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Z O O N O M I A;

O R,

THE LAWS

O F

G A N I C LIFE.

VOL. II.

By ERASMUS DARWIN, M.D. F.R.S.

AUTHOR OF THE BOTANIC GARDEN.

Principio coelum, ac terras, campofque HquenteSj
Lucentemque globum lunse, titaniaque aftra,
Spiritus intus alit, totamque infufa per artus
Mens agitat molem, et magno fe corpore mifcet.

ViRG. ^n. vi.

Earth, on whofe lap a thoufand nations tread.

And Ocean, brooding his prolific bed.

Night's changeful orb, blue pole, and filvery zones.

Where other worlds encircle other funs.

One Mind inhabits, one difFufive Soul

Wields the large limbs, and mingles with the whole.

LONDON!

PRINTED FOR J. JOHNSON, IN ST. PAUl's CHURCH-YARD.

1796.

dDiutreu at ^taitanei-s' l^aii.

Z O O N O M I A ;

OR,

THE LAWS OF ORGANIC LIFE.

PART n.

CONTAINING

A CATALOGUE OF DISEASES

DISTRIBUTED INTO

NATURAL CLASSES ACCORDING TO THEIR PROXIMATE CAUSES,

WITH THEIR

SUBSEQUENT ORDERS, GENERA, AND SPECIES,

AND WITH

THEIR METHODS OF CURE.

Hjec, ut pofero, explicabo ; nee tamen, qnafi Pythius Apollo, certa ut fint et fixa, quae
dixero ; fed ut Homunculus unus e multis probabiliora conje6tura fequens.

Cic. Tusc. Disp. 1. 1. 9.

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in 2010 witii funding from

Boston Library Consortium Member Libraries

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PREFACE,

All difeafes originate in the exuberance, deficiency, or re-
trograde acStion, of the faculties of the fenforium, as their
proximate caufe ; and confifl in the difordered motions of
the fibres of the body, as the proximate eflFeit of the exertions
of thofe difordered faculties.

The fenforium poffeffes four dhlin6t powers, or faculties,
which are occafionally exerted, and produce all the nations -
of the fibrous parts of the body ; thefe are the faculties of
producing fibrous motions in confequence of irritation which
is excited by external bodies ; ■ in confequence of fenfation
which is excited by pleafure or pain ; in confequence of vo-
lition which is excited by defire or averfion ; and in confe-
quence of affociation which is excited by other fibrous mo-
tions. We are hence fupplied with four natural claffes of
difeafes derived from their proximate caufes ; which we fliall
term thofe of irritation, thofe of fenfation, thofe of volition,
and thofe of alTociation.

Jn the fubfequent clafllfication of difeafes I have not ad-
hered to the methods of any of thofe, who liave preceded
Vol. IL A me ;

1734S0

Vi PREFACE.

me ; the principal of whom are the great names of Saiivages
and Ciillen ; but have neverthelefs availed myfelf, as much
as I could, of their definitions and diftin<Stions.

The e^ential chara6teriftic of a difeafe coniifts in its prox-
imate caufe, as is well obferved by Do<ftor Cullen, in his No-
fologia Methodica, T. ii. Prolegom. p. xxix, iiimilitudo qui-
dem morborum in fimilitudine caufae eorum proximcS, qua-
lifcunque fit, revera confifcit. I have taken the proximate
caufe for the clailic chara6ter. The charasSters of tlie orders
are taken from the excefs, or deficiency, or retrograde ac-
tion, or other properties of the proximate caufe. The
genus is generally derived from the proximate effeil. And
the fpecies generally from the locality of the difeafe in the
fyfiiem.

Many fpecies in this fyftem are termed genera in the
fyftems of other writers ; and the fpecies of thofe writers are
in confequence here termed varieties. Thus in Dr. Cullen's
Nofologia the variola or fmall-pox is termed a genus, and the
diftin6t and confluent kinds are termed fpecies. But as the
infe6lion,from the diftin6t kind frequently produces the con-
fluent kind, and that of the confluent kind frequently pro-
duces the diftinft ; it would feem more analogous to bota-
nical arrangement, which thefe nofologiilis profefs to imitate,
to call the diilhiit and confluent fmall-pox varieties than
fpecies. Becaufe the fpecies of plants in botanical fyftems
propagate others firailar to themfelves ; which does not
uniformly occur in fuch vegetable productions as are termed
varieties.

In

PREFACE. vii

In fome other genera of nofologifts the fpecies have no
analogy to each other, either in refpedt to their proximate
caufe, or to their proximate efFedl, though they may be
fomewhat fimilar in lefs elTential properties ; thus the thin
and .fahne difcharge from the noftrils on going into the cold
air of a frolly morning, which is owing to the deficient ac-
tion of the abforben-t veffels of the noftrils, is one fpecies ;
and the vifcid mucus difcharged from the fecerning veffels
of the fam.e membrane, when inflamed, is another fpecies
of the fame genus, Catarrhus. Which bear no analogy
either in reipe6t to their immediate caufe or to their imme-
diate effedl..

The ufes of the method here offered to the public of claff-
ing difeafes according to their proximate caufes are, firft,,
more diflindlly to underftand their nature by comparing
their elTential properties. Secondly, to facilitate the know-
ledge of the methods of cure; fince in natural claffification
of difeafes the fpecies of each genus, and indeed the genera
of each order, a few perhaps excepted, require the fame
general medical treatment. And laftly, to difcover the na-
ture and the name of any difeafe previoufly unknown to the
pbyiician ; which I am perfuaded will be m.ore readily and
mere certainly done by this natural fyflem, than by the arti-
ficial claliifications already publiflied...

The common names of difeafes are not well adapted to any
kind of claiTifiL ation, and leaft of all to this from their prox-
imate caufes. Some of their names in common language are
taken from the remote caufe, as worms, ftone of the blad-
der ; others from the remote effed^t, as diarrhoea, falivation,

A a hydro-

viii PREFACE.

•

hydrocephalus ; others from fome occidental fymptom of the
difeafe, as tooth-ach, head-ach, heart-burn; in which the
pain is only a concomitant circumftance of the excefs or de-
ficiency of fibrous adtions, and not the caufe of them.
Others again are taken from the deformity occafioned in
confequence of the unnatural fibrous motions, which con-
flitute difeafes, as tumours, eruptions, extenuations ; all thefe
therefore improperly give names to difeafes ; and fome dif-
ficulty is thus occafioned to the reader in endeavouring to dif-
cover to what clafs fuch diforders belong.

Another difficulty attending the names of difeafes is, that
one name frequently includes more than one difeafe, either
exifling at the fame time or in fuccellion. Thus the pain
of the bowels from worms is caufed by the increafed ac-
tion of the membrane from the ftimulus of thofe animals;
but the convulfions, which fometimes fucceed thefe pains in
children, are caufed by the confequent volition, and belong to
another clafs.

To difcover under what clafs any difeafe fliould be ar-
ranged, we muft firfl inveftigate the proximate caufe ; thus
the pain of the tooth-acli is not the caufe of any difeafed
motions, but the effect ; the tooth-ach therefore does not be-
long to the clafs of Senfation. As the pain is caufed by in-
creafed or decreafed a6lion of the membranes of the tooth,
and thefe actions are owing to the increafe or decreafe of
irritation, the difeafe is to be placed in the clafs of irrita-
tion.

To

PREFACE. ix

To difcov^er the order it muft be inquired, whether the
pain be owing to increafed or defective motion of the pained
membrane; which is known by the concomitant heat or
cokhiefs of the part, hi tooth-ach without inflammation
there is generally a coldnefs attends the cheek in its vicinity ;
as may be perceived by the hand of the patient himfelf, com-
pared with the oppolite cheek. Hence odontalgia is found to
belong to the order of decreafed irritation. The genus and
fpecies muft be found by infpe6ting the fynopfis of the fecond
order of the clafs of Irritation. See Clafs I. 2. 4. 12.

This may be further elucidated by confidering the natural
operation of parturition ; the pain is occafioned by the in-
creafed action or diftention of the vellels of the uterus, in
confequence of the ftimulus of the fetus ; and is therefore
caufed by increafed irritation ; but the a6tion of the abdomi-
nal mufcles in its exclufion are caufed by the pain, and be-
long to the clafs of increafed fenfation. See Clafs 11. i. i. 12.
Hence the difficulty of determining, under what clafs of dif-
eafes parturition fliould be arranged, conlifts in there being
two kinds of difeafed a6lions comprehended under one word ;
which have each their different proximate caufe.

In Se6t. XXXIX, 8. 4. and in Clafs II. 1. 1. i. we have en-
deavoured to give names to four links of animal caufation,
which conveniently apply to the claffification of difeafes ;
thus in common nictitation, or winking with the eyes with-
out our attention to it, the increafed irritation is the proxi-
mate caufe ; the ftimulus of the air on the dry cornea is the
remote caufe ; the clofing of the eyelid is the proximate ef-
fect; and the difiufion of tears over the eye ball is the re-
- 8 mote

X PREFACE.

mote efFeft. In fome cafes two more links of caufation may
be introduced ; one of them may be termed the pre-remote
caufe ; as the warmth or motion of the atmofphere, which
caufes greater exhalation from the cornea. And the other
the pofl-remote effecSl ; as the renewed pellucidity of the cor-
nea; and thus fix links of caufation may be exprened in
words.

But if amid thefe remote links of animal caufation any of
the four powers or faculties of the fenforium be introduced,
the reafoning is not juft according to the method here pro-
pofed ; for thefe powers of the fenforium are always the proxi-
mate caufes of the contra6lions of animal fibres ; and there-
fore in true language cannot be termed their remote caufes.
From this criterion it may always be determined, whether
more difeafes than one are comprehended under one name ;
a circumiiance which has much impeded the inveiligation of
the caufes, and cures of difeafes^

Thus the term fever, is generally given to a colledtion of
morbid fymptoms ; which are indeed fo many difi:in61: difeafes,
that fometimes appear together, and fometimes feparately ;
hence it has no determinate meaning, except it iignifies limply
a quick pulfe, which continues for fome horns ; in which
fenfe it is here ufed.

In naming difeafes I have endeavoured to avoid the affec-
tation of making new compound Greek words, wnt;re others
equally exprellive could be procured : as a fhort periphralis is
eafier to be underftood, and lefs burthenfome to the memory.

In

PREFACE. xi

In the Methodus Medendi, which is marked b}'- M. M. at the
end of many of the fpecies of difeafes, the words incitantia,
forbentia, torpentia, &;c. refer to the fiibfequent articles of
the Materia Medica, explaining the operations of medicines.

The remote caufes of many difeafes, their periods, and many
circumftances concerning them, are treated of in the preced-
ing volume ; the defcriptions of many of them, which I have
omitted for the fake of brevity, may be feen in the Nofologia
Methodica of Sauvages, and in the Synopfis Nofoldgiae of Dr.
Cullen, and in the authors to which they refer.

In this arduous undertaking the author folicits the candour
of the critical reader ; as he cannot but forefee, that many er-
rors will be difcovered, many additional fpecies will require
to be inferted ; and others to be tranfplanted, or erafed. Jf he
could expend another forty years in the practice of medicine,
he makes no doubt, but that he could bring this work nearer
perfecftion, and thence render it more worthy the attention of
philofophers. As it is, he is induced to hope, that fome ad-
vantages will be derived' from it to the fcience of medicine,
and confequent utility to the public, and leaves the completion
of his plan to the induftry of future generations.

Derby, Jan. ], 1796.

Z O O N O M I A.

PART 11.

CLASSES OF DISEASES.

I. DISEASES OF IRRITATION.

II. DISEASES OF SENSATION.

III. DISEASES OF VOLITION.

IV. DISEASES OF ASSOCIATION.

Vol. II. B ■ rhe

DISEASES OF IRRITATION. Class I.

\the Orders aiid Genera of the Firjl Clajs of Difeafes,

GLASS I.

DISEASES OF IRRITATION.

OR DO I.

Increafed Irritation.

GENERA.

1. With increafed actions of the fangniferous fyf!:em,

2. With increafed aftions of the fecerning fyftem.

3. With increafed aiElions of the abforbent fyftem.

4. With increafed aftions of other cavities and membranes.

5. With increafed a£tions of the organs of itwi^,

OR DO II.

Decreafed Irritation.

GENERA.

1. With decreafed actions of the fanguiferous fyftem,

2. With decreafed a6lions of the fecerning fyftem.

3. With decrcaled adions of the abforbent fyftem.

4. With decreafed adions of other cavities and membranes.

5. With decreafed aftions of the organs of fenfe.

ORDO III.

Retrograde Irritative Motions.

GENERA.

1. Of the alimentary canal.

2. Of the abforbent fyftem.

3. Of the fanguiferous fyftem.

"The 1

i

Class!, i. 2. DISEASES OF IRRITATION.

The Orders^ Genera^ and Species, of the Firjt Clafs of Difeafes,

GLASS I.

DISEASES OF IRRITATION.

ORDO I.

Increafed Irritation.

GENUS I.

With increafed Anions of the Sanguiferous Syflem,

1 . Ferris irritativa.

2. Ebrietas.

j. Hcemorrhagia arteriofa,

4. Hcemoptoe arteriofa.

5. Hcemorrhagia narium.

SPECIES.

Irritative fever.
Drunkennefs.
Arterial haemorrhage.
Spitting of arterial blood.
Bleeding from the nofe.

GENUS II.

With increafed ABiom of the Secerning Syftem.

1 . Calorfebrilism

2. Rubor febr His.

3. Sudor calidus.

SPECIES.

Febrile heat.
Febrile rednefs.
Warm fweat.

B 2

Sudor

DISEASES OF IRRITATION. Class!, i.

Sudor febr'iUs.

a labore.

• ab igne.

a medicamentis.

4. Ur'ina uberlor colorata.

5. JD'tarrhcea calida.

febrilh.

crapulofa.

r t7ifantum.

6. Salivatto calida.

7. Catarrhus calidus.

8. Expe&oratio calida.

9. Exfudatio pone aures.
Gonorrhcsa calida.
Fluor albus calidus.
H^emorrhois alba.
Serum e vijicatorio.
Perfpiratio fcetida.
Crines novi.

10.
II.
12.

14.
15-

Sweat in fevers.

from exerc'ife.

from fire.

from medicines.

Copious coloured urine.
Warm diarrhoea.

from fever.

from indigeftion.

of infants.

falivation.

catarrh.

expe£loration.

Difcharge behind the ears.
Warm gonorrhoea.
fluor albus.

White piles.

Difchargre from a blifter.

o

Fetid perfpiration.
New hairs.

GENUS III.

J4^ith iiicreafed AElions of the Abjorbent Syjlem^

SPECIES.

I . Lingua aridd.

Dry tongue.

2. Fauces aridce.

Dry throat.

3^. Nares aridi.

Dry noftrils.

4. FxpeBoratio folida.

Sohd expe6toration.

5. Conftipatio alvi.

Coftivenefs.

6. Cutis arida.

Dry Ikin.

7. Urina parcior colorata.

Diminiihed coloured urine.

S. Calculus

Class I. r.4.

8. Calculus fclleus et i£lerus.
9. rents .

10. vejtcce.

11. artbriticus.

1 2. R.heumattfmus chromcus.

13. Cicatrix vulnerum^

1 4. Cornece obfufcatio.

DISEASES OF IRRITATION.

Gall-ftone and jaundice.
Stone of the kidney.
Stone of the bladder.
Gout-ftone.
Chronic rheumatifm,
Healino; of ulcers.
Scar on the corneai

GENUS IV.
With incrcafcd ASiions of other Cavities and Membranes.

SPECIES.

I. NifJitaiio irritativa.
z. Deglutitio irritativui

3. Rejptratio et tujjis.

4. Exclujto bills,

5. Dent it io.

6. Priapifmus..

7. Diftenjio mamularujm

8. Defcenfus uteri.

9. Prolapfus ani.

10. Lumbricus.

1 1 . 1'cenia.

12. Afcarides.

13. Dracunculus,

14. Morptones,

15. Pediculi.

Irritative niftitation.

Irritative deglutition.

Refpiration and cough...

Exclufion of the bile.

Toothing.

Priapifm.

Diftention of the nipples,

Defcent of the uterus.

Defcent of the redtum.

Round worm.

Tape-worm.

Thread- worms.

Guinea-worm.

Crab-lice.

Lice.

GENUS

DISEASES OF IRRITATION. Class I. 2. i.

GENUS V.
With increafed A5lions of the Or gam ofSenfe.

SPECIES.

1. Vjfus acrior.

2. Audit us acrior.

3. Olfattiis acrior,

4. Gujius acrior.

5. 'Tadus acrior.

6. Sen/us caloris acrior.

7. extenjionis acrior.

8. 1'itillatio.

9. Pruritus.

10. Dolor urens.

1 1 . Confternatio.

Acuter fight.

■ hearing.

fmeil

tafle.

touch.

■ fenfe of heat.

fenfe of exteiifion.

Ticklins;.
Itching.
Smarting;.
Surprife.

O R D O. II.

Decreafed Irritation.

GENUS I.
With decreafed ASiions of the Sanguiferous Syjiem.

I. Fehris inirritativa.
z. Par efts inirritativa.

3. So7nnus inter ruptus.

4. Syncope.

5. Hamorrhagia venofa.

8

SPECIES.

Inirritative fever.

debility.

Interrupted fleep.
Fainting.
- Venous hiEmorrhaee.

6. Hamorrhois

Class I. 2. 2. DISEASES OF IRRITATION.

6.

Hdemorrho'is cruenla.

Bleeding piles.

7-

Hccmorrhagia renum.

-■ from the kidneys*

8.

• hepatis^

9-

Hcemoptoe venofa.

Spitting of venous blood.

10.

Palpitatio cordis.

Palpitation of the heart.

11.

Menorrhagia.

Exuberant menftruation^

12.

'Dyfmenorrhagta,

Deficient nienftruation.

13-

'Lochia nimia.

Too great lochia.

14.

Abortio Jpontanea.

Spontaneous abortion^

15-

Scorbutus.

Scurvy.

16.

Vibices.

Extravafations of blood»

1 7-

Petechice.

Purple fpots.

GENUS IL
With decreafed Anions of the Secerning Syjiem^

SPECIES.

Coldnefs in fevers.

1. Frigus febrile.
— — chronicum,

2. Pallor fugitivus.
permanens.

3. Pus par cms.

4. Mucus parcior.

5 . Urina parcior pallida.

6. Torpor hepaticus.

7. I'orpor pancreatis.

8. Torpor renis.

9. Pu7i5lce mucofce vultus.

10. Maculce cutis fulva.

1 1 . Canities.

12. Callus.

13. Cataradia,

permanent^

Palenefs fugitive.

permanent.

Diminifhed pus.
Diminiflied mucus.
Pale diminifhed urine»
Torpor of the liver.
Torpor of the pancreas.
Torpor of the kidney.
Mucous fpots on the face»
Tawny blots on the ikioo.
Grey hairs.
Callus.
Cataradl.

14,. Innutritio

8

DISEASES OP IRRITATION. Class I. 2.

14. Innutr'itio ojfium.

15. Rachitis.

16. Spina di/iortio.

17. Claudicatio cox aria.
';l8v Spina protuberafis.
.19. Spina bifida.

2.0. TiefeBus palati.

Innutrition .of the bones.

Rickets.

Diftortion of the fpine.

Lamenefs of the hip.

Protuberant fpine.

Divided fpine.

Defe£l of the palate.

GENUS III.
With decreafed Adtiom of the Abjorbent Syftem.

SPECIES.

a . Mucus faucium frigidus.

2. Sudor- frigidus.

3. Catarrhus frigidus.
.4. Expe£foratio frigida.

5. Urina uberior pallida,

6. Diarrhcea frigida.

7. Fluor albus frigidus.

8. Gonorrhcea frigida.

9. Hepatis tumor.
10. Chlorofis.

.11. Hydrocele.

1 2. Hydrocephalus ititernus.

13. Afcites.

14. Hydrothorax.

15. Hydrops ovarii.

16. Afiafarca pubnonum.
,17. Obefitas.

•18. Splenis tumor.

Cold mucus from the throat.

. fweat.

catarrh.

expedloration.

Copious pale urine.
Cold diarrhoea.

fluor albus.

gonorrhoea.

Swelling of the liver.

Green ficknefs.

Dropfy of the vagina teftis.

— of the brain.

■ of the belly.

of the cheft.

— • of the ovary..

of the lungs.

Corpulency.

Swelling of the fpleea.

19. Genu

Class I. 2.4. DISEASES OF IRRITATION.

19. Genu tumor albus,

20. Bronchocele.

21. Scrophula.

22. Schirrus.

23. re£it.

24. uretbrce.

25. afophagi.

White fwelling of the knee.
Swelled throat.

King's evil.

Schirrus.

of the recftum.
of the urethra,
of the throat.

26. La&eorum inirritabilitas. Inirritability of the la£leals.

27. Lytnphaticorum mirrhabllifas. Inirritability of the lymphatics.

GENUS IV.
JViih decreafed ASiions of other Cavities and Membranes,

SPECIES.

I . Slth cal'ida.

Thirft warm.

frjgida.

— cold.

2. Efuries.

• -Hunger.

3. Naufeajicca.

Dry naufea.

4. Mgritudo vetitriculu

Sicknefs of ftomach.

5. Cardialgia,

Heart-burn.

6. Arthritis ventricuU.

Gout of the ftomach.

7. CoJic a flatulent a.

Flatulent colic.

8. CoUca faturnina.

Colic from lead.

9. T'ympanitis.

Tympany.

ID. Hypochondria/is.

Hypochondriacifm-

1 1 . Cephalceafrigida.

Cold head-ach. '

12. Odontalgia.

Tooth-ach.

13. Otalgia,

Ear-ach.

14. Pleurodyne chronica.

Chronical pain of the fide.

Vol. 11.

C i^. Sciatica

DISEASES OF IRRITATION.

Gold feiatica.
lumbasfo.

70' i;ibivAi)Jii) Ui* iKKii Ai lUiN. ClassL 2.S>

15. Sciatica frigtda.

1 6. Lumbago frigida,

17. Hyjieralgiafrigida.

18. Pro5ia!gia frigida,

19. Fejicce felkce inirritibilitas et Iniriitability o£ the gall-bladder audi

iSerus, iaundice-

pain of the uterus,
paia of the re£lum.

GENUS -V.
TVith decreafed Anions of the Orgafis of' Senfei-

SPECIES-

I. Stiiltitia inirritabills,

1. Kifus ifiiminutus.

3. Mufc^wlitafites,

4. Strabifmus.

5. Amaiirojls.

6. Auditus imminittm,

7. O/faflus imminutus.

8. Guftiis hnmimitus^.

9. 'TaSlu^ imminutus,
10. Stupor,

Folly frominlrritabilityo-

Impaired vifion.

Dark moving fpecks.-

Squinting.

Palfy of the optic nerve^

Impaired hearing.

fmelL

■ tafte.

' touch.

Stupor,

ORDO'

Class I. 3.2. DISEASES OF IRRITATION.

II

ORDO III.

"Retrograde Irritative Mations^

GENUS I.
ty the Alimentary Canal.

SPECIES.

I. Ruminatio.
z. RuSlus.

3. Apepfta.

4. Fomitus.

5. Cholera.

6. Ileus.

7. Globus hyjlericus.

8. Vomendi conamen inane,

9. Borborigmus.

10. Hyfleria.

11. Hydrophobia.

Chewing the cud.

Eruftation.

ladigeftion, water-qualm.

Vomiting.

Cholera.

Iliac paffion.

Hyfteric flrangulation.

Vain efforts to vomit.

Gurgling of the bowels.

Hyfteric difeafe.

Dread of water.

GENUS II.
Of the Abforhent Syjlem.

SPECIES.

\.

Catarrhus lymphaticus.

Lymphatic catarrh.

2.

Sallvatio lymphatica.

Lymphatic falivation.

3-

Naufea humida.

Moift naufea.

^'

Diarrhoea lymphatica.

Lymphatic flux.

5'

Diarrhcea chylifera.

Flux of chyle.

6. DiahateSm

12

DISEASES OF IRRITATION. Class I... j.^:

6. Diabcetes,
, 7. Sudor lymphaticus.

8. Sudor afthmatlciis,

9. 1'ranJIatio puris.

10. ladis,

1 1 . - — ■ urlnce»

Diabetes.
Lymphatic fweat.
Afthmatic fweat.
Tranflation of matter,
■■ — ■ of milk..

»" of urinc».

GENUS lU.
Of the Sanguiferous Syjlem,

SPECIES.
I. Capillarium motus retrogrejfus. Retrograde motion of the capillarieSo

2. Palpitat'to cordis.

3. Anhelatio fpajmodica.

Palpitation of the heart-
Spafmodic pantin g.

CLAS^'

CiLAssI. X. r. DISEASES OF IRRITATION. rj^

CLASS I.

BISEASES OF IRRITATION.

ORDO r.

Increafed Irritation^,'

GENUS r..

With increafed Anions of the Sanguiferous Syflem,-

The irritability of the whole, or of part, of our fyftetn is per--
petually changing ; theft viciilitudes of irritability and of inirritability
are believed to depend on the accumulation or exhauftion of the fen-
forial power, as their proximate caufe ; and on the difference of the
prefent ftimulus, and of that which we had previoufly been accuf-
fomed to, as their remote caufe. Thus a fmaller degree of heat pro*
duces pain and inflammation in our hands, after they have been for a
rime immerfed in fnow r which is owing to the accumulation of fen-
forial power in the moving fibres of the cutaneous veffels during their
previous quiefcence, when they were benumbed with cold. And we
feel ourfelves cold in the ufual temperature of the atmofphere oriJ
coming out of a warm room ; which is owing to the exhauftion of^
fenforial power in the moving fibres of the vefTels of the Ikin by their
previous increafed adlivity, into which they were excited by unufual
heat.

Hence the cold fits of fever are th€ occafion of the fucceeding hot
ones; and the hot fits contribute to occafion in their turn the fucceed-^
ing cold ones. And though the increafe of ftimulus, as of heat, ex^
ercife, or diftention, will produce an increafed adlion of the ftimulated
fibres; in- the fame manner as it is produced by the increafed irritability

■ which;

•14 DISEASES OF IRRITATION, Class!, i. i.

which was occafioned by a previous defedc of fLimulus ; yet as the
exceffes of irritation from the ftimulus of external things are more
eafily avoided than the deficiencies of it ; the difeaies of this country,
except thofe which are the confequences of drunkennefs, or of im-
moderate excrcife, more frequently begin with torpor than with or-
gafra J that is, with inaftivity of fome parts, or of the whok of the
iyftem, and confequent coldnefs, than with increafed zCiivityy and
confequent heat.

If the hot fit be the confequence of the cold one, it may be allced
if they are proportionate to each other: it is probable that they are,
where no part is deftroyed by the cold fit, as in mortification or death.
But we have no meafure to diftinguifli this, except the time of their
duration ; whereas the extent of the torpor over a greater or lefs part
of the fyftem, which occafions ±he cold fit ; or of the exertion which
occafions the hot one; as well as the degree of fuch torpor or exer-
tion, are perhaps more material than the time of their duration. Be-
fides this fome mufeles are lefs liable to accumulate fenforial power
during their torpor, than others, as the locomotive mufeles compared
with the capillary arteries ; on all which accounts a long cold fit may
often be followed by a Ihort hot one.

SPECIES.

u Fel>ns Irritativa. Irritative fever. This is the fynocha of fome
writers, it is attended with ftrong pulfe without inflammation ; and
in this circumflance differs from the febris inirritativa of Clafs L 2.1.1.
which is attended with weak pulfe without inflammation. The in-
creafed frequency of the pulfation of the heart and arteries conllitutes
fever ; during the cold fit thefe pulfations are always weak, as the
energy of aftion is then decreafed throughout the whole fyftem ; aiid
therefore the general arterial ilrength cannot be determined by the
3 touch,

Class I. I.I. DISEx^SES OF IRRITATION. 15

touch, till the cold part of the paroxyfm ceafes,. This determinatioii
is fometimes attended with difficulty; as ftrong and weak are only
comparative degrees of the greater or lefs refiftance of the piilfation of
the artery to the compreflion of the finger. But the greater or lefs
frequency of the pulfations affords a collateral evidence in thofe cafes,,
where the degree of flrength is not very diflinguiftiable, which may
aflift our judgment concerning it- Since a moderately ftrong pulfe,.
when the patient is in a recumbent pofture,- and not hurried in mind,
feldom exceeds 120 ftrokes in a minute; whereas a weak one often
exceeds i 30 in a recumbent pofture, and 150 in an ereft one, in thofe.
fevers, which are termed' nervous or putrid. See Se£l. XII. i. 4.

The ixicreafed frequency of the pulfation of the heart and arteries,
as it is occafioncd either by excefs or defe6l of ftimulus, or of fenforiab
power,^ exifts both in the cold and hot fits of fever ; but when the
eold fit ceafes, and the pulfe becomes ftrong and full as well as quick,
iii'confequence of the increafed irritability of the heart and arteries, it
eonflitutes the irritative fever, or fyaocha. It is attendedvvith con-
fiderable heat during the paroxyfm, and generally terminates in a quar-
ter of a lunationy without any diHurbance of the faculties of the inind,
SeeClafs-IV. I.I.8..

M. M. Venefedion. Emetics,. Cathartics. Cool the patient in
the hot fir> and^ warm ■ him ' in the cold one. Reft; Torpentia,

2. Ebrieias. Drunkennefs. By the ftimulus of wine or opium
the whole arterial fyftem, as well as every other- pa Ft of the moving
fyftem, is excited into increafed adlion. All the fecretions, and with
them the produftion of fenforial power itfelf in the brain, feem to be'
for a time increafed, with an additional quantity of heat, and of plea-
fureable fenfation. See Se6l. XXI. on this fubjedli Thisexplains,
why at the commencement of the warm paroxyfm of fome fevers the
patient is in greater fpirits, or vivacity; becaufe, as in drunkennefsj
the. irritative motions are all increafed, and a-greater p.rodu(ftion of fen-
fation •

i;6 DISEASES OF IRRITATION. Class!, i.i.

fation is the confequence, which when in a certain degree is pleafure-
able, as in the diurnal fever of weak people^ Seft. XXXVI. 3. i .

3. Hctmorrhagia arter'iofa. Arterial haemorrhage. Bleeding with
a quick, ftroiig, and full pulfe. The haemorrhages from the lungs,
and from the nofe, are the moft frequent of thefe ; but it fometimes
happens, that a fmall artery but half divided, or the punfture of a
leech, will continue to bleed pertinacioiifly.

M. M. Venefeflion. Cathartic with calomel. Divide the wotind-
ed artery. Bind fponge on the pun£ture. If coffee or charcoal in-
ternally ? If air with lefs oxygen ?

4. Hcemoptoe arter'iofa. Spitting of arterial blood. Blood fpit up
from the lungs is florid, becaufe it has juft been expofed to the influ-
ence of the air in its paflage through the extremities of 'the pulmonary
artery ; it is frothj-, from the admixture of air with it in the bronchia.
The patients frequently vomit at the fame "time from the difagree-
able titillation of blood about the fauces ; and are thence liable to be-
lieve, that the blood is rejected from the ftomach.

Sometimes an haemoptoe for feveral fucceffive days returns in
gouty perfons without danger, and feems to fupply the place of the
gouty paroxyfms. Is not the liver always difeafed previous to the
haemoptoe, as in feveral other haemorrhages ? See Clafs I. 2. i. 9.

M. M. Venefeilioti, a purge, a blifter, diluents, torpentia ; and
afterwards forbentia, as the bark, the acid of vitriol, and opium. An
emetic is faid to flop a pulmonary hcemorrhage, which it may effeifl:,
as ficknefs decreafes the circulation, as is very evident in the great
ficknefs fometimes produced by too large a dofe of digitalis pur--
purea.

Dr. Rufli fays, a table fpoonful or two of common fait is fuccefsful'
iu haemoptoe ; this may be owing to its ftimulating the abforbent {y^-'
tems, both the lymphatic, and the venous. Should the patient re-

fpire

Class I. i. r. DISEASES OF IRRITATION. 17

fpire air with lefs oxygen ? or be made fick by whirling round in a
chair fufpended by a rope ? One immerfion in cold water, or a fudden
fprinkling all over with cold water, would probably flop a pulmonary
ha£mon'hage. See Se£l. XXVII. i.

5. H^morrhagia nanum. Epijiaxis. Bleeding at the nofe in el-
derly fubje£ls moft frequently attends thofe, whofe livers are enlarged.
or inflamed by the too frequent ul^f fermented liquors.

In boys it occurs perhaps iimply from redundancy of blood ; and
in young girls fometimes precedes the approach of the catamenia ; and
then it fhews a difpofition contrary to chlorofis ; which arifes from a
deficiency of red blood.

M. M. It is Hopped by plunging the head into cold water, with
powdered fait haftily diffolved in it ; or fometimes by lint flrewed
over with wheat flour put up the noflrils; or by a folution of fleel ia
brandy applied to the veffel by means of lint. The cure in other re-
fpefts as in haemoptoe ; when the bleeding recurs at certain periods,
after venefeiflion, and evacuation by calomel, and a blifter, the bark
and fteel muft be given, as in intermittent fevers. See Sedlion
XXVII. I.

Vol. II. D OR DO

i8 DISEASES OF IRRITATION, Class I. 1.2.

ORDO I,

Increqfed Irritation,

GENUS II.

With tncreafed A£lions of the Secerning Syjiem,

These are always attended with increafe of partial or of general
heat ; for the fecreted fluids are not limply feparated from the blood,
but are new combinations ; as they did not previoufly exift as fuch iu
the blood vefTels. But all new combinations give out heat chemically ;
hence the origin of animal heat, which is always increafed in pro-
portion to the fecretion of the part afFeded, or to the general quantity
of the fecretions. Neverthelefs there is reafon to believe, that as we
have a fenfe purpofely to diftinguifli the prefence of greater or lefs
quantities of heat, as mentioned in Sedt. XIV. 6. fo we may have
certain iTiinute glands for the fecretion of this fluid, as the brain is
believed to fecrete the fenforial power, which would more eafily ac-
count for the inftantancous produ£lion of the blufh of fhame, and of
anger. This fubjecl deferves further inveftigation.

SPECIES.

I. Calor fehrilis. The heat in fevers arifes from the increafe of
fome fecretion, either of the natural fluids, as in irritative fevers ; or
of new fluids, as in infectious fevers ; or of new veflels, as in inflam-
matory fevers. The pain of heat is a confequence of the increafed
extenfion or contradlion of the fibres expofed to fo great a ftimulus.
See Class I. 1.5. 6.

8 3. Rubor

Class I. 1.2. DISEASES OF IRRITATION. 19

2. Rubor fehr'ilis. Febrile rednefs. When the cold fit of fever
terminates, and the pulfations of the heart and arteries become ftrong
as well as quick from the increafe of their irritability after their late
quiefcetice, the blood is impelled forwards into the fine extremities of
the arteries, and the anaftomozing capillaries, quicker than the extre-
mities of the veins can abforb and return it to the heart. Hence the
pulfe at the wrifl: becomes full, as well as quick and ftrong, and the
(kin glows with arterial blood, and the veins become empty and lefs
vifible.

In elderly people the force of the heart and arteries becomes lefs,
while the abforbent power of the veins remains the fame ; whence
the capillary veffels part with the blood, as foon as it is received, and
the fkin in confequence becomes paler ; it is alfo probable, that in
more advanc-ed life fome of the finer branches of the arteries coalefce,
and become impervious, and thus add to the opacity of the Ikin.

3., Sudor cal'idm. Warm fweat may be divided into four varieties,
according to their remote caufes. Fuji, the perfpirable matter is fe-
creted in as great quantity during the hot fit of fever, as towards the
end of it, when the fweat is feen upon the Ikin. But during the hot
fit the cutaneous abforbents aft alfo with increafed energy, and the
exhalation is likewife increafed by the greater heat of the Ikin ; and
hence it does not appear in drops on the furface, but is in part reab-
forbed, and in part diflipated in the atmofphere. But as the mouths
of the cutaneous abforbents are expofed to the cool air or bedclothes ;
whilft thofe of the capillary glands, which fecrete the perfpirable
matter, are expofed to the warmth of the circulating blood ; the
former, as foon as the fever-fit begins to decHne, lofe their increafed
adlion firft ; and hence the abforption of the fweat is diminiflied,
whilft the increafed fecretion of it continues for fome hours afterwards,
which occafions it to ftand in drops upon the fkin.

As the Ikin becomes cooler, the evaporation of the perfpirable mat-

D 2 ter

20 DISEASES OF IRRITATION, Class!, i. 2c

ter becomes lefs, as well as the abforption of it. And hence the dif-
fipation of aqueous fluid from the body, and the confequent thirft,
are perhaps greater during the hot fit, than during the fubfequent
fweat. For the fvveats do not occur, according to Dr. Alexander's
experiments, till the fkin is cooled from 112 to 108 degrees of heat ;
that is, till the paroxyfm begins to decline. From this it appears,
that the fweats are not critical to the hot fit, any more than the hot
fit can be called critical to the cold one ; but fimply, that they are
the natural confequence of the decline of the hot fit, commencing
with the decreafed a£lion of the abforbent fyflem, and the decreafed
evaporation from the Ikin. And from hence it may be concluded,
that a fever-fit is not in general an effort of nature to reftore healthy
as Sydenham confidered it, but a neceffary confequence of the previ-
ous torpor ; and that the caufes of fevers would be lefs detrimental,
if the fever itfelf could be prevented from exifting ; as appears in the
cool treatment of the fmall-pox.

