of nervous
medicines.
Having thus far treated of the cure
of the feveral caules of nervous, hypo-
chondriac and hyfleric diforders, I fliall
conclude thefe obfervations with men-
tioning particularly, the remedies mofl:
proper for removing or palliating fome
of their mofl troublefome fymptoms.
CHAP.
* A remarkable inftance of this, we have in a young
man, who, from difappointment in marriage, was fuddenly
feized with a catalepjis, fo that he remained for a whole
day in his chair, in the fame pofture, without the leall
motion or feeming attention to any thing about him . Nay,
his whole body became as flifF as if he had been frozen.
However, no fooner was he told with a loud voice, that
he was to have his beloved objeft, than waking as out of
a deep fleep, he fprung from his feat, and recovered at
once. S^tTulpn obfervationes tnediae, lib. l. cb/crv. 2 3.
[ 44c> i
CHAP. VIII.
Of the Cure of fome of the moft remarkable
Nervous, Hypochondriac, ©r Hy-
steric Symptoms,
I. /^^Onvulsive motions or fixed
^^ Ipafins of the mufcles.
These are either general, affecting
ahnofl the whole body, or confined
to one or a few mufcles or organs.
As they often arife from very different
caufes, their radical or prophylactic
cure muft confifl in the removal or pre-
vention of thofe caufes *. But as the
immediate
* In fo far as they may proceed from fome peccant mat-
ter in the blood, from phlegm, acrid humours, worms or
wind in the ftomach and inteftines, from a great lofs of
blood, an obftruftion of the tnen/es, or afFeftions of the
mind, their radical cure is to be found in the preceding,
chapter.
Of the Cure, &€. 441
immediate caufe is, in every cafe, the
fame, viz. fomethiiig that irritates the
brain or nerves, or affe^ls them with a
difagreeable fenfation, their palliative or
temporary cure will be beft efFefted by,
(i) Such medicines, as by their ftu-
pifying or narcotic quality leflen the
fenfibility of the brain and nervous fy-
flem *.
In continued ipafms, as well as alter-
nate convullive contraftions of the flo-
mach and inteflines, nothing gives fo
flidden or fo fenfible relief as opiates ;
which are often not lefs efficacious when
the other mufcles are fpafmodically af-
fected. In that ipecies of the tetanus
called opijihotonuSf as well as that which
is confined to the lower jaw, opium is
the principal remedy f ; and as the /;y-
drophobia is only a violent convullion of
the gullet and (lomach, <6'c, ariiing from
the difagreeable fenfation excited by
any
* See above, p. 358, Cffr.
•j- See Medical Inquiries and Obfervations, vol. i.
442 Of the Cure of
any liquids touching the fauces^ or by
the effort the patient makes to fwallow
them, opiitm in large dofes, efpecially if
given by way of a clyfter, and repeated
at proper intervals, would probably be
found, at leaft, the beft palliative*.
Convulfive fits of the (lighter kind,
which returned daily at a certain time,
have been prevented by giving opium
an
• Altho' this reafoning fcems to be much confirmed by
the cure of Dr Nugem'i patient, (See his efTay on the fydro-
fhobia) yet, in this cafe, as mufk and other remedies were
ofed as well as opiates, it may be doubted whether the for-
mer had not fome confiderable fhare in the cure. It were
to be v/ifhed, therefore, that fuch as (hall have opportuni-
ties, would make a fair trial of opium alone in the hydro-
pbohia .
About the 20th of Auguft 1761, a farmer's fervant near
J^orbam in NortbumherlanJ, three weeks after having been
bit by a mad dog, became delirious, had violent fpafms, a
dread of water, and other fymptoms common in fuch cafes.
He was treated by Mr Davj/on Surgeon in CcUjireamy ac-
cording to Dr Nugcvji's method, and recovered fo quickly
as to be able to be employed iu reaping the corn before
the middle of September.
He was blooded, got every three hours mulk and cin-
nabar with honey in a' bolus, and a pill of cplum. A plaf-
ter cT galbanum with half an ounce of opium was applied to
the throat and neck.
Nervous Symptoms. 443
an. hour or more before that time. But
in an epileptic patient, who was feized
every day about two in the morning,
the fits were neither prevented nor fen-
fibly lefTcned by forty or fifty drops of
laudanum^ which I ordered him to take,
for feveral nights, about two hours be-
fore the return of the fit.
It is to be obferved, that in curing
or palliating violent fpafms or convulfive
motions, opiates muft be given in lar-
ger dofes than ufual, and repeated more
frequently ; for here, as in cafes of a-
cute pain, the patients bear thefe me-
dicines much better than in health.
In fome cafes, elpecially where the
vellels are full, bleeding and other
evacuations ought to precede the free
ufe of opium.
(2.) Such medicines as, though not
endued with a narcotic quality, are
found by experience to be ufeful in
Ipafms and alternate convulfions of the
mufcles ; and feem to produce their
good
444 V ^^^^ Cv RE of
good efFefts, by th^t Jiimulus which they
communicate to the nerves, eipecially
of the ftomach and inteftines. Of
this kind are camphire, caftor, mu(k, afa
fa:tida, the fpiritiu £thereiUf fpirit of hartf-
horn, 6'^.*
A DRAM of brandy, by ftimulating
the nerves of the ftomach, will almoft
inftantly lelTen a tremor of the hands^
and in fome cafes make the pulfe flow-
er : And, do not other ftimulating me-
dicines, in fbme fuch way, remove a pal-
pitation of the heart, and other convuL
five motions, as well as fixed fpalius of
the mufcles ? Thefe efFefts may happen
equally, whether thofe medicines excite,
in the nerves, an agreeable, or an un-
pleafant or painful feniation. Thus a
glafs of warm wine with cinnamon and
nutmeg, and a mixture with aqua fulegii
or ruUy tincture of cafior and afa footiday
will often have fimilar effects in flatulent
i^nd fpalinodic affedlions of the alimen-
tary
* See above, p, 364,
Nervous Symptoms. 445
tary canal ; and we fliall fee, below,
that blifters and other painful applica-
tions are fometimes ufeful in removing
fpafms and convulfive motions.
(3.) Such remedies as relax, and, at
the fame time, affeft with an agreeable
fenlation the mulcular fibres and nerves,
rendering them, thereby, lefs liable to
fiifFer from iiTitation ; viz. the warm
bath, femicupiufHy and pediluvium, emolli-
ent clyflers and warm fomentations ap-
plied to the feet and legs, or other parts
of the body *. To this clals alfo, we
may, perhaps, refer venaefeftion, which,
by emptying the vellels, produces a ge-
neral relaxation ; but whatever be in
this, we know from certain experience
that it has often very flidden and re-
markable effects in lellening or remo-
ving Ipafms and convulfive motions.
Olam Borichms mentions a young wo-
man liable to a periodic hiccup, which
returned regularly about tlie fame time
once
* 5ee above, p. 364.
446 Of the CvKE of
once a-year, who, after other remedies
had proved ineffectual, was always cured
by bleeding largely at the arm. It was
obfervable, that this hiccup was not lef^
fened by the menfes flowing plentifully
during the time the patient was affed:ed
with it *,
The warm bath affeCls the nerves
with an agreeable fenfation, removes
fpafms in the fmall veiFels, promotes an
equable circulation, gently expands the
fluids, and confequently fills the whole
vefFels of the body. But in whatever man-
ner the warm bath and fomentations may
aft, their power in givhig, often, imme-
diate relief from violent pain, and pre-
venting or allaying fpafms and conviil-
five motions, has been fufficiently afcer-
tained by experience. However, as the
ufe of the warm pedilitviiim and fomenta-
tions applied to the feet and legs in fe-
vers attended with a delirium^ tremors
and
* Ada Hofniesif.a, 167 1, and 1672. § Ixxiii.
Nervous Symptoms.
447
and convulfions *, may not be fo gene-
rally known, I ftiall give fome inftances
of their good efFe^ls.
(a) Mrs aged 23, on Saturday
the tliird day after being delivered of
her firft child, was feized with a cold-
nefs and fliuddering, flicceeded by a
hot fit and fweating. Next day fhe was
better, but after a reftlefs night between
Sunday and Monday, her fkin felt hot and
dry, and her pulfe was quicker. Her u-
rine which, before, had been of a na-
tural colour, was now limpid and in too
great quantity. On Tttejday her pulfe
was much quicker than ever, viz, at 1 3 6
flrokes in a minute, but not full : She
became apprehenhve of dying, and,
after fome fits of vnieaiy breathing, fell
into a kind of hylteric fainting, wliich
did
* The fuccefi which fomenting the legs liad in a cafe of
this kind, was communicated to me about feven years fincc
by my learned and ingenious friend Dr John Prhigle physi-
cian to her Majefty. The Doaor mixed f part of vine-
gar with the water ; whereas I have always ufed hot wa-
ter alone.
44^ Of the Cure of
did not affed: the piilfe, altho' hef
breathing was fcarce perceptible. Du-
ring this fit, which lafted about an hour-
and a quarter, flie fighed and moaned
frequently. About mid-night, flie was
very reftlefs, her arms and head were
convulfed, and ilie became quite deliri-
ous. This day a rafli which had come
out on Monday, had in a great mealure
difappeared. All this time the lochia
continvied, though in a fmaller quanti-
ty than ufual. Hitherto diluents, dia-
phoretics, clyfters, fmall dofes of cam-
phire, laudanum, bliflers to the legs and
iinapifms to the foles had had no effect.