It muft be noted that the profufe fweats on the Ikin are more fre-
quent at the decline of fever-fits than the copious urine, or loofe
flools, which are mentioned below j as the cutaneous abforbents,
being expofed to the cool air, lofe their increafed adion fooner than
the urinary or inteftinal abforbents ; which open into the warm cavi-
ties of the , bladder and inteftines ; but which are neverthelefs often
affefted by their fympathy with the cutaneous abforbents. Hence
few fevers terminate without a moifture of the Ikin ; vi'hence arofe
the fatal praftice of forcing fweats by the external warmth of air or
bedclothes in fevers ; for external warmth increafes the adtion of the
cutaneous capillaries more than that of the other fecerning veflels ;
becaufe the latter are habituated to 98 degrees of heat, the internal
warmth of the body; whereas the cutaneous capillaries being nearer
the furface are habitually kept cooler by the contadl of the external
air. Sweats thus produced by heat in confined rooms are ftill more
detrimental ; as the air becomes then not only deprived of a part of

its

Class I. r. 2. DISEASES OF IRRITATION. at

its oxygene by frequent refpiration, but is loaded with animal effluvia
as well as with moifture, till it can receive no more ; and in confe-
quence, while the cutaneous fecretion flands upon the Ikin in drops
for want of exhalation, the lungs are expofed to an infalubrious at-
mofphere.

I do not deny, that fweating may be fo managed as to be fervice-
able in preventing the return of the cold paroxyfm of fevers ; like the
■warm bath, or any other permanent flimulus, as wine, or opium, or
the bark. For this purpofe it iliould be continued till paft the time of
the expelled cold fit, fupported by moderate dofes of wine- whey,
with fplrit of hartfhorn, and moderate degrees of warmth. Its falu^
tary efFe<£l, vv-hen thus managed, was probably one caufe of its havino^
been lb much attended to; and the fetid fm ell, which when profufe
is liable to accompany it, gave occafion to the belief, that the fup-
pofed material caufe of the difeafe was thus eliminated from the elr-
Gulation,

When too great external' heat is applied, the fyftem is weakened by
excefs of a6lion, and the torpor which caufes the cold paroxyfm recurs
fooner and more violently. For though fome ftimuli, as of opium
and alcohol, at the fame time that they exhauft the fenforial power
by promoting increafe of fibrous adion, may alfo increafe the pro-
du(flion or fecretion of it in the brain, yet experience teaches us, that
th'e exhauflion far out-balances the increafed produdion, as is evinced
by the general debility, which fucceeds intoxication*

In refpe£l to the fetor attending copious continued fweats, it is
owing to the animalized part of this fiuid being kept in that deo-ree of
warmth, which moft favours putrcfadion, and not fufFered to ex-
hale into the-- atmolphere. Broth, or other animal mucus, kept in
limilar circuraftances, would. in the fame time acquire a putrid fmell;
yet has this error frequently produced miliary eruptions, and increafed
every kind of inflammatory or fenfitive fever.

The cafe> whiclx the patient experiences during fv/eating, if it be

not

^■2 ^DISEASES OF IRRITATION. Class I. 1.2.;

riiot produced by much external heat, is fimilar to that of the warm
bath ; which by its ftimulus applied to the cutaneous veffels, which
are generally cooler than the internal parts of the lyflem, excites them
into greater adlion ; and pleafureable fenfation is the confequence of
thefe increafed adlions of the veffels of the ikin. From confidering
all thefe circumftances, it appears that it is not the evacuation by
fvveats, but the continued ftimulus, which caufes and fupports thofe
fweats, which is ferviceable in preventing the returns of fever-fits.
And that fweats too long continued, or induced by too great flimulus
of warmth, clothes, or medicines, greatly injure the patient by in-
creafing inflammation, or by exhaufling the fenforial power. See
vClafsI. I. 2. 14.

Secondly, The fvveats produced by exercife or labour are of the
warm kind x, as they originate from the increafed a6tion of the capil-
laries of the fkin, owing to their being more powerfully Simulated
:by the greater velocity of the blood, and by a greater quantity of it
.paffing through them in a given time. For the blood during violent
exercife is carried forwards by the a£lion of the mufcles fafter in the
arteries, than it can be taken up by the veins ; as appears by the
rednefs of the (kin. And from the confequent fweats, it is evinced,
that the fecretory veffels of the Ikin during exercife pour out the per-
fpirable matter fafter, than the mouths of the abforbent veffels can
drink it up. Which mouths are not expofed to the increafed muf-
cular a£lion, or to the ffimulus of the increafed velocity and quantity
of the blood, but to the cool air.

'Thirdly, the increafed fecretion of perfpirable matter occafioned by
the ftimulus of external heat belongs likevvife to this place ; as it is
caufed by the increafed motions of the capillary veffels ; which thus
feparate from the blood more perfpirable matter, than the mouths of
their correfpondent abforbent veffels can take up ; though thefe alfo
are ftimulated by external heat into more energetic adion. If the air
be ftationary, as in a fmall room, or bed with clofed curtains, the

fweat

Class I. 1.2. DISEASES OF IRRITATION. 23

fweat ftands in drops on the Ikin for want of a quicker exhalation pro^
portioned to the quicker fecretion.

h fourth variety of warm perfpiration is thafoccafioned by ftimu-
lating drugs, of which opium and alcohol are the moft powerful;
and next to thefe the fpices, volatile alkali, and neutral falts, efpeci-
ally fea fait ; that much of the aqueous part of the blood is diflipated..
by the ufe of thefe drugs, is evinced by the great thirft, which oc-
curs a few hours after the ufe of them. See Art. III. 2.12. and:
Art. III. 2. I.

We may from hence underftand, that the increafe of this fecretion
of perfpirable matter by artificial means, miift be followed by debility.
and emaciation.. When this is done by taking much fait, or falted
meat, the fea-fcurvy is produced ; which confifts in the inirritability
of the bibulous terminations of the veins arifing from the capillaries ;
fee Clafs I. 2. i. 14, The fcrophula, or inirritability of the lympha-
tic glands, feems alfo to be occafionally induced by an excefs in eating
fait added to food of bad nourilhment. See Clafs I. 2. 3. 21, If an.
excefs of perfpiration is induced by warm or ftimulant clothing, as by
wearing flannel in contaft with the Ikin in the fummer months, a
perpetual febricula is excited, both by the preventing the accefs of
cool air to the Ikin, and by perpetually goading it by the numerous
and hard points of the ends of the wool ; which when applied to the
tender Ikins of young children, frequently produce the red gum, a,s it
is called; and in grown people, either an eryfipelas, or amiliarjr-
eruption, attended with fever. See Clafs II. 1.3.12.

Shirts made of cotton or calico ftimulate the Ikin too much by the
points of the fibres, though lefs than flannel ; whence cotton hand--
kerchiefs make the nofe fore by frequent ufe. The fibres of cotton
are, I fuppofe, ten times fhorter than thofe of flax, and the number
of points in confequence twenty times the number ; and though the
manufadturers finge their calicoes on a red-hot iron cylinder, yet i;

have

24 DISEASES OF IRRITATION. Class!. 1.2,

liave more than once feen an eryfipelas induced or increafed by the
ilimulus of calico, as well as of flannel.

The increafe of perfpiration by heat either of clothes, or of fire,
contributes much to emaciate the body ; as is well known to jockeys,
who, when they are a ftone or two too heavy for riding, find the
qulckefb way to leffen their weight is by fweating themfelves between
blankets in a warm room ; but this likewife is a practice by no means
to be recommended, as it weakens the fyflem by the excefs of fo
general a ftimulus, brings on a premature old age, and fliortens the
fpan of life ; as may be further deduced from the quick maturity,
and Ihortnefs of the lives, of the inhabitants of Hindoftan, and other
tropical climates.

M. BufFon made a curious experiment to (hew this circumftance.
He took a numerous brood of the butterflies of filkworms, fome
hundreds of which left their eggs on the fame day and hour ; thefe he
divided into two parcels ; and placing one parcel in the fouth win-
dow, and the other in the north window of his houfe, he obferved,
that thofe in the colder fituation lived many days longer than thofe in
the warmer one. From thefe obfervations it appears, that the wear-
ing of flannel clothing next the fkin, which is now fo much in
fafhion, however ufeful it may be in the winter to thofe, who have
cold extremities, bad digeflions, or habitual coughs, muft greatly
debilitate them, if worn in the warm months, producing fevers,
eruptions, and premature old age. See Seft. XXXVII. 5. Clafs I.
I. 2, 14. Art. III. 2. I.

4. Ur'ina uberior color at a. Copious coloured urine. Towards the
end of fever-fits a large quantity of high coloured urine is voided, the
kidneys continuing to act ftrongly, after the increafed adion of the
abforbents of the bladder is fomewhat diminiflied. If the abforbents
continue alfo to atl ftrongly, the urine is higher coloured, and fo

loaded

Class I. 1.2. -DISEASES OF IRRITATION. 55

loaded as to depolit, when cool, an earthy fediment, erroneoufly
thought to be the material caufe of the difeafe ; but is fimply owing
to the fecretion of the kidnies being great from their increafed adlion;
and the thinner parts of it being abforbed by the increafed adion of
the lymphatics, which arefpread very thick on the neck of the blad-
der ; for the urine, as well as perhaps all the other fecreted fluids, is
produced from the kidnies in a very dilute (late ; as appears in thofc,
who from the flimulus of a flone, or other caufe, evacuate their urine
too frequently ; which is then pale from its not having remained in
the bladder long enough for the more aqueous part to have been re-
abforbed. The general ufe of this urinary abforption to the animal
oeconomy is evinced from the urinary bladders of fifh, which would
otherwife be unneceflary. High coloured urine in large quantity
fhews only, that the fecreting veffels of the kidnies, and the ab-
forbents of the bladder, have a£ted with greater energy. When there
is much earthy fediment, it ftiews, that the abforbents have adted
proportionally ftronger, and have confequently left the urine in a lefs
dilute ftate. In this urine the tranfparent fediment or cloud is mu-
cous ; the opake fediment is probably coagulable lymph from the
blood changed by an animal or chemical procefs. The floating fcurii
is oil. The angular concretions to the fides of the pot, formed as the
urine cools, is microcofmic fait. Does the adhefive blue matter on
the fides of the glafs, or the blue circle on it at the edge of the upper
furface of the urine, confift of Pruffian blue ?

5. Diarrhea <:aIiJa. Warm diarrhoea. This fpecies maybe di-
vided into three varieties deduced from their remote caufes, under the
names of diarrhoea febrilis, diarrhoea crapulofa, and- diarrhoea infantum.
The febrile diarrhoea appears at the end of fever-fits, and is erroneoufly
called critical, like the copious urine, and the fwcats ; whereas it
arifes from the increafed adion of thofe fecerning organs, which pour
Vol. II. E their

26 DISEASES OF IRRITATION. Class I. i, 2.

their fluids into the inteflinal canal (as the liver, pancreas, and mu-
cous glands), continuing longer than the increafed adion of the in-
teftinal abforbents. In this diarrhoea there is no appearance of curdled
chyle in the ftools, as occurs in cholera. I. 3. i. 5.

The diarrbcea craptilofa, or diarrhoea from indigeflion, occurs
"when too great a quantity of food or liquid has been taken ; which
not being compleatly digefted, ftimulates the inteftines like any other
extraneous acrid material; and thus produces an increafe of the fecre-
tions into them of mucus, pancreatic juice, and bile. When the
contents of the bowels are ftill more iflimulant, as when draftic
purges, or very putrefcent diet, have been taken, a cholera is in-
duced. See Sea. XXIX. 4.

The diarrhoea infantum^ or diarrhoea of infants, is generally owing-

to too great acidity in rheir bowels. Milk is found curdled in the

ilomacbs of all animals, old as well as young, and even of carnivorous

ones, as of hawks. (Spallanzani.) And it is the gaftric juiceof the

calf, which is employed to curdle milk in the procefs of making^

cheefe. Milk is the natural food for children, and muft curdle ia

their ftomachs previous to digeflion ; and as this curdling of the milk

deftroys a part of the acid juices of the fto-mach, there is no reafon for

difcontinuing the ufe of it, though it is occafionally ejedted in a

curdled ftate. A child of a week old, which had been taken from

the breaft of its dying mother, and had by fome uncommon error been

fuffered to take no food but water- gruel, became lick and griped in

twenty-four hours, and was convulfed on the fecond day, and died

on the third ! When all young quadrupeds, as well as children, have

this natural food of milk prepared for them, the analogy is fo ftroug

in favour of its falubrity, that a perfon fhould have powerful tefti-

mony indeed of its difagreeing, before he advifes the difcontinuance

of the ufe of it to young children in health, and much more fo in

ficknefs. The farmers lofe many of their calves, which are brought

up
8

Class I. 1.2. DISEASES OF IRRITATION. 27

up by gruel, or gruel and old milk ; and among the poor children of
Derby, who are thus fed, hundreds are flarved into the fcrophula,
and either perifh, or live in a ftate of wretched debility.

When young children are brought up without a breaft, they (hould
for the firft two months have no food but new milk ; fince the ad-
dition of any kind of bread or flour is liable to ferment, and produce
too much acidity ; as appears by the confequent diarrhoea with green
dejeftions and gripes; the colour is owing to a mixture of acid with
the natural quantity of bile, and the pain to its ftlmulus. And they
fliould never be fed as they lie upon their backs, as in that pofture
they are neceffitated to fwallow all that is put into their mouths; but
when they are fed, as they are fitting up, or raifed up, when they
have had enough, they can permit the reft to run out of their mouths.
This circumftance is of great importance to the health of thofe chil-
dren, who are reared by the fpoon, fince if too much food is given
them, indigeftion, and gripes, and diarrhoea, is the confequence ; and
if too little, they become emaciated ; and of this exa<5t quantity their
own palates judge the beft.

M. M. In this laft cafe of the diarrhoea of children, the food fhould
be new milk, which by curdling deftroys part of the acid, which co-
agulates it. Chalk about four grains every fix hours, with one drop
of fpirit of hartfhorn, and half a drop of laudanum. But a blifjer
about the fize of a (hilling is of the greateft fervice by reftoring the
power of digeftion. See Article III. 2. i. in the fubfequent Materia
Medica. . ^

- 6. Salivat'w caltda. Warm falivation. Increafed fecretion of faliva.
This may be efFefted either by ftimulating the mouth of the gland by
mercury taken internally ; or by ftimulating the excretory dudt of the
gland by pyrethrum, or tobacco; or limply by the movement of the
mufcles, which lie over the gland, as in mafticating any taftelefs
fubftance, as a lock of wool, or maftic,

E 2 la

28 DISEASES OF IRRITATION. ClaosI. i.2»

In about the middle of nervous fevers a great fpitting of faliva fome-
times occurs, which has been thought critical ; but as it continues
fometimes two or even three weeks without the relief of the patient,
it may be concluded to arife from fome accidental circumftance, per-
haps not unfimilar to the hyfteric ptyalifms mentioned in Ctafs L
3. 2, 2; See Sea. XXIV.

M. M. Cool air, diluents, v/arm bath, evacu-ations.

7. Catharrhus caltdus. Wai'm catarrh. Confifts in an increafed
fecretion of mucus from the noftrils without inflammation. This
difeafe, which is called a cold in the head, is frequently produced by
cold air adling for fome time on the membranes, which line the nof-
trils, as it palTes to the lungs in refpiration. Whence a torpor of the
adlion of the mucous glands is firfi: introduced, as in I. 2. 3. 3. and
an orgafm or increafed a£lion fucceeds in confequence. Afterwards
this orgafm and torpor are liable to alternate with each other for fome
time like the cold and hot fits of ague, attended with deficient or ex-
uberant fecretion of mucus in the noftrils.

At other times it arifes from reverfe fympathy with fome extenfive
parts of the Ikin, which have been expofed too long to cold, as of the
head, or feet. In confequence of the torpor of thefe cutaneous ca-
pillaries thofe of the mucous membrane of the noftrils a£t with greater
energy by reverfe fympathy ;. and thence fecrete more mucus from
the blood.. At the fame time the abforbents, acting alfo with greater
energy by their reverfe fympathy with thofe of fome diftant part of
the Ikin, abforb the thinner parts of the mucus more haftily ; whence
the mucus is both thicker and in greater quantity. Other curious
Gircumftances attend this difeafe ; the membrane becomes at times fo
thickened by its uicreafed action in fecrenng the mucus, that the
patient cannot breathe through his noftrils. In this fituation if he
warms his whole flan fuddenly by fire or bed-clothes, or by drinking
warm tea, the increafed action of. the membrane ceafes by its reverfe

fympathy

Class I. .1.2. DISEASES OF IRRITATION. 29

fympathy with the Ikin; or by the retraftion of the feuforlal power
to other parts of the fyftem ; and the patient can breathe again
through the noftrils. The fame fometimes occurs for a time on
going into the cold air by the dedu6lion of heat from the mucous
inembrane, and its confequent inaftivity or torpor. Similar to this
when the face and breafl have been very hot and red, previous to the
eruption of the fmaU-pox by inoculation, and that even when expofed
to cool air, 1 have obferved the feet have been cold: till on covering:
them with warm flannel, as the feet have become warm, the face
has cooled. See Se£t. XXXV. i. 3. Clafs II. i. 3. 5. IV. 2. 2. 10.
IV. I. I. 5.

M. M. Evacuations, abftinence, oil externally on the nofe, warm
diluent fluids, warm fhoes, warm night-cap.

8. ExpeSioratio cal'ida. Warm expeftoration confifts of the in-
creafed fecretion of mucus from the membrane, which lines the
bronchiae, or air-cells of the lungs, without inflammation. This
increafed mucus is ejeded by the aftion of coughing, and is called a
cold, and refembles the catarrh of the preceding article ; with which
it is frequently combined.

M. M. Inhale the fleam of warm water, evacuations, warm bath,
afterwards opium, forbentia..

9. Exfudatio pone aures. A difcharge behind the ears. This
chiefly afi^efls children, and is a morbid fecretion; as appears from
its fetor ; for if it was owing to defeft of abforption, it would be faline
and not fetid ; if a morbid aftion has continued a confiderable time, it
fhould not be flopped too fuddenly ; fince in that cafe fome other
morbid adtion is liable to fucceed in its flead. Thus children are be-
lieved to have had cholics, or even convulfions, confequent to the

7. too.

30 DISEASES OF IRRITATION. Class I. 1.2.

'too fudden healing of thefe morbid efFufions behind their ears. The
rationale of this is to be explained from a medical fadl, which I have
frequently obferved ; and that is, that a blifter on the back greatly
ftrengthens the power of digeftion, and removes the heart-burn in
adults, and green ftools in children. The ftimulus of the blifler
produces fenfation in the vefTels of the ikin ; with this additional fen-
forial power thefe veffels a£l more flrongly ; and with thefe the vef-
fels of the internal membranes of the ftomach and bowels a£t with
greater energy from their direct fympathy with them. Now the
acrid difchargc behind the ears of children produces fenfation on that
part of the ikin, and fo far adts as a fmall blifter. When this is fud-
denly ilopped, a debility of- the digeftive power of the ftomach fuc-
ceeds from the want of this accuftomed ftimulus, with flatulency,
green ftools, gripes, and fometimes confequent convulfions. See
Clafs II. 1. 5. 6. and II. i. 4. 6.

M. M. If the matter be abforbed, and produces fwelling of the
lymphatics of the neck, it fhould be cured as foon as poffible by duft-
ing the part with white lead, cerufla, in very fine powder; and to
prevent any ill confequence an iffue fhould be kept for about a month
in the arm ; or a purgative medicine fliould be taken every other day
for three or four times, which fliould confift of a grain of calomel,
and three or four grains of rhubarb, and as much chalk. If there be
no appearance of abforption, it is better only to keep the parts clean
by wafhing them with warm water morning and evening; or putting
fuller's earth on them ; efpecially till the time of toothing is paft.
The tinea, or fcald head, and a leprous eruption, which often ap-
pears behind the ears, are different difeafes.

10. Gonorrhoea caVida. Warm gleet. Increafed difcharge of mu-
cus from the urethra or proftrate gland without venereal defire, or
venereal infe(£lion. See Clafs I. 2. 3. 8.

M. M. Cantharides,

Class I. 1.2. DISEASES OF IRRITATION. 31

M. M. Cautharides, balfams, rhubarb, blifter in pennn^um, cold
bath, injeftions of metallic lalts,, flannel (hirt, change 01 inetorm of
the accuftomed chair or faddle of the patient.

n.. Fluor alBus calidus. Warm fluor albus. Increafed fecretioii>
of mucus iu.the vagina or uterus without venereal defire or venereal
ixife<5lion. It is diftinguiflied from the fluor albus frigidus by the in-
creafed fenfe of warmth in the part, and by the greater opacity or
fpiffitude of the material difcharged ; as the thinner parts are reab-
forbed by the increafed a6tion of the abfbrbents, along with the faline-
part, whence no fmarting or excoriation attends it.

M. M. Mucilage, as ifinglafs, hartfliorn jelly, gam arable. Tea-
grains of rhubarb every night. Callico or flannel fhift,, opium, bal-
fams. See Clafs I. 2. 3. 7..

12. Hcemorrhoh alba. White piles. An inereafed difcharo-e of
mucus from the re<Stum frequently miftaken for matter; is faid to
continue a few weeks, and recur like the bleeding piles ; and to obey
lunar influence. See Clafs I. 2. i. 6.

M. M. Abftinence from vinous fpirit. Balfam of copaiva.; Spice
fwallowed in large fragments, as ten or fifteen black pepper-corns cut
in half, and taken after dinner and fupper. Ward's parte, confifting
of black pepper and the powdered root of Helenium Enula..

13. Serum evejicatorio. Difcharge from a blirter. . The excretory
dufts of glands terminate in membranes, and are endued with great
irritability, , and many of them with fenfibility ; the latter perhaps in
confequence of their facility of being excitable into great adion ; in- -
fiances of this are the terminations of the gall-dudl in. the duodenum,
and of the falivary and lachrymal glands in the mouth and eye ; . which ,
produce a greater fecretion of, their adapted fluids, when the ends of
their excretory dudls are rt:im.ulated...

The::

32 DISEASES OF IRRITATION. Class I. 1.2,

The external fkin confifls of the excretory dufts of the capillaries,
with the mouths of the abforbents ; when thefe are flimulated by the
application of cantharides, or by a (lice of the frefti root of bryonia
alba bound on it, the capillary glands pour an increafed quantity of fluid
upon the ikin by their increafed a£l:ion ; and the abforbent veffels icn-
bibe a o-reater quantity of the more fluid and faline part of it ; whence
a thick mucous or ferous fluid is depofited between the Ikin and cu-
ticle.

1 4. Perfpiratlo fcet'ida. Fetid perfplration. The ufes of the per-
fpirable matter are to keep the Ikin foft and pliant, for the purpofes
of its eafier flexibility during the adlivity of our limbs in locomotiqn,
and for the prefervation of the accuracy of the fenfe of touch, which is
difFufed under the whole furface oif it to guard us againft the injuries
of external bodies j in the fame manner as the fecretion of tears is de-
flcrned to preferve the cornea of the eye moift, and in confequence
tranfparent ; yet has this cutaneous mucus been believed by many to
be an excrement ; and I know not how many fanciful theories have
been built on its fuppofed obftrudion. Such as the origin of catarrhs,
coughs, inflammations, eryfypelas, and herpes.

To all thefe it may be fufficient to anfwer, that the antient Gre-
cians oiled themfelves all over ; that fome nations have painted them-
felves all over, as the Pidls of this ifland ; that the Hottentots fmear
themfelves all over with greafe. And laftly, that many of our own
heads at this day are covered with the flour of wheat and the fat of
hoo-s, according to the tyranny of a filthy and wafleful fafliion, and
all this without inconvenience. To this mud be added the fl:ri6l
analogy between the ufe of the perfpirable matter and the mucous
fluids, which are poured for fimilar purpofes upon all the internal
membranes of the body ; and befides its being in its natural ftate
inodorous ; which is not fo with the other excretions of feces, or of
urine. ...

In

Class I. 1.2. DISEASES OF IRRITATION. 33^

In fome conftitutions the perfpirable matter of the kings acquires a
difagreeable odour ; in others the axilla, and in others the feet, eflait
difguftful effluvia ; like the fecretions of thofe glands, which have
been called odorifers ; as thofe, which contain the caftor in the
beaver, and thofe within the re6tum of dogs, the mucus of which
has been fuppofed to guard them againft the great coftivenefs, which
they are liable to in hot lummers ; and which has been thought to
occalion canine maduefs, but which, like their white excrement, is
more probably owing to the deficient fecretion of bile. Whether
thefe odoriferous particles attend the perfpirable matter in confequence .
of the increafed ^Ct'ion of the capillary glands, and can properly be
called excrementitous; that is, whether any thing is eliminated,
which could be hurtful if retained; or whether they may only con-
tain fome of the effential oil of the animal; like the fmell, which ad-
heres to one's hand on ftroking the hides of fome dogs ; or like the
effluvia, which is left upon the ground, from the feet of men and^
other creatures; and is perceptible by the nicer organs of the dogs^-
which hunt them, may admit of doubt.

M, M., Wafh the parts twice a day with foap and wafer ; with'
lime water ; cover the feet with oiled filk focks, which muft be
wafhed night and morning. Cover them with charcoal recently
made red hot, and beaten into fine powder and fifted, as foon as cold,
and kept well corked in a bottle, to be wadied ofFand renewed twice
a day. Internally rhubarb grains vi. or viii. every night, fo as to
procure a ftool or two extraordinary every day, and thus by increafing
one evacuation to decreafe another. Cool drefs, diluting liquids?

15.. Crines novi. New hairs. The black points on the faces of
fome people confift of mucus, which is become vifcid, and which,
adheres in the excretory du£ts of the glands of the fkin ; as defcribed .
in Clafs I, 2. 2. 9. and which may be preffed out by the fingers, •
and relembles little worms. Similar to this would feem the fabri-

Vol.. II.. F cation

34 DISEASES OF lURITATION. Class I. 1.2.

cation of filk, and of cobweb by the filk worm and fplder ; which is
a fecreted matter prefled through holes, which are the excretory-
duels of glands. And it is probable, that the produdlion of hair on
many parts of the body, and at different periods of hfe, may be
eiFefted by a fimilar procefs; and more efpecially as every hair may
be confidered as a (lender flexible horn, and is an appendage of the fkin.
See Seft. XXXIX. 3. 2. Now as there is a fenfitive fympathy be-
tween the glands, which fecrete the femen, and the throat, as ap-
pears in the mumps; fee Hydrophobia, Clafs IV. i. 2. 7. and
Parotitis, Clafs IV. i. 2. 19. the growth -of the beard at puberty
feems to be caufed by the greater adion of the cutaneous glands about
the chin and pubes in confequence of their fympathy with thofe of
the teftes. But this does not occur to the female fex at their time of
puberty, becaufc the fenfitive fympathy in them feems to exiil: be-
tween the fubmaxillary glands, and the pe6loral ones; which fecrete
the milk, and afford pleafure both by that fecretion, and by the
ereftion of the mamuliE, or nipples ; and by delivering the milk into
the mouth of the child; this fenfitive fympathy of the pe£loral and
fubmaxillary glands in women is alfo obfervable in the Parotitis, or
mumps, as above referred to.

When hairs grow on the face or arms fo as to be difagreeable, they
may be thus readily removed without pain or any ill confequence.
Warm the ends of a pair of nippers or forceps, and ftick on them a
little rofin, or burgundy pitch; by thefe means each fingle hair may
be' taken flUl hold of; and if it be then plucked off ilowly, it gives
pain; but if plucked off fuddenly, it gives no pain at all ; becaufe the
vis inertitc of the part of the Ikin, to which it adheres, is not over-
come; and it is not in confequence feparated from the cellular
membrane under it. Some of the hajrs may return, which are thus
plucked off, or others may be induced to grow near them ; but in a
littletime they may be thus fafely deflroyed; which is much to be
preferred to the methods faid to be ufed in Turkey to eradicate hair;

f«ch

Class I. 1.2. DISEASES OF IRRITATION. 35

fuch as a mixture of orpiment and quick limej or of liver of fulphur
in folution ;~ which injure the Ikin, if they are not very nicely
managed; and the hair is liable to grow again as after fhaving ; or
to become white, if the roots of it have been much inflamed by the
cauflicity of the application. See Clafs 1. 2. 2. 11. on grey hairs.

F'2 - ORDO

36 DISEASES OF IRRITATION. Class I. i.^.

O R DO I.

Increqfed Irritation,

GENUS III.
With increqfed Actions of the Abforbent Syjlem.

These are not attended with fo great increafe of heat as In the
former genus, becaufe the fluids probably undergo lefs chemical
change in the glands of the abforbent fyftem ; nor are the glands of
the abforbent veffels fo numerous or fo extenfive as thofe of the fe-
cerning ones. Yet that fome heat is produced by the increafed aftion
of the abforbents appears from the greater general warmth of the Ikin
and extremities of feeble patients after the exhibition of the peruviau
bark, and other medicines of the article Sorbentia.

SPECIES.

I. luingua arida. Dry tongue occurs in thofe fevers, where the
expired air is warmer than natural ; and happens to all thofe, who
fleep with their mouths open; the currents of air iq, refpiration in-
creafing the evaporation. There is alfb a drynefs in the mouth from
the increafed adlion of the abforbent veffels, when a floe or a crab-
apple are mafticated ; and after the perfpiration has been much in-
creafed by eating fait or fpice, or after other copious fecretions ; as
after drunkennefs, cathartics, or fever fits, the mucus of the mouth
becomes vifcid, and in fmall quantity, from the increafed abforption,
adhering to the tongue like a white flough. In the diabsetes, where
ihe thirfl is very great, this flough adheres more pertinacioufly, and

8 r becomes

Class I. 1.3. DISEASES OF IRRITATION. ^^

becomes black or brown, being coloured after a few days by our
aliment or drink. The infpiffated mucus on the tongue of thofe,
who fleep with their mouths open, is fometimes reddened as if mixed
with blood, and fometimes a little blood follows the expuition of it
from the fauces owing to its great adhefion. When this mucus ad-
heres long to the papillae of the tongue, the faliva, which it contains
in its interftices, like a fponge, is liable to become putrid, and to ac-
quire a bitter tafte, like other putrid animal fubftances; which is
generally miftaken for an indication of the prefence of bile.
M. M. Warm fubacid liquids. See Clafs I. 2. 5. 8.

2. Fauces aridce. Dry throat. The expuition of a frothy mucus
with great and perpetual hawking occurs in hydrophobia, and is very
diftrefring to the patient ; which may be owing to the increafed irri-
tability or fenfibility of the upper part of the oefophagus, which will
not permit any fluid to reft on it.

It afFe6ts fome people after intoxication, when the lungs remain
(lightly inflamed, and by the greater heat of the, air in expiration the
mucus becomes too haftily evaporated, and is expedlorated with dif-
ficulty in the ftate of white froth.

I knew a perfon, who for twenty years always waked with his
tongue and throat quite dry ; fo that he was neceffitated to take a
fpoouful of water, as foon as he awoke ; otherwile a little blood al-
ways followed the forcible expuition of the indurated mucus from
his fauces. See Clafs 11. i, 3. 17.

M. M. Steel-fprings fixed to the night-cap fo as to fufpend the
lower jaw and keep it clofed ; or fprings of elaftic gum. Or a pot
of water fufpended over the bed, with a piece of lift, or woollen cloth,
depending From it, and held in the mouth; which will aft like a
fyphon, and flowly fupply moifturc, or barley water (hould be fre-
quently fyriuged into the mouth of the patient,

•2. Nares

3§ DISEASES OF IRRITATION. Class I. 1.3.

3. Nares aridi. Dry noftrlls with the mucus hardening upon their
internal furface, fo as to cover them with a kind of fkiu or fcale,
owino- to the increafed adion of the abforbents of this membrane ; or
to the too great drynefsof the air, which pafies into the lungs j or
too preat heat of it in its expiration.

When air is fo dry as to lofe its tranfparency ; as when a tremulous
motion of it can be feen over corn fields in a hot fummer's day; or
when a dry mill, or want of tranfparency of the air, is vifible in very
hot weather ; the fenfe of fmell is at the fame time imperfed from
the drynefs of the membrane, beneath which it is fpread.

4. Expetloratio follda. Solid expedoration. The mucus of the
luno-s becomes hardened by the increafed abforption, fo that it adheres
and forms a kind of lining in the air-cells, and is fometimes fpit up
in the form of branching veffels, which are called polypi of the lungs.
See Tranfa£t. of the College, London. There is a ratthng or weez-
ino- of the breath, but it is not at firll attended with inflammation.

The Cynanche trachealis, or Croup, of Dr. CuUen, or Angina
polvpofa of Michaelis, if they differ from the peripneumony of in-
fants feem to belong to this genus. When the difficulty of refpira-
tion is o-reat, venefedion is immediately neceffary, and then an emeticj
and a blifter. And the child (hould be kept nearly upright in bed as
much as may be. See TonfiUitis, Clafs IL i. 3. 5.

M. M. Diluents, emetics, effence of antimony, foetid gums,
onions, warm bath for half an hour every day for a month. Inhaling
the fteam of water, with or without volatile alcali. Soap.

c. Conjlipatio alvl. Coftivenefs from increafed a6tion of the Intefti-
nal abforbents. The feces are hardened in lumps called fcybala.;
which are fometimes obliged to be extraded from the re£lum with a
kind of marrow fpoon. This is faid to have happened from th^
patient having taken much rufl of iron. The mucus is alfo harden-
ed

Class I. 1.3. DISEASES OF IRRITATION. 39

ed fo as to line the inteftiiies, and to come away in Ikins, rolled up
as they pafs along, fo as to refemble wornas, for which they are fre-
quently miftaken ; and fometimes it is evacuated in flill larger pieces,
fo as to counterfeit the form of the intefliues, and has been miftaken
for a portion of them. Balls of this kind, nearly as heavy as marble,
and confderably hard, from two inches to five in diameter, are fre-
quently found in the bowels of horfes. Similar balls found in goats
have been called Bezoar.

M. M. Cathartics, Diluents, fruit, oil, foap, fulphur, warm
bath. Sprinkling with cold water, cool clothing. See Clafs I. 2. 4. 18.

6. Cutis ar'ida. Dry (kin. This dry fkin is not attended with
coldnefs as in the beginning of fever-fits. Where this cutaneous
abforption is great, and the fecreted material upon it vifcid, as ou
the hairy fcalp, the fkin becomes covered with hardened mucus ;
which adheres fo as not to be eafily removed, as the fcurf on the
head ; but is not attended with inflammation like the Tinea, or
Lepra. The moifture, which appears on the Ikin beneath refinous
or oily plafters, or which is feen to adhere to fuch plafters, is owing
to their preventing the exhalation of the perfpirable matter, and not
to their increafmg the produ6ti'on of it, as fome have idly imagined,

M. M. Warm bathing, oil externally, oil-lkin gloves, refinous
plafters. Wax.

7. Ur'ina parca colorata. Diminiflied urine, which is laigh coloured,
and depofits an earthy fediment, when cold, is owing to the great
aftion of th-e urinary abforbents. See Clafs I. i. 2. 4. In fome drop-
fies the cutaneous abforbents are paralytic, as well as thofe opening
into the cellular membrane ; and hence, no moifture being acquired
from the atmofphere, or from the cellular membrane, great thirft is
excited ; and great abforption from all parts, where the abforbents
-are ftill capable of aftion. Hence the urine is in very fmall quantity,

6 ^ and

40 TDISEASES OF IRRITATION. Class I. 1.3,

and of deep colour, with copious fediment ; and the kidneys are erro^
neoufly blamed for not doing their office ; ftimulant diuretic medi-
cines are given in vain ; and very frequently the unhappy patient is
retrained from quenching his thirft, and dies a martyr to falle theory.
M. M. Diluent liquids, and warm bathing, are the natural cure
of this fymptom ; but it generally attends thofe dropfies, which arc
feldom curable ; as they are owing to a paralyfis both of the cutaneous
and cellular lymphatics.

8 Calculus fe Ileus. Gall-ftone. From the too hafty abforption of
the thinner parts of the bile, the remainder is left too vifcid, and
cryftallizes into lumps; which, if too large to pafs, obf1:ru£l the.
du6tus choledochus, producing pain at the pit of the flomach, and
jaundice. When the indurated bile is not harder than a boiled pea,
it may pafs through the bile-du£t with difficulty by changing its
form ; and thus gives thofe pains, which have been called fpaims of
the ftomach ; and yet thefe vifcid lumps of bile may afterwards dif-
folve, and not be vifible among the feces.

In two inflances I have feen from thirty to fifty gall-ftones voided
after taking an oil vomit as below. They were about the fize of
peas, and diftinguifhable when dry by their being inflammable like
bad wax, when put into the ftame of a candle. For other caufes of
jaundice, fee Clafs I. 2. 4. 19.

M. M.^ Diluents, daily warm bathing. Ether mixed with\yolk
of egg and water. Unboiled acrid vegetables, as lettice, cabbage,
muftard, and crefles. When in violent pain, four ounces of oil of
olives, or of almonds, fhould be fw allowed; and as much more in a
quarter of an hour, whether it flays or not. The patient fhould lie
on the circumference of a large barrel, firfi: on one fide, and then on
the other. Eleftric fhocks through the gall-du£l. Faditious Selter's
water made by diflblving one diam of Sal Soda in a pint of water ; to
half a pint of which made luke-warm add ten drops of marine acid ;

to

Class I. 1.3. DISEASES OF IRRITi\TION. ^ ^i

to be drank as foon as mixed, twice a day for feme months. Opium
mufl be ufed to quiet the pain, if the oil does not fucceed, as two
grains, and another grain in half an hour if neceflkry. See Clafs IV.
2. 2. 4.

9. Calculus renis. Stone of the kidney. The pain in the loins
and along the courfe of the ureter from a llone is attended with re-
tradion of the tefticle in men, and numbnefs on the infide of the
thigh in women. It is diftinguifhed from the lumbago or fciatiea, aS'
thefe latter are feldom attended with vomiting, and have pain on the
outfide of the thigh, fometimes quite down to the ankle or heeL
See Herpes and Nephritis.

Where the abforption of the thinner parts of the fecretion takeS'
place too haftily in the kidnies, the hardened mucus, and confequent
calculous concretions, fometimes totally flop up the tubuli uriniferi ;.
and no urine isfecreted. Of this many die, who have drank much,
vinous fpirit, and; fome of them recover by voiding a quantity of
white mucus, like chalk and water ; and others by voiding a great
quantity of fand, or fmall calculi. This hardened mucus frequently
becomes the nucleus of a ftone in the bladder. The falts of the
urine, called microcofmic fait, are often miftaken for gravel, but are
diftinguiftiable both by their angles of cryftallization, their adhefion
to the fides or bottom of the pot, and by their not being formed till the
urine cools. Whereas the particles of gravel are generally without
angles, and always drop to the bottom of the veflel, immediately as>
the water is voided.

Though the proximate caufe of the formation of the calculous con-
cretions of the kidneys, and of chalk-ftones in the gout, and of the
infoluble concretions of coagulable lymph, which are found on mem-
branes, which have been inflamed in peripneumony, or rheumatifm,
confifls in the too great a<fl:ion of the ablorbent veiTels of thofc parts;,
yet the remote caufe in thefe cafes is probably owing to the iuflamma-
VoL. 11. G tioa

42 DISEASES OF IRRITATION. Class I. 1.3,

tion of the membranes ; which at that time are believed to fecrete a
material more liable to coagulate or concrete, than they would other-
wife produce by increafed a6tion alone without the production of new
veffels, which conftitutes inflammation. As definedin Clafs II. i. 2.

The fluids fecreted from the mucous membranes of animals are of
various kinds and confiftencies. Hair, filk, fcales, horns, finger-
nails, are owing to natural procefies. Gall-flones, ftones found in
the inteftines of horfes, fcurf of the {km in leprofy, ftones of the
kidnies and bladder, the callus from the inflamed periofteum, which
unites broken bones, the calcareous cement, which repairs the injured
lliells of fnails, the calcareous cruft on the eggs of birds, the annually
renewed fliells of crabs, are all inftances of productions from mucous
membranes, afterwards indurated by abforption of their thinner parts.

All thefe concretions contain phofphoric acid, mucus, and cal-
careous earth in different proportions ; and are probably fo far analo-
gous in refpedl to their component parts as well as their mode of for-
mation. Some calcareous earth has been difcovered after putrefaction
in the coagulable lymph of animals. Fordyce's Elements of Praftice.
A little calcareous earth was deteCted by Scheel or Bergman in the
calculus of the bladder with much phofphoric acid, and a great
quantity of phofphoric acid is fhewn to exiH: in oyfter-fhells by their
becoming luminous on expofing them a while to the fun's light after
calcination ; as in the experiments of Wilfon. Botanic Garden, P. r.
Canto 1. 1. 182, note. The exchange of which phofphoric acid for
carbonic acid, or fixed air, converts fhells into limeftone, producing
mountains of marble, or calcareous flrata.

Now as the hard lumps of calcareous matter, termed crabs' eyes,
which are found in the ftomachs of thofe animals previous to the an-
nual renewal of their fhells, are rediflblved, probably by their gaftric*
acid, and again depofited for that purpofe ; may it not be concluded,
that the ftone of the bladder might be diflblved by the gaftric juice of
fifli of prey, as of crabs, or pike 3 or of voracious young birds, as

young

Class I. 1.3. DISEASES OF IRRITATION. 43

young rooks or hawks, or even of calves ? Could not thefe experi-
ments be tried by colleding the gaftric juice by putting bits of fponge
down the throats of young crows, and retracing them by a firing in
the manner of Spallanzani? or putting pieces of calculus down
the throat of a living crow, or pike, and obferving if they become
digefted ? and laftly could not gaflric juice, if it fliould appear to be
a folvent, be injefted and born in the bladder without injury by means
of catheters of elaftic refin, or caoutchouc ?

M. M. Diluents. Cool drefs. Frequent change of pofture.
Frequent horizontal reft in the day. Bathe the loins every morning
with a fponge and cold water. Aerated alcaline water internally,
Abflinence from all fermented or fpirituous liquors. Whatever in-
creafes perfpiration injures thefe patients, as it diffipates the aqueous
particles, which ought to dilute the urine. When the conftitution
begins to produce gravel, it may I believe be certainly prevented by
a total abflinence from fermented or fpirituous liquors ; by drinking
much aqueous fluids ; as toafl: and water, tea, milk and water, le-
monade ; and laftly by thin clothing, and fleeping on a hai'difli bed,
that the patient may not lie too long on one fide. See Clafs IV. 2. 2. 2.
There is reafon to believe, that the daily ufe of opium contributes to
produce gravel in the kidnies by increafing abforption, when they are
inflamed ; in the fame manner as is done by fermented or fpirituous
liquor. See Clafs I. 3. 2. 11.

When the kidnies are fo obftruded with gravel, that no urine
pafles into the bladder ; which is known by the external appearance
of the lower part of the abdomen, which, when the bladder is full,
feems as if contra£led by a cord between the navel and the bladder ;
and by the tenfion on the region of the bladder diftinguifhable by the
touch ; or by the introdudlion of the catheter ; the following methods
of cure are frequently fuccefsful. Venefe£tion to fix or eight ounces,
ten grains of calomel, and an infufion of fenna with falts and oil,
every three hours, till ftools are procured. Then an emetic. After

G 2 the

44- DISEASES OF IRRITATION. Class L i.-3.

the patient has been thus evacuated, a blifrer on the loins fhould be
ufed ; and from ten to twenty eledliic fliocks fliould be paffed through
the kidnies, as large as can be eafily borne, once or twice a day.
Along with this method the warm bath (hould be ufed for an hour
once or twice a day. After repeated evacuations a clyfter, confifting
of two drams of turpentine diffolved by yolk of egg, and fixty drops
of tin £tu re of opium, fhould be ufed at night, and repeated, with
cathartic medicines interpofed, every night, or alternate nights.
Aerated folution of alcali fhould be taken internally, and balfam of
copaiva, three or four times a day. Some of thefe patients recover
after having made no water for nine or ten days.

If a ftone flicks in the ureter with inceffant vomiting, ten grains of
calomel muft be given in fmall pills as above ; and fome hours after-
wards infufion of fenna and falts and oil, if it can be made to ftay on
the flomach. And after the purge has operated four or five times, an
opiate is to be given, if the pain continues, confifling of two grains
of opium. If this does not fucceed, ten or twenty ele*5lric fhocks
throuo-h the kidney fhould be tried, and the purgative repeated, and
afterwards the opiate. The patient fhould be frequently put into the
v/arm bath for an hour at a time. Eighty or an hundred drops of
laudanum given in a glyfi:er, with two drams of turpentine, is to be
preferred to the two grains given by the flomach as above, when the
pain and vomiting are very urgent.

lo. Calcukis vejica. Stone of the bladder. The nucleus, or ker-
nel, of thefe concretions is always formed in the kidney, as above de-
fcribed; and pafTmg down the ureter into the bladder, is there per-
petually increafed by the mucus and falts fecreted from the arterial
fyflem, or by the mucus of the bladder, difpofed in concentric flrata.
The ftones found in the bowels of horfes are alfo formed on a nucleus,
and confift of concentric fpheres; a^ appears in fawing them through
the middle. But as thefe are formed by the indurated mucus of the

i inteftiues

Class I. 1.5. DISEASES OF IRRITATION. 45

inteftines alone without the urinary faits, it Is probable a difference
would be found on their analyfis.

As the ftones of the bladder are of various degrees of hardnefs, and
probably differ from each other in the proportions at leaft of their com-
ponent parts ; when a patient, who labours under this afflidling
difeafe, voids any fmall bits of gravel ; ' thefe fhould be kept in warm
folutions of cauftic alcali, or of mild alcali well aerated ; and if they
diffolve in thefe folutions, it would afford greater hopes, that that
which remains in the bladder, might be affe£ted by thefe medicines
taken by the flomach, or inje£led into the bladder.

To prevent the increafe of a ftone in the bladder much diluent
drink fliould be taken ; as half a pint of water warmed to about
eighty degrees, three or four times a day : which will not only
prevent the growth of it, by preventing any microcofmic falts from
being precipitated from the urine, and by keeping the mucus fuf-
pended -in it ; but will alfo diminifh the ftone already formed, by
ibftening, and washing away its furface. To this muft be added cool
drefs, and cool bed-clothes, as dire£led above in the calculus renis.

When the ftone is puflied againfl: or into the neck of the bladder,
great pain is produced ; this may fometimes be relieved by the intro-
dudion of a bougie to pufh the flone back into the fundus of the
bladder. Sometimes by change of pofture, or by an opiate either
taken into the flomach, or by a clyfter.

A dram of fal foda, or of fait of tartar, dlflblved in a pint of water,
and well faturated with carbonic acid (fixed air), by means of Dr.
Nooth's glafs-apparatus, and drank every day, or twice a day, is the
moft efficacious internal medicine yet difcov^red, which can be eafily
taken without any general injury to the conftitution. An aerated
alcaline water of this kind is fold under the name of fadtitious Seltzer
water, by J. Schweppe, at N" 8, KingVftreet, Holborn, London;
which I am told is better prepared than can be eafily done in the ufual
glafs-veffels, probably by employing a greater preffure in wooden ones.

Lythotomy

46 DISEASES OF IRRITATION. Class!. 1.3.

Lythotomy is the laft recourfe. Will the gaftric juice of animals
diflblve calculi ? Will fermenting vegetable juices, as fweet-wort,
or fugar and water in the ad: of fermentation with yeft, diflblve any
kind of animal concretions ?

1 1, Calculus arthriticus, Gout-ftones are formed on inflamed
membranes, like thofe of the kidnies above defcribed, by the too
hafty abforption of the thinner and faline parts of the mucus. Simi-
lar concretions have been produced in the lungs, and even in the pe-
ricardium ; and it is probable, that the oflification, as it is called, of
the minute arteries, which is faid to attend old age, and to precede
fome mortifications of the extremities, may be a procefs of this kind.

As gout-ftones lie near the furface, it is probable, that ether, fre-
quently applied in their early ftate, might render them fo liquid as to
permit their reabforption ; which the flimulus of the ether might at
the fame time encourage.

12. Rheiimatifmus chronlcus. Chronic rheumatifm. After the
acute rheumatifm fome infpiflated mucus, or material fimilar to
chalk-flones of the gout, which was fecreted on the inflamed mem-
brane, is probacy left, owing to the too hafty abforption of the thin-
ner and faline part of it ; and by lying on the fafcia, which covers
fome of the mufcles, pains them, when they move and rub againfi
it, like any extraneous material.

The pain of the fhoulder, which attends inflammations of the upper
membrane of the liver, and the pains of the arms, which attend afth-
ma dolorificum, or dropfy of the pericardium, are diftinguiflied from
the chronic rheumatifm, as in the latter the pain only occurs on
moving the affedted mufcles.

M. M. Warm bath, cold bath, bandage of emplaflrum de minio
put on tight, fo as to comprefs the part. Cover the part with flan-
nel. With oiled filk. Rub it with common oil frequently. WitH

ether.

Class I. 1.3. DISEASES OF IRRITATION. 47

ether, A bliiler. A warmer climate. Venefeftion. A grain of
calomel and a grain of opium for ten fucceffive nights. The Peruvian
bark.

13. Ckati'ix vulnerum. The fear after wounds. In the healing of
ulcers the matter is firfl thickened by increafing the abforption in them ;
and then leffened, till all the matter is abforbed, which is brought by
the arteries, inftead of being depofed in the ulcer.

M. M. This is promoted by bandage, by the forbentia externally,
as powder of bark, white lead ; folution of fugar of lead. And by
the forbentia internally after evacuations. See Se£t. XXXIII. 3. 2.
. In thofe ulcers, which are made by the contadl of external fire, the
violent a£tion of the fibres, which occafions the pain, is liable to con-
tinue, after the external heat is withdrawn. This Ihould be relieved
by external cold, as of fnow, fait and water recently mixed, ether,
or fpirits of wine fufFered to evaporate on the part.

The cicatrix of an ulcer generally proceeds from the edges of it;
but in large ones frequently from the middle, or commences in feve-
ral places at the fame time ; which probably contributes to the un-
even nefs of large fears.

14. Cornece obfufcatio. Opacity of the cornea. There are few
people, who have paffed the middle of life, who have not at feme
time fufFered fome flight fcratches or injuries of the-cornea, which by
not healing with a perfedly fmooth furface, occafion fome refra(£lions
of light, which may be conveniently feen in the following manner :
fill a tea-faucer with cream and tea, or with milk, and holding it to
your lips, as if going to drink it, the imperfecflions of the cornea will
appear like lines or blotches on the furface of the fluid, with a lefs
white appearance than that furface. Thofe blemiflies of the eye are
difl:inguiflied from the mufc^e volitantes defcribed in Clafs I. 2. 5. 2.
by their being invariably feen at any time, when you look for them.

4 Ulcers

48 DISEASES OF IRRITATION. Class J. 1.3.

Ulcers may frequently be feea on tlie cornea after ophthalmy, like
little pits or indentations beneath tiie furface of it : in this cafe no ex-
ternal application fhould be iifed, left the fear fhould be left uneven ;
but the cure ftiould be confined to the internal ufe of thirty grains of
bark twice a day, and from five to ten drops of laudanum at night;,
with five grains of rhubarb, if neceffary.

After ulcers of the cornea, which have been large, the inequalities
and opacity of the cicatrix obfcures the fight ; in thia cafe could not
a fmall piece of the cornea be cut out by a kind of trephine about the
fizeof a thick briftle, or a fmall crow-quill, and would it not heal
with a tranfparent fear ? This experiment is worth trying, and might
be done by a piece of hollow fteel wire with a fharp edge, through
which might be introduced a pointed fteel fcrew ; the fcrew to be in-
troduced through the opake cornea to hold it up, and prefs it againft
the cutting edge of the hollow wire or cylinder; if the fear ftiould
heal without lofing its tranfparency, many blind people might be made
to fee tolerably well by this flight and not painful operation. An
experiment 1 wifh ftrongly to recommend to fome ingenious furgeoa
or oculift.

ORDO

Class I. 1.4' DISEASES OF IRRITATION. 4^

ORDO I.

Increafed Irritation.

GENUS IV.

With increafed ASiions of other Cavities and Membranes..

SPECIES.

I. Nedlitatio irritativa. Winking of the eyes is performed every
minute without our attention, for the purpofe of cleaning and moiften-
iflg the eye- ball ; as further fpoken of in Clafs II. 1.1.8. When
the cornea becomes too dry, it becomes at the fame time lefs tranfpa-'^
X.tv\\. ; which is owing to the pores of it being then too large, fo that
the particles of light are refrafted by the edges of each pore, inftead
of paffing through it ; in the fame manner as light is refracted by
pafling near the edge of a knife. When thefe pores are filled with
water, the cornea becomes again tranfparent. This want of tranf-
parency of the cornea is vifible fometimes in dying people, owing to
their in irritability, and confequent negle£l of ni£titation.

The increafe of tranfparency by filling the pores with fluid is {qq]x
by foaking white paper in oil ; which from an opake body becomes
very tranfparent, and accounts for a curious atmofpheric phenomenon ;
when there exifts a dry mift in a morning fo as to render difbant ob-
jects lefs diftin6t, it is a fign of a dry day ; when diftant obje£ls are
feen very diftinft, it is a fign of rain. See Botan. Garden, Part I. add.
note XXV. The particles of air are probably larger than thofe of water,
as water will pafs through leather and paper, which will confine air;
hence when the atmofphere is much deprived of moifture, the pores
of the dry air are fo large, that the rays of light are refrafted by their
Vol. II. . H edges

5A DISEASES OF IRRITATION. Class I. r. 4.

edges inffead of pafllng through them. But when as much moifturc
is added as can be perfeftiy diffolved, the air becomes traufparent j and
opake again, when a part of this moifture collects into fmall fpherules
previous to its precipitation. This alfo accounts for the want of tranf-
parency of the air, which is feen in tremulous motions over corn-fields
en hot fummer-days, or over brick-kilns, after the flame is extin-
guiflied, while the furnace flill remains hot,

2, Deglutitm irritatlva. The deglutition of our faliva is performed
frequently without our attention, and is then an irritative action ia
confequence of the ftimulus of it in the mouth. Or perhaps fome-
times for the purpofe of difFufing a part of it over the dry membranes
of the fauces and pharinx'; in the fame manner as tears are diffiifed
over the cornea of the eye by the ad: of niititation to clean or
moiflen it.,

3. 'Refplratio et'TuJptS irritailviss. In the a£ls of refpiration and of
eoughiag there is an increafed motion of the air-cells of the lungs ow-
iiag to fome ftimvilating caufe, as defcribed above in Clafs I. i. 2. 8» and
I. i» 3-4. and which are frequently performed without our attention
or confcioufnefs, and are then irritative adlions ; and thus differ from
thofe defcribed in Clafs II. i. i. 2. and 5. To thefe increafed a6lions
of the air-cells are fuperadded thofe of the intercoftal mufcles andi
diaphragm by irritative affociation. When any unnatural ftimulus
a(3:s fo violently on the organs of refpiration as to induce pain, the
fenforial power of fenfation becomes added to that of irritation, and
iBflammation of the membranes of thera is a general confequence..

,4. 'Exclufio bills,. The exclufion of the bile from the gall-bladder,,
and its derivation into the duodenum, is an irritative aci^ion in confe-
quence of the flimulus of the aliment oa the extremity of the biliary
dua, which terminates in. the intefline» The increafed fecretion o£

tears

Class I. i. 4. DISEASES OF IRRITATION. 51

tears is occafioned in a fimilar manner by any ftim-ulating material ia
the eyes ; which affedls the excretory du6ts of the lacrymal glands. A
pain of the external nlembrane of the eye fometimes attends any un-
ufual ftimulus of it, then the fenforial power of feufation becomes
added to that of irritation, and a fuperficial inflammation is induced.

^. Detititio, Toothing. The pain of toothing often begins much
earlier than is fufpedled ; and is liable to produce convullions ; which
are fometimes relieved, when the gum fwells, and becomes inflamed;
at other times a diarrhoea fupervenes, which is generally efteemed a
favourable circumftance, and feems to prevent the convulfions by fup-
plying another means of relieving the pain of dentition by irritative
exertion ; and a confequent temporary exha'uftion of fenforial powero
See Clafs I. i. 2. 5. Sed. XXXV. 2. i.

The convulfions from toothing generally commence lono- before the
appearance of the teeth ; but as the two middle incifors of the lower
jaw generally appear firft, and then thofe of the upper, it is advifeable
to lance the gums over thefe longitudinally in refpedt to the jaw-
bones, and quite down to the periofteum, and through it.

As the convulfions attending the commencement of toothino- are
not only dangerous to life in their greatefl degree, but are liable to in-
duce ftupor or infenfibility by their continuance even in a lefs degree,
the mofl eflScacious means fhould be ufed to cure them.

M. M. Lance the gum of the expeded teeth quite through the
periofteum longitudinally. Venefeaion by the lancet or by two or
three leeches. One grain of calomel as a purge. Tincture of jalap,
five or fix drops in water every three hours till it purges, to be re-
peated dally. After evacuations a fmall blifter on the back or behind
the ears. And laftly, two or three drops of laudanum accordino- to
the age of the child. Warm bath. See Clafs III. i. j. 5. and 6^

f* * 6. Priapifjma

52 DISEASES OF IRRITATION. Class I. 1.4.

6. Priaplfmus chronicus. I have feen two cafes, where an ereftion
of the penis, as hard as horn, contmued two or three weeks without
any venereal defires, but not without fome pain ; the eafiert attitude
of the patients was lying upon their backs with their knees up. At
length the corpus cavernofum urethr^e became foft, and in another day
or two the whole fubfided. In one of them a bougie was introduced,
hoping to remove fome bit of gravel from the caput gallinaginis,
camphor, warm bathing, opium, lime-water, cold afperfion, bleed-
ing in the veins of the penis, were tried in vain. One of them had
been a free drinker, had much gutta rofacea on his face, and died fud-
denly a few months after his recovery from this complaint. Was it
a paralyfis of the terminations of the veins, which abforb the blood
from the tumid penis ? or from the flimulus of indurated femen in
the feminal veffels ? In the latter cafe fome venereal defires fliould
have attended. Clafs III. i. 2. 16.

The priapifmus, which occurs to vigorous people in a morning
before they awake, has beea called the fignum falutis, or banner of
health, and is occafioned by the increafe of our irritability or fenfibi-
lity during fleep, as explained in Seft. XVIII. r5.

7. Dijientio mamularum. The diftention of the nipples of la<!lefcent
women is at firft owing to the flimulus of the milk. See Sedt. XIV. .8,
and Sea. XVI. 5. See Clafs II. i. 7. 10.

8. Defcenfus uteri. This is a very frequent complaint after bad
labours, the fundus uteri becomes inverted and defcends like the pro-
lapfus ani.

M. M. All the ufual peffaries are very inconvenient and ineffec-
tual. A piece of foft fponge about two inches diameter introduced intO'
the vagina gives great eafe to thefe patients, and fupports the uterus ;
it fhould have a firing put through it to retradl it by. .

8 There

^ Class I. 1.4. DISEASES OF IRRITATION. 55

There are alfo peffaries how made of elaftic gum, which are faid to
be eafily worn, and to be convenient, from their having a perforation
ill their centre.

9. Prolapfus an'i. The lower part of the reftum becomes inverted^
and defcends after every ftool chiefly in children ; and thus Simu-
lates the fphinfter ani hke any other extraneous body.

M. M. It fliould be dufted over with very fine powder of gum
fandarach, and then replaced Aflringent fomentations; as an in-
fufion of oak-bark, or a flight foUition of alum. Horizontal reft fre-
quently in the day;

10. Lumbrlcus. Round worm. The round worm is fufpcfted in-
children when the belly is tumid, and the countenance bloated and
pale, with fwellingof the upper lip. The generation of thefe worms
is promoted by the too dilute flate of the. bile, as is evident in the
fleuke-worm found in the biliary du£ts and fubftance of the liver in,
fheep ; and in water-rats, in the livers of which laft animals they
were lately detected in large numbers by Dr. Capelle. Tranfa£tions.
of the college at Philadelphia, v. i.

Now as the dilute ftate of the bile depends on the deficiency of the^
abforption of its thinner parts, it appears, that the tumid belly, and'
bloated countenance, and fwelled upper lip, are a concomitant cir-
cumftance attending the general inadivity of the abforbent fyflem ;
which is therefore to be elleemed the remote caufe of the generation
of worms.

The fimplicity of the ftrufture of worms probably enables them to
exift in more various temperatures of heat ; and their being endued
with life prevents them from being dcflroyed by digeftion in the
ilomach, probably in the fame manner as the powers of life prevent
the fermentation and putrefadion of the flomach itfelf. Hence I con-'

cludcj^

54. DISEASES OF IRRITATION. CLAssLi.4.

elude, that worms are originally talcen into our alimentary canal from
without ; as 1 believe fimilar wxirms of all kinds, are to be found out
of the body.

M. M, The round worm is deftroyed by a cathartic with four or
fix grains of calomel ; and afterwards by giving fix or eight grains of
filings of iron twice a day for a fortnight. See Hepatis tumor, Clafs I.
2. 3. 9. As worms are liable to come away in fevers, whether of the
hedtic or putrid kind, could they be removed, by purulent matter, or
rotten egg, or putrid flefh, fince in thofe fevers from the enfeebled
adion of the inteftines the faeces become highly putrid ?

II. Tania. Tape- worm confifl:s of a chain of animals extending
from the ftomach to the anus. See Sedt. XXXIX. 2. 3. It frequently
exifts in cats, rats, and geefe, and probably in many other animals.

The worms of this genus poflefs a wonderful power of retaining,
life. Two of them, which were voided by a pointer dog in confe-
quence of violent purgatives, each of which were feveral feet in
length, had boihng water poured on them in a bafon ; which feemed
not much to inconvenience them. When the water was cool, they
were taken out and put into gin orwhifkey of the flrongeft kind, in
which their life and adivity continued unimpaired ; and they were at
length killed by adding to the fpirit a quantity of corrofive fublimate.
Medic. Comment, for 1791, p. 2']o.

The tape-worm is cured by an amalgama of tin and quickfilver,
fuch as is ufed on the back of looking- glaffes ; an ounce fhould be
taken every two hours, till a pound is taken ; and then a brilk cathar-
tic of Glauber''s fait two ounces, and common falts one ounce, diflblv-
cd in two wine pints of water, half a pint to be taken every hour till
it purges. The worm extends from the fliomaeh to the anus, and the
amalgama tears it from the inteftine by mechanical preflure, ading
ujpon it the whole way. Eledlric fhocks through the duodenum

greatly

Glass r. 1.4. DISEASES OF IRRITATION. SS

greatly afllfts the operation. Large dofes of tin in powder. Iron
filinos in large dofes. The powder of fern-root feems to be ,of no
ufe, as recommended by M, Noufflier.

I 2. Afcarides. Thread-worms. Thefe worms are faid to be more
frequent in feme parts of this kingdom than in others, as near the
fens of Lincohifhire. Do they efcape from the body and become flies,
like the bott-worm in horfes? Do they crawl from one child to ano-
ther in the fame bed ? Are they acquired from flies or worms, which
are feen in putrid necei3ary houfes, as thefe worms as well as the tape-
worms, are probably acquired from without? this may account for
their re-appearance a few weeks or months after they have been deftroy-
ed; or can this happen from the eggs or parts of them retnaining ?.

Afearides appear to be of two kinds,, the common fmall ones like a
thread; which has a very fliarp head ji as- appears in the microfcope ;
and which is fo tender, that the cold air foon renders it motionlefs ;,
and a larger kind above an inch long, and nearly as thick as a very
fenall crow-quill, and which is very hard in refpeft to its texture, and
very tenacious of life. One of thefe laft was brought to me, and was
immediately immerfed in. a ftrong folution of fugar of lead, and lived
in it a very long time without apparent inconvenience..

M. M. Afearides are faid to be weakened by twenty grains of cin-
nabar and five of rhubarb taken every night, but not to be cured by
this |)rocefs. As thefe worms are found only in the redlumy variety
of clyfters have been recommended.. I was informed of a cale,., where
folutions of mercurial ointment were ufed as a clyfter every night for
a ra.onth without fuccefs.. Cly fters of Harrowgate water are rccomend-
ed, either of the natural, or of the faftitious,, as defcribed below,,
which might have a greater proportion of hver of fulphur in it.. As
the cold air foon deftroys them, after they are voided, could clyfters
©f iced water be ufed with advantage ? or of fpirit of wine and water?
or of ether and water ? Might not a piece of candle, about an inchi
I ^ long,-

56 DISEASES OF IRRITATION. Class I. i. 4.

long, or two fuch pieces, fmeared with mercurial ointment, and in-
troduced into the anus at night, or twice a day, be efFeftual by com-
prefling their nidus, as well as by the poilbn of the mercury.

The clyllers (houid be large in quantity, that they may pafs high
in the redlum, as two drams of tobacco boiled a minute in a pint of
water. Or perhaps what might be ftill more efficacious and lefs in-
convenient, the fmoke of tobacco injeOied by a proper apparatus every
night, or alternate nights, for fix or eight weeks. This v/as long fince
recommended, I think by Mr. Turner of Liverpool ; ^nd the reafon
it has not fucceeded, I believe to have been owing to the imperfedions
of the joints of the common apparatus for injedting the fmoke of to-
bacco, fo that it did not pafs into the inteftine, though it was fup-
pofed to do fo, as I once obferved. The fmoke (hould be received
from the apparatus into a large bladder ; and it may then be certainly
injeded like the common clyfter with fufficient force ; otherwife oiled
leathers (hould be nicely put round the joints of the machine ; and a
wet cloth round the injedling pipe to prevent the return of the fmoke
by the fides of it. Clyfters of carbonated hydrogen gas, or of other
faditious airs, might be tried.

Harrowgate water taken into the flomach, fo as to induce fix or fevtn
flools every morning, for four or fix weeks, is perhaps the mofl effi-
cacious method in common ufe. A faditious Harrowgate water may
be made probably of greater efficacy than the natural, by difl[blving
one ounce of marine fait, (called bay fait) and half an ounce of mag-
nefia Glauber's fait, (called Epfom fait, or bitter purging fait) hi
twenty-eight ounces of water. A quarter or half a pint of this is to
be taken every hour, or two hours in the morning, till it operates,
with a tea-fpoonful of a folution of liver of fulphur, which is to be
made by putting an ounce of hepar fulphurisjnto half a pint of water.
See Clafs IV. i. 2. 9.

13. Dracunculus. A thin worm brought from the coaft of Guinea.
It is found in the interftices of the mufcles, and is many yards long;

It

Class I. 1.4. DISEASES OF IRRITATION. 57

it makes a fmall ulcer J which is cured by extradling an inch of the
worm a day, and wrapping the extracted part flowly round a bit of
tobacco pipe till next day, fo as not to break it. I have twice feen
long worms, like a thick horfe-hair, in water in July in this country,
which appeared hard and jointed.

14. Morpiones. Crab-lice. The excrement of this animal ftains
the linen, and appears like diluted blood.

M. M. Spirit of wine. Mercurial ointment, fhaving the part.
Oil deftroys other infe^ls, if they be quite covered with it, as the
ticks on dogs, and would probably therefore deftroy thefe. Its man-
ner of operation is by ftopping up or filling their fpiracula, or breath-
ing pores ; a few drops of oil poured on a wafp, fo as to cover it, de-
flroys it in a iew feconds.

15. PedicuH. Lice. There is faid to be a difeafe, in which thefe
animals are propagated in indeftrudible numbers, fo as to deftroy the
patient.

M. M. Cleanlinefs, mercurial ointment, ftavis acria in powder,
or the tincture of it in fpirit of wine. Spirit of wine alone ? Bath
ofoil?

Vol. II. I OR DO

58 DISEASES OF IRRITATION. Class I. 1.5.

ORDO I.

Increafed Irritation..

GENUS V.
With Increafed Adtons of the Organs of Senfe,

SPECIES.

1. Fifus acrior. Acuter fight. There have been inftances of peo-
ple, who could fee better in the gloom of the evening, than in the
ftronger light of the day ; like owls, and bats, and many quadrupeds^
and flying infedls. When the eye is inflamed, great light becomes
eminently painful, owing to the increafed irritative motions of the
retina, and the confequent increafed fenfation. Thus when the eye
is dazzled with fudden light, the pain is not owing to the motion of
the iris_; for it is the contradion of the iris,, which relieves the pain
from fudden light ; but to the too violent contradlions of the moving
fibres, which conftitute the extremities of the optic nerve.

2. Auditus acrior. The irritative ideas of hearing are fo increafed
in energy as to excite our attention. This happens in fome difeafes of
the epileptic kind, and in fome fevers. Hence the whlfpering of the
currents of air in a room, the refpiration of the company, and noifea
before unperceived, become troublefome ; and founds louder than
•ufual, or unexpefted, produce ftarting, and convulfions.

M. M. Put oil of almonds into the ears. Stop the meatus audito-
rius with cotton wool. Set the feet of the patient's bed on cufhions,
or fufpend it by cords from the ceiling,

3. OlfaBus

Class I. 1.5. DISEASES OF IRRITATION. 59

3. OlfaSiiis acrior. The irritative ideas of fmell from the increafed
aftion of the olfa£tive nerve excite our attention. Hence common
odours are difagreeable ; and ' are perceived from variety of objefts,
which vs^ere before thought inodorous. Thefe are commonly believed
to be hallucinations of the fenfe.

M.^M. Snuff ftarch up the noftrils.

4. Gujius acrior. The irritative ideas of tafte, as of our own faliva,
and even of the atmofpheric air, excite our attention ; and common
taftes are difagreeably flrong.

M. M. Water. Mucilage. Vegetable acids. Scrape the tongue
clean. Rub it with a fage-leaf and vinegar.

5. TaSius acrior. The irritative ideas of the nerves of touch excite
our attention : hence our own preflure on the parts, we reft upon,
becomes uneafy with univerfal forenefs.

M. M. Soft feather-bed. Combed wool put under the patients,
which rolls under them, as they turn, and thus prevents their fri£tion
againft the flieets. Drawers of foft leather. Plafters of cerate with
calamy.

6. Senfus caloris acrior. Acuter fenfe of heat occurs in fome
difeafes, and that even wlien the perceptible heat does not appear
greater than natural to the hand of another perfon. See Clafs I. 1.2.
See Sed. XIV. 5. All the above increafed adions of our organs of
fenfe feparately or jointly accompany fome fevers, and fome epileptic
difeafes ; the patients complaining of the perception of the leaft light,
noifes in their ears, bad fmells in the room, and bad tafles in their
mouths, with forenefs, numbnefs, and other uneafy feels, and with
difagreeable fenfations of general or partial heat.

7. Sejtfus extenfionis acrior. Acuter fenfe of extenfion. The fenfe

1 3 of

6o DISEASES OF IRRITATION. Class I. 1.5.

of extenfion was fpoken of in Seft. XIV. 7. and XXXII. 4. The de-
fedi of diftention in the arterial fyflem is accompanied with faintnefs;
and its excefs with fenfations of fulnefs, or weight, or preflure.
This however refers only to the vafcular mufcles, \vhich are diftended
by their appropriated fluids ; but the longitudinal mufcles are alfo af-
fefted by different quantities of extenfion, and become violently pain-
ful by the excefs of it.

Thefe pains of mufcles and of membranes are generally divided into
acute and dull pains. The former are generally owing to increafe of
extenfion, as in pricking the Ikin with a needle ; and the latter gene-
rally to defea^of extenfion, as in cold head-aches ; but if the edge of
a knife, or point of a pin, be gradually preffed againft the fibres of
mufcles or membranes, there would feem to be three ftates or ftao-es
of this extenfion of the fibres; which have acquired names accordino-
to the degree or kind of fenfation produced by the extenfion of them j
thefe are i. titillation or tickling. 2. itching, and the 3. fmartino- ;
as defcribed below. See Seel. XIV. 9^

8. Trfil/atw. Tickling is a pleafureable pain of the fenfe of exten-
fion above mentioned, and therefore excites laughter; as defcribed iii
Se6l. XXXIV. I. 4, The tickling of the noftrils, which precedes the
efforts of fueezing, is owing to the increafed irritation occafioned by
external ftimulus ; and is attended with a pleafureable fenfation in
confequence of the increafed adipn of the part. When this action is
exerted in a greater degree, the fenfation becomes painful, and the
convulfion of fneezing enfues; as the pain in tickling the foles of the
feet of children is relieved by laughter.

A lady after a bruife on her nofe by a fall was affeded with incef-
fant fneezing, and relieved by fnuffing flarch up her noftrils. Per-
petual ineeezings in the meafles, and in catarrhs from cold, are ow=
ing to the ftimulus of the faline part of the mucous eifufion on the
membrane of the noftrils. See Clafs II. 1.1.2.

9. Pruritus.

Class I. 1.5- DISEASES OF IRRITATION. 6i

9. Pruritus. Itching feems to be a greater degree of titillation,
and to be owing to the ftimulus of fome acrid material, as the matter
of the itch ; or of the herpes on the fcrotum, and about the anus ; or
from thofe univerfal eruptions, which attend fome elderly people, who
have drank much vinous fpirit. It occurs alfo, when inflammations
are declining, as in the healing of bliRers, or in the cure of ophthal-
mia, as the aftion of the veHels is yet fo great as to produce fenfation;-
which, like the titillations that occafionlaughter, is perpetually chang-
ing from plealure to pain.

_When the natural efforts of fcratching do not relieve the pain of
itching, it fometimes increales fo as to induce convulfions and mad-
nefs. As in the furor uterinus, and fatyriaiis, and in the fphinfter
ani and fcrotum. See Clals II. 1.4. 14. IV. z. 2.6.

M. M. Warm bath. Fomentation. Alcohol externally. Poul-
tice. Oiled filk. Mercurial ointments on fmall furfaces at once. See
Clafs II. 1.4. 12. Solutions of lead on fmall furfaces at once.

10. Dohr urens. Smarting follows the edge of a knife in making
a wound, and feems to be owing to the diftention of a part of a fibre,
till it breaks. A fmarting of the fkin is liable to afFedl the fears left
by herpes or Ihingles ; and the callous parts of the bottoms of the
feet ; and around the bafes of corns on the toes ; and frequently ex-
tends after fciatica along the outfide of the thigh, and of the leg, and
part of the foot. All thefe may be owing to the flimulus of exten-
fion, by blood or ferum being forced into veffels nearly coalefced.