On Wednefdaj, the dclirmm increafed : at
noon two leeches were applied to each
temple, and foon after, becoming pret-
ty diltin(fl, file faid flic found herfelf
much eafier : But, about eight in the
evening, flie grew more delirious than
ever, crying out in a diflraded manner,
and was fo ftrongly convulfed, that with
dllliculty file could be kept in her bed
by
Nervous Symptoms. 449
by two flrong perfons employed for
that purpofe. At this time, I ordered
large pieces of flannel wrung out of hot
water to be wrapped round her feet and
legs. This application, which was re-
newed once in fifteen or twenty mi-
nutes, and continued near three hours,
had a mofi: happy effecft ; for her deliri-
Jim, and flruggling to get up, ibon be-
gan to abate ; flie fell afleep at eleven,
and did not awake till two in the morn-
ing, when (he was quite calm and fen-
fible ; after this fhe fleept near three
hours more, and was pretty eafy and
clear in her head all Tim? f day, till the
evening, when the delirium returned in
a lefs degree. But this fymptom being
foon removed by frefli fomentations, flie
pafled a good night, and gradually re-
covered, without any return of the ra-
ving, fainting, or convulfions.
[b) R. B. a boy aged eleven, was
feized with a headach and fever ; Mon-
day, he complained of a iliarp pain in
F f his
45^ ^f ^^^^ Cure of
his right fide, on which account i^ear
eight ounces of blood were taken from
him. On Tiiefda^y his hea.d wi^s eafier,
but the pain in the fide contuiued ; his
piilfe beat 120 times in a minute. Tliis
evening a bhfter was applied to the
right fide. Next morning the pain
Avas much abated, but a llight delirium.
began, and increafed towards the even-
ing, when his pulfe was about 1 30,
though no-ways full. Leeches were
applied to the temples, and poultices to
the feet. On Tlmrfda^ morning, the
delirium and fever continuing, his head
was fliaved, and afterwards fomented
with cloths wrung out of hot water.
Tliis made him fomewhat drowfy and
calmer for a fliort time ; but about
mid-day, his pidfc became quicker,
iliarpcr and fmaller, and the delirium
increafed. At three afternoon he was
quite inlenfible, had a fubfultus^ tmdinum
with catchings, and liis pulle which was
fmall beat near 150 times in a minute.
In
Nervous Symptoms. 451
In this flate, I ordered his feet and legs
to be immediately fomented, as in the
preceding cale : the effe^l was, that he fell
ibon afleep and waked at four, Ibmewhat
calmer, and with a little fweat on his
fkin. The fotdentations were renewed ;
he had another fleep, and about lix in
the evening he was much lefs delirious,
and his puHe did not exceed 124. At
eight the legs were fomented again, a
conliderable time. He Kad feveral good
fleeps during the night, and, Friday
morning, was quite diftinft, with a puHe
at 96. From tliis time he recovered
daily, without any return of the fever
or deli rum*
(c) A middle-aged man, who was
feized with a continued fever, in a few
days became delirious, had a quick and
very fmall pulfe, a parched tongue,
fiufliings in his face, and twitchings ;
and he palled his urine infenfibly. He
was treated with the common remedies,
and liad a bliftcr applied between his
F f 2 fl\oulders.
452 Of the CVKE of
Ihoiilders, but with little advantage*
My advice being alked about the 8 th or
9 th day of the difeale, I ordered his legs
and feet to be fomented with flannel
wrung out of hot water. This, in a
little time, put him afleep ; and, next
day, his pulfe was fuller and lefs quick,
the delirium was abated, his tongue was
moifter, and a gentle fweat came on.
After this, the fever decreafed gradual-
ly, and the patient recovered.
Having found fuch benefit from the
warm fomentations in fevers attended
with a delirium, tremors and fpafms ; I
thought it might be worth while to
make trial alfo of the warm pediluvium in
fuch cafes ; and I foon found this to
liave tlie fame, but more powerful, ef-
fecTts than the fomentations : for in
fome cafes, when thefe laft had failed to
lelTen the tolling, raving and convul-
fions, the pedihroium fucceeded, not only
in the time the patient ufed it, but its
effects continued a good while after;
and
3
Nervous Symptoms. 45
and when they ceafed, it was renewed
again with the fame advantage as be-
fore. In fome cafes, I have ordered the
feet and legs to be put in warm water
four or five times in 24 hours, and to
continue in it from half an hour to near
an hour at a time, unlefs the patients
became faintifli.
(a) A Lady aged about 20, on the
fourth day after being delivered of her
iirft child, began to be feverifli, and fleept
none. After this (lie became very de-
lirious, talked conftantly, had fome-
times tremors, and was fo reftlefs, that
for two days flie 'lad not lain one mi-
nute in the fame pofture, and was with
difficulty kept in bed by two or three
nurfes. On the loth day after her de-
livery, when I firft fliw her, the fymp-
toms now mentioned were all increafed,
only (lie fpoke none, and feemed to un-
derftand nothing that was faid to her :
her pulfe, which was but of a moderate
^rength, beat above 1 50 times in a mi-
nute.
i-
454 ^f ^^^^ Cure of
niite. Nay once, when flie was more
agitated than iifual, it rofe to i8o
ftrokes in that time, and became withal
very fmall. As (he had been blooded
and bliftered, and iifed fever al other re-
medies without advantage, I ordered
her feet and legs to be put immediately
into the warm pediluvhmiy which was
done by making her lit up on the bedr
fide. At firft, it required two people
to keep her feet in the water, but, in
lefs than a quarter of ah hour, fhe grew
calmer, and made little motion either
with her legs or any other part of lier
body. After ufing the pcdihivhim for
half an hour, flie was put to bed; but
foon began to grow as refllefs as for-
merly ; upon w^hich account warm fo-
mentations were applied to her legs and
feet, and renewed from time to time for
near two hours, but without any bene-
fit. I therefore thought it beft to re-
new the pcdiliroiitm, which was ufed at
this time for a full hour; it foon made
her
Nervous Symptoms. 455
her fit quiet, and after flie was put to
bed, altho' flie did not fall afleep, yet
fhe lay feveral hours without toiling as
ufual, and her pulle was reduced to 136.
As often as flie began to be any ways
reftlefs, the pediluvmm was renewed.
After ufing it the fourth time, flie got
feveral fliort fleeps, was lefs delirious,
and her pulfe only made i 20 flrokes in
a minute ; from this time (viz, the e-
leventh day after her delivery) the pe-
diiiivium, which was never repeated above
twice in 24 hours, procured her longer
fleeps, and leflened all her bad fymp-
toms ; fo that in two days more, flie
was quite free of the delirium, and her
pulfe did not exceed c^o in a minute.
(b) A Gentleman aged 40, after
having had a continued fever feven or
eight days, began to rave, and the deli-
rhim increafed fo much, that about the
I ith day, he could not be kept in bed ;
nor would he allow either fomentations,
bliflers or finapifms to be applied to his
legs
456 Of the Cure of
legs or feet. In this condition, I ad-
viled to take him out of bed, as often as
he infifted upon riling, and, while he
fat up, to keep his feet and legs in
warm water. Between feven and half
an hour pad eleven in the evening, he
was feven times out of bed, and as often
ufed the pediluvium for about a quarter
of an hour, or longer, at a time. Be-
fore midnight the hurry of his fpirits
began to abate, he talked lefs, and feem-
ed drowfy. In the fu'll part of the
night he had fome fliort fleeps, and
towards the morning, he flept three
hours at once. His pulfe was now re-
duced from 120 to 100 flrokes in a mi-
nute ; and from this time the dellriimt
decreafed gradually for feveral days,
and he recovered.
[c) Having been called to A. A.
aged 30, in a continued fever with in-
flamed eyes, and fo violent a deliriwn,
that he could not be kept in bed ; I or-
dered him to be taken up, and to have
his
Nervous Symptoms. 457
liis feet and legs put in warm water for
twenty minutes. This was done thrice
in the fpace of thirteen hours ; and it
always leflened his raving, made him
quieter, and procured a fleep after he
went to bed. Next day, he became a
good deal comatous, and liis eyes were
rather more inflamed ; but the day
after, he grew more lenfible, his eyes
looked better, and his pulfe had fallen
from about 170, (which was its quick-
nefs when at the worfl,) to 128 llrokes
in a minute. After tliis, he recovered
gradually.
(d) Another patient aged 25, in a
continued fever, with a pulfe above 140,
inflamed eyes, and a violent delirium, ib
that two ftrong men had been employed
to keep him in bed, recovered, after
being taken up thrice, and having his
feet and legs kept in warm Water for
above twenty minutes each time. The
v/arm water always lefTened the deliriimiy
and, after he returned to bed, made
him fall afleep.
Instead
45S Of the Cure of
Instead of adding more cafes, liliall
only obferve, that I have faved more
patients who appeared to be in great
danger, in the delirious flate of a fever,
by the fomentations, and efpecially by
the warm pediluviiim, than by any other
remedy : and even in thofe cafes, where
thefe applications were infufficient to
compleat the cure, they, almofl always,
gave fome prefent relief, by making the
patients fomewhat quieter and difpofing
them to fleep.
Th e fomentations and wai'm bath to
the feet are particularly ufeful in fevers,
where the brain and nervous fyflem are
much irritated. In cafes where the
eyes are inflamed, they will anfwier bet-
ter, if the patient has been bled at the
temples with leeches, before their appli-
cation. When the Hck cannot bear the
■pcdihroiinn in an ereft pofture, I order
dieir legs to be put o^ er the fide of the
bed, fo as they may be immerfcd in the
warm water ; the heat of which fhould
not
Nervous Symptoms. 45^
not be lefs than 100 degrees of Faren-
hcit*s fcale.
I SHALL only add on this lubjecl, that
I have found the warm femicnpmn or fe-
diluvium, the beffc remedy for thofe con-
vullions which fometimes precede the
eruption of the fmall pox ; and for that
general tremor of the whole body, which
often happens towards the end of that
difeafe, when the puftles are of a very
bad kind. But to return,
(4.) In convuliive motions or fpafms,
fuch remedies are often ufeful, as, by
painfully affefting the nerves of fome
part of the body that is found, in a
great meafure lefTen or deftroy the fenfe
of that irritation which was the caufe of
thofe fymptoms*. Of this kind are
blifters, aprid cataplafins, diy cu2:)ping,
fridiion and the cold bath.
About feventeen years iince, a wo-
man aged 20, was leized with an alter-
nate motion of die abdominal mufcles.
lu
* Hippocrat, aphor. lib, ii. N" 46.