M. M. Empiaifrum de minio put like a bandage on the part.
Warm fomentation. Oil and camphor rubbed on the part. Oil-filk
covering. A blifler on the part. Ether, or alcohol, fuffered to evapo-
rate on the part.

11. Conjiernatio. Surprife. As our eyes acquaint us at the fame
time with lefs' thair half of the objedls, which furround us, we have

learned

/_

62 DISEASES OF IRRITATION. Class I, 1.5.

learned to confide much in the organ of hearing to warn us of ap-
proaching dangers. Hence it happens, that if any found flrikes us,
which we cannot immediately account for, our fears are inflantly
alarmed. Thus in great debility of body, the louc clapping of a door,
or the fall of a fire-fhovel, produces alarm, and ioiiieames even con-
vulfions ; the fame occurs from unexpeiled {ighis, and in the dark
from unexpedted obje6ls of touch.

In thefe cafes the irritability is lefs than natural,' though it is erro-
neoufly fuppofed to be greater,; and the mind is bufied in exciting a
train of ideas inattentive to external objedts ; when this train of ideas
is diffevered by any unexpefted ftimulus, furprife is excited ; as ex-
plained in Se6t. XVII. 3. 7. and XVIIl, 17. then as the fenfibility
in thefe cafes is greater, fear becomes fuperadded to the furprife; and
convulfions in confequence of the pain of fear. See SeiSt. XIX. 2.

The proximate caufe of furprife is the increafed irritation induced
by fome violent ftimulus, which diflevers our ufual trains of ideas ;
but in difeafes of inirritability the frequent flarting or furprife from
founds not uncommon, but rather louder than ufual, as the clapping
of a door, fhews, that the attention of the patient to a train of fenfi-
tive ideas was previoufly flronger than natural, and indicates an in-
cipient delirium.; which is therefore worth attending to in febrile
difeafes.

ORDO

Class I. 2. i. DISEASES OF IRRITATION. 63

ORDO II.

Decreafed Irritation,

GENUS I.
With decreafed ASlion of the Sanguiferous Syfiem.

'The reader fhould be here apprized, that the words ftreagth and
debiUty, when applied to animal motions, may properly exprefs the
quantity of refinance fuch motions may overcome ; but that, when
they are applied to mean the fufceptibility or infufceptibility of ani-
mal fibres to motion, they become metaphorical terms; as in Sedl.
XII. 2. I. and would be better expreffed by the words activity and
inadlivity.

There are three fources of animal ina£livity ; firft, the defefl of the
natural quantity of ftimulus on thofe fibres, which have been accuf-
tomed to perpetual ftimulus ; as the arterial and fecerning fyflems.
When their accuftomed ftimulus is for a while intermitted, as when
fnow is applied to the fkin of the hands, an accumulation of fenforial
power is produced ; and then a degree of ftimulus, as of heat, fome-
what greater than that at prefent applied, though much lefs than the
natural quantity, excites the veffels of the Ikin into violent acftion.
We muft obferve, that a deficiency of ftimulus in thofe fibres, which
are not fubje£t to perpetual flimulus, as the locomotive mufcles, is
not fucceeded by accumulation of fenfor^l power ; thefe therefore are.
more liable to become permanently inactive after a diminution of fti-
mulus ; as in ftrokes of the pally, this may be called inaftivity from
defeitl of ftimulus.

2. A fecond fource of animal inacStivity exifts, when the fenforial

power in any part of the fyftem has been previoufly exhaufled by vio-

8 " ' lent

64 DISEASES OF IRRITATION. Class I. 2.1/

lent fliniuli ; as the eyes after long expofure to great light ; or the
ftomach, to repeated fpirituous potatien ; this may be termed inac-
tivity from exhauftion of fenforial power. See Se£l. XII. 3. i.

3. But there is a third fource of inadivity owing to the deficient
produdtion of fenforial power in the brain ; and hence ftimuli ftronger
than natural are required to produce the accuftomed motions of the ar-
terial fyftem ; in this cafe there is no accumulation of fenforial power
produced; as in the inadlivity owing to defe£l of ftimulus; nor any
previous exhauftion of it, as in the inactivity owing to excefs of
ftimulus.

This third kind of inaftivity caufes many of the difeafes of this
ge;ius ; which are therefore in general to be remedied by fuch medi-
cines as promote a greater produ6lion of fenforial power in the brain ;
as the incitantia, confifting of wine, beer, and opium, in fmall re-
peated quantities ; and fecondly of fuch as fimply ftimulate the arte-
rial and glandular fyftem into their jnatural a£lions ; as fmall repeated
blifters, fpices, and efiential oils. And laftly the forbentia, which
contribute to fupply the more permanent ftrength of the fyftem, by
promoting the abforption of nouri{hment from the ftomach, and in-
teftines ; and of the fuperfluous fluid, which attends the fecretions.

SPECIES.

I. FebrJs inirrltativa. Inirritative fever. This is the typhus
mitior, or nervous fever of fome writers ; it is attended with weak
pulfe without inflammation, or fymptoms of putridity, as they have
been called. When the produdlion of fenforial power in the brain is
lefs than ufual, the pulfe becomes quick as well as weak ; and the
heart fometimes trembles like the limbs of old age, or of enfeebled
drunkards; and when this force of the contractions of the heart and
arteries is diminiflied, the blood is puflied on with lefs energy, as well

as

Class I. 2. r. DISEx^SES OF IRRITATION. 6^^

as in lefs quantity, and thence its ftimulus on their fides is diminifhed
in a duplicate ratio. In compreffions of the brain, as in apoplexy,
the piilfe becomes flower and fuller ; for in that difeafe, as in natural
lleep, the irritative motions of the heart and arteries are not dirainlfh-
ed, volition alone is fufpended or deflroyed.

If the abforption of the terminations of the veins is not equally im-
paired with the force of the heart and arteries, the blood is taken up
by the veins the inflant it arrives at their extremities ; the capillary
veflels are left empty, and there is lefs refiftance to the current of the
blood from the arteries ; hence the pulfe becomes empty, as well as
weak and quick ; the veins of the Ikin are fuller than the arteries of
it ; and its appearance becomes pale, bluilh, and (hrunk. See Clafs
II. 1.3. I.

When this pulfe perfifts many hours, it conftitutes the febris inirri-
tativa, or typhus, of nervous fever, of fome writers ; it is attended
with little heat, the urine is generally of a natural colour, though in
lefs quantity; with great proftration of ftrength, and much difturb-
ance of the faculties of the mind. Its immediate caufe feems to be a
deficient fecretion of the fenforial power from the inadtion of the
brain ; hence almofl: the whole of the fenforial power is expended in
the performance of the motions neceffary to life, and little of it can
be fpared for the voluntary aftions of the locomotive mufcles, or organs
of fenfe, fee Clafs I. 2. 5. 3. Its more remote caufe may be from a
paralyfis or death of fome other part of the body; as of the fpleen,
when a tumour is felt on the left fide, as in fome intermittents; or
of the kidnies, when the urine continues pale and in fmall quan-
tity. Does the revivefcence of thefe affe6led parts, or their torpor,
recurring at intervals, form the paroxyfms of thefe fevers? and their
permanent revivefcence eftablifh the cure ? See Clafs IV. 2. i. 19.

M. M. Wine and opium in fmall quantities repeated every three
hours alternately ; fmall repeated blifters ; warm but frefh air; for-

VoL. II. K bentia;

66 DISEASES OF IRRITATION. Class I. 2.1.

bentia; nutrientia ; transfufion of blood. Small ele£tric (hocks pafTed
through the brain in all directions. Oxygene air ?

2. Pare/ts m'lrritativa. lairrltative debility. A defective a6llon of
the irritative motions without increafe of the frequency of the pulfe.
It continues three or four weeks like a fever, and then either termi-
nates in health, or the patient finks into one kind of apoplexy, and
perifhes. Many fymptoms, which attend inirritative fevers, accom-
pany this difeafe, as cold hands and feet at periodic times, fcurf on
the tongue, want of appetite, muddy urine, with pains of the head,
and fometimes vertigo, and vomiting.

This difeafe differs from the inirritative fever by the pulfe not being
more frequent than in health. The want of appetite and of digeftion
is. a principal fymptom, and probably is the caufe of the univerfal de-
bility, which may be occafioned by the want of nourifhment. The
vertigo is a fymptom of inirritability, as fliewn in Clafs IV. i. 2. 6.
the muddy urine is owing to increafed abforption from the bladder in
confequence of the diminifhed cutaneous and cellular abforption, as
in anafarca, explained in Seft. XXIX. 5. i. and is therefore a confe-
quence of the inirritability of that part of the fyftem ; the foul tongue
is owing to an increafed abforption of the thinner part of the mucus
in confequence of the general deficiency of fluid, which fhould be ab-
forbed by the fkin and flomach. The ficknefs is owing to decreafed
adion of the flomach, which is probably the primary difeafe, and is
connected with the vertigo.

M. M. An emetic. Calomel, grains iv. once or twice. Then a
blifter. Peruvian bark. Valerian. Columbo. Steel. Opium and
wine in fmall quantities, repeated alternately every three hours. Small
eledlric percufTions through the flomach.

3. Somnus interruptus. Interrupted fleep. In fome fevers, where
the inirritability is very great, when the patient falls afleep, the pulfe

in

Class I. 2. i. DISEASES OF IRRITATION. 67

in a few minutes becomes irregular, and the patient awakes in great
diforder, and fear of dying, refufing to fleep again from the terror of
this uneafy fenfation. In this extreme debility there is reafon to be-
lieve, that fome voluntary power during our waking hours is employed
to aid the irritative flimuli in carrying on the circulation of the blood
through the lungs ; in the fame manner as we ufe voluntary exertions,
when we liften to weak founds, or wilh to view an obje6t by a fmall
light ; in fleep volition is fufpended, and the deficient irritation alone
is not fufficient to carry on the pulmonary circulation. This expla-
nation feems the mdfl probable one, becaufc in cafes of apoplexy the
irritative motions of the arterial fyftem do not feem to be impaired,
nor in common fleep. See Incubus III. 2. i. 13.

M. M. Opium in very fmall dofes, as three drops of laudanum.
A perfon fhould watch the patient, and awaken him frequently ; or
he fhould meafure the time between flumber" and flumber by a flop-
watch, and awaken the patient a little before he would otherwife
j^wake ; or he fliould keep his finger on the pulfe, and fliould forcibly
awaken him, as foon as it becomes irregular, before the diforder of
the circulation becomes fo great as todiflurb him. See Clafs I. 2. i. 0.
and Sea. XXVII. 2.

4. Syncope. Fainting confifls in the decreafed action of the arterial
fyftem ; which is fometlmes occafioned by defed of the ftimulus of
diftention, as after venefe£lion, or tapping for the dropfy. At other
times it arifes from great emotions of the mind, as in fudden joy or
grief. In thefe cafes the whole fenforial power is exerted on thefe in-
terefting ideas, and becomes exhaufted. Thus during great furprife
or fear the heart flops for a time, and then proceeds with throbbii\o-
and agitation ; and fbmetimes the vital motions become fo deranged,
as never to recover their natural luccefiive adion ; as when children
have been frightened into convulfions. See Sedl. XII. 7. i.

K 2 Mifs

68 DISEASES OF IRRITATION. Class I. 2.1,

Mifs , a young lady of Stafford, in travelling in a chalfe was-

fo affedled by feeing the fall of a horfe and poftillion, in going down a
hill, though the carriage was not overturned, that fhe fainted away,
and then became convulfed, and never fpoke afterwards; though fhe
lived about three days in fucceffive convulfions and flupor.

5. Hcemorrhagia venofa. A bleeding from the capillaries arifing
from defeft of venous abforption, as in lome of thofe fevers common-
ly termed putrid. When the blood ftagnates in the cellular mem-
brane, it produces pet-echiae from this torpor or paralyfis of the abforb-
ent mouths of the veins. It muft be obferved, that thofe people who
have difeafed livers, are more liable to this kind of hemorrhages, as
well as to the hijemorrhagia arteriofa ; the former, becauie patients
with difeafed livers are more fubjeft to paralytic complaints in general,
as to hemiplegia, and to dropfy, which is a paralyfis of the lympha-
tics ; and the latter is probably owing to the delay of the circulation in
the vena porta by the torpor of this hepatic veflel, when the liver is
not much enlarged ; and to its preiTure on the vena cava, when it is
much enlarged.

M. M. Vitriolic acid, opium, fleel, bark. Sponge bound on the
part. Steel difllblved in fpirit of wine externally. Flour,

6. Hamorrhols crUenta-. In the bleeding piles the capillary velTels
of the re<5lum become diflended and painful from the defeft of the
venous abforption of the part, and at length burft ; or the mucous
glands are fo dilated as to give a paffage to the blood ; it is faid to ob-
ferve lunar periods. -

M. M. Venefe£lion, poultices, cathartics, fpice, cold bath, and
forbentia. External compreflion by applying lint, fponge, or cotton.
Internal compreflion by applying a bit of candle fmeared with mercu-
rial ointment. Strangulate the tumid piles with a filk firing. Cut

them oiF. See Ciafs I. 2. 3. 22.

Mrs.

Class I. 2. i. DISEASES OF IRRITATION. 69

Mrs. had for twelve or fifteen years, at intervals of a year or

lefs, a bleeding from the redum without pain ; which however flop-
ped fpoiitaneoufly after {he became weakened, or by the ufe of injec-
tions of brandy and water. Lately the bleeding continuqd above two
months, in the quantity of many ounces a day, till (he became pale
and feeble to an alarming degree. Injedlions of folutions of lead, of
bark and fait of il:eel, and of turpentine, with fome internal aftfingents,
and opiates, were ufed in vain. An injeftion of the fmoke of tobacco,
with ten grains of opium mixed with the tobacco, was ufed, but
without efFe£l the two firft times on account of the imperfedion of
the machine; on the third time it produced great ficknefs, and verti-
go, and nearly a fainting fit ; from which time the blood entirely
flopped. Was this owing to a fungous excrefcence in the recSum;
or to a blood-veflel being burft from the difficulty of the blood pafling
through the vena porta from fome hepatic obftrudlion, and which had
continued to bleed fo long? Was it flopped at laft by the fainting
fit ? or by the ftimulus of the tobacco ?

7. Hcemorr/jagia renum. Haemorrhage from the kidiiies, when at-
tended with no pain, is owing to defeft of venous abforption in the
kidney. When attended with pain on motion, it is owing to a bit of
gravel in the ureter or pelvis of the kidney ; which is a much more
frequent difeafe than the former. See Se6t. XXVII. i.

M. M. I. Venefedlion in fmall quantity, calomel, bark, fteel, an
opiate ; cold immerfion up to the navel, the upper part of the body
being kept cloathed. Neville-Holt water. 2. Alcalized water aerated.
Much diluent liquids. Cool drefs. Cool bed-room.

Cows are much fubjeft to bloody urine, called foul water by the
farmers ; in this difeafe about fixty grains of opium with or without &^
much ruft of iron, given twice a day, in a ball mixed with flour and
water, or diffolved in warm water, or warm ale, is, I believe, an

8 efficacious

70 DISEASES OF IRRITATION. Class I. 2. i.

efficacious remedy, to which however fliould be added about two quarts
of barley or oats twice a day, and a cover at night, if the weather be cold.

8. HcemorrhagiaHepatis. Haemorrhage from the liver. It fome-
times happens in thofe, who have the gutta rofea, or paralytic affec-
tions owing to difeafed livers induced by the potation of fermented
liquors, that a great difcharge of black vifcid blood occafionally comes
away by flool, and fometimes by vomiting : this the ancients called
Melancholia, black bile. If it was bile, a fmall quantity of it would
become yellow or green on dilution with warm water, which was
not the cafe in one experiment which I tried ; it mufi: remain
fome time in the inteftines from its black colour, when it paffes down-
wards, and probably comes from the bile-dufts, and is often a fatal
fymptom. When it is evacuated by vomiting it is lefs dangerous, be-
caufe it fliews greater remaining irritability of the inteftinal canal,
and is fometimes falutary to thofe who have difeafed livers.

M. M. An emetic. Rhubarb, fleel, wine, bark.

9. Mcemoptoe venofa. Venous h^moptoe frequently attends the be-
o-inning of the hereditary confumptions of dark-eyed people; and in
others, vvhofe lungs have too little irritabihty. Thefe fpittings of
blood are generally in very fmall quantity, as a tea-fpoonful; and re-
turn at firft periodically, as about once a month ; and are lefs danger-
ous in the female than in the male fek ; as in the former they are often
relieved by the natural periods of the menfes. Many of thefe patients
are attacked with this pulmonary hzemorrhage in their firft fleep ; be-
caufe in feeble people the power of volition is neceffary, befides that
of irritation, to carry on refpiratlon perfedly ; but, as volition is fuf-
pended during fleep, a part of the blood is delayed in the veffels of the
lungs, and in confequence efFufed, and the patient awakes from the
difagreeable fenfation. See Clafs I. 2. i. 3. II. i. 6. 6. III. 2. i. 10.

M. M. Wake

Class I. 2. r. DISEASES OF IRRITATION. 71

M. M. Wake the patient every two or three hours by an alarum
clock. Give half a grain of opium at going to bed, or twice a day.
Onions, garlic, flight chalybeates. Iflues. Leeches applied once a
fortnight or month to the hemorrhoidal veins to produce a new habit.
Emetics after each period of h2emoptoe, to promote expedoration, and
diflodge any efFufed blood, which might by remaining in the lungs
produce ulcers by its putridity. A hard bed, to prevent too found
fleep. A periodical emetic or cathartic once a fortnight.

10. Palpitatio cordis. The palpitation of the heart frequently at-
tends the hsemoptoe above mentioned ; and confifls in an ineffedlual
exertion of the heart to pufli forwards its contents in due time, and
with due force. The remote caufe is frequently fome impediment to
the general circulation ; as the torpor of the capillaries in cold pa-
roxyfms of fever, or great adhefions of the lungs. At other times it
arifes from the debility of the adion of the heart owing to the deficient
fenforial power of irritation or of alTociation, as at the approach of
death.

In both thefe cafes of -weak exertion the heart feels large to the
touch, as it does not completely empty itfelf at each contradion ; and
on that account contradls more frequently, as defcribed in Se«£t,
XXXII. 2 2. Another kind of palpitation may fometimes arife from
the retrograde motions of the heart, as in fear. See Clafs I. 2. 1.2.
and IV. 3.1.6.

1 1 . Menorrhagia. Continued flow of the catamenia. The
monthly efFufion of blood from the uterus or vagina is owing to a tor-
por of the veins of thofe membranes in confequence of the defedl of
venereal ftimulus ; and in this refped refembles the mucus difcharo-ed
in the periodical venereal orgafm of the female quadupeds, which are
fecluded from the males. The menorrhagia, or continued flow of

I this

72 DISEASES OF IRRITATION. GlassT. 2. i.

this difcharge, is owing to a continued defe6t of the venous abforptioii
of the naenibranes of the uterus or vagina. See Clafs IV. 2. 4. 7.

Mi M. Venefe£tion in fnriall quantity. A cathartic. Then
opium, a grain every night. Steel. Bark. A blifler. Topical af-
perfion with cold water, or cold vinegar.

r2. Dyfmenorrhagia. A difficulty of menflruation attended with
pain. In this complaint the torpor of the uterine veffels, which pre-
cedes menftruation, is by fympathy accompanied with a torpor of the
lumbar membranes, and confequen.t,-.pain ; and frequently with cold
extremities, and general debility. The fmall quantity and difficulty,
of the difcharge is owing to arterial inaftivity, as in chloroiis.
Whence it happens, that chalybeate medicines are of efficacy both to
flop or prevent too great menflruation, and to promote or increafe
deficient menflruation ; as the former is owing to inirritability of the
veins, and the latter of the arteries of the uterus. See Article IV. 2. 6«
in the Materia Medica.

M. M. Opium, fteel, pediluvium. Warm bath.

13. Lochia nimia. Too great difcharge after delivery. In that
unnatural pradlice of fome hafly accoucheurs of introducing the hand
into the uterus immediately after the delivery of the child, and forci-
bly bringing away the placenta, it frequently happens, that a part of
■ it is left behind ; and the uterus, not having power to exclude fo fmall
a portion of it, is prevented from complete contradlion, and a great
haemorrhage enfues. In this circumftance a bandage with a thick
comprefs on the lower part of the belly, by appreffing the fides of the
uterus oh the remaining part of the placenta, is likely to check the
haemorrhage, like the application of a pledget of any foft fubftance on
a bleeding velTel.

In other cafes the lochia continues too long, or in too great quantity,
owing to the deficiency of venous abforption.

M. M. An

Class!. 2. i. DISEASES OF IRRITATION. 73

' M. M. An enema. An opiate. A blifter. Slight chalybeates.
JPeruvian bark. Clothes dipped in cold vinegar and applied externally.
Bandages on the limbs to keep niore blood in them for a time hav^
been recommended.

14. Abortio fpontanea. Some delicate ladies are perpetually liable
to fpontaneous abortion, before the third, or after the feventh, month
of geftation. From fome of thefe patients I have learnt, that they ,
have awakened with a flight degree of difficult refpiration, fo as to in-
duce them to rife haftily up in bed ; and have hence fufpedled, that
this was a tendency to a kind of afthma, owing to a deficient abforp-
tion of blood in the extremities of the pulmonary or bronchial veins ;
and have concluded from thence, that there was generally a deficiency
of venous abforption ; and that this was the occafion of their frequent
abortion. Which is further countenanced, where a great fanguinary
difcharge precedes or follows the exclufion of the fetus.

M. M. Opium, bark, chalybeates in fmall quantity. Change to
a warmer climate. 1 have dire«n:ed with fuccels in four cafes half a
grain of opium twice a day for a fortnight, and then a whole grain
twice a day during the whole geftation. One of thefe patients took
befides twenty grains of Peruvian bark for feveral weeks, '^y thefe
means being exadly and regularly perfifted in, a new habit became
eftabliflied, and the ufual mifcarriages were prevented.

Mifcarriages more frequently happen from eruptive fevers, and from
rheumatic ones, than from other inflammatory difeafes. I faw a mofl
violent pleuriiy and hepatitis cured by repeated venefeiftion about a
week or ten days before parturition ; yet another lady whom I attend-
ed, mifcarried at the end of the chicken pox, with which her chil-
dren were at the fame time affedled. Mifcarriages towards the ter-
mination of the fmall pox are very frequent, yet there have been a
it"^ inftances of children, who have been born with the eruption on
them. The blood in the fmall pox will not inoculate that difeafe, if
Vol. II. L taken

74 DISEASES OF IRRITATION. Class I. 2. i.

taken before the commencement of the fecondary fever ; as fliewn in
Seel. XXXIII. 2. 10. becaufe the contagious matter is not yet formed,
but after it has been oxygenated through the cuticle in the puftules, it
becomes contagious ; and if it be then abforbed, as in the fecondary
fever, the blood of the mother may become contagious, and infe£t
the child. The fame mode of reafoning is applicable to the chicken
pox. See Clafs IV. 3. i, 7.

15. Scarbutus. Sea-fcurvy is caufed by fait diet, the perpetual
ftimiilus of which debilitates the venous and abforbent fyftems.
Hence the blood is imperfectly taken up by the veins from the capil-
laries-, whence brown and black fpots appear upoh the fkin without
fever. The limbs become livid and edematous, and laftly ulcers are
produced from deficient abforption. See Se£l. XXXIII. 3, 2. and
Clafs II. I. 4. 13. For an account of the fcurvy of the lungs, fee
Sea. XXVII. 2.

M. M. Frefli animal and vegetable food. Infufion of malt. New
beer. Sugar. Wine. Steel. Bark. Sorbentia. Opium ?

16. Vtbices. Extravafations of blood become black from their bein»^
fecluded from the air. The extravafation of blood in bruifes, or in fome
fevers, or after death in fome patients, efpecially in the parts which
were expofed to preflure, is owing to the fine terminations of the
veins having been mechanically comprefTed fo as to prevent their ab-
forbing the blood from the capillaries, or to their inadivity froni,
difeafe. The blood when extravafated undergoes a chemical change
before it is fufficiently fluid to be taken up by the lymphatic abforb-
ents, and in that procefs changes its colour to green and then yellow.

1 7. Petechice, Purple fpots. Thefe attend fevers with great
venous inirritability, and are probably formed by the inability of a
(ingle termination of a vein., whence the correfponding capillary be-
comes

Class I. 2. i. DISEASES OF IRRITATION. 75

comes ruptured, and efFufes the blood into the cellular membrane
round the inert termination of the vein. This is generally efleemed a
fign of the putrid ftate of the blood, or that ftate contrary to the in-
flammatory one. As it attends feme inflammatory difeafes which are
attended with great inirritability, as in the confluent fmall pox.
But it alfo attends the fcurvy, where no fever exifts, and it therefore
limply announces the inaftivity of the terminations of fome veins ;
and is thence indeed a bad fymptom in fevers, as a mark of approach-
ing inactivity of the whole fanguiferous fyflem, or death. The blue
colour of fome children's arms or faces in very cold weather is owing
in like manner to the torpor of the abforbent terminations of the
veins, whence the blood is accumulated in them^ and fometimes burfts
them.

L2 QRDO

76 DISEASES OF IRRITATION, Class I. 2,. a,

ORDO IL

Decreafed Irritation.

GENUS II.
Decreafed Adion of the Secerning Syfiem.

These are always attended with decreafe of partial, or of general
heat ; for as the heat of animal bodies is the coaiequence of their va-
rious fecretions, and is perpetually pafling away into the ambient air,
c.r other bodies in contadl with them ; when thefe fecretions become
diminiflied, or ceafe, the heat of the part or of the whole is foon di-
miniHied, or ceafes along with them.

SPECIES.

I. Frigus febrile. Febrile coldnefs. There is reafon to believe,
that the beginning of many fever-fits originates in the quiefcence of
fome part of the abforbent fyftem, efpecially where they have been
owing to external cold ; but that, where the coldnefs of the body is-
not owing to a diminution of external beat, it arifes from the inaction
of fome part of the fecerning fyftem. Hence fome parts of.the body
are hot whilft other parts are cold; which I fuppofe gave occafioii
to error in Martyn's Experiments; where he fays, that the body is.
as hot in the cold paroxyfms of fevers as at other times.

After the fenforial power has been much diminifhed by great pre-
ceding aftivity of the fyflem, as by long continued external heat, or
violent exercife, a fudden expofure to much cold produces a torpor
both greater in degree and over a greater portion of the fyftem, by

fubtrading

Class I. 2.2. DISEASES OF IRRITATION. 77

fubtrailing their accuftomed ftimulus from parts already much de-
prived of their irritability. Dr. Franklin in a letter to M. Duberge,
, the French tranflator of his works, mentions an inftance of four youno-
men, who bathed in a cold fpring after a day's harveft work ; of
■whom two died on the fpot, a third on the next morning, and the
other furvived with difficulty. Hence it would appear, that thofe,
who have to travel in intenfely cold weather, will fooner perifh, who
have previoufly heated themfelves much with drams, than thofe who
have only the ftimulus of natural food; of which I have heard one
well attefted inftance. See Article VII. 2. 3. Clafs III. 2. i. \n.

Frtgus chronkum. Permanent coldnefs. Coldnefs of the extremi-
ties, without fever, with dry pale fkin, is a fymptom of general de-
bility, owing to the decreafed adion of the arterial fyftem, and of the
capillary veilels; whence the perfpirable matter is fecreted in lefs
quantity, and in confequence the fkm is lefs warm. This coldnefs is
obfervable at the extremities of the limbs, ears, and nofe, more than in
any other parts : as a larger furface is here expofed to the contact of
the air, or clothes, and thence the heat is more haftily carried away.

The pain, which accompanies the coldnefs of the fkin, is owino- to
the deficient exertion of the fubcutaneous veflels, and probably to the
accumulation of fenforial power in the extremities of their nerves.
See Sea. XII. 5. 3. XIV. 6. XXXIl. 3. and Clafs I. 2. 4. i.

M. M. A blifter. Incitantia, nutrientia, ibrbentia. Exercife,
Clothes. Fire. Joy. Anger.

2. Pallor fiigitivus: The fugitive palenefs, which accompanies
the coldnefs of the extremities, is owing to a lefs quantity. of blood
pafling through the capillaries of the ikin in a given time ; where the
abforbent power of the veins is at the fame time much diminifhed, a
part of the blood lingers at their jundlion with the capillary arteries^
and a bluifh tinge is mixed with the palenefs ; as is feen in the loofe
. ._ Ikia

yS DISEASES OF IRRITATION. Class I. 2. 2.

Ikin under the eye-lids, and is always a mark of temporary debility-
See Clafs II. I. 4. 4. Where the paleneis of the Ikin is owing to the
deficiency of red globules in the blood, it is joined with a yellowifh
tinge; which is the colour of the ferum, with which the blood then
abounds, as in chlorofis, and in torpor or paralyfis of the liver, and
is often miftaken for a fuperabundance of bile.

A permanent palenefs of the fkin is owing to the coalefcence of the
minute arteries, as in old age. See Clafs I. 2. 2. 9. There is another
fource of palenefs from the increafed abforption of the terminations of
the veins, as when vinegar is applied to the lips. See Se<fl. XXVII. i.
and another from the retrograde motions of the capillaries and fine
extremities of the arteries. See Clafs II. 3. i. i.

M. M. A blifter, nutrientia, incitantia, exercife, oxygene gas.

3. Pus parcius. Diminiflied pus. Drynefs of ulcers. In the cold
fits of fever all the fecretions are diminifhed, whether natural or arti-
ficial, as their quantity depends on the adtions of the glands or capil-
laries, which then fhare in the univerfal inaclion of the fyftem.
Hence the drynefs of iflues and blifters in great debility, and before
the approach of death, is owing to deficient fecretion, and not to in-
creafed abforption.

M. M. Opium, wine in very fmall quantities, Peruvian bark.

4. Mucus parcior. Diminiflied mucus. Drynefs of the rnouth
and noflrils. This alfo occurs in the cold fits of intermittents. In
thefe cafes I have alfo found the tongue cold to the touch of the fin-
ger, and the breath to the back of one's hand, when oppofed to it,
which are very inaufpicious fymptoms, and generally fatal. In fevers
with inirritability it is generally efleemed a good fymptom, when the
noftrils and tongue become moift after having been previoufly dry; as
it fhews an increafed aftion of the mucous glands of thofe membranes,
which were before torpid. And the contrary to this is the facies

I Hippocraticaj

Class I. 2. 2. DISEASES OF IRRITATION. 79

Hippocratica, or countenance fo well defcribed by Hippocrates,
which is pale, cold, and flirunk; all which are owing to the
inactivity of the fecerning veffels, the palenefs from ther« being
lefs red blood paffing through the capillaries, the coldnefs of the Ikin
from there being lefs fecretion of perfpirable matter, and the fhrunk.
appearance from there being lefs mucus fecreted into the cells of the
cellular membrane. See Clafs IV. 2. 4. 11.
M. M. Blifters. Incitantia.

5. Urina parcior pallida. Paucity of pale urine, as in the cold fits
of intermittents; it appears in fome nervous fevers throughout the
whole difeafe, and feems to proceed from a palfy of the kidnies ;
which probably was the caufe of the fever, as the fever fometimes
ceafes, when that fymptom is removed : hence the ftraw-coloured

, urine in this fever is fo far falutary, as it fhews the unimpaired adion
of the kidnies.

M. M. Balfams, eflential oil, afparagus, rhubarb, a blifter. Can-
th arides, internally .

6. Torpor hepatlcus. Paucity of bile from a partial ina<3:ion of the
liver ; hence the bombycinous colour of the fkin, grey ftools, urine
not yellow, indigeftion, debility, followed by tympany, dropfy, and
death.

This paralyfis or inirritabillty of the liver often deftroys thofe who
have been long habituated to much fermented liquor, and have fud-
denly omitted the ufe of it. It alfo deftroys plumbers, and houfe-
painters, a;nd in them feems a fubftitute for the colica faturnina. See
Se6t. XXX.

M. M. Aloe and calomel, then the hark, and chalybeates. Mer-
curial ointment rubbed on the region of the liver. Rhubarb,, three
or four grains, with opium half a grain to a grain twice a day. Equi-
tation, warm bath for half ail hour every day.

7. Torpor

8o DISEASES OF IRRITATION. Class I. 2. 2.

7. Torpor Pancreatis. Torpor of the pancreas. I law what I
■conjedured to be a' tumour of the pancreas with indigeftion, and
which ternainated in the death of the patient. He had been for many
years a great confumer of tobacco, infomuch that he chewed^ that
noxious drug all the morning, and fmoaked it all the afternoon. As
the fecretion from the pancreas reiembles faliva in its general'appear-
ance, and- probably in its office of aflifting digeftion, by preventing
the fermentation of the aliment ; as would appear by the experiments
of Pringle and Macbride ; there is reafon to i\i('^e.Cc, that a fympathy
may exift between the falivary and pancreatic glands ; and that the
perpetual ftimulus of the former by tobacco might in procefs of time
injure thd latter. See Tobacco, Article III. 2. 2.

S. Torpor rents. Inirritability or paralyfis of the kidnies is proba-
bly frequently miftaken for gravel in them. Several, who have lived
rather intemperately in refpeft to fermented or fpirituous liquors, be-
come fuddenly feized about the age of fixty, or later, with a total
f!:oppage of urine; though they have previoufly had no fymptoms of
gravel. In thefe cafes there is no water in the bladder ; as is known
by the introdu6lion of the catheter, of which thofe made of elafliic
gum are faid to be preferable to metallic ones ; or it may generally be
known by the fhape of the abdomen, either by the eye or hand.
Bougies and catheters of elaftic gum are fold at N° 37, Red Liou-
ftreet, Holborn, London.

M. M. Eleftric fhocks, warm bath. Emetics. See calculus renis,
Clafs I. 1.3. 9. When no gravel has been previoufly obferved, and
the patient has been a wine-drinker rather than an ale-drinker, the
cafe is generally owing to inirritability of the tubuli uriniferi, and is
frequently fatal. See Clafs I. 2. 4. 20.

g. Pun^ce mucofee vultus. Mucous fpots on the face. Thefe are

owing

Class I. 2.2. DISEASES ^F IRRITATION. 8i

owing to the inaftivity of the excretory dufts of the mucous glands ;
the thinner part of this fccretion exhales, and the remainder becomes
infpiffated, and lodges in the du£l ; the extremity of which becomes
black by expofure to the air.

M. M. They may be preffed out by the finger-nails. Warm
water. Ether frequently applied. Blifter on the part ?

10. Macule^ cutis fiihce. Morphew or freckles. Tawny blotches
on the fkin of the face and arms of elderly people, and frequently on
their legs after flight eryfipelas. The freckles on the face of you nger
people, who have red hair, feem to be a fimilar produdion, and feem
all to be caufed by the coalefcence of the minute arteries or capillaries
of the part. In a fear after a wound the integument is only opake;
but in thefe blotches, which are called morphew and freckles, the
fmall vefTels feem to ^lave become inadlive with fome of the ferum of
the blood flagnating in them, from whence their colour. See Clafs III.

I. 2. 12. .

M. M. Warm bathing. A blifter on the part ?

1 1. Canities. Grey hair. In the injedion of the veflels of animals
for the purpofes of anatomical preparations, the colour of the injeded
fluid will not pafs into many very minute vefiels ; which neverthelefs
uncoloured water, or fpirits, or quickfilver will permeate. The fame
occurs in the filtration of fome coloured fluids through paper, or very
fine fand, where the colouring matter is not perfedly dilTolved, but

-only difFu fed through the liquid. This has led fome to imagine, that
the caufe of the whitenefs of the hair in elderly people may arife
from the diminution, or greater tenuity, of the glandular vefTels,
which fecrete the mucus, which hardens into hair ; and that the fame
difference of the tenuity of the lecerning veflTels may poffibly make
the difference of colour of the filk from different filk-worms, which
is of all Ihades from yellow to white.

Vol, II. M But

82 DISEASES OF IRRITATION. Class I. 2. z. '

But as the fecreted fluids are not the coiifequence &f mechanical fil-
tration, but of animal feleSion j we muft look out for another caufe,
which muft be found ia the decreafing adivity of the glands, as we
advance in life; and which affefts many of our other fecretions as
well as that of the mucus, which forms the hair. Hence grey hairs
are produced on the faces of horfes by whatever injures the glands at
their roots, as by corrofive blifters ; and frequently on the human fub-
je6l by external injuries on the head ; and fometimes by fevers. And
as the grey colour of hair coniifts in its want of tranfparency, like
water converted into fnO'W ; there is reafon to fuppofe, that a defect
of fecreted moiflure fimply may be the caufe of this kind of opacity,
as explained in Catarafta, Clafs I. 2. 2. 13.

M. M. Whatever prevents the inirrltability and infenfibility of the
fyftem, that is, whatever prevents the approach of old age, will fo
far counteraft the produftion of grey hairs, which is a fy mptom of it.
For this purpofe in people, who are not corpulent, and perhaps ia
thofe who are fo, the warm bath twice or thrice a week is particular-
ly ferviceable. See Se6l. XXXIX. 5. i. on the colours of animals,
and Clafs I. i. 2. 15.