460 Of the Cure of
In the night, when in bed, flie was
pretty free of this aihiient ; but, through
the day, thofe mufcles were ahnoft con-
ftantly in motion, and it was not in her
power to reftrain them in the fmalleft
degree. After (lie had tried many me-
dicines without any benefit, I ordered
a circular blifter of about eight inches
diameter to be applied to the abdomen,
Tliis put a flop to the convullive mo-
tions for feveral days ; and altho' they
returned afterwards, they were much
weaker and lefs frequent, and in a (liort
time, they ceafed entirely, without the
alliftance of any medicine, except a few
dofes of camphire.
In cafes, where epileptic convullions
took their rife from an uneafy fenfation
in fome part of the arm or leg, I have
found blifters appHed to thefe parts the
bed remedy. It may be proper, how-
ever, to obferve, that, in people whofe
nerves are uncommonly delicate and
fenfible, it is often better to attempt the
cure
Nervous Symptoms. 461
cure of conviilfive motions or ipafms
by opiates, miifk, camphire, and the
Avarm bath or pcdiluvhauy than by bliilers,
which fometimes do harm by the vio-
lent pain which they occafion.
I HAVE found dry cupping not only
iifeful in convulfive contractions of the
mufcles*, but aHb in removing recent
rheumatic pains from cold, where there .
was no fever ; nay, in older pains of
this kind, I have feen patients relieved,
at leaft, for fome time, by this remedy.
I order the cupping glafs to be applied
* j
to the pained part and all round it, and
let it ftick each time three or four mi-
nutes, or till it falls off. The liiclion is
often fo ftrong as to occafion fiiiall effu-
fions of blood below the fcarf-fkin. The
good
* A man aged about 50, who had for many years been
coaftantly afflnfled with an alternate motion of the mufcles
of his head and neck, found more benefit from dry cupping
along the back part of the neck and fhoulders, than from
any other remedy. It is true indeed, the good effedls of
this application lafled only for a few days; but, had the
diforder been lefs fixed, it is probable, that repeated cup-
ping might have made a perfe<ft cure.
4^2 Of the Cure of
good effects of dry cupping do not pro-
ceed Iblely from the pain it occafions,-
which is not very confiderable ; but
chiefly from the change it makes in the
circulation of the blood through the
lub cutaneous parts : for^ while the cup-
ping-glafs remains fixed, the blood
which ufed to be fent to the parts be-
low, is, in a good raeaflire, derived into
the velfels of the memhrana adipofa and
fkin ; and, even for fome time after, the
motion of the fluids through thefe parts
continues to be greater than uflial, on
account of that irritation, and flight
degree of inflamation wliich is generally
occafloned by cupping.
The cold bath is often ufeful in cu«
ring thofe convulflons wliich go by the
name of St Vitush dance : And cold
water thrown on a perfon labouring
under the hydrophobia, has enabled him,
for fome time, to drink pretty freely'^'.
Was
* See Mead on poifons, edit. v. pag. 182. and Fan Sivie-
tCK. comment, in aphor. Boerhaave, torn, iii. p. 576.
Nervous Symptoms. 463
Was not this effeS: owing to the ftrong
impreifion made on the nei-vous lyflem
by the cold water, which, in fome niea-
fure, deftroyed or lefTened the unnatu-
ral fenfibility of the nerves of the fauces
and gullet ? For the inability to fwal-
low liquids in the h'jdrophohia, is not
owing to a palfy of the throat, as fome
authors of great cliaracler have thought,
but folely to the difagreeable fenfation
excited in the fiiuces a.nd gullet, by the
touch of water and other fluids, which
raife as great fpallns and convullive
contractions in thole parts and the fto-
mach, as they do in the mulcles of re-
fph'ation, Ayhen, by an accident in fwal-
lowing, they get into the trachea,
(5.) Fear, furprizc, attention, or o-
ther ftrong affecllons of the mind, will
frequently put a ftop to convulfive mo-
tions and fpafms, and fometimes fuc-
ceed after other remedies have failed, as
in the following cafe.
A
464 ^f the Cure of
A GIRL aged eight, in the beginning
of September 175^)9 was feized with an
alternate motion of the maffeter and tem-
poral mufcles, for which no caufe covild
be alTigned. This motion exactly imi-
tated the pulfation of the heart. Only
thofe miifcles were contracted and re-
laxed above 140 times in a minute,
while the heart did not make above
90 ftrokes. Their contradlions were all
of equal ftrength, and the intervals be-
tween them were alfo equal. When
the patient prefTed the teeth of the lower
jaw ftrongly againft thole of the upper
one, by a voluntary contracT:ion of the
majfeter and temporal mufcles, their con-
vullive motions were much lefs remark-
able ; and when flie pulled down the
lower jaw as much as flie could, and,
by the continued aftion of its mufcles,
kept it in this fituation, the majfeter and
temporal mufcles were no ways con-
vulfed. Before I faw this patient, ilie
had been bliflered upon the courfe of
the
Nervous Symptoms. 465
the affected miiTcles, which lefTened
theu* convulfive motions, while the bhi-
tered parts continued to run, but no
longer. I ordered plaflers of the em-
■plaflrum antih'jjiericiim with fome opium
to be applied where the blifters had for-
merly been. Thele were kept on no
longer than two days, during which
time, the convulllons were weaker and
leis frequent, not being repeated above
50 or 60 times in a minute ; however,
in a day or two after the removal of
theie plaflers, the convuliive contrac-
tions became as llrong and as frequent
as ever. Brimilone, in powder, was
rubbed on the temples and cheeks with-
out any vifible effecl. Suipecting that
this convulfive diforder might, perhaps,
proceed from worms, I prelcribed a bolus
of rhubarb with calomel, which the
girl obflinately refulmg to take, her
father went to fetch a horfe-whip to
beat her. The fear of this aiFecled her
fo flrongly, that, without the hohis, the
G g convulfions
466 Of the Cure of
convulfions of the majfeter and temporal
mufcles inftantly ceafed ; and have ne-
ver returned fince, except once on oc-
cafion of a fright, when they continued
near an hour, and then went off with-
out any remedy.
Cdfus, in the fpafmus- opticus ^ recom-
mends pouring on the patient's head,
v/arm fea-water and llilphur* : And a
roll of brimftone, held in the hand, is
frequently ufed, now a-days, as a cure
for cramps or fixed ipafins of the muf-
cles ; and I have known it fucceed in
feveral cafes. The fnapping of the
brimftone, which often happens, has
been, by fomc, afcribed to the eleclrical
lire being difcharged in great quantity
out of the body, but without any rea-
fon. The truth is, that a roll of pure
brimftone held in the hand when warm,
will frequently break, whether the per-
fon be affected with the cramp or not ;
and the fame thing happens to brim-
ftone,
* De medidna, lib. iv. cap.2, ^
Nervous Symptoms. 467
flone, when placed before the fire in a
heat equal to, or a little greater than
that of the human body. I am, there-
fore, of opinion, that brimftone cures
fpafms not by any medical virtue ; but
that its effects are to be afcribed to the
patient's attention* and faith, or rather
to the fiirprize occafioned by the roll
fnapping in his hand : And as a confir-
mation of this, I have known fome af-
fected with the cramp, who, having
been informed that the breaking of the
brimftone was owing to the heat of the
hand, miffed of a cure.
(6.) Convulsive motions or fpafms
are often prevented or cured by com-
preflion, which braces and renders fir-
mer fuch parts of the body as are moft
fubjeCt to them. Thus cramps in the
Gg 2 legs
* I have been often cured of a flight hiccup by looking
ftedfaftly, for two or three minutes, on the impreflion upon
a fhilllng, or any other coin : And I know a Lady who,
though very liable to hyfteric fits, is never afFefted with
them, or even flighter complaints, when any of her children
happen to be dangeroufly ill.
468 Of the Cure of
legs are prevented by tight bandages;
and when convnliions arife from a fla-
tulent diflenfioii of the inteftines, or
from fpafms beginning in them, they
may be often leflened or cured by ma-
king a pretty flrong comprellion upon
the abdomen by means of a broad belt.
The Baron Van Swieten, mentions the
cafe of a young Lady, whofe legs,
thighs and belly, were kept tight with
rollers for feveral months, in order to
prevent convulfions, which, from an
uncommon delicacy of her nerves, flie
was frequently fubjed: to*. Epileptic
fits, which take their rife from a pecu-
liar fenfation in fome part of the legs
or arms, may be kept oif by making a 1
tioht lio-ature about thefe members as
foon as that fenfation begins, or at leafl,
before it has reached the fuperior parts
of the body.
To the remedies already mentioned
maybe added the bark, which has fome-
times
* Comment, in aphor. Boerhaave, torn, l:
Nervous SyxMPtoms. 469
times cured periodic convulfions after
other medicines had failed*.
I SHALL only obferve further, that
Avhen fpafms, or convuKive motions, a-
rile from fliarp humours in the ftomach
and inteflines, nothing will procure any
lading relief till thefe are either cor-
redled f or expelled J.
II.
* See Philofoph. Traiifaft. N» 174.
•}■ A young man under 20, in a continued fever, was
affefted with a ftrong delirium and convulfions of his face,
throat, and almoft all the parts of his body, particularly his
arms and legs. At the fame time, he complained of a great
thirft and heat within him. After having been in this way for
two or three days, he had a fweet orange given him, which
he eat greedily, and calling always for more, confumed
near two dozen of them in two days. After he began
to eat the oranges, the convulfions abated, and went quite
off in three days.
X For the following cafe, in which violent convulfive
fits were removed by repeated vomits, I am obliged to
Dr John Gardiner, Phyfician in this place,
A young woman of 17 years of age, of a delicate frame,
after having been a good deal fatigued, was feized, on the
20th of Julyy with convulfions of almoft every part of her
body, which continued about five minutes ; after which
fhe fainted away, and the convulfions ceafed ; but upon her
recovery, the convulfive motions of her arms, and the
niufcks of refpiration, returned. Thefe convulfions i-.aving
continued,
470 Of the Cure of
II. Hysteric faintings with con-
vulfions.