12. Callus. The callous Ikin on the hands and feet of laborious
people is owing to the extreme veffels coalefcing from the perpetual
preffure they are expofed to.

As we advance in life, the finer arteries lofe their power of adion,
and their fides grow together; hence the palenefs of the Ikrns of
elderly people, and the lofs of that bloom, which is owing to the nu-
merous fine arteries, and the tranfparency of the Ikin, that enclofes

them.

M. M. Warm bath. Paring the thick Ikin with a knife.

Smoothing it with a pumice flone. Cover the part with oiled filk to

prevent the evaporation of the perfpirable matter, and thus to keep it

moid.

13. CataraBa,.

Class I. 2. 2. DISEASES OF IRRITATION. 83

13. CataraEla is an opacity of the cryftalline lens of the eye. It is
a difeafe of light-coloured eyes, as the gutta ferena is of dark ones.
On cutting off with fciffars the cornea of a calf's eye, and hold-
ing it in the palm of one's hand, fo as to gain a proper light, the ar-
tery, which fupplies nutriment to the cryftalline humour, is eafily
and beautifully feen ; as it rifes from the centre of the optic nerve
through the vitreous humour to the cryftalline. It is this point,
where the artery enters the eye through the cineritious part of the
optic nerve, (which is in part near the middle of the nerve^) which is
without fenfibility to light ; as is (liewn by fixing three papers, each
of them about half an inch in diameter, againft a wall about a foot
diftant from each other, about the height of the eye ', and then look-
ing at the middle one, with one eye, and retreating till you lofe fight
of one of the external papers. Now as the animal grows older, the
artery becomes lefs vifible, and perhaps carries only a tranfparent fluid,
and at length in fome fubjefts I fuppofe ceafes to be pervious ; then it
follows, that the cryftalline lens, lofing fome fluid, and gaining none,
becomes dry, and in confequence opake ; for the fame reafon, that
wet or oiled paper is more tranfparent than when it is dry, as explain-
ed in Clafs I. 1.4. i. The want of moifture in the cornea of old
people, when the exhalation becomes greater than the fupply, is the
caufe of its want of tranfparency ; and which like the cryftalline gains
rather a milky opacity. The fame analogy may be ufed to explain the
whitenefs of the hair of old people, which lofes its pellucidity alono-
with its moifture. See Clafs I. 2. 2. 11.

M. M. Small eledric ftiocks through the eye. A quarter of a
grain of corrofive fublimate of mercury dlflblved in brandy, or taken in
a pill, twice a day for fix weeks. Couching by depreffion, or by ex-
tradiou. The former of thefe operations is much to be preferred to
the latter, though the latter is at this time fo faftiionable, that a fur-
geon is almoft compelled to ufe it, left he ftiould not be thoucrht an
expert operator. For depreffing the catarad is attended with nopain,

M 2 no

84 DISEASES OF IRRITATION. Class I. 2. 2,

no danger, no confinement, and may be as readily repeated, if the
cryftalline fhould rife again to the centre of the eye. The extradion
of the catarafl: is attended with confiderable pain, with long confine-
ment, generally with fever, always with inflammation, and frequently
with irreparable injury to the iris, and confequent danger to the whole
eye. Yet has this operation of extradlion been trumpeted into univer-
fal fafliion for no other reafon but becaufe it is difficult to perform, and
therefore keeps the bufinefs in the hands of a few empyrics, who re-
ceive larger rewards, regardlefs of the hazard, which is encountered
by the flattered patient,

A friend of mine returned yefterday from London after an abfence
of many weeks ; he had a cataract in a proper ftate for the operationy
and in fpite of my earnefl: exhortation to the contrary, was prevailed
upon to have it extrafted rather than depreffed. He was confined to
his bed three weeks after the operation, and is now returned with the
iris adhering on one fide fo as to make an oblong aperture ; and which
is nearly, if not totally, without contradlion, and thus greatly impedes
the little vifion, which he poffeffes. Whereas I faw fome patients
couched by depreffion many years ago by a then celebrated erapyric,
Chevalier Taylor, who were not confined above a day or tv/o, that
the eye might gradually beaccuftomed to light, and who faw as well
as by extradlion, perhaps better, without either pain, or inflammation^
or any hazard of lofing the eye.

As the inflammation of the iris is probably owing to forcino- the
cryftalline through the aperture of it in the operation of extrading it,
could it not be done more fafely by making the opening behind the iris
and ciliary procefs into the vitreous hum.our ? but the operation' would
ftill be more painful, more dangerous, and not more ufeful than that
by depreffing it.

14. Innutritto ojfmm. Innutrition of the bones. Not only the
bleed elFufed in vibices and petechia, or from bruifes, as well as the

blood

Class I. 2. 2. DISEASES OF IRRITATION. 85

blood and new veffels in inflamed parts, are reabforbed by the increaf-
ed adion of the lymphatics; but the harder materials, which confti-
tute the fangs of the firil fet of teeth, and the ends of exfoliating
bones, and fometimes the matter of chalk-flones in the gout, the co-
agulable lymph, which is depofited on the lungs, or on the mufcles
after inflammation of thofe parts, and which frequently produces dif-
ficulty of breathing, and the pains of chronic rheumatifm, and lafily
the earthy part of the living bones are diffolved and abforbed by the
increafed adtions of this fyftem of veffels. See Se£l. XXXIII. 3. i.

The earthy part of bones in this difeafe of the innutrition of them
feems to fufFer a folution, and reabforption ; while the fecerning vef--
fels do not fupply a lufficient quantity of calcareous earth and phof-
pharic acid, which conftitute the fubflance of bones. As calcareous
earth abounds every where, is the want of phofphoric acid the remote
caufe ? One caufe of this malady is given in the Philofophic Traiif-
. adions, where the patient had been accuftomed to drink large quan- ■
titles of vinegar.- Two cafes- are defcribed by Mr. Gouch. In one
cafe, which I law, a conliderable quantity of calcareous earth, and
afterwards of bone-alhes,- and of decoftion of madder, and alfo of
fublimate of mercury, were given without efFe£t. All the bones be-
came foft, many of them broke, and the patient feemed to die from
the want of being able to diifend her cheft owing to the foftnefs of
the ribs.

M. M. Salt of urine, called fal microcofmicum, phofphorated
foda. Calcined hartfhorn. Bone-a(hes. Hard or petrifying water, .
as that of Matlock, or fuch as is found in all limeftone or marly
countries. The calcareous earth in thefe waters might pollibly be
carried to the bones, as madder is known to colour them. Warm
bath. Volatile or fixed alcali as a lotion on the fpine, or effential
oils.

The innutrition of the bones is often firft to be perceived by the
difficulty of breathing and palpitation of the heart on walking a little

fafter

86 DISEASES OF IRRITATION. Class I. 2. 2,

fader than ufual, which I fuppofe is owing to the foftnefs of the ends
of the ribs adjoining to the fternum; on which account they do not
perfedtly diftend the cheft, when they are raifed by the pe£toral and
intercoftal mufcles with greater force than ufual. After this the fpine
becomes curved both by the foftnefs of its vertebrae, and for the pur-
pofe of making room for the difturbed heart. See Species 16 of this
genus.

As thefe patients are pale and weak, there would feem to be a de-
ficiency of oxygene in their blood, and in confequence a deficiency of
phofphoric acid ; which is probably produced by oxygene in the adl of
refpiration. ■ .

Mr. Bonhome in the Chemical Annals, Auguft, 1793, fuppofes
the rickets to arife from the prevalence of vegetable or acetous acid,
which is known to foften bones out of the body. Mr. Dettaen feems
to have efpoufed a fimilar opinion, and both of them in confequence
give alcalies and teftacea. If this theory was juft, the foft bones of
fuch patients fliould fliew evident marks of fuch acidity after death ;
which I believe has not been obferved. Nor is it analogous to other
animal fads, that nutritious fluids fecreted by the fineft veffels of the
body fhould be fo little animalized, as to retain acetous or vegetable
acidity.

The fuccefs attending the following cafe in fo fliort a time as a
fortnight I afcribed principally to the ufe of the warm bath ; in whicti
the patient continued for full half an hour every night, in the degree
of heat, which was moft grateful to her fenfation, which might be I

fuppofe about 94. Mifs , about ten years of age, and very tall

and thin, has laboured under palpitation of her heart, and difficult
breathing on the lead: exercife, with occafional violent dry cough, for
a year or more, vv'ith dry lips, little appetite either for food or drink,
and dry Ikin, with cold extremities. She has at times been occalion-
ally worfe, and been relieved in fome degree by the bark. She began
to bend forwards, and to lift up her flioulders. 1 he former feem ed
8 owir>g

Class I. 2. 2. DISEASES OF IRRITATION. 87

owing to a beginning curvature of the fpine, the latter was probably
caufed to facilitate her difficult refpiration.

M. M. She ufed the warm bath, as above related ; which by its
warmth might increafe the irritability of the fmalleft feries of veffels, .
and by fupplying more moifture to the blood might probably tend to
carry further the materials, which form calcareous or bony particles,.
or to coqyey them in more dilute folution. She took twice a day
twenty gi'ains of extract of bark, twenty grains of foda phofphorata, ,
and ten grains of chalk, and ten of calcined hartfhorn mixed into a
powder vi(ith ten drops of laudanum ; with flefh food both to dinner,
and fupper ; and port wine and water inflead of the fmall beer, fhe
had been accuftomed to ; flie lay on a fofa frequently in a day, and
occafionally ufed a neck-fwing

15. Rachitis. Rickets. The head is large, protuberant chiefly on
the forepart. The fmaller joints are fwelled ; the ribs depreffed ; the
belly tumid, with other parts emaciated. This difeafe from the in-
nutrition or foftnefs of the bones arofe about two centuries ago ; feems
to have been half a century in an increafing or fpreading flate ; con-
tinued about half a century at its height, or greateft diffufion ; and is
now nearly vanished : which gives reafon to hope, that the fmall-
pox, meafles, and venereal difeafe, which arc all of modern produc-
tion, and have already become milder, may in procefs of time vanifh
from the earth, and perhaps be fucceeded by new ones ! See the
preceding fpecies.

1 6. Spince dijiortio. Diftortion of the fpine is another difeafe origi-
nating from the innutrition or foftnefs of the bones. I once faw a
child about fix years old with palpitation of heart, and quicknefs of
refpiration, v/hich began to have a curvature of the fpine; I then
doubted, whether the palpitation and quick refpiration were the caufe
or confequence of the curvature of the fpine ; fufpefting either that

nature

S3 DISEASES OF IRRITATION. Class I. 22.

nature had bent the fpine outwards to give room to the enlarged heart ;
or that the malformation of the cheft had compreffed and impeded the
movements of the heart. But a few weeks ago on attending a
young lady about ten years old, whofe fpine had lately began to be
diftorted, with very great difficulty and quicknefs of refpiration, and
alarming palpitation of the heart, I convinced myfelf, that the pal-
pitation and difficult refpiration were the effe6t of the change of the
cavity of the cheft from the diftortion of the fpine ; and that the
whole was therefore a difeafe of the innutrition or foftnefs of the
bones.

For on direfliing her to lie down much in the day, and to take the
bark, the diftortion became lefs, and the palpitation and quick refpi-
ration became lefs at the fame time. After this obfervation a neck-
fwino" was dire6ted, and flie took the bark, madder, and bone-affies ;
and fhe continues to amend both in her fliape and health.

Delicate young ladies are very liable to become awry at many board-
iiio- fchools. This is occafioned principally by their being obliged too
lono" to preferve an ere£t attitude, by fitting on forms many hours to-
gether. To prevent this the fchool-feats fhould have either backs, ou
which they may occafionally reft themfelves; or deiks before them,
on which they may occafionally lean. This is a thing of greater con-
fequence than may appear to thofe, who have not attended to it.

When the ieaft tendency to become awry is obferved, they fliould
be advifed to lie down on a bed or fofa for an hour in the middle of the
day for many months ; which generally prevents the increafe of this
deformity by taking off for a time the preffure on the fpine of the
back, and it at the fame time tends to make them grow taller.
Young perfons, when nicely meafured, are found to be half an inch
hicrher in a morning than at night; as is well known to thofe, who
iiilift very young men for foldiers. This is owing to the cartilages be-
tween the bones of the back becoming comprefled by the weight of
the. head and flioulders on fliem during the day. It is the fame

preffure

L '/a/S J. 2. '2 . 16 -/Jf'//'' '"^O-

3.vhtr jiulp .

Tubli//u-d /if J.Johiuon S'.fauh- Chutvk-l'ard. March ..iiK!j,/6.

Class I. 2. 2. DISEASES OF IRRITATION. 89

preffure which produces curvatures and diflortions of the fplne ia
growing children, where the bones are fofter than ufual ; and which
may thus be reUeved by an horizontal pofture for an hour in the mid-
dle of the day, or by being frequently allowed to lean on a chair, or
to play on the ground on a carpet.

Young ladies (hould alfo be diredled, where two fleep in a bed, to
change every night, or every week, their fides of the bed ; which
will prevent their tendency to fleep always on the fame iide ; which
is not only liable to produce crookednefs, but alfo to occafion difeafes
by the internal parts being fo long kept in uniform contact as to grour
together. For the fame reafon they fhould not be allowed to fit
always on the fame fide of the fire or window, becaufe they will then
be inclined too frequently to bend themfelves to one fide.

Another great caufe of injury to the (hape of young ladies is from
the preflure of flays, or other tight bandages, which at the fame
time caufe other difeafes by changing the form or fituation of the in-
ternal parts. If a hard part of the ftays, even a knot of the thread,
with which they are fewed together, is preffed hard upon one fide
more than the other, the child bends from the fide moft painful, and
thus occafions a curvature of the fpine. To counteratl this effect
fuch flays, as have fewefl hard parts, and efpecially fuch as can be
daily or weekly turned, are preferable to others.

Where frequent lying down on a fofa in the day-time, and fwino--
ing frequently for a ftiort time by the hands or head, with loofe drefs
do not relieve a beginning diftortion of the back ; recourfe may be
had to a chair with fluffed moveable arms for the purpofe of fufpend-
ing the weight of the body by cufhions under the arm-pits, like refl-
ing on crutches, or like the leading firings of infants. From the top
of the back of the fame chair a curved fteel bar may alfo projedl to
fufpend the body occafionally, or in part by the head, like thefwino-
above mentioned. The ufe of this chair is more efficacious in
flraightening the fpine, than fimply lying down horizontally; as it

VoB. IL . , N not

po DISEASES OF IRRITATION. Class I, 2. 2.

not only takes off the prelTure of the head and flioulders from the
fpine, but at the fanrie tinrie the inferior parts of the body contribute
to draw the fpine ftraight by their weight ; or lailly, rccourfe may be
had to a fpinal machine firft defcribed in the Memoires of the academy
of furgery in Paris, Vol. III. p. 600, by M. Le Vacher, and fince
made by Mr. Jones, at N" 6, North-ftreet, Tottenham-court Road,
London, which fufpends the head, and places the weight of it on the
hips. This machine is capable of improvement by joints in the bar at
the back of it, to permit the body to bend forwards without diminifli-
ing the extenfion of the fpine.

The objedlions of this machine of M. Vacher, which is made by
Mr. Jones, are firft, that it is worn in the day-time, and has a very
unfightly appearance. Mr. Jones has endeavoured to remedy this, by
taking away the curved bar over the head, and fubftituting in its
place a forked bar, rifing up behind each ear, with webs faftened to
it, which pafs under the chin and occiput. But this is not an im-
provement, but a deterioration of M. Vacher's machine, as it prevents
the head from turning with facility to either fide. Another objedtion
is, that its being worn, when the mufcles of the back are in adidn,
it is rather calculated to prevent the curvature of the fpine from be-
coming greater, than to extend the fpine, and diminifti its curvature.
For this lattef purpofe I have made a fleel bow, as defcribed in the
annexed plate, which receives the head longitudinally from the fore-
head to the occiput; having a fork furnifhed with a web to fuftain the
chin, and another to fuftain the occiput. The fummit of the bow is
fixed by a fwivel to the board going behind the head of the bed above
the pillow. The bed is to be inclined from the head to the feet about
twelve or fixteen inches. Hence the patient would be conftantly
Hiding down during fleep, unlefs fupported by this bow, with webbed
forks, covered alfo with fur, placed beneath the chin, and beneath
the occiput. There are alfo proper webs lined with fur for the hands
to take hold off occafionally, and alfo to go under the arms. By

thefe

C7a/s I.<2.'2. 76. /Ji^'/c (JO.

FiMi//ied iy J.JcA/uoti, Sf I'auL' C/mrc/i l',ip,f.MiircA.jafm6.

Class I. 2.2. DISEASES OF IRRITATION. 91

thefe means I fliould hope great advantage from gradually extending
the fpine during the inactivity of the mufcles of the back ; and that
it may be done without difturbing the fleep of the patient, and if this
fhould happen, the bow is made to open by a joint at the fummit of
it, fo as to be inftantly difengaged from the neck by the hand of the
wearer. This bow I have not yet had opportunity to make ufe of,
but it may be had from Mr. Harrifon, whitefmith, Bridge-gate, Derby.

It will be from hence ealily perceived, that all other methods of
confining or direfting the growth of young people fhould be ufed with
great Ikill ; fuch as back-boards, or bandages, or flocks for the feet ;
and that their application fhould not be continued too long at a time,
left worfe confequences fhould enfue, than the deformity they were
defigned to remove. To this may be added, that the flifF erefb atti-
tude taught by fome modern dancing maflers does not contribute to
the grace of perfon, but rather militates againfl: it ; as is well feen in
one of the prints in Hogarth's Analyfis of Beauty ; and is exemplifyed
by the eafy grace of fome of the antient flatues, as of the Venus de
Medici, and the Antinous, and in the works of fome modern artifts,
as in a beautiful print of Hebe feeding an Eagle, painted by Hamil-
ton, and engraved by Eginton, and many of the figures of Angelica
Kauffman.

Where the bone of one of the vertebras of the back has been fwelled
on both fides of it, fo as to become protuberant, ifTues near the fwell-
ed part have been found of great fervice, as mentioned in Species 18
of this genus. This has induced me to propofe in curvatures of the
fpine, to put an ifTue on the outfide of the curve, where it could be
certainly afcertained, as the bones on the convex fide of the curve
muft be enlarged ; in one cafe I thought this of fervice, and recom-
mend the further trial of it.

In the tendency to curvature of the fpine, whatever ftrengthens the
general conflitution is of fervice ; as the ufe of the cold bath in the

N 2 fummer

DISEASES OF IRRITATION. Class L a.

O « • ■«;«

fummer mouths. This however requires fo me reftriclion both in re-
i'pe&. to the degree of coldaefs of the bath, the time of contitiuing m
it, and the feafon of the year. Common fprings, which are of forty-
eight degrees of heat, are too cold for tender conftitutioas, whether
of children or adults, and frequently do them great and irreparable in-
jury. The coldnefs of river water in the fummer months, which is
about fixty-eight degrees, or that of Matlock, which is about fixty-
eight, or of Buxton, which is eighty-two, are much to be preferred.
The time of continuing in the bath fhould be but a minute or two,
or not fo long as to occafion a trembling of the limbs from cold. In
refpedl to the feafon of the year, delicate children fhould certainly
only bathe in the fummer months ; as the going frequently into the
cold air in winter will anfwer all the purpofes of the cold bath..

17. ClauScatio c&xaria. Lamenefs of the hip. A nodding of the
thigh-bone is faid to be produced in feeble children by the foftnefs of
the neck or upper part of that bone beneath the cartilage ; which is
naturally bent, and in this difeafe bends more downwards, or nods, by
the preffure of the body ; and thus renders one leg apparently fhorter
than the other. In other cafes the end of the bone is protruded out
of its focket, by inflammation or enlargement of the cartilages or liga-
ments of the joint, fo that it refts on fome part of the edsie of the
acetabulum, which in time becomes filled up. When the legs arc
ftraight, as in ftanding ereft, there is no verticillary motion in the
knee-joint ; all the motion then in turning out the toes further than
nature defigned, muft be obtained by draining in fome degree this
head of the thigh-bone, or the acetabulum, or cavity, in which it
moves. This has induced me to believe, that this misfortune of the
nodding of the head by the bone, or partial diflocation of it, by which
one leg becomes fhorter than the other, is fometimes occalioned by
making very young children fland in what are called ftocks ; that is

with

Class I. 2. 2. DISEASES OF IRRITATION. 93,

with their heels together, and their toes quite out. Whence the
jfocket of the thigh-bone becomes inflamed and painful, or the neck
of the bone is bent downward and outwards.

In this cafe there is no expeftation of recovering the ftraightnefs of
the end o^ the bone ; but thefe patients are hable to another misfor-
tune, that is, to acquire afterwards a diftortion of the fpine; for as
one leg is fliorter than the other, they fink on that fide, and in con-
fequence bend the upper part of their bodies, as their flioulders, the
cbntrary way, to balance themfelves ; and then again the neck is bent
back again towards the lame fide, to preferve the head perpendicular j
and thus the figure becomes quite diflorted like the letter S, owing
originally to the deficiency of the length of one limb. The only
way to prevent this curvature of the fpine is for the child to wear a
high-heeled flioe or patten on the lame foot, fo as to fupport that
iide on the fame level with the other, and thus to prevent a greater
deformity.

I have this day feen a young lady about twelve, who docs not
limp or waddle in walking; but neverthelefs, . when {he flands or
fits, fhe -finks down towards her right fide, and turns out that toe
more than the other. Hence, both as fhe fits and flands, fhe bends
her body to the right ; whence her head wouldhang a httle over her
right fhoulder i but to replace this perpendicularly, fhe lifts up her
left fhoulder and contraQs the mufcles on that fide of the neck ; which
are therefore become thicker and flronger by their continued adlion ;
but there is not yet any very perceptible dlfiortion of the fpine.

As her right toe is turned outward rather more than natural, this
fhews the difeafe tec be in the hip-joint ; becaufe, when the limb is
ftretched out, the toe cannot turn horizontally in the leaft without
moving the end of the thigh-bone ; although when the knee is bent,
the toe can be turned through one third or half of a circle by the
lotation of the tibia and fibula of the leg round each other., Hence

94 DISEASES OF IRRITATION. Class I. 2.2.

if children are fet in {locks with their heels touching each other as
they fit, and are then made to rife up, till they ftand ere6l, the
focket or head of the thigh-bone becomes injured, efpecially in thofe
children, whofe bones are foft ; and a ftiortnefs of that limb fucceeds
either by the bending of the neck of the thigh-bone, or by its getting
out of the acetabulum ; and a confequent riling of one fhoulder,
and a curvature of the fpine is produced from fo diftant a caufe.

M. M. An elaftic cufhion made of curled hair fliould be placed
tinder the affected hip, whenever {he {its ; or {hould be {itted to
the part by means of drawers, fo that {he cannot avoid {itting on
it. A neck-fwing, and lying down in the day, fhould be occaiionally
ufed to "prevent or remove any curvature of the fpine. The refl: as
in Species 13 and 15 of this genus.

18. Spina protuberans. Protuberant fpine. One of the bones of
the fpine fwells, and rifes above the reft. This is not an uncommon
difeafe, and belongs to the innutrition of the bones, as the bone
mu{l become foft before it fwells ; which foftnefs is owing to defeft
of the fecretion of phofphorated calcareous earth. The fwelling of
the bone compre{res a part of tlie brain, called the fpinal marrow,
within the cavity of the back-bones ; and in confequence the lower
Hmbs become paralytic, attended fometimes with difficulty of empty-
ing the bladder and re£lum.

M. M. Wues put on each fide of the prominent bone are of great
efFeft, I fuppofe, by their ftimulus ; which excites into action more
of the fenforial powers of irritation and fenfation, and thus gives
greater adivity to the vafcular fyflem in their vicinity. The
methods recommended in diilortion of the fpine are alfo to be at-
tended to.

19. Spina bijida. Divided fpine, called alfo Hydrorachitis, as well

4 as

Class I. 2. a. DISEASES OF IRRITATION, gs

as tlhe Hydrocephalus externus, are probably owing in part t@ a
defe£t of oflification of the fpine aad cranium; and that the
colledlion of fluid beneath them may- originate from the general
debiUty of the fyftem ; which afFefts both the fecerning, and ab-
forbent veffels.

A curious circumftance, which is affirmed to attend the fpina bifida,
is, that on compreffing the tumor with the hand gently, the whole
brain becomes affedled, and the patient falls .afleep. I fuppofe the
fame muft happen on compreffing the hydrocephalus externus ? See
Sed. XVIII. 20.

20. OJ/is palati defeSiiis. A defedl of the bone of the palate,
which frequently accompanies a divifion of the upper lip, occurs
before nativity ; and is owing to the deficient a£lion of the fecernino-
fyftem, from whence the extremities are not completed. From a
fimilar caufe I have feen the point of the tongue deficient, and one
joint of the two leaft fingers, and of the two leaft toes, in the fame
infant ; who was otherwife a fine girl. See Sed. XXXIX. 4. 4.

The operation for the hare-Hp is defcribed by many furo-ical
writers ; but there is a perfon in London, who makes very ingeni-
ous artificial palates ; which prevents that defeat of fpeech, which
attends this malformation. This fadlitious palate confifts of a thin
plate of filver of the fhape and form of the roof of the mouth ;
from the front edge to the back edge of this filver plate four or five
holes are made in a ftraight line large enough for a needle to pafs
through them ; on the back of it is then fewed a piece of fpono-e I
which when expanded with moifture is ;iearly as large as the filver
plate. This fponge is flipped through the divifion of the bone of
the palate, fo as to lie above it, while the filver plate covers the
aperture beneath, and is fufpended by the expanding fponge. This
is removed every night and waftied, and returned into its place in the

morning;

96 DISEASES OF IRRITATION. Class I. 2. 2.

morning ; on this account it is convenient to have five or fix of
them, for the fake of cleanlinefs. I have been more particular in
defcribing this invention, as I do not knovs^ the name, or place of
refidence, of the maker.

ORpO ]

Class I. 2. 3. DISEASES OF IRRITATION, ^7

ORDO II.

Decreafed Irritation,^

GENUS III.
7he decreafed ABion of the Ahforbent Syflem^

Some decreafe of heat attends thefe difeafes, though in a lefs
degree than thofe of the laft genus, becaufe the abforbent fyftem of
glands do not generate fo much heat in their healthy ftate of a6tioii
as the fecerning fy ftem of gbnds, as explained in Clafs I. 1.3.

SPECIES.

I. Mucus fancium frigidus. Cold mucus from the throat. Much
mucus, of rather a faline tafle, and lefs infpiffated than ufual, is
evacuated from the fauces by hawking, owing to the deficient ab-
forption of the thinner parts of it. This becomes a habit in fome
elderly people, who are continually fpitting it out of their mouths ;
and has probably been brought on by taking fnufF, or fmoking to-
bacco ; which by frequently Simulating the fauces have at length
rendered the abforbent veflels lefs excitable by the natural ftimulus of
the faline part of the fecretion, which ought to be reabforbed, as foon
as fecreted.

M. M. A few grains of powder of bark frequently put into the
mouth, and gradually difFufed over the fauces. A gargle of barley
water.

Vol. II. O 2.. Sudor

98 ~ DISEASES OF IRRITATION. Class I. 2.3.

2. Sudor fngidus. The cold dampnefs of the hands of fome people
is caufed by the deficient abforption of perfpirable matter ; the clam-
my of vifcid feel of it is owing to the mucous part being left upon the
Ikin. The coldnefs is produced both by the decreafed a£lion of the
abforbent fyflem, and by the evaporation of a greater quantity of the
perfpirable matter into the air, which ought to have been abforbed.

M. M. Wafh the hands in lime water, or with a fmall quantity
of volatile alcali in water.

3. Catarrhus frigidus. The thin difcharge from the noftrils in
cold weather. The abforbent veflels become torpid by the diminution
of external heat, fooner than the fecerning ones, which are longer
kept warm by the circulating blood, from which they feleft the
fluid they fecrete ; whereas the abforbent veflels of the noftrils drink
up their fluids, namely the thin and faline part of the mucus, after it
has been cooled by the atmofphere. Hence the abforbents ceafing to
aft, and the fecerning veflels continuing fome time longer to pour
out the mucus, a copious thin difcharge is produced, which trickles
down the noflirils in cold weather. This difcharge is fo acrid as to
inflame the upper lip ; which is owing to the neutral falts, with
which it abounds, not being reabforbed ; fo the tears in the fifliula
lacrymalis inflame the cheek. See Clafs I. i. 2. 7.

4. ExpeStoratio fr'igida. Cold expeftoration. Where the pulmo-
nary abforption is deficient, an habitual cough is produced, and a fre-
quent expe£loration of thin faline mucus ; as is often {t&w in old en-
feebled people. Though the fiiimulus of the faline fluid, which at-
tends all fecretions, is not fufficient to excite the languid abforbent
veflels to imbibe it ; yet this faline part, together with the increafed
quantity of the whole of the fecreted mucus, ftimulates the branches
of the bronchia, fo as to induce an almoft inceflant cough to difcharge
it from the lungs. A fingle grain of opium, or any other flimulant

drug.

Class I. 2. 3. DISEASES OF IRRITATION. ^g

drug, as a wine-poffet with fplrit of hartfliorn, will cure this cold
cough, and- the cold catarrh of the preceding article, like a charm, by
ftimulating the torpid mouths of the abforbents into a6lion. Which
has given rile to an indifcriminate and frequently pernicious ufe of the
warm regimen in coughs and catarrhs of the warm or inflammatory
kind, to the great injury of many,

M. M. Half a grain of opium night and morning promotes the
abforption of the more fluid and faline parts, and in confequence
thickens the mucus, and abates its acrimony. Warm diluent drink,
wine- whey, with volatile alcali.

5. Urina uherior paliida. On being expofed naked to cold air, or
fprinkled with cold water, a quantity of pale urine is foon difcharged ;
for the abforbents of the bladder become torpid by their fympathy
with thofe of the fkin ; which are rendered quiefcent by the diminu-
tion of external heat ; but the kidnies continue to fecrete the urine,
and as no part of it is ablbrbed, it becomes copious and pale. This
happens from a (imilar caufe in cold fits of agues ; and in lefs degree
to many debilitated conftitutions, whofe extremities are generally cold
and pale. The great quantity of limpid water in hyfteric cafes, and
in diabaetes, belongs to Clafs I. 3. i. 10. I. 3. 2. 6.

M. M. Tindure of cantharides, opium, alum, forbentia. Flan-
nel fhirt in cold weather. Animal food. Beer. Wine. Fridlion.
Exercife. Fire.

6. Diarrhcea frigida. Liquid ftools are produced by expofing the
body naked to cold air, or fprinkling it with cold water, for the fame
reafon as the laft article.

But this difeafe is fometimes of a dangerous nature ; the inteftlnal
abforption being fo impaired, that the aliment is faid to come away
undiminifhed in quantity, and almoft unchanged by the powers of di-
geftion, and is then called lientcry.

O 2 The

100 DISEASES OF IRRITATION. Class I. 2. ij.

O'

The mucus of the re£lurn fometlmes comes away like pellucid
hartfliorn jelly, and liquefies by heat like that, towards the end of
inirritative fevers, which is owing to the thinner part of the mucus
not being abforbed, and thus refembles the catarrh of fome old
people.

M. M. Opium, campechy wood, armenian bole. BHfler. Flan-
nel fhirt in cold weather. Clyfters with opium. Friiflion on the
bowels morning and night. Equitation twice a day.

7. Fluor a/bus frigidus. Cold fluor albus. In weak conflitutions,
where this difcharge is pellucid and thin, it muft proceed from want
of abforption of the mucous membrane of the vagina, or uterus, and
not from an increafed fecretion. This I fufpeft to be the moll: fre-
quent kind of fluor albus; the former one defcribed at Clafs I. i. 2. 11.
attends menftruation, or is a difcharge inftead of it, and thus refem-
bles the venereal orgafm of female quadrupeds. The difcharge in
this latter kind being more faline, is liable to excoriate the part, and
thus produce fmarting in making water; in its great degree it is diffi-
cult to cure.

M. M. Increafe the evacuation by flool and by perfpiration, by
taking rhubarb every night, about fix or ten grains with one grain of
opium for fome months. Flannel fhirt in winter. Balfam copaiva.
Gum kino, bitters, chalybeates, fridtion over the whole Ikin with
flannel m^orning and night. Partial cold bath, by fprinkling the loins
and thighs, or fponging them with cold water. Mucilage, as ifin-
glafs boiled in milk ; blanc mange, hartfhorn jelly, are recom-
mended by fome. Tin6lure of cantharides fometimes feems of
fervice given from ten to twenty drops or more, three or four
times a day. A large plafter of burgundy pitch and armenian bole,
fo as to cover the loins and lower part of the belly, is faid to have
fometimes fucceeded by increafing abforption by its compreflion
in the manner of a bandage. A folutioii of metallic falts, as white

vitriol.

Class I. 2.3. DISEASES OF IRRITATION. lor

vitriol, fixty grains to a pint; or an infufion of oak-bark may be iti-
je£led into the vagina. Cold bath.

8. Gonorrhoea frigida. Cold gleet. Where the gleet is thin and
pellucid, it muft arife from the u'^ant of ttbforption of the membranes
of the urethra, rather than from an increased fecretion from tbem.
This I fuppofe to be a more common difeafe than that mentioned at
Clafs I. I. 2. lo.

M. M. Metallic injedlions, partial cold bath, internal method as
in the fluor albus above defcribed. Balfam of copaiva. Tin6lure of
cantharides.

9. Hepath tumors The liver becomes enlarged from defe£l of the
abforption of mucus from its cells, as in anafarca, efpecially in feeble
children ; at the fame time lefs bile is fecreted from the torpid circu-
lation in the vena port^e. And as the abforbents, which refume the
thinner parts of the bile from the gall-bladder and hepatic dufts, are
alfo torpid or quiefcent, the bile is more dilute, as well as in lefs
quantity. From the obftruftion of the paffage of the blood through
the compreffed vena porta thefe patients have tumid bellies, and pale
bloated countenances ; their palenefs is probably owing to the de-
ficiency of the quantity of red globules in the blood in confequence of
the inert ftate of the bile.

Thefe fymptoms in children are generally attended with worms,
the dilute bile and the weak digeftion not deftroying them. In fleep
i have feen fleuke-worms in the gall-du6ts themfelves among the dilute
bile; which gall-du6ls they eat through, and then produce ulcers,
and the he£lic fever, called the rot. See Clafs I. i. 4. 10. and
Article IV. 2. 6.

M. M. After a calomel purge, crude iron-filings are fpecific in
this difeafe in children, and the worms are deftroyed by the returning

8 acrimony

102 DISEASES OF IRRITATION. Class I. 2.3.

acrimony and quantity of the bile, A blifter on the region of the
Jiver. Sorbentia, as vvorna-feed, fantonicum. Columbo. Bark.,

10. Chlorojis. When the defedl of the due action of both the ab-
forbent and fecerning veffels of the liver affefls women, and is attend-
ed with obftrn6lion of the catamenia, it is called chlorofis ; and is
cured by the exhibition of fteel, which reftores by its fpecific ftimulus
the abforbent power of the liver ; and the menftruation, which was
obftrudled in confequence of debility, recurs.

•Indigeftion, owing to torpor of the ftomach, and a confequent too
great acidity of its contents, attend this difeafe ; whence a defire of
eating chalk, or marl. Sometimes a great quantity of pale urine is
difcharged in a morning, which is owing to the ina6lion of the ab-
forbents, which are diftributed on the neck of the bladder, during
fleep. The fwelling of the ankles, which frequently attends chloro-
fis, is another effe6t of deficient aftion of the abforbent fyftem ; and
the pale countenance is occafioned by the deficient quantity of red glo-
bules of blood, caufed by the deficient quantity or acrimony of the
bile, and confequent weaknefs of the circulation. The pulfe is fo
quick in fome cafes of chlorofis, that, when attended with an acci-
dental cough, it may be miftaken for pulmonary confumption. This
quick pulfe is owing to the debility of the heart from the want of
Ilimulus occafioned by the deficiency of the quantity, and acrimony of
the blood.

M. M. Steel. Bitters. Conftant moderate exercife. Fridion
with flannel all over the body and limbs night and morning. Rhu-
barb five grains, opium half a grain, every night. Flefh diet, with
fmall beer, or wine and water. The difeafe continues fome months,
but at length fubfides by the treatment above defcribed. A bath of
about eighty degrees, as Buxton Bath, is of fervice ; a colder bath may

do.great injury.

1 1 . Hydrocele^

Class I. 2. 3. DISEASES OF IRRITATION. 103

II. Hydrocele. Dropfyofthe vagina teftis. Dropfies have been
divided into the incyfted and the difFufed, meaning thofeofthe cellu-
lar membrane, the cells of which communicate with each other like a
fponge, and thofe of any other cavity of the body. The colleftions
of mucous fluids in the various cells and cavities of the body arife from
the torpor of the abforbent veffels of thofe parts. It is probable, that
in dropfies attended with great thirft the cutaneous abforbents become
paralytic firft ; and then from the great thirft, which is thus occafion-
ed by the want of atmofpheric moiftiire, the abforption of the fat en-
fues ; as in fevers attended with great thirft, the fat is quickly taken
up. See Obefitas I. 2. 3. 16. Some have believed, that the cellular
and adipofe membranes are different ones ; as no fat is ever depofited
in the eye-lids or fcrotum, both which places are very liable to be dif-
tended with the mucilaginous fluid of the anafarca, and with air in
Emphyfema. Sometimes a gradual abforption of the accumulated
fluid takes place, and the thinner parts being taken up, there remains
a more vifcid fluid, or almoft a folid in the part, as in fome fwelled
legs, which can not eafily be indented by the preflure of the finger, and
are called fcorbutic. Sometimes the paralyfis of the abforbents is com- '
pletely removed, and the whole is again taken up into the circulation*
The Hydrocele is known by a tumor of the fcrotum, which is
without pain, gradually produced, with fludluation, and a degree of
pellucidity, when a candle is held behind it ; it is the moft fimple in-
cyfted dropfy, as it is not in general complicated with other difeafes, as
afcites with fchirrous liver, and hydrocephalus internus, with o^eneral
debility. The cure of this difeafe is efFefted by different ways ; it
confifts in difcharging the water by an external aperture ; and by fo
far inflaming the cyft and tefticle, that they afterwards grow too-ether,
and thus prevent in future any fecretion or efiufion of mucus ; the
difeafe is thus cured, not by the revivefcence of the abforbent power
of the lymphatics, but by the prevention of fecretion by the adhefion
of the vagina to the teftis. This I believe is performed with lefs pain,
7 and

-I04 DISEASES OF IRRITATION. Class I. 2.3.

and is more certainly manageable by tapping, or difcharging the fluid
by means of a trocar, and after the evacuation of it to fill the cyft with
a mixture of wine and water for a few minutes till the neceffary de-
gree of ftimulus is produced, and then to withdraw.it ; as recommend-
ed by Mr. Earle. See alfo Medical Commentaries by Dr. Duncan,
for 1793.

^ 12. Hydrocephalus inlenius, or dropfy of the ventricles of the brain,,
is fatal to many children, and fome adults. When this difeafe is lefs
in quantity, it probably produces a fever, termed a nervous fever, and
which is fometimes called a worm fever, according to the opinion of
Dr. Gilchrift, in the Scots Medical effays. This fever is attended
with great inirritability, as appears from the dilated pupils of the eyes,
in which it correfponds with the dropfy of the brain. And the latter
difeafe has its paroxyfms of quick pulfe, and in that refpedl correfponds
with other fevers with inirritability.

The hydrocephalus internus is diftinguiflied from apoplexy by its
beino- attended with fever, and from nervous fever by the paroxyfms
beinc^ very irregular, with perfe£l intermiffions many times in a day.
In nervous fever the pain of the head generally asTeds the middle of
the forehead ; in hydrocephalus internus it is generally on one fide of
the head. One of the earlieft criterions is the patient being uneafy oii
raifino- his head from the pillow, and wifliing to lie down again im-
mediately ; VN'hich I fuppofe is owing to the preffure of the water on
the larger trunks of the blood-velTets entering the cavity being more
intolerable than on the fmaller ones ; for if the larger trunks arecom-
prefied, it muft inconvenience the branches alfo ; but if fome of the
fmall branches are comprefled only, the trunks are not fo immediate-
ly Incommoded.

Blifters on the head, and mercurial ointment externally, with calo-
mel internally, are principally recommended in this fatal difeafe.
When the patient cannot bear to be raifed up in bed without great

uneafinefs^

Class I. 2.3. DISEASES OF IRRITATION. 105

uneafitiefs, it is a bad fymptom. So I believe is deafnefs, which is
commonly miftaken for jftupor. See Clafs I. 2. 5. 6. And when the
dilatation of the pupil of either eye, or the fquinting is very apparent,
or the pupils of both eyes much dilated, it is generally fatal. As by
il:imulating one branch of lymphatics into inverted motion, another
branch is liable to abforb its fluid more haftily ; fuppofe flrong errhines,
as common tobacco fnufFto children, or one grain of turpeth mineral,
(Hydrargyrus vitriolatus), mixed with ten or fifteen grains of fugar, was
gradually blown up the noflrils ? See Clafs I. 3. 2. r. I have tried
common fnufF upon two children in this difeafe ; one could not be
made to fnecze, and the other was too near death to receive advan-
tage. When the mercurial preparations have produced falivation, I
believe they may have been of fervice, but I doubt their good efFed;
otherwife. In one child I tried the tincture of Digitalis ; but it was
given with too timid a hand, and too late in the difeafe, to determine
its effects. See SeOi. XXIX. 5. 9.

As all the above remedies generally fail of fuccefs, I think frequent,
almoft hourly, (hocks of eledricity from very fmall charges might be
pafled through the head in all diredions with probability of good event.
And the ufe of the trephine, where the afFe<^ed fide can be diftin-
guiflied. See Strabifmus, Clafs I. 2. 5. 4. When one eye is affed-
ed, does the difeafe exifl in the ventricule of that fide ?

1 3. A/cites. The dropfy of the cavity of the abdomen is known by
a tenfe fwelling of the belly ; which does not found on being fiiruck
like the tympany ; and in which a fluduation can be readily perceived -
by applying one hand expanded on one fide, and flriking the tumour
on the other. -

Effufions of water into large cavities, as into that of the abdo-
men or thorax, or into the ventricules of the brain or pericardium, are
more difficult to be reabforbed, than the efFufion of fluids into the cel-
lular membrane ; becaufe one part of this extenfive fponge-Uke {y^tm.
Vol. II. P of

io6 DISEASES OF IRRITATION. Class I. 2. j.

of cells, which conneds all the folid parts of the body, may have its
power of abforption impaired, at the fame time that fome other
part of it may fliill retain that power, or perhaps poffefs it in an in-
creafed degree ; and as all thefe cells communicate with each other,
the fluid, which abounds in one part of it, can be transferred to an-
other, and thus be reabforbed into the circulation.

In the afcites, cream of tartar has fometimes been attended with
fuccefs ; a dram or tw.o drams ace given every hour in a morning till
it operates, and is to be repeated for feveral days ; but the operation
of tapping is generally applied to at laft. Dr. Sims, in the Memoirs
of the Medical Society of London, Vol. III. has lately propofed, what
he believes to be a more fuccefsful method of performing this opera-
tion, by making a pundlure with a lancet in the fear of the navel,
and leaving it to difcharge itfelf gradually for feveral days, without in-
troducing a canula, which he thinks injurious both on account of the
too fudden emiffion of the fluid, a.nd the danger of wounding or fti-
mulating the vifcera. This operation I have twice known performed
with lefs inconvenience, and I believe with more benefit to the
patient, than the common method.

After the patient has been tapped, fome have tried injections into
the cavity of the abdomen, but hitherto I believe with ill event. Nor
are experiments of this kind very promifing of fuccefs. Firft becaufe
the patients are generally much debilitated, moft frequently by fpiritu-
ou.s potation, and have generally a diiea'fe of the liver, or of other vif-
cera. And fecondly, becaufe the quantity of inflammation, neceffary
to prevent future fecretion of mucus into the cavity of the abdomen,
by uniting the peritoneuna with the inteflines or mefentery, as hap-
pens in the cure of the hydrocele, wouldT fuppofe generally deftroy
the patient, either immediately, or by the confequence of fuch ad-
hefions.

This however is not the cafe in refped to the dropfy of the ovari-
-am, or in the hydrocele,

14. Hydrops

Class I. 2.3. DISEASES OF IRRITATION: 107

14. Hydrops thoracis. The dropfy of the qhell: commences with '
lofs of flefh, cold extremities, pale countenance, high coloured urine
in fmall quantity, and general debility, like many other dropfies. The
patient next complains of numbnefs in the arms, efpecially when ele-
vated, with pain and difficulty of fwaliowing, and an r^bfolute im-
poffibility of lying down for a few minutes, or with fudden ftarting
from fleep, with great difficulty of breathing and palpitation of his
heart.

The numbnefs of the arms is probably owing more frequently to
the increafed action of the pedoral mufcles in refpiration, whence
they are lefs at liberty to perform other offices, than to the connexion
of nerves mentioned in Se6t. XXIX. 5. 2. The difficulty of fwal-
iowing is owing to the compreffion of the oefophagus by the lymph
in the cheft j and the impoffibility of breathing in an horizontal pof-
ture originates from this, that if any parts of the lungs muft be ren-
dered ufelefs^ the inability of the extremities of them muit be lefs in-
convenient to refpiration ; fince if the upper parts or larger trunks of
the air-veffels fhould be rendered ufelefs by the compreffion of the ac-
cumulated lymph, the air could not gain admittance to the other parts,
and the animal mufl immediately perifh.

If the pericardium is the principal feat of the difeafe, the pulfe is
•quick and irregular. If only the cavity of the thorax is hydropic, the
pulfe is not quick nor irregular.

If one fide is more afre(Sed than the other, the patient leans moft
that way, and has more numbnefs in that arm.

The hydrops thoracis is diftinguiffied from the anafarca pulmonum,
as the patient in the former cannot lie down half a minute ; in the
latter the difficulty of breathing, which occalions him to rife up,
cornes on more gradually ; as the tranlition of the lymph in the
cellular membranes from one part to another of it is flower, than that
of the effufed lymph in the cavity of the cheft.

The hydrops thoracis is often complicated with fits of conr

P 3 vulfive

ro8 DISEASES OF IRRITATION. Class I, 2. j.

vulfive breathing ; and then it produces a difeafe for the time very
fimilar to the common periodic afthma, which is perhaps owing to a
temporary anafarca of the lungs ; or to an impaired venous abforptiou
in them. Thefe exacerbations of difficult breathing are attended with
cold extremities, cold breath, cold tongue, upright pofture with the
mouth open, and a defireof cold air, and a quick, weak, intermittent
pulfe, and contradled hands.

Thefe exacerbations recur fometimes every two or three hours, and
are relieved by opium, a grain every hour for two or three dofes,
with ether about a dram in cold water ; and feem to be a convulfion
of the mufcles of refpiration induced by the pain of the dyfpnea. As
in Clafs III. i . 1.9.

M. M. A grain of dried fquill, and a quarter of a grain of blue vi-
triol every hour for fix or eight hours, unlefs it vomit or purge. A
grain of opium. Blifters. Calomel three grains every third day,
with infufion of fenna. Bark. Chalybeates. Pundlure in the fide.

Can the fludluation in the cheft be heard by applying the ear to
the fide, as Hippocrates alTerts ? Can it be felt by the hand or by the
patient before the difeafe is too great to admit of cure by the paracen-
tefis ? Does this dropfy of the cheft: often come on after peripneu-
mony ? Is it ever cured by making the patient fick by tinfture of
digitalis ? Could it be cured, if on one fide only, by the operation of
pundlure between the ribs, and afterwards by inflaming the cavity by
the admifiion of air for a time, like the cure of the hydrocele ; the
pleura afterwards adhering wholly to that lobe of the lungs, fo as to
prevent any future eifufion of mucus?

15. Hydrops ovarii. Dropfy of the ovary is another incyfled
dropfy, which feldom admits of cure. It is difl:in(;uilhed from alcites
by the tumour and pain, efpecially at the beginning, occupying one
fide, and the fluctuation being lefs diftindly perceptible. When it
feappens to young fubjeds it is lefs liable to be miftaken for afcites.

It

Class I. 2.3. DISEASES OF IRRITATION. 109

It afFefts women of all ages, either married or virgins ; and Is pro-
duced by cold, fear, hunger, bad food, and other debilitating caufes.
I faw an elegant young lady, who was fliortly to have been married
to a fenfible man, with great profpedl of happlnefs ; who, on being
overturned in a chaife in the night, and obliged to walk two or three
miles in wet, cold, and darknefs, became much indifpofed, and gra-
dually afflided with a fwelling and pain on one fide of the abdomen ;
which terminated in a dropfy of the ovary, and deftroyed her in two
or three years. Another young woman I recoUeft feeing, who was
about feventeen, and being of the very inferior clafs of people, feemed
to have been much weakened by the hardlhip of a cold floor, and
little or no bed, with bad food ; and who to thefe evils had to bear
the unceafing obloquy of her neighbours, and the perfecution of parifh
officers.

The following is abftradted from a letter of my friend Mr. Power,
furgeon, at Bofworth in Leicefterfhire, on examining the body of an
elderly lady who died of this difeafe, March 29, 1793. " On open-
i[ig the abdomen I found a large cyll: attached to the left ovarium by
an elaftic neck as thick as the little finger, and fo callous as not to
admit of being feparated by fciffars without confiderable difficulty.
The fubftance of the cyft had aa appearance much refembling the
gravid uterus near the full period of geftation, and was as thick. It
had no attachment to the peritonaeum, or any of the vifcera, except
by the hard callous neck I have mentioned ; fo that the blood muft
with difficulty have been circulated through it for fome time. Its
texture was extremely tender, being eafily perforated with the finger,
was of a livid red colour, and evidently in a fphacelated ftate. It con-
tained about two gallons of a fluid of the colour of port wine, with-
out any greater tenacity. It has fallen to my lot to have opened two
other patients, whofe deaths were occafioned by incyfted dropfy of
the ovarium. In one of thefe the ovarium was much enlarged with
eight or ten cj'fts on its furface, but there was no adhefion formed by

any

no DISEASES OF IRRITATION. Class I. 2.3,

any of the cyfts to any other part ; nor had the ovarium formed any
adhefion with the peritonaeum, though in a very difeafed ftate. Iti
the other the difeafe was more fimple, being only one cyfl, without
any attachment but to the ovarium.

" As the ovarium is a part not neceflary to life, and dropfies of
this kind are fo generally fatal in the end, I think I fliall be induced,
notwithflanding the hazard attending wounds, which penetrate the
cavity of the abdomen, to propofe the extirpation of the difeafed part
in the firft cafe, which occurs to me, in which 1 can with precifion
fay, that the ovarium is the feat of the dileafe, and the patient in
other refpecls tolerably healthy ; as the cavity of the abdomen is often
opened in other cafes without bad confequences."

An argument, which might further countenance the operation thus
propofed by Mr. Power, might be taken from the difeafe frequently
afFe£l;ing young perfons ; from its being generally in thefe fubjefts
local and primary ; and not like the afcites, produced or accompanied
with other difeafed vifcera ; and laftly, as it is performed in
adult quadrupeds, as old fows, with fafety, though by awkward
operators.

16. Anafarca pulmonum. The dropfy of the cellular membrane of
the luno-s is ufually conne£ted ' with that of the other parts of the
fyftem. As the cells of the whole cellular membrane communicate
with each other, the mucaginous fluid, which remains in any part of
it for want of due abforption, finks down to the moft depending cells;,
hence the legs fwell, though the caufe of the difeafe, the deficiency
of abforption, may be in other parts of the fyftem. The lungs how-
ever are an exception to this, fince they are fufpended in the cavity
of the thorax, and have in confequence a depending part of their
own. -

The anafarca of the lungs is known by the difficulty of refpiration

accompanied with fwelled legs, and with a very irregular pulfe. This

8 laft

Class I. 2.3- DISEASES OF IRRITATION. iii

laft circumftance has generally been afcribed to a dropfy at the fame
time exifting in the pericardium, but is more probably owing to the
difficult paffage of the blood through the lungs ^ becaufe I found on
diffeftion, in one inftance, that the mofl: irregular pulfe, which I
ever attended to, was owing to very extenfive adheiions of the lungs j
infomuch that one lobe intirely adhered to the pleura ; and fecondly,
becaufe this kind of dropfy of the lungs is fo certainly removed for
a time along with the anafarca of the limbs by the ufe of digitalis.

This medicine, as well as emetic tartar, or fquill, when given fo
as to produce ficknefs, or naufea, or perhaps even without pro-
ducing either in any perceptible degree, by affedling the lymphatics of
the flomach, fo as either to invert their motion, or to weaken them,
increafes by reverfe fympathy the aftion, and confequent abforbent
■power of thefe lymphatics, which open into the cellular membrane.
But as thofe medicines feldom fucceed in producing an abforption of
thofe fluids, which (tagnate in the larger cavities of the body, as in
the abdomen, or chefl, and do generally fucceed in this difficulty of
'breathing with irregular pulfe above defcribed, I conclude that it is
not owing to an effufi'on of lymph into the peiricardium, but limply
to an anafarca of the lungs.

M.M. Digitalis. See Art. V. 2. I. Tobacco. Squill. Emetic
tartar (antimonium tartarizatum). Then Sorbentia. Chalybeates.
Opium half a grain twice a day. Raifin wine and water, or other
wine and water, is preferred to the fpirit and water, which thefe pa-
tients have generally been accuflomed to.

The ufual caufe of anafarca is from a difeafed liver, and hence it
moft frequently attends thofe, who have drank much fermented or
fptr.ituovs liquors ; but I fufpedt that there is another caufe of ana-
faica, which originates from the brain ; and which is more certainly
fatal than that, which originates from a difeafed liver. Thefe patients,
where the anafarca originates from, or commences in, the brain, have
jaot other fymptoms of difeafed liver ; have Ifefs difficulty of breathing

at

112 DISEASES OF IRRITATION. Class I. 2.5.

at the beginning ; and hold themfelves more upright in their chair,
and in walking. In this kind of dropfy I fufpe£l the digitalis has lefs
or no etfefl ; as it particularly Increafes the ablorption from, the
lungs.

17. Obejitas. Corpulency may be called an anafarca or dropfy of
fat, fince it mud: be owing to an analogous caufe ; that is, to the de-
ficient abforption of fat compared to the quantity fecreted into the cells
which contain it. See Clafs II. i. 1.4.

The method of getting free from too much fat without any injury
to the conftltution, confifls, firft, in putting on a proper bandage on
the belly, fo that it can be tightened or relaxed with eafe, as a tlghtifh
under walftcoat, with a double row of buttons. This is to comprefs
the bowels and incrcafe their abforption, and It thus removes one prin-
cipal caufe of corpulency, which is the loofenefs of the Ikin. Secondly,
he fhould omit one entire meal, as fupper; by this long abftinence
from food the abforbent fyftem will a£l on the mucus and fat with
greater energy. Thirdly, he (hould drink as little as he can with
eafe to his fenfations ; fince, If the abforbents of the flomach and
bowels fupply the blood with much, or perhaps too much, aqueous
fluid, the abforbents of the cellular membrane will a6l with lefs
energy. Fourthly, he fhould ufe much fait or falted meat, which
"will increafe the perfplratlon and make him thirfly ; and if he bears
this thirfi:, the abforption of his fat will be greatly increafed, as ap-
pears in fevers and dropfies with thirfi: ; this I believe to be more effi-
Gacious than foap. Fifthly, he may ufe aerated alcallne water for
his drink, which may be fuppofed to render the fat more fluid, — or
he may take foap In large quantities, which will be decompofed In
the flomach. Sixthly, ftiort reft, and conftant exerclfe.

18. Splenis tumor. Swellings of the fpleen, or In Its vicinity,
are frequently perceived by the hand in intermittents, which are

called

Class I. 2. 3. DISEASES OF IRRITATION. 1 13

called Ague-cakes, and feem owing to a deficiency of abforption in the
afFeded part.

Mr. Y , a young man about twenty-five years of age, who

lived intemperately, was feized with an obftinate intermittent, which
had become a continued fever with flrong pulfe, attended with daily
remiflion. A large hard tumour on the left fide, on the region of the
fpleen, but extending much more downward, was fo diftindtly percepti-
ble, that one feemed to get one's fingers under the edge of it, much hke
the feel of the brawn or fliield on a boar's Ihoulder. He was repeat-
edly bled, and purged with calomel, had an emetic, and a blifter 011
the part, without diminiftiing the tumour j after fome time he took the
Peruvian bark, and flight dofes of chalybeates, and thus became free
from the fever, and went to Bath for feveral weeks, but the tumour
remained. This tumour I examined every four or five years for above
thirty years. His countenance was pale, and towards the end of his
life he fufFered much from ulcers on his legs, and died about fixty, of
general debility ; like many others, who live intemperately iu refpe(5t
to the ingurgitation of fermented or fpirituous liquors.

As this tumour commenced in the cold fit of an intermittent fever,
and was not attended with pain, and continued fo long without en-
dangering his life, there is reafon to believe it was fimply occafioned
by deficient abforption, and not by more energetic aflion of the vef-
fels which conftitute the fpleen. See Clafs II. i. 2. 13.

M. M. Venefedion. Emetic, cathartic wdth calomel ; then for-
bentia, chalybeates, Peruvian bark.

1 9. Genu tumor albus. White fwelling of the knee, is owing to de-
ficient abforption of the lymphatics of the membranes including the
joint, or capfular ligaments, and fometimes perhaps of the gland
which fecretes the fynovia ; and the ends of the bones are probably

affeded in confequencco , ;i-; ,

Vol. II. Q^ .,.';, I faw

J 14 DISEASES OF IRRITATION. Class I. 2. 3.

I faw aii inftance, where a cauftic had been applied by an empi-
ric on a large white fvvelling of the knee» and was told, that a fluid
had been difcharged from the joint, which became anchylofed, and
healed without lofs of the limb.

M. M. Repeated blifters on the part early in the difeafe are faid to
cure it by promoting abforption ; faturnine folutions externally are re-
commended,, Bark, -animal charcoal, as burnt fponge, opium ia
finall dofes. Fri3:ion with the hand.

20.- Bronchocele,. Swelled throat. An enlargement of the thyroid^
glands, faid to be frequent in mountainous countries, where river
water is drank, which, has its fburce from diffolving fnows. This idea
is a very ancient one, but perhaps not on that account to be the more
depended upon, as authors copy one another. Tumidum guttur
quis miratur in alpibus, feems to have been a proverb in the time of
Juvenal. The inferior people of Derby are much fubjecSt to this
difeafe,. but whether more fo than other populous towns, I can not;
determine ; certain it is, that they chiefly drink the water of the Der-
went, which arifes in a mountainous country, and is very fre-
quently blackened as it paffes through the moraffes near, its fource ;.
and is generally of a darker colour, and attended with a whiter foam,,,
than the Trent, into which it falls ; the greater quantity and whitenefs
of its froth I fuppofe may be owing to the vifcidity communicated to.
It by the colouring matter. The lower parts of the town of Derby.
.might be eafily fupplied with fpring water from St. Alkmond's. well ;;
er the whole of it from the abundant fprings near Bowbridge^
the v/ater from which might be conveyed to the town in hol-
low bricks, or clay-pipes, at no very great expcnce, and might
be received into frequent refervoirs with pumps to themi, or laid,
into the houfes.

M. M. Twenty grains of burnt fponge with ten of nitre made

w,ith,.

Class I. 2.3- DISEASES OF IRRITATION. ' 1,5

with mucilage into lozenges, and permitted to diflblve flowly under
the tongue twice a day, is afferted to cure in a few months; perhaps
other animal charcoal, as candle-fnufFs, might do the fame.

I have direded in the early ftate of this difeafe a mixture of common
fait and water to be held in the mouth, particularly under the tonoue,
for a few minutes, four or fix times a day for many weeks, which
has fometlmes fucceeded, the fait and water is then fpit out again, or
in part fwallowed. Externally vinegar of fquills has been applied, or
a mercurial plafter, or fomentations of acetated ammoniac ; or ether.
Some empirics have applied cauftics on the bronchocele, and fome-
times, I have been told, with fuccefs; which (houid certainly be
ufed where there is danger of fufFocation from the bulk of it. One
cafe I faw, and one I was well informed of, where the bronchocele
was cured by burnt fponge, and a he£lic fever fupervened with colli-
quative fweats; but I do not know the final event of either of
thein.

De Haen ajffirms the cure of bronchocele to be efFe(3:ed by flowers
of zinc, calcined egg-fhells, and fcarlet cloth burnt together in
a clofe crucible, which was tried with fuccefs, as he afTured me, by
a late lamented phyfician, my friend. Dr. Small of Birmingham ;
who to the cultivation of modern fciences added the integrity of an-
cient manners ; who in clearnefs of head, and benevolence of heart,
had few equals, perhaps no fuperiors.

21. Scrophula. King's evil is known by tumours of the lymphatic
glands, particularly of the neck. The upper lip, and divifion of the
noflrils is fwelled, with a florid countenance, a fmooth fkin, and a
tumid abdomen. Cullen. The abforbed fluids in their courfe to the
veins in the fcrophula are arrefted in the lymphatic or conglobate
glands ; which fwell, and after a great length of time, inflame and
fuppurate. Materials of a peculiar kind, as the variolous and venereal
matter, when abforbed in a wound, produce this torpor, and confe.

0^2 quent

ii6 DISEASES OF IRRITATION. ClassI. 2.3.

quent inflammation of thofe lymphatic glands, where they firft ar-
rive, as in the axilla and groin. There is reafon to fufpeft, that the
tonfils frequently become inflamed, and ftippurate from the matter ab-
forbed from carious teeth ; and I faw a young lady, who had both the
axillary glands fvvelled, and which fuppurated ; which was believed
to have been caufed by her wearing a pair of new green gloves for
one day, when flie had perfpired much, and was much exhaufted
and fatigued by walking ; the gloves were probably dyed in a folution
of verditer.

Thefe indolent tumours of the lymphatic glands, which conftitute
the fcrophu la, originate from the inirritability of thofe glands j which
therefore fooner fall into torpor after having been Simulated too vio-
lently by fome polfonous material; as the mufcles of enfeebled people
fooner become fatigued, and ceafe to adt, when exerted, than thofe of
ilroncrer ones. On the fame account thefe fcrophulous glands are
much longer in acquiring increafe of motion, after having been ftimu-
lated into ina£ti\rity, and either remain years in a ftate of indolenccj
or fuppurate with difficulty, and fometimes only partially.

The difFerence between fcrophulous tumours, and thofe before de-
fcribed, confifts in this ; that in thofe either ghnds of different kinds
were difeafed, or the mouths only of the lymphatic glands were become
torpid ; whereas in fcrophula the conglobate glands themfelves become
tumid, and generally fuppurate after a great length of time, whea
■ they acquire new fenfibility. See Seft. XXXIX. 4, 5.

Thefe indolent tumours may be brought to fuppurate fometimes by
pafilng eledric {hocks through them every day for two or three
weeks, as I have witneffed. It is probable, thatTihe alternate appli-
cation of fnow or iced water to them, till they become painfully cold,
and then of warm flannel or warm water, frequently repeated, might
refl:ore their irritability by accumulation of fenforial power j and
thence either facilitate their difperfion, or occafion them to fuppurate,.

See Clafs IL i. 4. 13.,

This-

Class I. 2.3- DISEASES OF IRRITATION, 117

This difeafe is very frequent amongft the children of the poor in
large towns, who are in general iU fed^ ill lodged, and ill clothed i
and who are further weakened by eating much fait with their fcanty
meal of infipid vegetable food, which is feldom of better quality than
water gruel, with a little coarfe bread in it. See diarrhoea of infants,
Clafs I. I. 2. 5. Scrophulous ulcers are difficult to heal, which is
owing to the deficiency of abforption on their pale and flabby furfaces,
and to the general inimtability of the fyftem. See Clafs L i. 3. 13.
M. M. Plentiful diet of flefh-meat and vegetables with fmall-beer.
Opium, from a quarter of a grain to half a grain twice a day. Sor-
bentia. Tincture of digitalis, thirty drops twice a day. Externally
fea-bathing, or bathing in fait and water, one pound to three gallons^,
made warm. The application of Peruvian bark in fine powder, fevea
parts, and white lead, (ceruflk) in fine powder one part, mixed to-
gether and applied on the ulcers in dry powder, by means of lint and
a bandage, to be renewed every day. Or very fine powder of calamy
alone, lapis calaminaris. If powder of manganefe I

22. Schirrus. After the abforbent veins of a gland ceafe to perform=
their office, if the fecerning arteries of it continue to ad: fome time
longer, the fluids are puftied forwards, and ftagnate in the receptacles-
or capillary veflels of the gland ; and the thinner part of them only
being rel-umed by the abforbent fyftem of the gland, a hard tumour gra—
dlially fucceed-s ; which continues like a lifelefs mafs, till from fome
accidental violence it gains fenfibility, and produces cancer, or fuppu"
rates. Of this kind are the fchirrous glands of the breafts, of the
lungs, of the mefentery, and the fcrophulous tumours about the necL
and the bronchocele.

Another feat of fchirrus is in the membranous parts of the fyftem^.
as of the re<5lum inteflinum, the urethra, the gula or throat ; and of
this kind is the verucca or wart, and the clavus pedum, or corns oa
tjlie toes. A. wen fometimes arifes on. the back of the neck, and

fometimea

ii8 DISEASES OF IRRITATION, Class!. 2.3.

fometimes between the fhouldersj and by diftending the tendinoui
fafcia produces great and perpetual pain.

M. M. Mercurial olntmeat. Cover the part with oiled filk. Ex-
tirpation. Eleftric fhocks through the tumour. An iflue into the fub-
ftance of the wen. Opium. Ether externally.

23. Schirrus reSii inteft'ini. Schirrus of the reftum. A fchirrus
frequently affefts a canal, .and by contra(£ling its diameter becomes a
painful and deplorable difeafe. The canals thus obftrudted are the
redura, the urethra, the throat, the gall-dudbs, and probably the ex-
cretory dufts of the lymphatics, and of other glands.

The fchirrus of the redum is known by the patient having pain in
the part, and being only able to part with liquid feces, and by the in-
trodu£tion of the finger; the fwelled part of the inteftine is fometimes
protruded downwards, and hangs like a valve, fmooth atid hard to the
touch, with an aperture in the centre of it. Sec a paper on this
fubjedt by J. Sherwin. Memoirs of a London Medical Society,
Vol. II. p. 9.

M. M. To take but little folid food. Aperient medicines. In-
troduce a candle fmeared with mercurial ointment. Sponge-tent.
Clyfters with forty drops of laudanum. Introduce a leathern canula,
or gut, and then either a wooden maundril, or blow it up with air,
fo as to diftend the contraft^d part as much as the patient can bear.
Or fpread mercurial plafter on thick foft leather, and roll it up with
the plafter outwards to any thicknefs and length, which can be eafily
introduced and worn ; or two or three fuch pieces may be introduced
after each other. The fame may be iifed to comprefs bleeding inter-
nal piles. See Clafs I. 2. i . 6.

ii4. Schirrus urethrce, Schirrus of the urethra. The paflage be-
comes contracted by the thickened membrane, and the urine is forced
through with great difficulty, and is thence liable to diflend the canal

behind

-Class I. 2.3. DISEASES OF IRRITATION. 119

behind the flridlure; till at length an aperture is made, and the urine
forces its waj into the cellular membrane, making large finufes.
This fituation fometimes continues many months, or even years, and
{o much matter is evacuated after making water, or at the fame time,
by the adion of the mufcles in the vicinity of the finufes, that it has
been miftaken for an increafed fecretion from the bladder, and has
been erroneoufly termed a catarrh of the bladder. See a paper by Df^
R. W. Daru'in in the Medical Memoirs.

M. M. Dlilend the part gradually by catgut bougies, which by
their compreffioii will at the fame time diminifh the thicknefs of the
membrane, or by bougies of elaflic gum, or of horn boiled foft,.
The patient fhould gain the habit of making water {lowly, which is
a matter of the utmoft coniequence, as it prevents the dillention, and
Gonfequent rupture,, of that part of the urethra,, which is- betweea
the ftri^lure and the neck of the bladders.

When there occurs an external ulcer in the perlnjeumi, and the-
larine is in- part difcharged thatr way» the difeafe can not be miflaken*
Gtherwlfe from the quantiry, of matter, it is generally fuppofed to=
come from, the bladder, or predate gland-^ and the urine, Vi/hich ef-
capes from the ruptured urethra, mines its way amongd: the mufcles
and membranes, and- the patient dies tabid, owing to the want of aa.
external orifice to difcharge the matter. See Clafs II. i. 4. 1 1*

2:5.. Schkr.ui.afophagi. A ichirrus of the throat contracts the pafr
ftge fo as to render the fwaliowing of folids impra£i:icable, and of
liquids difficult. It affefts patients of ail ages, but is probably, moft
frequently produced by fwaliowing hard angular fubftances, when
people have loft theic teeth ; by which this membrane is over difteud-
cd, or torn, or otherwife injured.

M- M. Put milk into a bladder tied to a canula or catheter; in-
troduce it part the ftridure, and prefs it into the ftomach. Diftend
the ftridure gradually by a fponge-tent faftened to the end of whale-

6 bone 3,

7 20 DISEASES OF IRRITATION. Class I. 2. 3.

bone, or by a plug of wax, or a fpermaceti candle, about two inches
long ; which might be introduced, and left there with a ftring only
fixed to it to hang out of the mouth, to keep it in its place, and to re-
tra£l it by occafionally ; for which purpofe the ftring muft be put
through a catheter or hollow probang, when it is to be retraced. Or
laflly introduce a gut fixed to a pipe; and then diftend it by blow-
ing wind into it. The fwallowing a bullet with a ftring put through
it, to retradl it on the exhibition of an emetic, has alfo been propofed.
Externally mercurial ointment has been much recommended. Poultice.
Oiled filk. Clyfters of broth. Warm bath of. broth. Transfufioa
of blood into a vein three or four ounces a day ? See Clafs III.- i. i. 1^.
I diredled a young woman about twenty-two years of age, to be fed
with new milk put into a bladder, which was tied to a catheter, and
introduced beyond the ftridlure in her throat ; after a few days her
fpirlts funk, and fhe refufed to ufe it further, and died. Above thirty
years ago I propofed to an old gentleman, whofe throat was entirely
impervious, to fupply him with a few ounces of blood daily from an
afs, or from the human animal, who is ftill more patient and tradable,
in the following manner. To fix a filver pipe about an inch long to
■ each extremity of a chicken's gut, the part between the two filver
•ends to be meafured by filling it with warm water ; to put one end into
the vein of a perfon. hired for that purpofe, fo as to receive the blood
returning from the extremity j and when the gut was quite full, and
the blood running through the other filver end, to introduce that end
into the vein of the patient upwards towards the heart, fo as to admit no
air along with the blood. And laftly, tofupport the gut and filver ends
on a water plate, filled with water of ninety-eight degrees of heat, and
to meafure how many ounces of blood was introduced by paffing the
finger, fo as to comprefs the gut, from the receiving pipe to the de-
livering pipe ; and thence to determine how many gut-fulls were
given from the healthy perfon to the patient. See Clafs IV. 2. 4. i x. L.
Mr, — — confidered a day on this propofal, and then another day,

7 • and

Class I. 2.3. DISEASES OF IRRITATION. izt

and at lensth anfwered, that " he now found himfelf near the houfe
of death; and that if he could return, he was now too old to have
much enjoyment of life; and therefore he wifhed rather to proceed to
the end of that journey, which he was now fo near, and which he
muft at all events foon go, than return for fo fliort a time." He
lived but a few days afterwards, and feemed quite carelefs and eafy
_ about the matter.

26. La&eorum inirr'itahilitas. Inirritability of the la6leals is dc-
fcribed in Sedt. XXVIII. under the name of paralyfis of the ladeals ;
but as the word paralyfis has generally been applied to the difobediencc
of the mufcles to the power of volition, the name is here changed to
inirritability of the ladleals, as more charafteriftic of the difeafe.

27, Lymphattcorwninirrttabilitas. The inirritability of the cellular
and cutaneous lymphatics is defcribed in Seift. XXIX. 5. r. and ia
Clafs I. 2. 3. 16. The inirritability of the cutaneous lymphatics gene-
rally accompanies anafarca, and is the caufe of the great thirft in that
malady. At the fame time the cellular lymphatics adt with greater
energy, owing to the greater derivation of fenforial power to them in
confequence of the lefs expenditure of it by the cutaneous ones ; and
hence they abforb the fat, and mucus, and alfo the thinner parts of
the urine. Whence the great emaciation of the body, the muddy fe-
diment, and the fmall quantity of water in this kind of dropfy.

R OR DO

T*

122 DISEASES OF IRRITATION. Class I. 2.4.

ORDO IL

Decreafed Irritation^

GENUS IV.
With decreafed ASiions of other Cavities and Membranes^.

Many of the dlfeafes of this genus are attended with pain, and
with cold extremities, both which ceafe on the exhibition of wine or
opium ; which fhews, that they originate from deficient adion of the
affedled organ. Thefe pains are called nervous or fpafmodic, are no£
attended with fever, but are frequently fucceeded by convulfions and
madnefs ; both which belong to the clafs of volition. Some of them
return at periods, and when thefe can be afcertained, a much lefs
quantity of opium will prevent them, than is neceffary to cure them,
when they are begun ; as the veffels are then torpid and inirritable
from the want of fenforial power, till by their ina£tion it becomes
again accumulated.

Our organs of fenfe properly fo called are not liable to pain from
the abfence of their appropriated ftimuli, as from darknefs or filence ;
but the other fenfes, which may be more properly called appetites,
as thofe by which we perceive heat, hunger, thirft, luft, want of
frefli air, are afFe£led with pain from the defeat or, abfence of their
accuftomed ftimuli, as well as with pleafure by the poffeilion of them ;
it is probable that feme of our glands, v/hofe fenfe or appetite requires
or receives fomething from the circulating blood, as the pancreas,
liver, tertes, proftate gland, may be affefted with aching or pain,
■when they cannot acquire their appropriated fluid.

Wherever

Glass T. 2. 4. DISEASES OF IRRITATION. ^ 123

. Wherever this defeft of ftimulus occurs, a torpor or ina(9:ion of the
organ enfues, as in the capillaries of the fkin, when expofed to cold;
and in the glands, which fecrete the gaflric juice, when we are
hungry. This torpor however, and concomitant pain, which is at
firft owing to defeft of ftimulus, is afterwards induced by other affo-
ciations or catenations, and conftitutes the beginning of ague fits.