If the pulfe be full, or the patient
any ways plethoric, fome blood flioiild
be
continued, except in rime of fleep to the 22d, when I was
called, I ordered a bolus of ten grains of mufk to be taken,
every three or four hours with two table-fpoonfuls of a
musk julep. On the zzd, 23d and 24th, fhe was, feveral
times, free from the convulfions for half an hour, or fome-
times an hour : But, upon the leaft noife in the room, or
any thing that occafioned furprize, they returned. The
drawing the curtain of her bed, or the lifting of the latch
of the door, ufed to have this eiFeft. Nay, altho' fhe faw
her fillers going to open or ftiut the door, or to handle the
tea-cnps, and therefore expefted to hear fome little noife,
yet fo powerful was the impreflion made by it on her
nerves, that by no effort could ihe prevent the convulfions
from coming on.
In order to lelTen this uncommon fenfibility of the ner-
vous fyllem, camphire was added to the mufli bolus, and
fhe got 1 2 drops of laudanum in a difh of valerian tea five
or fix times in 24 hours. After this, fhe was oftener free
from the convulfions ; but when they returned, they were
more fevere. On the 27th, altho' her menfes came at the
ufual time, her fymptoms did not abate. After this flux
ceafed, fhe had a blifter applied between her fhoulders, ufed
z (o\\ii\on oi a/a faticla, and increafed the laudanum to 2.
hundred drops a-day.
On
Nervous Symptoms. 471
be taken away ; after wliich, we may
endeavour to roufe her by the linoak
of
On the 31ft of July, (he began to be feized with faint-
ings, for about five minutes at a time ; and foon after this,
the convulfions became uni\ erfal, and attacked her from
twelve to eighteen times a-day in regular paroxyfms, which
lafted two or three minutes. In the night, Ihe was almolt
always free of diem. I now prefcribed for her an ounce
of the bark, half an ounce of valerian and a dram of caftor,
to be made with fyrup of white poppies into an eleduary,
of which fhe fwallowed the bulk of a nutmeg three or four
times a-day, at the fame time continuing the laudanum and
bolufes of mu(k. After ther 3d oi Augujl, fiie was feized
with fevere afthmatic fits, which, together with her faintings
and convulfions, would often make thirty paroxyfms in a
day : Some days after this, upon the convulfions leaving
her, fhe was feized with continued fpafms in her arms,
legs and thighs ; after which, flie fometimes complained
of a fmall degree of pain and confufion in her head.
Her pulfe during all thefe complaints, feldom exceeded
80 ftrokes in a minute, nor were there any appearances of
her ftomach being difordered. However, on the 9th of
Auguji, I prefcribed a vomit of ipecacuanha, which made
her throw up a great deal of dark greenilh and very bitter
bile ; about an hour after this, fhe was attacked with one of
the convulfive fits, but had no more of them that day. On the
loth ol Auguft, fhe had twelve, and on the r ith, fourteen
of thefe fits. Upon the 12th, in the morning, fhe got ano-
ther vomit, which was alfo repeated on the 13th. Each
time (he threw up a good deal of bile, and had no fit either
of thefe two days. On the 14th, fhe took a decoction of
tamarinds \4'\x\i fenna, which purged her five cr fix times,
and
472 Of the Cure of
of afa fostida or burnt feathers, or by
oleum fitccini and fpirit of hartfliorn
dropt on cotton and put into the
noftrils. Thefe medicines, by the ftrong
and fudden impreffion they make on
the very fenfible nerves of the nofe, not
only tend to excite the feveral organs
into a6lion, but to lefTen or deflroy the
difagreeable fenfation in that part of
the body, which brought on the fit.
With the fame view, hot bricks may be
applied
and in the evening, flie was attacked fix times with the
convulfions and fainting fits. On the 15th, their number
was near double that; but on the i6th, when the vomit
was repeated, fhe efcaped tliem altogether. Having been
informed that a peaiiTue, which had been long kept open
.in one of her arms, had dried up near twelve months be-
fore flie fell ill, an ifiue, fufficient to receive two or three
peas, was made in each arm. Every other day for a week,
fhe took a vomit of pul-v. ipecacuanhee gr. 'v. and tart. emet.
gr. i. and at night, fometimes, a fmall dofe of elixir fa-
crum ; by which means, before the beginning of September^
fhe got quite free of the fainting fits and convulfions.
It was obfervable, that, during her illnefs, in the inter-
vals of the fits, fhe was often very chearful, and fometimes
jocofe ; but after fhe recovered, fhe became grave, thought-
ful and fomewhat raorofe, v/hich was her natural difpQ-
fition.
Nervous Symptoms. 473
applied to the foles of the feet ; and the
legs, arms and belly may be ftrongly
rubbed. But there is no remedy, which
I have found fo effectual in removing
hyfteric faintings with convulfions, as
the warm pediluvium ; for after many
other things had been tried to no pur-
pofe, I have feen the patients reflored
to their fenfes, almoft inftantly, by put-
ting their feet and legs in water a little
more than blood-warm : And it was re-
markable, that upon difcontinuing the
pediluvium too foon, the fainting and
cat;chings often retm'ned in a lefs de-
gree, and the pulfe became fmaller and
irregular. In a few cafes, where the
patients were plethoric, and the con-
vulfions very ftrong, the pedihroium has
failed.
Warm water thus ufed, is not only
the Ipeedieft, but the fafeft cure for
hyfteric faintings; while ftrong volatile
fpirits held to the nofe, are apt to
t;hrow
474 Of the Cure of
throw Ibme very delicate women into
more violent convvilfions.
In cafe of coftivenefs, a laxative
clyfter with afa foctida will be proper ;
and, as foon as the patient can fwallow,
two table-fpoonfuls of a folution of afa
foctida^ or fome cordial julep, may be
given.
After the fit is over, the radical
cure muft vary according to the diffe-
rent caufes from which it may proceed.
However, fuch medicines will com-
monly be found moft efficacious as
ftrengthen the alimentary canal and the
whole nervous fyftem. An antihyfleric
plafler applied to the abdomen has been,
in fome cafes, ufeful ; as alfo gentle vo-
mits and ftomachic purges.
III. A VIOLENT pain with cramps
in the ilomach.
The method which I have found
niofl fuccefsful in tliis cafe, is, to make
the patient, if there be any inclination
to
Nervous Symptoms. 475
to vomit, take fome draughts of warm
water to clean his ftomach. After this,
I order a clyfter of fix ounces of water
and from 50 to So drops of Imidamim,
This is much furer than laudanum given
by the mouth, which is often vomited
up ; and, in fome cafes, increafes the
pain and fpafms in the ftomach.
If the pain and cramps return with
great violence, after the effects of the
anodyne clyfter are over, I order ano-
ther to be given, with an equal or lar-
ger quantity of laudanum ; and, once in
four hours, two table-fpoonfuls of fuch
a julep as the following.
R Mofch. fcrup. ii.
optime teratur cum
Sacchar. alb. drach. ii.
Dein adde
Mucilag. gum. Arab. unc. fs.
Aqu. cinnamom. f. v.
menth. piper, ana unc. ii.
aromat. drach. vi.
M. f. a.
If the patient has been coftlve, a lax*
ative clyfter muft be given before the
anodyne ones.
The
476 Of the Cure of
The anodyne balfani rubbed into
the ftomach, and the warm femicupium are
often ufeful. After the pain and cramps
have been removed, the emplajlrum an-
tibyjtericum appHed to the epigaftric re-
gion, has fometimes contributed to pre-
vent their return.
In all very violent or lading pains of
the ftomach, fome blood ought to be
taken away, unlefs the weaknefs of the
patient makes it improper ; for this e-
vacuation will always leilen the danger
of an inflammation, and can feldom do
any conflderable harm.
When the p^in or fpafms in the fto-
mach, proceed from a fuppreftion of the
mc?i/l'jy venaefe(^ion is of great ufe. If
they are owing to the true gout, befides
latdanwn and mufk, (piceries and fome of
the ftronger cordial waters, or a large
dramof brandy or rum, will be neceflary,
together with blifters to the ancles.
V, An
Nervous Symptoms. 477
IV. An indigeflion and vomiting,
with pains in the ftomach.
1. When thefe complaints proceed
from noxious humom's in the ftomach,
the beft remedies are vomits and gentle
ftomachic purges ; together with elixir of
vitriol or the teftaceous powders, accord-
ing to the different nature of thofe hu-
mours.
2. When, from fcirrhous obftrudlions
in the alimentary canal, we can do little
more than to palliate by means of grate-
ful ftomachic medicines, and opiates.
However, in cafes of this kind, a fmall
glafs of Spa or Fymont water frequently
repeated, has fometimes ftaid on the
ftomach, \vhen every thing elfe has been
thrown up.
When there is a fcirrhous obftruclion
in the coats of the ftomach near the f)-
loriiSy this paftage is often fo much ftrait-
ened, that only the thinner part of the
aliment can get into the duodermm ; while
the
47^ Of the Cure of
the more folid part, after remaining fe-
veral hours in the ftomach, and occa-
fioning heart-burning and ficknefs, is
at laft difcharged by vomiting. Pa-
tients in this fituation, always find them-
lelves eafieft, when they ufe only the
thinner kinds of aliments, flich as light
broths, milk, panada, fago, falep, and
the like.
3. When a ficknefs and pain in the
ftomach, with vomiting foon after eat-
ing, are owing to a too great delicacy
or an unnatural fenlibility of the nerves
of the ftomach, either in confequence of
an irregularity of the menjlriia^ or of
fome acrid humour in the blood falling
on thofe nerves ; while we palliate with
agreeable cordials and aromatics, we
muft endeavour to ftrengthen the fto-
mach by the bark, bitters, chalybeates,
and exercife. But, in cafes of this kind,
I have found nothing produce fuch im-
mediate good effecls, as laudanum given
an hour or more before dinner or
fappcr.