Itmuft be further obferved, that in the difeafes of pain without
fever, the pain is frequently not felt in the part where the caufe of
the difeafe refides ; but is induced by fympathy with a diflant part,
whofe irritability or fenfibility is greater or lefs than its own. Thus
a ftone at the neck of the bladder, if its ftimulus is not very great,
only induces the pain of ftrangury at the glans penis. If its ftimulus
be greater, it then induces pain at the neck of the bladder. The
concretions of bile, which are protruded into the neck of the gall-
bladder, when the difeafe is not very great, produce pain at the other
extremity of the bile-dudl, which enters the duodenum immediately
under the pit of the ftomach ; but, when the difeafe is great from
the largenefs of the bile-ftone, the pain is felt in the region of the liver
at the neck of the gall-bladder.

It appears from hence, that the pains enumerated in this genus are
confequences of the inactivity of the organ ; and, as they do not oc-
cafion other difeafes, fhould be claffed according to their proximate
'<;aufe, which is defe£live irritation ; there are neverthelefs other pains
from defed; of ftimulus, which produce convulfions, and belong to
Clafs III. I. I. ; and others, which produce pains of fome diflant part
by affociation, and belong to Clafs IV. 2. 2.

SPECIES.

I. Ski's. Thirft. Tiie ienfes of thirft and of hunger feem to have
this connexion, that the former is fituated at the upper end, and the

R 2 latter

124 DISEASES OF IRRITATION. Class I. 2. 4'

latter at the lowec end of the fame canal. One about the pharinx,
where the cefophagus opens into the mouth, and the other about the
cardia ventricuii, where it opens into the ftomach. The extremities
of other canals have been fhewn to poffefs correfpondent fenfibiUties,
or irritablhtieS, as the two ends of; the urethra, and of the commoa
gall-duft. See IV. 2. 2. 2. and 4.

The membrane of the upper end of the gullet becomes torpid, and
confequently painful, when there is a deficiency of aqueous fluid in
the general fyllem ; it then wants its proper flimulus. In the lame
manner a want of the ftimulus of more folid materials at the other end
of the canal, which terminates in the flomach, produces hunger;
as mentioned in Sedl. XIV. 8. The proximate caufes of both of them
therefore confift in deficient irritation, when they are confidered as
pains ; becaufe thefe pains are in conlequence of the inaftivity of the
organ, according to the- fifth law. of animal caufat ion. Sect, IV. 5.
But when they are confidered as delires, namely of liquid or folid ali-
ment, their proximate caufe confifts in the pain of them, according to
the fixth law of animal caufation. So the proximate caufe of the pain
of coldnefs is the inaftivity of the organ, and perhaps the confequent
accumulation of fen forial power in it ; but the pain itfelf, or the con-
fequent volition, is the proximate caufe of the fliuddering and gnafh-
ine the teeth in cold fits of intermittent fevers. See Clafs I. 2. 2. i.

Thirft may be divided into two varieties alluding to the remote
caufe of each, and may be termed fitis calida, or warm thirft, and
fitis frigida, or cold thirft. The remote caufe of the former arifes
from the diflipation of the aqueous parts of our fluids by the increafed
fecretion of perfpirable matter, or other evacuations. And hence it
occurs in hot fits of fever, and after taking much wine, opium,
fpice, fait, or other drugs of the Art. incitantia or fecernentia. The
thirft, which occurs about three hours after eating a couple of red
herrings, to a perfon unaccuftomed to falted meat, is of this kind ;
the increafed aftion of the cutaneous veffels diffipates fo much of our

4 fluids

Class I. 2.4. DISEASES OF IRRITATION. 125

fluids by infenfible perfplration^ as to require above two quarts of
water to reftore the fluidity of the blood, and to wafli the fait out of
the fyftem. See Art, III. 2. i.

M. M. Cold water. Vegetable acids. Warm bath.

The remote caufe; of fitis frigida, or cold thlrft, is owing to the in-
aftion of the cutaneous, pulmonary, urinary, and cellular abforbents;
V.' hence the blood is deprived of the great fupply of moifture, which
it ought to receive from the atmofphere, and from the cells of the
cellular membrane, and from other cyfts; this caufe of thirfi: exifts
in dropfies, and in the cold fits of intermittents. The defire of
fluids, like that of folids, is liable to acquire , periods, and may
therefore readily become difeafed by indulgence in liquids grateful to
the palate.

Of difeafed thirft, the moft common is either owing to defedl of
the adlion of the numerous abforbent veflels on the neck of the blad-
der, in which 'the patient makes much paleirti water ; or to the de-
fective abforption of the fkin and lungs, in which the patient makes
but little water, and that high-coloured, and with fediment. In both
the tongue and lips are liable to become very dry. The former in its'
greateft degree attends diabaetes,- and the latter anafarca.

M. M. Warm water, warm wine, warm bath. Opium. Cold
bath. Iced water. Lemonade. Cyder.

2. E/un'es. Hunger has been fancifully afcribed to the fides of the
flomach rubbing againfl each other, and to the increafed acidity of
the gaftric juice corroding the coats of it. If either of thefe were the
caufe of hunger, inflammation muft occur, when they had continued
fome time ; but, on the contrary, coldnefs and not heat are attendant
on hunger ; which evinces, that like thirft it is owing to the inac-
tivity of the membrane, which is the feat of it ; while the abundant
nerves about the cardia ventricuh, and the pain of hunger being

felt

126 DISEASES OF IRRITATION. Class T. 2.4,

felt In that part, gives great leafon to conclude, that it is there
fituated.

The fenfe of hunger as well as of thirft is liable to acquire habits
in refpe£t to the times of its returning painfulnefs, as well as in re-
fpedl to the quantity required to fatiate its appetency, and hence may
become difeafed by indulgence, as well as by want of its appropriate
flimulus. Thofe who have been accuftomed to diftend their flomach
by large quantities of animal and vegetable food, and much potation,
find a want of diftention, when the ftomach is empty, which occa-
fions faintnefa, and is miflaken for hunger, but which does not ap-
pear to be the fame fenfation. I was well informed, that a woman
near Lichfield, who eat much animal and vegetable food for a wager,
affirmed, that fince diftending her flomach fo much, (he had never
felt herfelf fatisfied with food ; and had in general taken twice as
much at a meal, as fhe had been accuflomed to, before fhe eat fo
much for a wager.

o

3. Naufea Jtcca. Dry naufea. Confifts in a quiefcence or torpor
of the mucous or falivary glands, and precedes their inverted motions,
defcribed in naufea humida, Clafs I. 3. 2. 3. In the fame manner as
ficknefs of the flomach is a quiefcence of that organ preceding the
a£lion of vomiting, as explained in Se6l. XXXV. i. 3. This is fome-
times induced by difagreeable drugs held in the mouth, at other times
of difguftful ideas, and at other times by the aflbciation of thefe ac-
tions with thofe of the flomach ; and thus according to its different
proximate caufes may belong to this, or to the fecond, or to the fourth
clafs of difeafes^

M. M. Lemonade. Tafleful food. A blifler. Warm bath.

4. Mgritudo •ventriculi. Sicknefs of flomach is produced by the
quiefcence or inadivity of that organ, as is explained in Sed:. XXXV.

6 1.3.

C LASS I. 2. 4. DISEASES OF IRRITATION. 127

1.3. It confifts in the ftate between the ufual periftaltic motions of
that organ, in the digeftion of our aliment, and the retrograde mo-
tions of it in vomiting ; for it is evident, that the diredl motions of it
from the cardia to the pylorus muft flop, before thofe in a contrary
diredion can commence. This ficknefs, like the naufea above de-
fcribed, is fometimes produced by difgufliful ideas, as when nafty ob-
jefts are feen, and nafty ftories related, as well as by the exhauftion
of the fenforial power by the ftimulus of fome emetic drugs, and by
the defeat of the produ£i:ion of it, as in enfeebled drunkards.

.Sicknefs may likewife confift in the retrograde motions of the lym-
phatics of the ftomach, which regurgitate intait the chyle or lymph,
which they have lately abforbed, as in Clafs I. 3. 2. 3. It is probable,
that thefe two kinds of ficknefs may be different fenfations, though
they have acquired but one name ; as one of them attends hunger,
and the other repletion ; though either of them may poflibly be in-
duced by affociation with naufeous ideas.

M. M. A blifter on the back. An emetic. Opium. Crude
mercury. Covering the head in bed. See Se6l, XXV. 1 6. Clafs IV.
J. 1.2. and 3.

5. Cardialgia. Heartburn originates from the inaftivity of the
ftomach, whence the aliment, inrtead of being fubdued by dio-eftion
and converted into chyle, runs into fermentation, producino- acetous
acid. Sometimes the gaftric juice itfelf becomes fo acid as to o-lve
pain to the upper orifice of the flomach ;. thefe acid contents of the
ftomach, on falling on a marble hearth, have been feen to produce an
efFervefcence on it. The pain of heat at the uoper end of the o-nllpt
when any air is brought up from the fermenting contents of the
ilomach, is to be afcribed to the lympathy between thefe two extre-
mities of the oefophagus rather than to the pungency of the carbonic
gas, or fixed air ; as the fenfation in fvvallowing that kind of air ia
water is of a different kind. See Clafs I. 3, 1.3. and IV, 2. 2. 5.

M.M.

128' DISEASES OF IRRITATION. Class I. 2.4.

M. M. This difeafe arifing from indigeftion is often very pertina-
cious, and afRi6ling ; and attended with emaciation of the body from
want of fufficient chyle. As the faUva fwallowed along with our
food prevents its fermentation, as appears by the experiments of
Pringle and Macbride, fome find confiderable relief by chewing
parched wheat, or maftic, or a lock of wool, frequently in a day,
when the pain occurs, and by fwallowing the faliva thus efFufed ; a
temporary relief is often obtained from antiacids, as aerated alcaline
water, Seltzer's water, calcareous earths, alcaline falts made into
pills with foap, foap alone, tin, milk, bitters. More permanent ufe
maybe had from fuch drugs as check fermentation, as acid of vitriol ;
but ftill more permanent relief from fuch things as invigorate the di-
geftion, as a blifter on the back ; a due quantity of vinous fpirit and
water taken regularly. Steel. Temperance. A fleep after dinner. A
waiflcoat made fo tight as flightly to comprefs the bowels and ftomach.
A flannel fliirt in winter, not in fummer. A lels quantity of pota-
tion of all kinds. Ten black pepper-corns fwallowed after dinner.
Half a grain of opium twice a day, or a grain. The food (hould con-
fifl: of fuch things as do not eafily ferment, as flefti, fliell-fifh, fea-
bifcuit, toafted cheefe. I have {een toafted cheefe brought up from
the ftomach 24 hours after it had been fwallowed, without ap-
parently having undergone any chemical change. See Clafs II. i. 3.
17. and IV. I. 2. 13.

6. Arthritis VentricuU. Sicknefs of the ftomach in gouty cafes is
frequently a confequence of the torpor or inflammation of the liver,
and then it continues many days or weeks. But when the patient is
feized with great pain at the flomach with the fenfation ofcoldnefs,
which they have called an ice-bolt, this is a primary affection of the
ftomach, and deftroys the patient in a i&^ hours, owing to the torpor
or inadlion of that vifcus fo important to life.

The

Class I. 2.4- DISEASES OF IRRITATION. 129

This primary gout of the flomach, as it is a torpor of that vifcus,
is attended with fenfatioa of coldnefs, and with real defedl of heat,
in that part, and may thence be diftingui/hed from the pain occafioned
by the pafTage of a gall-Hone into the duodenum, as well as by the
weak pulfe, and cold extremities ; to which mull be added, that it
affefts thofe only, who have been long afflicted with the gout, and
much debilitated by its numerous attacks.

M.M. Opium. Vinous fpirit. Volatile alcali. Spice. Warmth
applied externally to the flomach by hot cloths or fomentation.

7. Coh'ca flatuknta. The flatulent colic arifes from the too great
diftention of the bowel by air, and confequent pain. The caufe of
this difeafe is the ina£tivity or want of fufficiently powerful contrac-
tion of the coats of the bowel, to carry forwards the gas given up by
the -fermenting aliment. It is without fever, and generally attended
with cold extremities.

It is diflinguifhed, firft, from the pain occafioned by the paflage of
a gall-ftone, as that is felt at the pit of the flomach, and this nearer
the navel. Secondly, it is diflinguifhed from the colica faturnina, or
colic from lead, as that arifing from the torpor of the liver, or of fome
other vifcus, is attended with greater coldnefs, and with an aching
pain ; whereas the flatulent cholic being owing to diftention of the
mufcles of the bowel, the pain is more acute, and the coldnefs lefs.
Thirdly, it is diflinguifhed from inflammation of the bowels, or ileus,
as perpetual vomiting and fever attend this. Fourthly, it is diflin-
guifhed from cholera, becaufe that is accompanied with both vomiting
and diarrhoea. And laftly, from the colica epileptica, or hyfleric colic,
as that is liable to alternate with convulfion, and fometimes with in-
fanity ; and returns by periods.

M. M. Spirit of wine and warm water, one fpoonful of each.
Opium one grain. Spice. Volatile alcali. Warm fomentation ex-
ternally. Rhubarb.

Vol. II.^ S .8. Colica

17P DISEASES OF IRRITATION. ClassI. 2. 4.

8. Colica faturn'ina. Colic from lead. The paia is felt about the
navel, is rather of an aching than acute kind at firfl:, which increafes
after meals, and gradually becomes more permanent and more acute.
It terminates in paralyiis, frequently , of the mulcles of the_arm, fo
that the hand hangs down, when the arm is extended horizontally. It
is not attended with fever, or increafe of heat. The feat of the dif-
eafe is not well afcertained, it probably afFefts fome part of the liver,
as a pale bluifh countenance and deficiency of bile fometimes attends
or fucceeds it, with confequent anafarca ; but it feems to be caufed
immediately by a torpor of the inteftine, whether this be a primary
or fecondary afFe6lion, as appears from the conftipation of the bowels,
which attends it ; and is always produced in confequence of the great
flimulus of lead previoufly ufed either internally for a length of time,
or externally an a large furface.

A delicate young girl, daughter of a dairy farmer, who kept his
milk in leaden cifterns, ufed to wipe off the cream from the edges of
the lead with her finger ; and frequently, as flie was fond of cream,^
licked it from her finger. She was feized with the faturaine colic,
and femi-paralytic wrifts, and funk from general debility.

A feeble woman about 40 years of age fprained her ancle, and
bruifed her leg and thigh ; and applied by ill advice a folution of lead
over the whole limb, as a fomentation and poultice for about a fort-_
nicrht. She was then feized with the colica faturnina, lofi the ufe of
her wrifts, and gradually funk under a general debility.

M. M. Firft opium one or two grains, then a cathartic of fenna,
jalap, and oil, as foon as the pain is relieved. Oleum ricini. Alum.
Oil of almonds. A blifter on the navel. Warm bath. The flimulus
of the opium, by reftoring to the bowel its natural irritability in this
cafe of painful torpor, afliils the adliou of the cathartic.

9. Tympanitis, Tympany confifls in an elaftic tumor of the ab-

domen^

Class I. 2,4. DISEASES OF IRRITATION. 131

domen, which founds on being ftruck. It is generally attended with
coftivenefs and emaciation. In one kind the air is faid to exift in the
bowels, in which cafe the tumor is lefs equal, and becomes lefs tenfe
and painful on the evacuation of air. In the other kind the air exifts
in the cavity of the abdomen, and fometimes is in a few days ex-
changed for water, and the tympany becomes an afcites.

Air may be diftinguifhed in the ftomach of many people by the
found on ftriking it with the fingers, and comparing the found with
that of a fimilar percullion on other parts of the bowels; but towards
the end of fevers, and efpecially in the puerperal fever, a diftentiou
of the abdomen by air is generally a fatal fymptom, though the
cafe, and often cheerfulnefs, of the patient vainly flatters the at-
tendants.

M, M. In the former cafe a clyfter-pipe unarmed may be intro-
duced, and left fome time in the redum, to take off the refiftance of
the fphinfler, and thus difcharge the air, as it is produced from the
fermenting or putrefying aliment. For this purpofe, in a difeafe
fomewhat fimilar in horfes, a perforation is made into the reftum on
one fide of the fphin£ler; through which fiflula the air, which is pro-
duced in fuch great excefs from the quantity of vegetable food which
they take, when their digeftions are impaired, is perpetually evacu-
ated. In both cafes alfo, balfams, effential oil, fpice, bandage on
the abdomen, and, to prevent the fermentation of the aliment, acid
of vitriol, faliva. See Clafs I. 2. 4. 5.

10, Hypochondriafis. The hypochondriac difeafe confifts in indi-
geflion and confequent flatulency, with anxiety or want of pleafure-
able fenfation. When the aftion of the ftomach and bowels is im-
paired, much gas becomes generated by the fermenting or putrefcent
aliment, and to this indigeflion is catenated languor, coldnefs of the
Ikin, and fear. For when the extremities are cold for too lono- a
time in fome weak conilitutions, indigeflion is produced by dire(a

S 2 ■ fympathy

152 DISEASES OF IRRITATION. Class L 2.4.

fytnpathy of the fkin and the ftomach, with confequent heart-burnj
and flatulency. The fame occurs if the Ikin be made cold by
fear, as in riding over dangerous roads in winter, and hence con-
verfely fear is produced by indigeflion or torpor of the ftomach by
affociation.

This difeafe is confounded with the fear of death, which is an in-
fanity, and therefore of a totally different nature. It is alfo con-
founded with the hyfteric difeafe, which confifts in the retrograde
motions of the alimentary canal, and of fome parts of the abforbent
fyflem.

The hypochondriafis, like chlorofis, is fometimes attended with
very quick pulfe ; which the patient feems to bear fo eafily in thefe
two maladies, that if an accidental cough attends them, they may be
miftaken for pulmonary confumption ; which is not owing primarily
to the debility of the heart, but to its dired fympathy with the ac-
tions of the ftomach.

M. M. Blifter. A plafter on the abdomen of Burgundy pitch.
Opium a grain twice a day. Rhubarb iix grains every night. Bark.
Steel. Spice. Bath-water. Siefta, or fleep after dinner. Unifoi'm
hours of meals. No liquor ftronger than fmall beer, or wine and
water. Gentle exercife on horfeback in the open air uniformly per-
fifted in. See Cardialgia, I. 2. 4. 5.

II. Cephalcea. Head-ach frequently attends the cold paroxyfm of
intermittents; afflifls inebriates the day after intoxicatioii ; and many
people who remain too long in the cold bath. In all which cafes
there is a sreneral inadion of the whole fyftem, and as thefe mem-
branes about the head have been more expofed to the variations of
heat and cold of the atmofphere, they are more liable to become
afFe£led fo far as to produce fenfation, than other membranes; which
are ufually covered either with clothes, or with mufcles, as men-
tioned in Se£t. XXXIIL 2. 10,

8 The

Class I. 2.4. DISEASES OF IRRITATION. j ^^

The promptitude of the membranes about the fcalp to fympathize
with thofe of other parts of the fyftem is fo great, that this cephaltea
without fever, or quicknefs of pulfe, is more frequently a fecondary
than a pr'mary difeafe, and then belongs to Clafs IV, i. 2. 11. The
hemicrania, or partial head-ach, I believe to be almofl: always a dif-
eafe from afibciation ; though it is not impoffible, but a perfon may-
take cold on one fide of the head only. As fome people by fittino"
always on the fame fide of the fire -in winter are liable to render
one fide more tender than the other, and in confequence more fub-
jetl to pains, which have been erroneoufly termed rheumatic. See
Clafs IV. 2. 1.7. & 8.

M, M. The method of cure confifts in rendering; the habit more
robuft, by gentle conftant exercife in the open air, flefli diet, fmall
beer at meals with one glafs of wine, regular hours of refi: and rifing,
and of meals. The cloathing about the head fliould be warmer'
during fleep than in the day ; becauie at that time people are more
liable to take cold ; that is, the membranous parts of it are more li-
able to become torpid. As explained in Se6l. XVIII. 15. In refpe6t
to medicine, two drams of valerian root in powder three or four
times a day are recommended by Fordyce. The bark.- Steel in
iBoderate quantities. An emetic. A blifter. Opium, half' a grain
twice a day. Decayed teeth (hould be extrafted, particularly fuch as
either ache, or are uielefs. Cold bath between 60 and 70 degrees of
heat. Warm bath of 94 or 98 degrees every day for half an hour
during a month. See Clafs IV. 2. 2. 7. and 8.

A folution of arfenic, about the fixteenth part of a grain, is reported
to have great effedl in this difeafe. It fhould be taken thrice a day,
if it produces no griping or ficknefs, for two or three weeks, A me-
dicine of this kind is fold under the name of taftelefs ague-drops ; but
a more certain method of afcertaining the quantity is delivered in the
fubfequent materia medica, Art. IV. 2. 6.

12. Odontalgia,

154 DISEASES OF IRRITATION. Class I. 2.4.

12, Odontalgia. Tooth-ach. The pain has been erroueoufly fup-
pofed, where there is no inflammation, to be owing to fome acrid
matter from a carious tooth ftimulating the membrane of the alveolar
procefs into violent a6lion and confequeiit pain ; but the effe£l feems
to have been miftaken for the caufe, and the decay of the tooth to
have been occafioned by the torpor and confequent pain of the difeafed
membrane.

Firft, becaufe the pain precedes the decay of the tooth in regard to
time, and is liable to recur, frequently for years, without certainly
being fucceeded at lafl: by a carious tooth, as I have repeatedly ob-
ferved.

Secondly, becaufe any flimulant drug, as pyrethrum, or oil of
cloves, applied to the tooth, or ether applied externally to the cheek,
fo far from increafing the pain, as they would do if the pained mem-
brane, already a£led too ftrongly, that they frequently give imme-
diate relief like a charm.

And thirdly, becaufe the torpor, or deficient adlion of the mem-
brane, which includes the difeafed tooth, occafions the motions of the
membranes moft connected with it, as thofe of the cheek and tem-
ples, to a(£l with lefs than their natural energy ; and hence acoldnefs
of the cheek is perceived eafily by the hand of the patient, comparing
it with the other cheek ; and the pain of hemicrania is often produced
in the temple of the affefted fide.

This coldnefs of the cheek in common tooth-ach evinces, that the
pain is not then caufed by inflammation j becaufe in all inflammations
fo much heat is produced in the fecretions of new veffels and fluids,
as to give heat to the parts in vicinity. And hence, as foon as the
gum fwells and inflames along with the cheek, heat is produced, and
the pain ceafes, owing to the increafed exertions of the torpid mem-
brane, excited by the activity of the fenforial power of fenfation ;
which previoufly exifted in its paifUve ftate in the painful torpid mem-
brane. See Odontitis, Clafs II. i. 4. 7. and IV. 2. 2. 8.

6 M. M.

Class I. 2.4. DISEASES OF IRRITATION. 135

M. M. If the painful tooth be found, venefe6lion. Then a ca-
thartic. Afterwards two grains of opium. Camphor and opium,
one grain of each held in the mouth ; or a drop or two of oil of cloves
put on the painful tooth. Ether. If the tooth has a fmall hole in it,
it (hould be widened within by an inflrument, and then flopped with
leaf-gold, or leaf-lead ; but fhould be extradled, if much decayed.
It is probable that half a fmall drop of a ftrong folution of arfenic, put
carefully into the hollow of a decayed aching tooth, would deftroy
the nerve without giving any additional pain ; but this experiment
requires great caution, left any of the folution fhould touch the

tonsrue or gums.

Much cold or much heat arc equally injurious to the teeth, which
are endued with a fine fenfation of this univerfal fluid. The beft me-
thod of preferving them is by the daily ufe of a brufli, which is not
very hard, with warm water and fine charcoal duft. A lump of
charcoal fliould be put a fecond time into the fire till it is red hot, as
foon as it becomes cool the external afhes ftiould be blown off, and it
fhould be immediately reduced to fine powder in a mortar, and kept
clofe flopped in a phial. It takes away the bad fmell from decayed
teeth, by wafhing the mouth with this powder diffufed in water im-
mediately. The putrid fmell of decaying flumps of teeth may be
deftroyed for a time by wafhing the mouth with a weak folution of
alum in water. If the calcareous crufb upon the teeth adheres very
firmly, a- fine powder of pumice-ftoue may be ufed occafionally, or a-
tooth inflrument.

Acid of fea-falt, much dilated, may be ufed ; but this very rarely,.
and with the greateft caution, as in cleaning fea-fhells. When the
gums are fpongy, they fhould be frequently pricked with a lancet.
Should black fpots in teeth be cut out ? Does the enamel grow agaia
when it has been perforated or abraded ?

1-3. Otalgia^

136 DISEASES OF IRRITATION. Class I. 2. 4.

13. Otalgia. Ear-ach fometimes continues many days without
apparent infiaoimatloa, and is then frequently removed by filling the
ear with laudanum, or with ether ; or even with warm oil, or vi'arm
water. See Clafs II. i. 4. 8. This pain of the ear, like hemicrania,
is frequently the confequence of aflbciation with a difeafed tooth ; in
that cafe the ether fliould be applied to the cheek over the fufpefted
tooth, or a grain of opium and as much camphor mixed together and
applied to the fufpected tooth. In this cafe the otalgia belongs to the
fourth clafs of difeafes.

14. Pleurodyjie chronica. Chronical pain of the fide. Pains of the
membranous parts, which are not attended with fever, have acquired
the general name of rheumatic ; which fliould, neverthelefs, be re-
ftrifted to thofe pains which exift only when the parts are in motion,
and which have been left after inflammation of them ; as defcribed in
Clafs I. I. 3. 12. The pain of the fide here mentioned affects many
■ ladies, and may poffibly have been owing to the preffure of tight
ftays, which has weakened the aftion of the veffels compofing fome
membranous part, as, like the cold head-ach, it is attended with pre-
fent debility ; in one patient, a boy about ten years old, it was at-
tended with daily convulfions, and was fuppofed to have originated
from worms. The difeafe is very frequent, and generally withftands
the ufe of bliflers on the part ; but in fome cafes I have known it re-
moved by eleftric fliocks repeated every day for a fortnight through
the affefted fide.

Pains of the fide may be fometimes occafioned by the adhefion of
the lungs to the pleura, after an inflammation of them ; or to the
adhefion of fome abdominal vifcera to their cavity, or to each other ;
which alfo are more liable to afFe£t ladies from the unnatural and un-
graceful preffure of tight ftays, or by fitting or lying too long in one
pofture. But in thefe cafes the pain (hould be more of the fmarting,
than of the dull kind.

M. M.

Class I. 2.4- DISEASES OF IRRITATION. 137

M. M. Ether. A. blifter. A plafter of Burgundy pitch. An
iffue or feton on the part. Eledric fhocks. Fridlion on the part
with oil and camphor. Loofe drefs. Frequent change of pofture
both in the day and night. Internally opium, valerian, bark.

15. Sciatica frlgida. Cold fciatica. The pain along the courfe of
the fciatic nerve, from the hip quite down to the top of the foot,
when it is not attended with fever, is improperly termed either rheu-
matifm or gout ; as it occurs without inflammation, is attended
with pain when the limb is at reft ; and as the pain attends the courfe
of the nerve, and not the courfe of the mufcles, or of the fafcia,
which contains them. The theory of Cotunnius, who believed it to
be a dropfy of the fheath of the nerve, which was compreffed by the
accumulated fluid, has not been confirmed by diffeftion. The dif-
eafe feems to confift of a torpor of this fheath of the nerve, and the
pain feems to be in confequence of this torpor. See Clafs II. i. 2. 13.

M. M. Venefedlion. A cathartic. And then one grain of calo-
mel and one of opium every night for ten fucceffive nights. And a
hlifter, at the fame time, a little above the knee-joint on the outfide
of the thigh, where the fciatic nerve is not fo deep feated. Warm
bath. Cold bath. Cover the limb with oiled filk, or with a plafter-
bandage of emplaftrum de minio.

16. Lumbago frigi da. Cold lumbago. When no fever or inflam-
mation attends this pain of the loins, and the pain exifts without mo-
tion, it belongs to this genus of difeafes, and refembles the pain of
the loins in the cold fit of ague. As thefe membranes are extenfive,
and more eafily fall into quiefcence, either by fympathy, or when
they are primarily affected, this difeafe becomes very affli£ling, and
of great pertinacity. See Clafs II. i. 2. 17.

M.. M. Venefedlion. A cathartic. IfTues on the lohis. Adhefive

plafter on the loins. Blifter on the os facrum. Warm bath. Cold

Vol. II. T bath.

138 DISEASES OF IRRITATION. Class!. 2.4.

bath. Remove to a warmer climate in the winter. Loofe drefs
about the waift. Fridion daily with oil and camphor.

I 7. Hyjreralgiafrig'tda. Cold pain of the uterus preceding or ac-
companying menftruation. It is attended with cold extremities^
want of appetite, and other marks of general debility.

M. M. A clyfter of half a pint of gruel, and 30 drops of lauda-
num ; or a grain of opium and fix grains of rhubarb every night. To
fit over warm water, or go into a warm bath.

18. ProBaJgla frigida. Cold pain at the bottom of the reftum
previous to the tumor of the piles, which fometimes extends by fym-
pathy to the loins ; it feems to be fimilar to the pain at the beginning
of menftruation, and is owing to the torpor or inirritability of the ex-
tremity of the alimentary canal, or to the obftrudion of the blood in
its paffage through the liver, when that vifcus is afFeded, and its
confequent delay in the veins of the redum, occafioning tumors of
them, and dull fenfations of pain.

M. M. Calomel. A cathartic. Spice. Clyfler, with 30 drops
of laudanum. Sitting over warm water. If chalybeates after eva-
cuation ? See Clafsl. 2. 3. 23. and I. 2. i» 6.

19. Vefcce fellece inirrttabilitas. The inirritability of the gall-blad-
der probably occafions one kind of tSiei-us, or jaundice ; which is ow-
ing to whatever obftru<fts the paffage of bile into the duodenum. The
jaundice of aged people, and which attends fome fevers, is believed
to be moft frequently caufed by an irritative palfy of the gall-bladder %
on which account the bile is not preffed from the cyft by its contrac-
tion, as in a paralyfis of the urinary bladder.

A thickening of the coats of the common bile-dudl by inflammation
or increafed action of their veffels fo as to prevent the paffage of the
bile into the inteftine, in the fame manner as the membrane, which

lines

Class I. 2. 4. DISEASES OF IRRITATION. 139

lines the noftrils, becomes thickened in catarrh fo as to prevent the
paffage of air through them, is probably another frequent caufe of
jaundice, efpecially of children ; and generally ceafes in about a fort-
night, like a common catarrh, without the aid of medicine ; which
has criven'rife to the charafter, which charms have obtained in fome
countries for curing the jaundice of young people.

The fpiflitude of the bile is another caufe of jaundice, as mentioned
in Clafs I. 1,3. 8. This alfo in children is a difeafe of little danger,
as the gall-duds are diftenfrble, and will the eafier admit of the exclu-
fion of gall-ftones ; but becomes a more ferious difeafe in proportion
to the age of the patient, and his habits of life in refped to fpirituous
potation.

A fourth caufe of jaundice is the compreffion of the bile-dud: by
the enlargement of an inflamed or fchirrous liver ; this attends thofe
who have drank much fpirituous liquor, and is generally fucceeded by
drop iy and death.

M. M. Repeated emetics. Mild cathartics. Warm bath. Elec-
tricity. Bitters. Thenfleel, which, when the pain and inflamma-
tion is removed by evacuations, ads like a charm in removing the re-
mainder of the inflammation, and by promoting the abforption of the
new veffels or fluids ; like the application of any acrid eye-water at
the end of ophthalmia ; and thus the thickened coats of the bile-dud
become reduced, or the enlargement of the liver leffened, and a free
paffage is again opened -for the bile into the inteftine. Ether with
yolk of egg is recommended, as having a tendency to diflblve in-
fpiffated bile. And a decodion of madder is recommended for the
fame purpofe ; becaufe the bile of animals, whofe food was mixed
with madder, was found always in a dilute flate. i\erated alcaline
water, or Seltzer's water. Raw cabbage, and other acrid vegetables,
as water-creifes, muftard. Horfes are faid to be fubjed to infpiflated
bile, with yellow eyes, in the winter feafon, and to get well as foon"

as they feed on the fpring grafs.

T 2 The

I40 DISEASES OF IRRITATION. Class I. 2,4.

The largeft bile-ftone I have feen was from a lady, who had parted
with it fome years before, and who had abftained above ten years
from all kinds of vegetable diet to prevent, as fhe fuppofed, a colic of
her ftomach, which was probably a pain of the biliary du£l ; on re-
fuming the ufe of fome vegetable diet, fhe recovered a better flate of
health, and formed no new bilious concretions,

A flrong aerated alcaline water is fold by J. Schweppe, No. 8,
King's-ftreet, Holborn. See Clafs I. i. 3. 10.

20. Pelvis renalh mlrritab'iUtai. Inirritability of the pelvis of the
kidney. When the nucleus of a flone, whether it be infpiflated mu-
cus, or other matter, is formed in the extremity of any of the tubuli
uriniferi, and being detached from thence falls into the pelvis of the
kidney, it is liable to lodge there from the want of due irritability of
the membrane ; and in that fituation increafes by new appofitions of
indurated animal matter, in the fame manner as the flone of the blad-
der. This is the general caufe of hzemorrhage from the kidney; and
of obtufe pain in it on exercife ; or of acute pain, when the flone ad-
vances into the ureter. See Clafs I. 1.3. 9.

ORDO

Class I. 2.5. DISEASES OF IRRITATION. hi

ORDO 11.

Decreafed Irritation.

GENUS V.
Decreafed ASiion of the Organs of Senfe.

SPECIES.

1. Stultitia inirritabilis. Folly from iairritabllity. Dulnefs of
perception. When the motions of the fibrous extremities of the
nerves of {cuie are too weak to excite fenfation with fufficient quick-
nefs and vigour. The irritative ideas are neverthelefs performed,
though perhaps in a feeble manner, as fuch people do not run againft
a poft, or walk into a well. There are three other kinds of folly ;
that from deficient fenfation, from deficient volition, and from de-
ficient aflbciation, as will be mentioned in their places. In delirium,
reverie, and fleep, the power of perception is aboliflied from other
caufes.

2. Ffus imminutus. Diminifhed vifion. In our approach to old
age our vifion becomes imperfeft, not only from the form of the cor-
nea, which becomes lefs convex, and from its decreafed tranfparency
mentioned in Clafs I. 2. 3. 26. ; but alfo from the decreafed irritabihty
of the optic nerve. Thus, in the inirritative or nervous fever, the pupil
of the eye becomes dilated ; which in this, as well as in the dropfy
of the brain, is generally a fatal fymptom. A part of the cornea as
well as a part of the albuginea in thefe fevers is frequently fecn during
fleep ; which is owing to the inirritability of the retina to light,
or to the general parefis of mufcular adion, and in . confequence

4 to

142 DISEASES OF IRRITATION. ClassI. 2. 5.

to the lefs contraaion of the fphinaer of the eye, if it may be fo called,
at that time.

There have been iaftances of fome, who could not diftinguifh cer-
tain colours ; and yet whofe eyes, iii other refpeds, were not im-
perfect. Philof. Tranfaft. Which feems to have been owing to the
want of irritability, or the inaptitude to aftion, of fome claffes of
fibres which compofe the retina. Other permanent defe£ls depend on
the difeafed ftate of the external organ. Clafs I. 1.3. 14. I. 2. 3. 25.

1V=2. l.II.

3. Mufcse voUtantes. Dark fpots appearing before the eyes, and
chancTia<^ their apparent place with the motions of the eyes, are ow-
ino- to a temporary defed of irritability of thofe parts of the retina,
which have been lately expofed to more luminous obje£ls than the
other parts of it, as explained in Seft. XL. 2. Hence dark fpots are
feen on the bed-clothes by patients, when the optic nerve is become
lefs irritable, as in fevers with great debility; and the patients are
perpetually trying to pick them off with their fingers to difcover what
they are ; for thefe parts of the retina of weak people are fooner ex-
haufted by the ftimulus of bright colours, and are longer in regaining
their irritability.

Other kinds of ocular fpedtra, as the coloured ones, are alfo more
liable to remain in the eyes of people debilitated by fevers, and to
produce various hallucinations of fight. For after the contraction of
a mufcle, the fibres of it continue in the laft fituation, till fome an-
tagonift mufcles are exerted to retrad them ; whence, when any one
is much exhaufi:ed by exercife, or by want of fleep, or in fevers, it is
eafier to let the fibres of the retina remain in their laft fituation, after
having been iliimulated into contradion, than to exert any antagoniil:
fibres to replace them.