{a) An
Nervous Symptoms. 47^
(a) An unmarried Gentlewoman aged
44, irregular as to the menfesy was feized
with a pain in her flomach, and foon
after every meal became fick, and vo-
mited what flie had eat. After having
been in this way for eight or ten days,
fhe took a vomit of ipecacuanhay feveral
dofes of the elixir facrum, and tinBura rhor-
barbari amara ; file alfo ufed warm cla-
ret with cinnamon and nutmeg, and a
julep of pepper-mint water with the
fpirit. voiat. okofi but without any ad-
vantage. As file flept ill, I advifed her
to take twenty drops of laudanum at bed-
time, which made her refl better in the
night, but did not lefTen the vomiting
the following day. Next night I de-
fired her to take the laiidammi, not at
bed-time, but an hour before fupper.
The firft dofe, in this way, prevented
her vomiting after flipper, and next day
after breakfafl ; but fhe threw up her
dinner as ufual. However, by increa-
iing the laudanum^ before fupper, to twen-
ty-
480 Of the Cure of
ty-five drops, in three or four days fhe
got free of the pain and ficknefs at her
ftomach, as well as of the vomiting af-
ter meals.
{h) A MARRIED Lady, aged about
30, after having been, for fome time,
ii'regular as to the monthly evacuation,
upon eating freely of almoft any kind
of meat, but efpecially fuch as lay hea-
vy on her ftomach, was apt be affected J
with ficknefs, faintings and flight con-
vulfive motions, attended with a fmall
irregular and quick pulfe, and a cold-
nefs of her whole body. After flie had
ufed vomits, the bark, bitters, facred
elixir, and various grateful ftomachic
medicines to little purpofe, I advifed
her to take Ibme laudanum every day, an
hour or two before dinner. Having
been formerly much accuftomed to this
medichie, ftie began with thirty-five
drops, and foon incrcafed them to fifty
or lixty. The laudanum, inftead of ma-
king lier drowfy, gave her better fpi-
rits,
Nervous Symptoms. 481
rits, and enabled her to eat at dinner as
ufual, without being afFed:ed with fick-
nefs or faintings after it. She conti-
nued the ufe of the laudanum, in this
way, pretty conflantly for five or fix
weeks. Some days, when (he had ne-
glected the laudanum before dinner, if
fhe took it as loon as flie began to be
uneafy after eating, it foon lefiened the
ficknels at her ftomach, and prevented
the faintings and convulfive motions.
{c) Another married Lady, aged
about thirty, who had been often trou-
bled with a pain, a fournefs and wind
in her ftomach, and, when thefe left
her, with afthmatic fits ; complained of
a lump in her throat, flatulence, and
fuch a weaknefs of her ftomach and in-
digeftion, that every kind of food oc-
calioned pain, fickneis and vomiting,
except bread and wine, or a very little
boiled or roafted chicken. After trying
the bark, vomits, facred elixir, and
exercifc, vvdth fcarce any benefit, I de-
H h fired
482 Of the Cure 0/
fired her to take fome landamtm an
hour before dhmer. Altho' (he did not
exceed fixteen drops, yet ftie ahvays
eat her dinner better, and digefted it
with the fame eafe, as when flie was in
health ; nor did flie find any inconve-
nience from the laicdamimf except that it
made her thirfly in the afternoon.
4. In fbme cafes, I have known a
pain in the ftomach with vomiting after
eating, cured by foap taken daily to the
quantity of two drachms ; in other
cafes, half a pint of tepid lime-water,
drunk thrice a-day, has anfwered better
than the foap.
When a heat and forenefs in the
flomach arife from an acid, the tefla-
ceous powders ought to be taken freely.
They have alfo cured, at leaft, for the
time, fome, who, upon drinking a glafs
of wine, have felt, in their flomach,
a burning heat inflantly fpreading
through, alniofl, their whole body.
Several
Nervous Symptoms. 483
Several have found great relief from
a pain in the ftomach, both before and
after eating, by taking a large draught
of warm water with a little wine or
brandy in it.
In the 2d vol. of the Medical Inquiries
and Ohfervations, we have an account
of a violent pain in the region of the
right kidney in one patient, and of a
pain in the ftomach in another, imme-
diately relieved by a draught of equal
parts of fountain-water boiling, and
Fymont or Bath water. But, I imagine
the relief procured in thefe cafes, was
rather owing to the warmth of the li-
quor than any virtue in the Pyrmont or
Bath water ; for a patient of mine near
eighty, who, after having been long
llibjed: to bloody urine, came at laft to
have an ulcer in his bladder, found his
pains always much leilened, and fome-
times almoft quite removed, by drink-
ing largely of Arabic emulfion, tea, milk
nnd water, or weak broth, a good deal
II h 2 more
484 Of the Cure of
more than blood-warm. As the good
ciFect of thefe warm liquors was always
immediate, it muft have been owing
folely to their aclion on the nerves of
the flomach. We know that warm
-water applied externally, often eafes
internal pains ; it is no wonder then,
that warm liquors received into the fto-
mach, a part much more fenfible than
the fkin, and whofe nerves have a re-
markable fympathy with almoft every
part of the body, fhould have equal or
more powerful effects in relieving pains,
even in fuch parts as are not imme-
diately connected with it.
V. A C o L I c of the hyfleric or flatu-
lent kind.
If the patient be coflive, as is almoft
always the cafe, the body muft be open-
ed by laxative clyfters, to wliich a
drachm or two of afa fxtida may be
added. H there are violent vomitings,
after feveral draughts of toaft and water.
Nervous Symptoms. 485
a mixture ought to be given, of fait of
wormwood, lemon-juice and pepper-
mint water*, together with laudanum.
However, thefe draughts are ofcen inef-
fe(ftual, and in fome few patients the
vomiting is increafed by the laudanum.
In
* The draughts of fait of wormwood and juice of le-
mons are obferved, in a great meafure, to lofe their power
of flopping a vomiting, when they are not fwallowed in
the aft of efFervefcence : And is not their fuperior antieme •
tic power, in this ftate, owing to their making a much
ftronger imprefiion upon the nerves of the ftomach, while
they continue to emit their fixed air, and when all their
parts are in violent motion, than after faturation, when
they can aft only by their faline quality ? For while the
nerves of the ftomach are afFefted with this brifl< and unufual
Jiimulus, that difagreeable fenfation which produced the
vomiting muft be lefTened or deftroyed. And is it not the
efFeft, which thofe draughts fometimes have in preventing
the attack of intermittent fevers, to be afcribed folely to
their aftion on the very fenlible nerves of the ftomach, and
not to any fudden change which they may be fuppofed to
produce in the nature of the humours contained in the
prim.r vi^e ? Further, are not many of thofe mineral-waters
which contain a good deal of fixed air and fparkle in the
glafs, much more grateful, as well as invigorating to the
ftomach when drunk at the well, than after they have ftood
for fome time in an open veflel, becaufe in this laft cafe
they have, together with their fixed air, loft their power of
gratefully ftimulating the nerves of the ftomach ?
486 Of the Cure of
In fuch cafes I have always fucceeded,
by ordering a clyfter of fix ounces of
water, with fifty, fixty or even eighty
drops of laudanum ; and when no tho-
rough paffage could be procured, I gave,
by favour of this opiate, fome pills of
aloes with calomel ; which palling into
tlie inteflines before the vomiting re-
turned, generally procured a plentiful
evacuation by ftool, which, either whol-
ly, or in a great nieafure, removed the
difeafe.
If the purging pills fail to open the
body, and the pain and vomiting re-
turn, another anodyne clyfler mufl be
given, and foon after it, a larger dofe
of the pills ; and a little before the
time thefe pills may be expecfted to
Avork, the patient fhould go into the
warm bath. In patients of a full habit,
efpecially if the pain be very great,
fome blood ought to be taken away.
To prevent the frequent return of
liyfleric colics, an antihyfleric plafler
applied
Nervous SyiMPtoms. 487
applied to the abdomen, a dofe of the
lacred tincfture or elixir once a- week
and exercife, elpecially riding, will be
found ufeful. A milk diet has fome-
times cured thofe who have been much
afflicled with thofe colics ; and the
fulphureous water of Moffat, drunk for
two or three months in the Summer
has, in fome cafes, made their returns
much lefs frequent,
VI. FxATULENCE in the ilomach
and bowels.
The medicines moft proper in com-
plaints of this kind, are either iuch as
procure fpeedy relief by expelling the
wind, or thofe which, by ftrengthening
the alimentary canal, lefTen its genera-
tion. Among the former, I have found
none more efficacious than the fpiritus
ssthereus and laudanum. I commonly give
the laudanum in a mixture with pepper-
mint water and tindure of cafior, or
ffiritus nitri dnkis. In fome cafes, in
place
488 Of the Cure of
place of this, I prcfcribe opium in pills
with afa fa;tida. And here it may be
worth while to obferve, that the good
efFedls of opiates are equally confpicu-
ous, whether the flatulence be con-
tained in the flomach or inteftines ;
whereas thofe warm medicines com-
monly called carminative, do not often
give immediate relief, except when the
wind is in the flomach.
With regard to the fpiritus eethereus,
I have frequently feen very good eiFe<fls
from it in flatulent complaints ; of
which I fliall content myfelf with giving
one inftance. A Lady aged between
40 and 50, about the time the menfes
were leaving her, found her belly in-
creafe fo much in bulk, that, for fome-
time, file fufpe6led herfelf to be with
child. In the morning, flie was often
fo much fwelled about the flomach, as
not to be able to bear her flays, or
breathe freely. She ufed a variety of
medicines, but nothing gave fuch im-
mediate
Nervous Symptoms. 489
mediate relief as a tea-ipoonful of the
fpirims aethereusy mixed with two table-
Ipoonfuls of water. This ahvays made
her bring up a good deal of wind, and
leUened the flraitnefs and fwelling about
her jftomach.
In gouty cales, the fpiritiis athcreiis,
a dram of French brandy or of the aqtia
aromatica ; and ginger, either in fub-
ftance, or infufed in boiling water, are
among the beft medicines to expel
wind.
When the cafe of flatulent pa-
tients is fuch as to make it improper to
give them warm medicines inwardly, a
plafter made of equal parts of the ejn-
plaftriim autibyjleriatm and Jiomacbiatm may
be applied to the ftomach or belly witli
advantage ; or four or five tea-fpoonfuls
of the following liniment may be rub-
bed into them at bed-time.
R. Balf anodyn. Batean. unc. i.
01. mac. perexprefT. unc. fs.
menth. drach. ii. Mifce,
The
49<5 Of the Cv KE of
The remedies moil: proper for
fh-engthening the flomach and bowels,
and confequently for lefTening the pro-
duction of flatulence, are the bark, bit-
ters, chalybeates and exercife. In fla-
tulent cafes, I add to the tinClure of the
bark and bitters, which I have fo often
recommended, fome nutmeg or ginger.
And when I prefcribe the filings of
iron, I join tliem with the piilvis diaroma-
ton. When windy complaints are at-
tended with coftivenefs, nothing an-
fwers better than four or five of the fol-
lowing pills every other night at bed-
time,
R. h{. fcEtid. drach. ii.
Aloes focotiin.
Sal. Mart.
Rad. zinziber. ana drach. i.
Elix. proprietat. q. 1". ut. f. pil. gr. iv.
On the other hand, when the body
is too open, twelve or fifteen grains of
rhubarb, with half a drachm or two
fcruples of the confedio Japonka, given
every other evening, will have very
o;ood effecls.
In
Nervous Symptoms. 491
In thofe flatulent complaints which
come on about the time the menfes ceafe,
repeated fmall bleedings, often give
more relief than any other remedy.
With regard to diet, I fliall only
obferve, that tea and all flatulent ali-
ments are to be avoided ; and that, for
drink, water with a little brandy or
rum, is not only preferable to malt li-
quor, but, in mofl cafes, alfo to wine.
VII. A NERVOUS or fpalhiodic afthma,
(i.) In the true fpafmodic afthma,
where there is no fixed obllrud:ion in
the lungs, nor any load of phlegm op-
preffing them, the fits are befl: relieved
by bleeding and opium. If the patient
be of a full habit, we may bleed largely ;
if otherwife, we mufl: either take away
little blood, or omit this evacuation al-
together.
The opium may be given either in the
form of the elixir paregoriamiy or in fuch
a draught as the following.
R. Aqu.
49^ Of the Cure of
R. Aqu. menth. unc. i. fs.
Laud, liquid.
Sp. volat. oleof. ana gutt. xxv.
Syr. commun. drach. ii. Mifce.
Si r Richard Blackmore tells of a phyfi-
cian, much afFecled in the winter-time
with a dry aflhmn, who every morning
took thu'ty drops of laudanmn, without
w hich he found himfelf unable to go a-
broad about his bufinefs.
Nor are opiates lefs fliccefsful when
a true fpafmodic afhma arifes from fym-
pathy with the flomach, than when the
nerves of the lungs are themielves pri-
marily affecfled *.
That
* A Gentleman, aged 25, after having taken mercury
for feveral weeks, on account of a venereal diforder, be-
came peevifh becaule of his confinement, and would eat
no meat for upwards of twenty-four hours, but drank
largely of whey and water-gruel. In the afternoon he
began to be afFedled with a difficulty of breathing, unat-
tended with any cough or fpitting. The tinfture oi cajior,
fpirit of hartfliorn and other medicines, which were pre-
fcribed, gave very little relief; and the afthmatic fit be-
coming much woife about midnight, a draught with twenty
drops ot laudanum w;is ordered. This foon lefTened ths
difiicuity of breathing fu much, that he fell afleep, and
next
Nervous Symptoms, 4^3
That fenfe of faintnefs about the
flomach, with a frequent fighing and a
difficulty of breathing, with which wo-
men after child-bearing are fbmetimes
affefted, when the miliary eruption does
not come properly out, are often leflen-
ed or removed by a dofe of the elixir
faregoricwn, or a bolus of cajior, JaL corn,
cerv. and opium.
In the true fpafmodic ajihma, efpeci-
ally when it is owing to wind in the
flomach and bowels, or increafed by
this, a fblution of qfa fa!tida, the tint^ure
of cajior and Ipirit of hartfhorn, are often
ufeful, altho' their antifpafmodic virtue
is much lefs than that of opiion.
(2.) When an afihma of the fpafmo-
dic kind is occafioned by, or attended
with fome fixed obftruclions in the
kuigs or a confiderable accumulation of
luimours in them, we mufl ufe a method
.of cure fomewhat different from the
above.
next morning awaked in a great raeafure free of this com-
plaint, which, after eating feme broiled chicken to din-
ner, left him entirely.
494 Of the Cure of
above. For altho' bleeding is equally
uieful, and often more neceflary here,
than in the true fpafmodic tijlh?na ; yet
opiates are not to be given to leflen the
fits, till after the lungs have been fuffi-
ciently cleared by evacuations and at^
tenuating medicines. A large blifter
between the fhonlders is of excellent ufe
to promote expectoration and relieve
the lungs. Vomits are likewife proper,
but cannot be fafely given, till after the
afthmatic fit begins to abate. In fome
patients, a purge of manna and glauber
fait, or of ibluble tartar, almoft always
lelfens or carries off the fit : while in
others, who have weaker bowels, what-
ever purges brifkly, whether it be food
or medicine, is apt to bring on, or, at
leafb, to increafe the fit.
For prefent relief, I commonly give
fyir'it of hartfliorn or compounded tinc-
ture of caftor, diluted with a fufficient
quantity of water. With the fame
view alfo, a table-fpoonful of a folution
of
Nervous Symptoms. 495
of eqvial parts of gum ammoniac^ and afa
fxtida in penny-royal water, may be
taken five or fix times in twenty-four
hours.
A DRAUGHT of Water, with ^ part
of vinegar, and fweetened with honey
or fligar, often gives confiderable re-
lief in afthmatic fits ; altho' fuch is the
difference of conflitutions, that I have
met with fome perfons whofe breatliing
was ahvays made worfe by acids of
every kind.
Those aflhmatic patients, whofe flo-
mach and bowels are weak, and much
troubled with flatulence, do better with
the lighter flefh-meats and a little wine,
than with a milk and vegetable diet ;
and the folution of ginn ammoniac, with
acetum fcillitiaim or ihe pilule Jailitiae, do
not commonly agree fo well with them
as the afa fcotida and volatile alcaline
falts.
When elderly perfons have been
feized with an aftmatic paroxyfm from
the
49 6 Of the Cure of
the gout attacking the lungs, I have
found mofl benefit from blifters applied
between the (lioulders and to the leo-s.
and from bolufes of gum ammoniac, faL
vol. ammon, and camphire, given twice
or thrice a-day.
(3.) To prevent the return of the
fits in the true fpafmodic aflhma, we
muft: endeavour to flrengthen the lungs
and whole nervous iyllem by means
of the bark, chalybeates, elixir of vi-
triol, a proper diet, country air, and
riding.
A FLANNEL waiffccoat next the fkin,
or a large piece of flannel wore on the
breaft, has contributed to prevent the
frequent return of afthmatic fits.
Th e patients fliould, above all things,
-avoid eating or drinking fb much, at
once,, as to burden their flomach.
In the mixed ajihma, the bark mufl
be ufed with more caution, efpecially
if the lungs be confiderably obflrudled,
or loaded with phlegm ; and the cure
mufl
Nervous Symptoms. 4^7
miifl be chiefly attempted by iiTues in
the back and arms, or a feton in the
fide ; and by other medicines that tend
to remove the obftruclion in the pul-
monary vefTels, or lelTen the flux of hu-
mours to them ; of this kind are, the
piluU fcilliticce taken in fiich quantity as
keep the body ahva^/s open ; pills of
garlic and foap; the juice of forty or
fifty millipede in two or three table-
fpoonfiils of French white-wine, Rheuijh
or cyder, taken twice a-day ; and crude
mercury, or quickfilver pills, which have
fometimes cured aflhmatic ailments af-
ter other remedies had failed.
As not only different patients are re-
lieved by different remedies, but the
fame patients, from a change in their
conflitution, or in the nature of the
dilbrder, often require a confiderable
change in their medicines and diet, it
may not be amifs to add the following
caie of one who has been long fubjecl
to (evere afthmatic fits.
I i A Gen-le-
498 Of the Cure of
A Gentleman, aged about forty, of
a ipare make, lively, healthy and ullng
a great deal of exercife, one day, after
too great an exertion of his ftrength,
began to feel a pain in his breaft about
the fiernum. Two years after this, he
was, at times, affecfted with a difficulty
of breathing ; which continued to in-
creafe for feveral years, and was gene-
rally attended with a great flux of hu-
mours upon his lungs, and a confider-
able expedloration of a thick phlegm.
In violent fits, he found the moft im-
mediate relief from bleeding and bliflcr-
ing ; and he ufed, with advantage, vo-
mits of ipecacuanha with the oxymel fcilli-
ticwTif and xhe.piliiU fcillitic^e or a folu-
tion of gum ammoniac with acetum fcilliti''
cum. He abftained for feveral years
from wine, malt-liquor, and all flefh-
meats, except chicken ; and often made
Ills dinner of bread and butter-milk on-
ly. He frequently found his breathing
made eaficr, by drinking water with a
little
Nervous Symptoms. 4^^
little vinegar, feveral times through the
day.
After he had fuffered much by ma-
ny violent attacks of this diforder, he
began to complain of wind in his fto-
mach ; and, upon vomiting, difcharged
a good deal of tough phlegm. His
body became likewife too open, and
whatever food or medicine increafed
this dilpofition was hurtful to him. The
fquill-pills and the lac ammoniacum with
the acetiim fcillitkum, did not now agree
near fo well with him, or do him fo
much fervice as the compound tinOure
of cajlor, or a folution of afa fatida with
a little fal. vol. ammon, in penny-royal or
mint-water : And a bit of broiled meat,
with two or three glailes of claret after
his meals, agreed better with him than
vegetable food, or watery liquors alone ;
but he found it befl to eat little at a
time, and often. Now alfo, he found
great benefit from the bark, not only in
the intervals, but alfo in the decline of
I i 2 the
500 Of the Cure of
the fits. He took it in deco<flion, witii
four ounces of the tincture added to
each pound, tjo the quantity of two
table-ipoonfuls four times a-day ; and>
fo far from finding it increafe his whee-
zing or diifi culty of breathing, he thought
it often lefFened them, and prevented or
broke the force of finaller paroxyfms.
Soon after he became fubjecl to fits
of loofenefs, he began to fpit lefs than
ke had done for feveral years before ;
and now I obferved that bUfters, which
run longer with him tlian mofl people,
did him lefs fervice than formerly, when
he had a greater exped:oration and no
tendency to a loofenefs. During the vio-
lence of the worft fits, he Ibmetimes al-
mofl lofes his fight, nor is he then able to
cough till they begin to abate. At firfl
he brings up a little tough phlegm with
great difficulty, but as the conftri^lion
in the lungs lefTens, he expectorates
more freely*
For
Nervous SyxMptoms. 501
For fome years, he had more fre-
quent returns of his difeafe in Summer
and Autumn than in winter ; fudden
changes of weather, cold or fatigue
bring on the ajlbmay which he can fome-
times foretel by the palenefs of his
m'ine. Flatulent aliments and what-
ever purges him much, will now, in
his befl health, occafion a flight fit. Al-
tho' he has been often free from any
violent attack for two or three months,
yet he feldom breathes in the night fo
freely as one in perfect health. His
pulfe is often fmall, his extremities cold,
and face livid, during a fevere fit. After
bleeding, his pulfe becomes fuller and
quicker ; but does not return to its na-
tural flownefs till his breathing is free.
The fits are generally over in two or
three days, fometimes they lafl: eight
or ten ; and, after yielding in part, re-
turn a fecond time with more violence.
He is commonly worfl in the evening
or in the night ; and has fometimes
exacerbations
502 Of the Cure of
exacerbations evening and morning.
The paroxyfms of late are almoft always
attended with complaints of flatulence
in his itomach, and he finds relief as
often as he brings up wind. The re-
medies which in this flate have been
of moft fervice to his flomach, are the
bark, a folution of afa fcctiday the emplaf-
trtim antibyjiericum applied to the epiga-
flric region, and the diet of flefh-meats
with claret. A bit of mutton-chop has
often given him relief in leller fits of
bad breathing. Obferving that, even in
the intervals of the fits, he often breath-
ed with difliculty about three or four
in the afternoon, he eat a little mutton-
chop, beef-ilake, or broiled chicken be-
tween eight and nine in the morning,
and dined between one and two on
panada with a little claret, or fomething
equally light. By this means he found
the wheezing and difficulty of breathing
in the afternoon ahvays much leffened,
and fometimes prevented altogether.
He
Nervous Symptoms. 503
He often cirank near two-thirds of a
bottle of claret daily, but feldom took
above a quarter of a pint of it at once.
By this diet, and the conflant ufe of the
bark, for above two months, firfl in
tind:ure and deco£lion, and afterwards
in fubftance, he not only breathed more
eafily at all times, but was kept much
longer free of the afthmatic fits than
uflial, not having had an attack of this
kind worth mentioning, from the begin-
ning of November till tlie April or M^y
following ; notwithftanding his having
been affected feveral times, during the
winter months, with a cough and a con-
fiderable expectoration of thick phlegm.
VIII. A PALPITATION of the heart.
(i) When, from a weak or diforder-
ed ftate of the ftomach, the heart, by
fympathy, is rendered fo irritable, as
from very flight caufes to be liable to
flrong palpitations, the moft proper re-
medies are, the tindure of the bark and
bitters.
504 Of the Cv K E of
bitters, and moderate exeixife. If there
be any noxious humours lodging in the
ftomach, vomits will be proper ; and,
if the patient be any ways coftive, a
table-lpoonful of the facred elixir may
be given once in two or three nights.
For prefent relief, fpirit of hartfhorn,
the tiiiBura cajiorei compofita, fpiritus tethc'
reus and opiates generally anfwer beft.
(2) When palpitations proceed from
the gouty matter affecting the heart, we
ought to trufl chiefly to warm llomacliic
laxatives, to campliire, the volatile falts,
the warm pedilirjium, bliflers applied to
the legs, or iinapifms to the foles of the
feet ; and to bleeding, if the patient be
of a full habit.
(3) When palpitations arife from the
fupprelhou of fome habitual evacuation ;
if this cannot be reflored, the redun-
dant humours are to be carried off by
fmall bleedings, gentle purges, diapho-
retics or iilues.
(4) Lastly,
Nervous Symptoms. 505
(4) Lastly, when palpitations are
owing to pol'jpi in the heart itfelf, or in
the great blood-vefTels opening into it,
to accretions of the pericardium to the
heai't, olfiiied valves or fuch like caufes ;
the difeafe may be looked upon as in-
curable ; fince, hitherto, we know of no
medicines which can remove thefe
caufes. However, fome relief may be
procured by frequent fmall bleedings,
gentle purges, and a cooling attenuating
light diet ; at the fame time, avoiding
all viicid, incrafTating and heating ali-
ment, and every kind of exercife that
too much quickens the motion of the
blood.
IX. An immoderate difcharge of
pale urine.
As I have obferved above*, that the
proximate caufe of that great difcharge
of pale-water, to which hyfleric people
are frequently liable, is an increafed
motion
* See chapter VI. N". VIII.
5o6 Of the Cure of
motion of the fecretory vefTels of the
kidneys ; fo there is no medicine that
will generally lefTen it fo foon, or fo
remarkably as of him * ; but as opimn does
not ftrengthen the kidneys, nor remove
the feveral remote caufes of this increa-
led fecretion, other remedies are re-
quired to prevent its frequent returns.
Those which have fucceeded beft
with me are, the bark, either in fubflance
or decoction, with fome cinnamon add-
ed to it ; fmall dofes of the tiuBura
rhaharhari amara cum vim once in three or
four nights, moderate exercile on horfe-
back or in a chaifc, and a diet confiding
chiefly of rice, iago, falep, and the light-
er fle/li-meats roafled, together with a
few
* Altho' in fome flatulent or fpafmodic cafe?, cpitan
often proves one of the beil diaretics, yet it has a contrary
effi;d, when, on account of an uncommon irritation of the
nervous fyflem, the urine is fecreted in too great quantity.
I know an elderly Lady, who is frequently hot and uneafy
in the night, and pafles a great deal of pale-water, whom
A dole of lavdamm, at bed-time, always relieves, in a great
nieature, of this Sax, aitho' it feldom procures her good
reih
Nervous Symptoms. 507
few glafles of claret or red port after
meals.
In cafes, where the flux of pale urine
is attended with hectical heats, I add
to the above remedies the tlndura rofu'
rujiiy or ehxir of vitriol.
When the increafed fecretion is, in
a great meafure, owing to a particular
debility of the kidneys, a flannel-fliirt
will fometimes leflen the quantity of
the urine, by increaling the perfpira-
tion.
A TIGHT belt about the loins, or a
ftrengthening plafter applied to them,
has been attended with remarkable
effects, as will appear by the following
cafes.
(i) A GENTLEMAN near 40, troubled
with wind in his ftomach, and with
gouty pains in his feet, in Auguft 1753,
w^as attacked Avith fits of ficknefs at his
ftomach, attended with a quicknefs of
pulfe, for which he lay in bed and
fweated for fever al days. After this,
he
50 8 Of the Cure of
he began to make great quantities of
pale water, info much that in the night,
he commonly ufed to pais near an
Englifh pint every two hours : After
getting up, the quantity began to leflen,
and continued to diminifli as the day
advanced. Notwithftanding the ufe of
the bark, conferve of rofes, alom and
feveral other medicines, for near a fort-
night, this flux of urine increafed, and,
for the two laft days, it had been made
almoft as plentifully in the day as in the
night. From a fufpicion that this pro-
fuie fecretion might arife either from a
laxity or weaknefs of the renal vellels,
or from their being affefted with an
luicommon alternate motion, about two
in the afternoon, a broad pofting belt
was put about the belly and loins, as
tight as the patient could bear it : And
altlio' all that morning, and the day
before, he had made, every two hours
at Icaft, three gills of urine, almoft as
clear .as rock-water, yet, after the belt
was
Nervous SymptoiMs. 509
was on, he voided none for above four
hours, and then not quite half a pint.
About ten at night, he pafTed much the
fame quantity ; but not being able to
fuffer the belt in bed, it was removed,
and the flux of urine returned in the
night time, though not to that degree
it had done for feveral nights before.
From this time, by keeping to the belt,
riding out in a chaife, and returning to
the ufe of light fiefli meats, which, on
account of a quicknefs in his pulfe and
great thirft, he had almoft wholly ab-
ftained from, the flux of urine daily
leflened, and the patient recovered.
(2.) A Gentleman, upwards of 30,
after having been in a flow fever, at-
tended with rlieumatic pains, for ten
or twelve days, began (November 20.
1745) to make a great deal of pale
water, and chiefly in the night time,
this diforder, notwithflanding the uie
of the bark, tinBura rofamm and other re-
medies, continued without any fenflble
abatement till the 24th of December^
when
51 o Of the CvKE of
when a large plafter of the cmplaftriim
defenftviim being applied to the os facrum
and loins, had fo good an efFed:, that,
on the night following, he made no wa-
ter till after he had been three hours in
bed ; though, for fome time before, he
had feldom lain an hour and a half
without a call. The fecond night, he
was above four hours in bed before he
was diftiu'bed, and the quantity of urine
through the whole night did not exceed
five gills; whereas, for feveral weeks
before, it had commonly amounted to
three Englifl) pints a-night, and fome-
times to much more. In leis than a
week, from the time he had the plafter,
the urine returned to its natural colour
and quantity, and die patient foon re-
covered his ftrength.
The fame Gentleman, in November
1750, after a fever and cough, was a-
gain attacked with his old diftemper,
upon which he had immediately re-
courle to the emplaftrum defenfivum^ which,
though
Nervous Symptoms. 511
though it feemed, fbmewhat, to reftrahi
tlie flux, for the firll night, yet had no
effect afterwards. But it is to be ob-
ferved, that, on this relapfe, neither the
bark nor the other flrengtheners had
been ufed before the plafter.
(3) Mr J. P. aged above 50, after a
tedious fever in Jul^ 175S, began to
make in the night great quantities of
pale water, which much retarded his
recovery. After ufing the bark, claret,
and other remedies, I advifed him to
apply to his loins the fame ftrengthen-
ing-plafter wliich I had found fo fervice-
able to the laft mentioned patient; by-
means of Avhich, the flux was in a few
clays fenfibly diminiOied, although not
quite ftopt for fever al weeks.
X. Periodical headachs.
(i.) When thefe arife from a dilbr-
dered (late of tlie ftomach, the befl
medicines are vomits, flomachic laxa-
tives, and bitters. If there is an acid
in
512 Of the Cv KE of
in the ftomach, the teflaceous powderSj,
magnefia alba or lime-water will be of
great ufe.
(2) When periodic headachs pro-
ceed from a rheumatic or gouty hu-
mour affecting the fmall veflels or nerves
of the pericranium, or other parts of the
head; the propereft remedies are bli-
fters applied to the head or legs ; iiTues
in the head or neck ; the warm pcdilu-
vium, with dry friftion of the legs and
feet, and frequent doles of facred tinc-
ture*.
In a violent pain of the head from a
rheumatic humour, after feveral other
remedies had failed, I have feen good
effecT:s from fifteen or twenty grains of
gwjh guaiac. with ten grains of fal. vol.
ammon.
* The following efFeft of an extraordinary dofe of facred
tindlure was communicated to me by a phyfician of cha-
ratler. A Lady, affliifted with a rheumatic pain in her
head, by miflake. drank over night at once, near an Englifh
pint of facred tinftnre. Next day, fhe purged feven times,
and, for three days after, falivated, as if fhe had taken mer-
cury, but was entirely cured of the pain of her head.
Nervous Symptoms. 513
ammon. given in a bolus at bed-time,
and repeated for feveral nights.
Th e pulvis foL afari ufed as a fternu-
tatory has fometimes cured obflinate
headachs, by making a large evacuation
from the vellels of the nofe.
(3.) When periodic or frequently re-
turning pains of the head are owing to
a peculiar weaknefs or delicacy of the
nerves of that part, rendering them li-
able to be affected by flight caufes, we
mud attempt to relieve the patients by
the bark, chalybeates, moderate exer-
cife, and daily wafliing of the head with
cold water. Here alfo, fome of thofe
medicines, commonly called nervous,
may be of ufe, fiich as camphire, mufk,
and valerian. The laft of thefe has
been commended as a kind of ipecific
in obftinate hemicranias * ; and I have
found it ferviceable in removing a con-
fufion of the head, with which an epi-
leptic patient, of very delicate nerves,
K k was
* See Fordjce de Hemicrania.
514 Of the CvKE of
was almofl conftantly afFecled ; as well
as ill lefTening or protracting the returns
of the convulfive fits. The valerian, in
this cafe, was given in the form of an
electuary, and to the quantity of three
drachms daily.
(4.) When headachs are regular as
to their periods, vomits fliould be given
an hour and a half, or two hours, before
the returns of the fits, and the bark be-
tween them.
I HAVE known a violent hemicrania,
which returned regularly at a certain
time of the day, in a good meaflire
prevented by taking the following
draught, an hoiTr before the coming on
of the pain.
R. Laud. liquid, gutt. xl.
Tinft. ipecacuan. gutt. xlv.
Sp. Minderer, unc. fs.
Aqu. rofar. unc. i.
Sacch. alb. drach. ii. Mifce.
This medicine, while it leiTens the
pain, feldom fails to raife a plentiful
fvveat.
(5) When
Nervous SyiMptoms. 515
(5.) When headachs, whether regu-
larly periodic or not, arife from a fup-
prelTion of the menjh, we muft endea-
vour to reflore this evacuation ; but if
that cannot be done, bleeding, efpecial-
ly at the ancles, perpetual bliflers or
iflues in the head or neck, and laxatives,
are the beft remedies.
(6.) When the returning pain has
been attended with a fwelling of the
part, after other medicines had failed,
mercurial laxative pills have fucceeded*.
(7.) To relieve prefent pain in vio-
lent periodic headachs, the beft remedies
are
* A Lady, between 25 and 30, of a thin habit and deli-
cate conftitution, was feveral years fince attacked with a
hemicrania, which returned commonly every afternoon ; at
which time, that part of her forehead, which was affedted,
was often fenfibly fwelled. She kept a perpetual blifter
on her head for many months, ufed facred elixir and
tinfture, pul'vis afari as a fternutatory, and other remedies,
without any benefit ; infomuch that after a twelvemonth,
lier complaint was rather worfe than ever. I then advifed
her to take from twelve to fixteen grains of the pilula ?ner-
curiales laxantes every other night. By the ufe of thefe
pills, a gentle falivation was raifed, and kept up for about
twelve days, which intirely removed the headachy nor
has flie had any return of it fince.
5 1 6 Of the Cv KE of
are the warm pediluvium, flannel cloths
wrung out of hot water, or a hot de-
coction of rofeniary, anxl applied to the
fliaved head ; x\\q fpiritus athereiu applied
in the hollow of one's hand to the
pained part, and kept there for fome
minutes ; large dofes of laiidamim, and,
in fome cafes, leeches put to the tem-
ples.
Cold water will give eafe in fome
headachs, while hot applications do
moll: fervice in others. In like manner,
ftiaving the head relieves fome patients,
but is hurtful to others.
It may be proper to obferve, that in
all violent headachs, we ought to be-
gin the cure with bleeding, either by
applying leeches to the temples, or
opening the artery there. If the pa-
tient be plethoric, a larger quantity of
blood may be taken from the jugular
vein.
Moderate exercife is generally ufe-
fiil in periodic headachs, from which-
foever
Nervous SymptOxMs. 517
fbever of the foregoing caufes they may
arife, but the proper^me for it is in
the intervals of the fits.
XL Low fpirits.
Hypochondriac and hyfteric pa-
tients are commonly afFecled with this
complaint, in a greater or lefs degree.
In general, exercife and the cold bath
are among the beft remedies. But to
be more particular,
(i.) When low fpirits are owing to
a weak flate of the nerves of the flo-
mach and bowels, the tincture of the
bark and bitters, chalybeates, aromatics,
a proper diet * and riding, will do mofl
fervice.
(2,) When they arife from obflruc-
tions in the hypochondriac vifcera, or
a foulnefs of the flomach and inteflines,
the mofl proper medicines are, aloetic
purges, Harrigate 'waters, and foluble
tartar,
? Sce^bove, p. 35i,&c.
51 8 Of the CVKZ of
tartar. I commonly prefcribe the fo-
luble tartar in the followhig manner,
R. Tartar, folub. drach. ii. ad unc. fs.
Solve in aqu. fontan. imc. viii.
Cui adde aqu, cinnamom. f. v.
Syr. violar. aa unc. i. Mifce.
This fohition is to be taken at two
or three draughts, either every morning,
or only once in two days, and to be
continued for feveral weeks.
Doctor Muzzel has publifhed,
Ibme years lince, feveral inftances of the
Htccefs of the foluble tartar in mad-
nefs and melancholy. In cafes of low
Ipirits, I have found it cool the patients,
dilpofe them to lleep, and quiet the hur-
ry of their fpirits ; but it fometimes be-
comes hurtful by increafing flatulence,
and occafioning a faintnefs : and, as
far as I have obferved, the foluble tartar
is more ufeful in maniac or melancholic
diforders, proceeding from noxious hu-
mours in the pn?!i£ vice, than in thofe
which are owing to a fault in the brain,
(3.) When
Nervous Sympto:-:3. 519
[3.) \Vhen low rpirits proceed from
a lupprellion of tlie ?kc::Uj or hxmor-
rhoids ; if thcfe evacuations cannot be
rellored, fome oiliers mull: be lubftitutcd
in their pLice : but notliing lias fucli
fudden good eftects as bleeding*.
(4.) Lastly,
* A Gentkwomaii, aged Mcf, foon after die mai/es had
left her, was feized'with a coogh, and fomedmes with a
flight lutmsftte. This laft fymptom went off in a few
mondis, hot die coogh lafied abore three years ; and npoa
its ceaflng, fhe began to be mach tioabled \nth wind la
her ftomach, low ipirits, a confnfion in her head, and a
want of fkep. In this condition Ihe condnoed for feveral
months, daring which, thefe complaints incieafed, notwith-
fiandiog the free oie of warm, carminative, aromatic, chaly-
beate and antihyfteric medicines. A bkfier applied to her
head leflened the confxifion in it, acd procured her better
reft for a few m^ts. BeUering zr.a: ii : : . :>. ws;, ia
ibme meafore, a oonfeqoence :: : rrenlon of the
memfesy fo the wind in the ftc '.:--■ fririts were
owing to the nerves of this or^- - ': ie ..i. by that
matter which ofed to be thrown o€ by die longs ; aliho'
her poUe was neither full nor qaick, I orderei :; -. : -r.ces
of blood to !?e tsken from the arm; imicc^. v ^."Bcr
V. rich, hs: re relieved, the confofion in her head
removed, and die flatdent fymptoms
This peribn afterwards, upon the return of the fame
fymptoms, has found bleeding do her more fenrice than
any other remedy.
$20 Of the Cure of, See,
(4.) Lastly, when low fpirits or me-
lancholy have been owing to long con-
tinued grief, afixious thoughts, or other
diftrefs of the mind, nothing has done
more fervice than agreeable company,
daily exercife, efpecially travelling, and
a variety of amufements.
THE END.
C'-ii
7>
S r^.
IT'" - "^
ft"
'/.■■^.'