As the optic nerves at their entrance into the eyes are each of them
as thick as a crow-quill, it appears that a great quantity of fenforial

6 power

Class I, 2. 5. DISEASES OF IRRITATION. 143

power is expended during the day in the perpetual adivity of our fenfe
of vifion, befides that ufed in'the motions of the eye-balls and eye-
lids ; as much I fuppofe as is expended in the motions of our arms,
which are fupplied with nerves of about the fame diameters. From
hence we may conclude, that the lighl fhould be kept from patients
in fevers with debility, to prevent the unneceffary exhauftion of the
ijenforial power. And that on the fame account their rooms fhould
be kept filent as well as dark ; that they fhould be at, reft in an hori-
zontal pofture ; and be cooled by a blaft of cool air, or by wafliing
them with cold water, whenever their Ikins are warmer than na-
tural,

4. Strabifmus, Squinting is generally owing to one eye being lefs
perfedl than the other ; on which account the patient endeavours to
hide the worft eye in the fhadow of the nofe, that his vifion by the
other may not be confufed. Calves, which have an hydatide with
infefts inclofed in it in the frontal finus on one fide, turn towards the
affe6led fide ; becaufe the vifion on that fide, by the preffure of the
hydatide, becomes lefs perfect ; and the difeafe being recent, the
animal turns round, expeding to get a more diftindl view of
obje£ls.

In the hydrocephalus internes, where both eyes are not become
infenfible, the patient fquints with only one eye, and views objedls
with the other, as in common ftrabifmus. In this cafe it may be
known on which fide the difeafe exifts, and that it does not exift oa
both fides of the brain ; in fuch circumflances, as the patients I be-
lieve never recover as they are now treated, might it not be advife-
able to perforate the cranium over the ventricule of the affeded fide ?
which might at leafl: give room and flimulus to the afFeded part of
the brain ?

M. M. If the fquinting has not been confirmed by long habit,
and one eye be not much worfe than the other, a piece of gauze

llretched

144- DISEASES OF IRRITATION. Class I. t. 5.

flretched on a circle of whale-bone, to cover the beft eye in fuch a
manner as to reduce the difl:in£laefs of vifion of this eye to a limilar
degree of imperfeftion with the other, (hould be worn fome hours
every day. Or the better eye fliould be totally darkened by a tin cup
-covered with black filk for fome hours daily, by which means the
better eye will be gradually weakened by the want of ufe, and the
worfe eye will be gradually ftrengthened by ufing it. Covering an
inflamed eye in children for weeks together, is very liable to produce
fquinting, for the fame.reafon.

5. Amaurofis. Gutta ferena. Is a bllndnefs from the inlrritabllity
of the optic nerve. It is generally efteemed a palfy of the nerve, but
fhould rather be deemed the death of it, as paralyiis has generally
been applied to a deprivation only of voluntary power. This is a dif-
eafe of dark eyes only, as the catara6l is a difeafe of light eyes only.
At the commencement of this difeafe, very minute eledric (hocks
fliould be repeatedly paffed through the eyes ; fuch as may be pro-
duced by putting one edge of a piece of filver the fizeof a half-crown
piece beneath the tongue, and one edge of a piece of zinc of a fimilar
fize between the upper lip and the gum, and then repeatedly bringing
their exterior edges into contaft, by which means very fmall eledlric
fparks become vifible in the eyes. See additional note at the end of the
iirft volume, p. 567. and Secfl. XIV. 5.

M. M. Minute ele£lric fhocks. A grain of opium, and a quarter
of a grain of corrofive fublimate of mercury, twice a day for four or
fix weeks. Blifter on the crown of the head.

6, Auditus imminutus. Diminiflied hearins:. Deafnefs is a fre-
quent fymptom in thofe inflammatory or fenfitive fevers with debi-
lity, which are generally called putrid ; it attends the general ftupor
in thofe fevers, and is rather efleemed a falutary fign, as during this
ftupor there is lefs expenditure of fenforial power.

In

Class I. 2. 5. DISEASES OF IRRITATION. 145

In fevers of debility without inflammation, called nervous fevers,
I fufped deafnefs to be a bad fymptom, arifing like the dilated pupil
from a partial paralyfis of the nerve of fenfe. See Clafs IV. 2. r. 15.

Nervous fevers are fuppofed by Dr. Gilchrift to originate from a
congeftion offerumor water in fome part of the brain, as many of
the fymptoms are fo fimilar to thofe of hydrocephalus internus, iu
which a fluid is accumulated in the ventricules of the brain ; on this
idea the inadlivity of the optic or auditory nerves in thefe fevers may
arife from the compreffion of the effufed fluid; while the torpor at-
tending putrid fever may depend on the meninges of the brain beino-
thickened by inflammation, and thus comprefling it ; now the new
veflels, or the blood, which thickens inflamed parts, is more fre-
quently reabforbed, than the effufed fluid from a cavity ; and hence
the ftupor in one cafe is lefs dangerous than in the other.

In inflammatory or fenfitive fevers with debility, deafnefs may
fbmetimes arife from a greater fecretion and abforptionof the ear-wax
which is very fimilar to the bile, and is liable to fill the meatus audi-
torius, when it is too vifcid, as bile obftrudts the gall-dufts.

M. M. In deafnefs without fever Dr. Darwin applied a cupping-
glafs on the ear with good effed, as defcribed in Phil. Tranf. Vol.
LXIV. p. 348. Oil, ether, laudanum, dropped into the ears.

7. Olf actus hnminutus. Inactivity of the fenfe of fmell. From
our habits of trufl:ing to the art of cookery, and not examining our
food by the fmell as other animals do, our fenfe of fmell is lefs per-
fe6l than theirs. See Se6t. XVI. 5. Clafs IV. 2. i. 16.

M. M. Mild errhines.

8. Guftus hnminuius. Want of tafte is very common in fevers,
owing frequently to the drynefs or fcurfof the tongue, or external
organ of that i^wit, rather than to any injury of the nerves of tafle.
See Clafs I. i. 3. i. IV. 2. i. 16.

M- M Warm fubacid liquids taken frequently.
_ Vol. II. . U 9. TaSlus

146 DISEASES OF IRRITATION. Class I, 2. 5.

9. Tadus hnminutus. Numbnefs is frequently complained of m
fevers, and in epilepfy, and the touch is fometimes impaired by the
drynefs of the cuticle of the fingers. See Clals IV. 2. i. 16.

When the fenfe of touch is impaired by the compreffion of the
nerve, as in fitting long with one thigh crofled over the other, the
limb appears larger, when v/e touch it with our hands, which is to
be afcribed to the indiftin<3:nef3 of the fenfation of touch, and may be
explained in the fame manner as the apparent largenefs of objeds
feen through a mift. In this laft cafe the minute parts of an objed,
as fuppofe of a diftant boy, are feen lefs diftindtly, and therefore we
inftantly conceive them to be further from the eye, and in confequence
that the whole fubtends a larger angle, and thus we believe the boy
to be a man. So when any one's fingers are prefled on a benumbed
limb, the fenfation produced is lefs than it (hould be, judging from
vifible circumftances ; we therefore conceive, that fomething inter-
vened between the objeil and the fenfe, for it is felt as if a blanket
was put between them ; and that not being vifibly the cafe, we
judge that the limb is fwelled.

The fenfe of touch is alfo liable to be deceived from the acquired
habits of one part of it a£llng in the vicinity of another part of it.
Thus if the middle finger be crofled over either of the fingers next to
it, and a nut be felt by the two ends of the fingers fo crofled at the
fame time, the nut appears as if it was two nuts. And laftly, the
fenfe of touch is liable to be deceived by preconceived ideas; which
we believe to be excited by external objeSs, even when we are
awake. It has happened to me more than once, and I fuppofe to
moft others, to have put my hands into an ennpty bafon ftanding in an
obfcure corner of a room to wafli them, which I believed to contain
cold water, and have inftantly perceived a fenfation of warmth, con-
trary to that which I expefted to have felt.

In fbme paralytic affedlions, and in cold fits of ague, the fenfation
of touch has been much impaired, and yet that of heat has remained.
See Sea. XIV. 6.

M. M. Fridion

Class I. 2.5- DISEASES OF IRRITATION. 147

M. M. Fri6liou alone, or with camphorated oil, warm bath.
Ether. Volatile alcali and water. Internally fpice, fait. lucitantia.
Secernentia.

10. Stupor. The ftupor, which occurs in fevers with debility, is
generally efleemed a favourable fymptom ; which may arife from the
lefs expenditure of fenforial power already exifting in the brain and
nerves, as mentioned in fpecies 6 of this genus. But if we fuppofe,
that there is a continued produftion of fenforial power, or an accumu-
lation of it in the torpid parts of the fyftem, which is not improbable,
becaufe fuch a produftion of it continues during fleep, to which
flupor is much allied, there is ftill further reafon for believing it to be
a favourable fymptom in inirritable fevers; and that much injury is
often done by blifters and other powerful ftimuli to remove the ftupor.
See Sedl. XII. 7. 8. and XXXIII. 1.4.

Dr. Blane in his Croonian Lecture on mufcular motion for 1788,
among many other ingenious obfervations and deduiflions, relates a
curious experiment on falmon, and other fifh, and which he repeated
upon eels with limilar event.

" If a fifh, immediately upon being taken out of the water, is ftun-
ned by a violent blow on the head, or by having the head crufhed,
the - irritability and fweetnefs of the raufcles will be preferved much
longer, than if it had been allowed to die with the organs of fenfe en-
tire. This is fo well known to fifhermen, that they put it in pradice,
in order to make them longer fufceptible of the operation called
crimping. A falmon is one of the fiih leafl: tenacious of life, infomuch,
that it will lofe all figns of life in lefs than half an hour after it is
taken out of the water, if fuffered to die without any farther
injury ; but if, immediately after being caught, it receives a violent
blow on the head, the mufcles will (hew vifible irritabihty for more
than twelve hours afterwards."

Uz Dr.

148 DISEASES OF IRRITATION. Class I. 2. 5.

Dr. Blane afterwards well remarks, that *' in thofe diforders in
which the exercife of the fenfes is in a great meafure deftroyed, or
fufpended, as in the hydrocephalus, and apople<5lic palfy, it happens
Bot uncommonly, that the appetite and digeftion are better than 'm
health."

OR DO

Class I. 3. i. DISEASES OF IRRITATION. 149

ORDO III.

Retrograde Irritative Motions.

GENUS I.

Of the Alimentary Canal.

The retrograde motions of our fyflem originate either from defedt
of ftimulus, or from defe£l of irritability. Thus ficknefs is often
induced by hunger, which is a want of flimulus ; and from ipecacu-
anha, in which laft cafe it would feem, that the ficknefs was induced
after the violence of the ftimulus was abated, and the confequent tor-
por had fucceeded. Hence fpice, opium, or food relieves ficknefs.

The globus hyftericus, falivation, diabetes, and other inverfions
of motion attending hyfteric paroxyfms, feem to depend on the want
of irritability of thofe parts of the body, becaufe they are attended with
cold extremities, and general debility, and are relieved by wine, opi-
um, fteel, and fiefli diet ; that is, by any additional flimulus.

When the longitudinal mufcles are fatigued by long a6tion, or are
habitually weaker than natural, the antagonift mufcles replace the
limb by ftretching it in a contrary direction ; and as thefe mufcles have
had their aftions aflbciated in fynchronous tribes, their adions ceafe
together. But as the hollow mufcles propel the fluids, which they con-
tain, by motions aflbciated in trains ; when one ring is fatigued from
its too great debility, and brought into retrograde adion; the next
ring, and the next, from its aflbciation in train falls into retrograde
aftion. Which continue fo long as they are excited to act, like the
tremors of the hands of infirm people, fo long as they endeavour to

aa.

I50 DISEASES OF IRRITATION. Class I. 3. i.

a6l. Now as thefe hollow mufcles are perpetually ftimulated, thefe -
retrograde aftions do not ceafe as the tremors of the longitudinal
mufcles, which are generally excited only by volition. Whence the
retrocrrade motions of hollow mufcles depend on two circumftances,
in which they differ from the longitudinal mufcles, namely, their
motions being affociated in trains, and their being fubjeft to perpetual
flimulus. For further elucidation of the caufe of this curious fource
of difeafes, fee Se£t. XXIX. 11. 5. ' .

The fluids difgorged by the retrograde motions of the various vafcu-
lar mufcles may be dlftinguifhed, i. From thofe, which are pro-
duced by fecretion, by their not being attended by increafe of heat,
which always accompanies increafed fecretion. 2. They may be dif-
tinguifhed from thofe fluids, which are the confequence of deficient
abforption, by their not poflelfing the faline acrimony, which thofe
fluids poiTefs ; which inflames the {kin or other membranes on which
they fall; and which have a faline tafte to the tongue. 3. They may
be diftinguifhed from thofe fluids, which are the confequence both
of increafed fecretion and abforption, as thefe are attended with
increafe of warmth, and are infpiffated by the abftradlion of their
aqueous parts. 4. Where chyle, or milk, are found in the feces or
urine, or when other fluids, as matter, are tranflated from one part
of the fyftem to another, they have been the produ6t of retrograde
aftion of lymphatic or other canals. As explained in Seft. XXIX. 8.

SPECIES.

I. Ruminatio. In the rumination of horned cattle the retograde
motions of the oefophagus are vifibk to the eye, as they bring up the
foftened grafs from their firft ftomach. The vegetable aliment in the
firfl: ftomach of cattle, which have filled themfelves too full of young
clover, is liable to run into fermentation, and diftend the flomach,

fo

Class I. 3.1. DISEASES OF IRRITATION. 151-

fo as to preclude its exit, and frequently to deftroy the animal. To
difcharge this air the farmers frequently make an opening into the
flomach of the animal with fuccefs. I was informed, I believe by
the late Dr. Whytt of Edinburgh, that of twenty cows in this iitua-
tion two had died, and that he diredted a pint of gin or whi{ky, mixed
with an equal quantity of water, to be given to the other eighteen;
all of which eru£led immenfe quantities of air, and recovered.

There are hirtories of ruminating men, and who have taken plea-
sure in the aft of chewing their food a fecond time. Philof. Tra'nfadl.

'a

2. Rucfm. Eruftation. An inverted motion of the ftomach ex-
cluding through its upper valve an elaftic vapour generated by the fer-
mentation of the aliment ; which proceeds lo haftily, that the digef-
tive power does not fubdue it. This is fometimes acquired by habit,
fo that fome people can eru£t when they pleafe, and as long as they
pleafe ; and there is gas enough generated to fupply them for this
purpofc ; for by Dr. Hale's experiments, an apple, and many other
kinds of aliment, give up above fix hundred times their own bulk of
an elaftic gas in fermentation. When people voluntarily ejedt the fix-
able air from their flomachs, the fermentation of the aliment pro-
ceeds the farter; for (topping the vefiels, which contain new wines,
retards their fermentation, and opening them again accelerates it ;
hence where the digeftion is impaired, and the ftomach fomewhat
dlftended with air, it is better to reftrain than to encourage eructa-
tions, except the quantity makes it necelfary. When wine is con-
fined in bottles the fermentation ftill proceeds (lowly even for years,
till all the fugar is converted into fpirit ; but in the procefs of di-
geftion, the faccharine part is abforbed in the form of chyle by the
bibulous mouths of the numerous ladleals, before it has time to run
into the vinous fermentation.

3. Appjia. Indigeftion, Water-qualm. A few mouthfuls of

8 the

152 DISEASES OF IRRITATION. Class I. 3. 1.

the aliment are rejefted at a time for fome hours after meals. Whea
the aliment has had time to ferment, and become acid, it produces
cardialo-ia, or heart-burn. This difeafe is perhaps generally left after
a flio-ht inflammation of the ftomach, called a furfeit, occafioned by-
drinking cold liquors, or eating cold vegetables, when heated with
exercife. This inflammation of the flomach is frequently, I believe,
at its commencement removed by a critical eruption on the face,
which differs in its appearance as well as in its caufe from the gutta
rofea of drunkards, as the flvin round the bafe of each eruption is lefs
inflamed. See Clafs 11. 1.4.7. This difeafe differs from Cardial-
gia, Clafs I. 2. 4. 5. in its being not uniformly attended with pain of
the cardia ventriculi, and from its retrograde motions of a part of the
ftomach about the upper orifice of it. In the fame manner as hyfleria
differs from hypochondriafis ; the one confifting in the weaknefs and
indigeftion of the fame portions of the alimentary canal, and the other
in the inverted motions of fome parts of it. This apepfia or water-
qualm continues mai:iy years, even to old age; Mr. G of Lich-
field fuffered under this difeafe from his infancy ; and, as he grew old,
found relief only from repeated dofes of opium.

M. M. A blifter, rhubarb, a grain of opium twice a day. Soap,
iron-powder. Tin-powder.

4. Vom'itus. An inverted order of the motions of the ftomach and

cefophagus with their abforbent veffels, by which their contents are

evacuated. In the zQt of vomiting lefs fenforial power is employed

than in the ufual periftaltic motion of the ftomach, as explained in

Seft. XXXV. I. 3. Whence after the operation of an emetic the di-

gertion becomes ftronger by an accumulation of fenforial power during

its decreaied a6lion. This decreafed aition of the ftomach may be

either induced by want of ftimulus, as in the licknefs which attends

hunger; or it may be induced by temporary want of u'ritability, as

in cold fits of fevers or from habitual want of irritability, as the

vomitinaf
o

Class I. 3. 1. DISEASES OF IRRITATION. 153

vomiting of enfeebled drunkards. Or laftly, by having been previ*.
oufly too violently ftimulated by an emetic drug, as by ipecacu-
anha.

M. M. A blifter. An emetic. Opium. Warmth of a bed,
covering the face for a while vv'ith the bed-clothes. Crude mercury^
A poultice with opium or theriaca externally.

5. Cholera, When not only the flomach, as in the laft article,
but alfo the duodenum, and ilium, as low as the valve of the colon,
have their motions inverted ; and great quantities of bile are thus
poured into the ftomach ; while -at the fame time fome branches of
the lafteals become retrograde, and difgorge their contents into the
upper part of the alimentary canal ; and other branches of them dif-
gorge their contents into the lower parts of it beneath the valve of the
colon ; a vomiting and purging commence together, which is called
cholera, as it is fuppofed to have its origin from increafed fecretion of
bile ; but I fuppofe more frequently arifes from putrid food, or poi-
fonous drugs, as in the cafe narrated in Seft. XXV. 13. where other
circumftances of this difeafe are explained. See Clafs II. i. 2. rr.

The cramps of the legs, which are liable to attend cholera, are ex-
plained in Clafs III. i. i. 15.

6. Ileus. Confifts in the inverted motions of the whole inteftinal
canal, from the mouth to the anus ; and of the ladleals and abforbenta
which arife from it. In this pitiable difeafe, through the valve of the
colon, through the pylorus, the cardia, and the pharinx, are ejefted,
firft, the contents of the flomach and inteflines, with the excremenfe
and even clyfters themfelves ; then the fluid from the ladleals, whicb
i& now poured into the inteftines by their retrograde motions, is-
thrown up by the mouth ; and, laf!:ly, every fluid, which is abforb-
ed by the other lymphatic branches, from the cellular membrane,
the flcin, the bladder, and all other cavities of the body; and which-

Yql.1I. X is

154 DISEASES OF IRRITATION. Class I. 3. j,

IS then poured into the ftomach or inteftiaes by the retrograde mo-
tions of the lafteals ; all which fupply that amazing quantity of
fluid, which is in this difeafe continually ejefled by vomiting. See
Seil. XXV. 15. for a further explanation of this difeafe.

M. M. Copious venefeftion. Twenty grains of calomel in fmali
pills, or one grain of aloe every hour till ftools are procured. Blifters.
Warm bath. Crude mercury. Clyfber Of ice-water. Smear the
ikin all over with greafe, as mentioned in Sedl. XXV. 15.

As- this malady is occafioned fometimes by an introfufception of a
part of the inteftine into another part of it, efpecially in children,,
could holding them up by their heels for a fecond or two of time be
of ferv^ice after venefe6lion ? Or the exhibition of crude quickfilver
two ounces every half hour, till a pound is taken, be particularly
ferviceable in this circumftance ? Or could half a pound, or a pound,
of crude mercury be injefted as a clyfter, the patient being elevated
by the knees and thighs fo as to have his head and fhoulders much
lower than his bottom, or even for a fhort time held up by the heels?
Could this alfo be of advantage in flrancrulated hernia ?

Where the difeafe is owing to ftrangulated hernia, the part fhould
be fprinkled with cold water, or iced water, or fait and water recent-
ly mixed, or moiftened with ether. In cafes of ftrangulated hernia,
could acupuniflure, or pun£lure with a capillary trocar, be ufed with
fafety and advantage to give exit to air contained in the ftrangulated
bowel? Or to ftimulate it into a£tion ? It is not uncommon for
bafhful men to conceal their being afflidled with a fmall hernia,
which is the caufe of their death j this circumftance fhould therefore
always be enquired into. Is the feat or caufe of the ileus always be-
low the valve of the colon, and that of the cholera above it ? See
Clafs II. I. 2. II.

7. Globus hyjiericus. Hyfteric fuffocation is the perception of a
globe rolling round in the abdomen, and afceading to the ftomach

and

Class!. 3, i. DISEASES OF IRRITATION. 155

and throat, and there Inducing ftrangulation. It confifts of an Inef-
feftual inverfion of the motions of the oefophagus, and other parts of
the alimentary canal ; nothing being rejefted from theftomach.

M. M. Tincture of caftor. Tindt. of opium of each 15 drops, ~
See Hyfteria, Clafsl. 3. i. 9.

8. Fomendi conamen inane. An ineffectual effort to vomit. It fre-
quently occurs, when the ftoraach is empty, and in fome cafes con-
tinues many haurs j but as the lymphatics of the ftomach are not
inverted at the fame time, there is no fiipply of materials to be eject-
ed J it Is fometimes a fyraptom of hyfleria, but more frequently at-
tends irregular epilepfies or reveries ; which however may be diflin-
guifhed by their violence of exertion, for the exertions of hyfteric
motions are feeble, as they are caufed by debihty ; but thofe of epi-
lepfies, as they are ufed to relieve pain, are of the moft violent kind?
infomuch that thofe who have once feen. thefe inefFe(5tual efforts ta-
vomit in fome epilepfies, can never again miflake them for fymptoms
of hyfleria. See a cafe in Se6t. XIX. 2.

M. M. Blifter. Opium. Crude mercury.

9. Borborigtnus^ A gurgling of the bowels proceeds from a par-
tial invertion of the periftaltic motbns of them, by which the gas is
brought Into a'fuperlor part of the bowel, and bubbles through the
defcendlng fluid, like air rufhing into a bottle as the water is poured'
out of it. This is fometimes a diftrefling fymptom of the debility of
the bowels joiiied with a partial inverfion of their motions. I attend-
ed a young lady about fixteen, who was In other refpefts feeble-, whofer
bowels almoft inceflantly made a gurgling noife fo loud as to be heard.!
at a confiderable diltance, and to attract the notice of all v^ho Avere
near her. As' this nolle never ceafed a minute together for many
hours In a day, It could not be produced by the uniform defcent af

X 2. water.^

156 DISEASES OF IRRITx\TION. Class I. 3.1.

water, and afcent of air through it, but there muft have been alter-
nately a retrograde movement of a part of the bowel, which muft
again have pufhed up the water above the air ; or which might
raife a part of the bowel, in which the fluid was lodged, alternately
above and below another portion of it ; which might readily happen
in fome of the curvatures of the fmaller inteftines, the air in which
might be moved backward and forward like the air-bubble in a glafs-
level.

M. M. EfTential oil. Ten corns of black pepper Iwallowed
whole after dinner, that its efFedt might be flower and more perma-
nent} a fmall pipe occafionally introduced into the reftum to facili-
tate the efcape of the air. Crude mercury. See Clafs I. 2. 4. 9.

10. Hyfteria. The three lafl: articles, together with the lym-
phatic diabaetes, are the moll common fymptoms of the hyfteric
difeafe ; to which fometimes is added the lymphatic falivation, and
fits of fyncope, or convulfion, with palpitation of the heart (which
probably conlifts of retrograde motions of it), and a great fear of
dying. Which lad circumflance diftinguifhes thefe convulfions
from the epileptic ones with greater certainty than any other
fingle fymptom. The pale copious urine, cold fkin, palpitation,
and trembling, are the fymptoms excited by great fear. Hence
in hyfteric difeafes, when thefe fymptoms occur, the fear, which
has been ufually affociated with them, recurs at the fame time, as in
hypochondriafis, Clafs I. 2. 4. 10. See Sedt. XVI. 8. r.

The convulfions which fometimes attend the hyfteric difeafe, are
exertions to relieve pain, either of fome torpid, or of fome retro-
grade organ ; and in this refpedl they refemble epileptic convulfions,
except that they are feldom fo violent as entirely to produce in-
fenfibility to external ftimuli ; for thefe weaker pains ceafe before
Ihe total exhauftion of fenforial power is produced, and the patient

finks

Class!. 3. I. DISEASES OF IRRITATION- 157

finks into imperfedl fyncope ; whereas the true"epilepfy generally
terminates in temporary apoplexy, with perfe6l infenfibility to
external objeds. Thefe convulfions are lefs to be dreaded than
the epileptic ones, as they do not originate from fo permanent a
caufe.

The great difcharge of pale urine in this difeafe is owing to
the inverted motions of the lymphatics, which arife about the neck
of the bladder, as defcribed in Se6l. XXIX. 4. 5. And the lympha-
tic falivation arifes from the inverted motions of the falivary lym-
phatics.

Hyfteria is diftinguifhed from hypochondriafis, as in the latter
there are no retrograde motions of the alimentary canal, but (imply
a debility or inirritability of it, with diftention and flatulency. It is
diftinguifhed from apepfia and cardialgia by there being nothing
ejected from the flomach by the retrograde motions of it, or of the
cefophagus.

M. M. Opium. Camphor. Aflafoetida. Caftor, with finapifms
externally ; to which mufl: be added a clyller of cold water, or iced
water; which, according to Monf. Pomme, relieves thefe hyfteric
fymptoms inftantaneoufly like a charm ; which it may effedl by
checking the inverted motions of the inteftinal canal by the torpor
occafioned by cold ; or one end of the inteftinal canal may become
flrengthened, and regain its periftaltic motion by reverfe fympathy,
when the other end is rendered torpid by ice-water. (Pomme des
AfFedtions Vaporeufes, p. 25.) Thefe remove the prefent fymp-
toms; and bark, fteel, exercife, coldifh bath, prevent their returns.
See Art. VI. 2. i.

1 1 . Hydrophobia. Dread of water occafioned by the bite of a mad
dog, is a violent inverfion of the motions of the cefophagus on the
contadl or even approach of water or other fluids. The pharinx ■
feems to have acquired the fenfibility of the larinx in this difeafe, and

is

15S DISEASES OF IRRITATION. Class!. 3.1.

is as impatient to feje£l any fluid, which gets into it. Is not the car-
dia ventriculi the feat of this difeafe ? As in cardialgia the pain is often
felt in the pharinx, when the acid naaterial ftimulates the other end
of the canal, which terminates in the flomach. As this fatal difeafe
refembles tetanus, or locked jaw, in its tendency to convulfion from
a diftant wound, and affedls fome other parts by aflbciationj it is
treated of in ClafsIII. i. i, 15. and IV. 2. 1.7.

ORDO

ClassI. 3- 2. DISEASES OF IRRITATION. 159

ORDO III.

Retrograde Irritative Motions.

GENUS II.
Of the Abforbent Syjiem,

SPECIES. ^ ,

I . Catarrhus lymphaticus. Lymphatic catarrh. A periodical de-
fluxion of a thin fluid from the noftrils, for a few hours, occafioned
by the retrograde motions of their lymphatics ; which may probably
be fupplied with fluid by the increafed abforption of fome other lym-
phatic branches in their vicinity. It is diftinguiflied from that mucous
difcharge, which happens in frofty weather from decreafed abforption,
becaufe it is lefs fait to the tafte ; and from an increafed fecretion of
mucus, becaufe it is neither fo vifcid, nor is attended with heat of
the part. This complaint is liable to recur at diurnal periods, like aa
intermittent fever, for weeks and months together, with great fneez-
ing and very copious difcharge for an hour or two.

I have feen two of thefe cafes, both of which occurred in delicate
women, and feemed an appendage to other hyfleric fy mptomsi
whence I concluded, that the difcharge was occafioned by the in-
verted motions of the lymphatics of the noftrils, like the pale urine
in hyfteric cafes; and that they might receive this fluid from fome
other branches of lymphatic velTels opening into the frontal or maxil-
Liry cavities in their vicinity.

Could fuch a difcharge be produced by ftrong errhines, and ex-
7 cite

i<5o , DISEASES OF IRRITATION. Class I. 3.2.

cite an abforption of the congeftion of lymph in the dropfy of the
brain ?

2. Salivatw lymphatica. Lymphatic falivation. A copious expu-
ition of a pellucid infipid fluid, occafioned by the retrograde motions
of the lymphatics of the mouth. It is fometimes periodical, and of-
ten attends the hyfteric difeafe, and nervous fevers ; but is not ac-
companied with a faline tafte, or vi'ith heat of the mouth, or
naufea.

3. Naufea humida. Moifl naufea confifls in a difcharge of fluid,
owing to the retrograde motions of the lymphatics about the fauces,
without increafe of heat, or faline tafte, together with fome retro-
grade motions of the fauces or pharinx ; along with this naufea a
licknefs generally precedes the a6f of vomiting ; which may confift
of a fimilar difcharge of mucus or chyle into the ftomach by the re-
trograde motions of the lymphatics or lacSteals, which open into it.
See Clafs I. 2. 4. 3. and I. 2. 4. 4.

M. M. Subacid liquids. Wine. Opium. A blifter.

4. Diarrhoea lymphatica. Lymphatic diarrhoea. A quantity of
mucus and lymph are poured into the inteftines by the inverted mo-
tions of the intefl:inal lymphatics. The feces are lefs fetid and more
liquid ; and it fometimes portends the commencement of a diabaetes,
or dropfy, or their temporary relief. This lymphatic diarrhoea fome-
times becomes chronical, in which the atmofpheric moifture, ab-
forbed by the cutaneous and pulmonary lymphatics, is poured into
the inteftines by the retrograde motions of the lafteals. See Se<flion
XXIX. 4. 6. where fome cafes of this kind are related.

5. Diarrhoea chylifera. caliaca. Chyliferous diarrhoea. The

chyle drank up by the ladeals of the upper inteftines is poured into

4 the

Class!. 3.2. DISEASES OF IRRITATION. r6r

the lower ones by the retrograde motions of their lafteals, and appears
in the dejedlions. This Gircumftance occurs at the beginning of di-
arrhoea crapulofa, where the patient has taken and digefted more ali-
ment than the fyftem can conveniently receive, and thus eliminates
a part of it ; as appears when there is curdled chyle in fome of the de-
jedions. See Se£t. XXIX. 4. 7. It differs from the lymphatic diar-
rhoea^ as the chyliferous diab^etes differs from the aqueous and rauca^
ginous diabetes.

6. Diabnetes. By the retrograde motions of the urinary lymphatics,-
an immenfe quantity of fluid is poured into the bladder. It is either
termed chyliferous, or aqueous, or mucaginous, from the nature of
the fluid brought into the bladder ; and is either a temporary difeafe,
as in hyfteric women, in the beginning of intoxication^, in worm
cafes, or in thofe expofed to cold damp air, or to great fear,- er
anxiety, or iii the commencement of fbme dropfies ; or it becomes
ehronicaU

When the urinary lymphatics invert their motions, and pour their
refluent contents into the bladder, fome other branch of the abforbent
fyftem acfls with greater energy to fupply this fluid. I-f it is the in-
teftinal branch, the chyliferous diabaetes is produced r if it is the cu-
taneous or pulmonary branch, the aqueous diabstes is produced : and
if the cellular or cyftic branches, the mucaginous diabaetes. In the
two laft the urine is pellucid, and contains no fugar.

In dropfies the fluid is fometimes abforbed, and poured into the blad-
der by the r-etrograde motions of the urinary lymphatics, as during
the exhibition of digitalis. In the beginning of the dropfies of infirm
gouty patients, I have frequently obferved,, that they make a large
quantity of water for one night, which relieves them for feveral days*
In thefe cafes the patient previoufly feels a fulnefs about the precordiajr
with diflSiCult refpiration, and fymptoms fimilar to thofe of hyfteria».
Perhaps a previous defeat of abforption takes place in fome part of
V0L..IL Y the

i6<2 DISEASES OF IRRITATION. ClassI. 3. 2.

the body in thofe hyfteric cafes, which are relieved by a copious dif-
charge of pale urine. See Diabaetes explained at large, Section
XXIX. 4.

A difcharge of blood fometimes attends the diabaetes, which was
occafionally a fymptom of that difeafe in Mr. Brindley, the great na-
vigable canal maker in this country. Which may be accounted for
by the communication of a lymphatic branch with the gaftric branch
of the vena portarum, as difcovered by J. F. Meckel. See Sedion
XXVII. 2.

M. M. Alum. Earth of Alum. Cantharides. Calomel. Bark.
Steel. Rofui. Opium. See Se£t. XXIX. 4.

7. Sudor lymphaticiis. Profufe fweats from the inverted motions
of the cutaneous lymphatics, as in fome fainting fits, and at the ap-
proach of death ; and as perhaps in the fudor anglicanus. See Se6l.
XXIX. 5. Thefe fweats are glutinous to the touch, and without
increafed heat of the Ikin ; if the part is not covered, the fkin becomes
cold from the evaporation of the fluid. Thefe fweats without heat
fometimes occur in the adt of vomiting, as in Se<St. XXV. 9. and are
probably the caufe of the cold fweaty hands of fome people. As men-
tioned in Se£t. XXIX. 4. 9. in the cafe of R. Davis, which he cured
by frequent application of lime. Though it is poffible, that cold
fweaty hands may alfo arife from the want of due abforption of the
perfpirable matter effufed on them, and that the coldnefs may be
owing to the greater evaporation in confequence.

The acid fweats defcribed by Dr. Dobfon, which he obferved in a
diabaetic patient, and afcribes to the chyle effufed on the (kin, muft
be afcribed to the retrograde adlion of the cutaneous lymphatics. See
Sea. XXIX. 6.

8. Sudor ajihmattcus. The cold fweats in this difeafe only cover
the head, arms, and breaft, and are frequently exceedingly profufe.

4 Thefe

Class I. 3.2. DISEASES OF IRRITATION. 163

Thefe fweats are owing to the inverted motions of the cutaneous lym-
phatics of the upper part of the body, and at the fame time the iu-
creafed abforption of the pulmonary abforbents : hence thefe fweats
when profufe relieve the prefent fit of afthma. There is no other
way to account for fweats appearing on the upper parts of the body
only, but by the fluid having been abforbed by the lymphatic branch
of the lungs, and effufed on the Ikin by the retrograde movements
of the cutaneous lymphatics; which join thofe of the lungs before
they enter into the venous circulation. For if they were occafioned,
as generally fuppofed, by the difficulty of the circulation of the blood
through the lungs, the whole ikin muft be equally afFe£l:ed, both of
the upper and lower parts of the body; for whatever could obftru6l
the circulation in the upper part of the venous fyflem, muft equally
obftrudl it in the lower part of it. See Se£t. XXIX. 6. In the con-
vullive afthma thefe fweats donot occur; hence they may be diftin-
guiftied ; and might be called the hydropic afthma, and the epileptic
afthma.

9. T'ranflatto puris. Tranflation of matter from one part of the
fyftem to another can only be explained from its being abforbed by one
branch of the lymphatic- fyftem, and depofited in a diftant part by the
retrograde motions of another branch ; as mentioned Seft. XXIX.
7. I. It is curious, that thefe tranflations of matter are attended ge-
nerally, I believe, with cold fits ; for lefs heat is produced during the
retrograde aftlon of this part of the fyftem, as no fecretion in the
lymphatic glands of the affedted branches can exift at the fame time.
Do any ineffedual retrograde motions occafion the cold fits of agues ?
The time when the gout of the liver ceafes, and the gout in the foot
commences, is attended with a cold fit, as I have obferved in two in-
ftances, which Is difficult to explain, without fuppofingthe new vef-
fels, or the matter produced on the inflamed liver, to be abforbed,

. Y 2 and

1 64 DISEASES OF IRRITATION. Class I. 3.2.

and either eliminated by fome retrograde motion, or carried to the
newly inflamed part ? See Clafs IV. i. 2. 15.

10. TranJJatio laSlis. Tranflation of milk to the bowels in puer-
peral fevers can only be explained by the milk being abforbed by the
pedloral branch of lymphatics, and carried to the bowels by the retro-
grade motions of the inteftinal lymphatics or la<9:eals. See many in-
fiances of this in Se£t. XXIX. 7. 4.

II. Tranflatio urtnce. Tranflation of urine. There is a curious
cafe related in the Tranfaftion of the College of Phyficians at Phila-
delphia, Vol. L p. 96, of a girl, who labouring under an ifcuria vo-
mited her urine for many months ; which could not be diftinguiflied
from that which was at other times drawn off by the catheter. After
having taken much opium, fhe feems at length to have formed gravel,
fome of which was frequently brought up by vomiting. Dr. Senter
afcribes this to the retrograde motions of the lymphatics of the fto-
mach, and the increafed ones of thofe of the bladder, and refers to
thofe of Se£l. XXIX. of this work ; which fedlion was firft publifhed
in 1 780 J and to Macquire's Dictionary of Chemiftry, Art. Urine.

The patient above defcribed fometimes had a difcharge of urine by
the navel, and at other times by the redum, and fometimes by uri-
nous fweats.

ORDO

iXAss 1,3' 3' DISEASES OF IRRITATION. 165

ORDO IIL

Retrograde Irrigative Motions.

GENUS III.

Of the Sanguiferous Syjiem.

SPECIES.

1. Capillarium motus reirogrejfus. In microfcopic experiments it
is ufual to fee globules of blood regurgitate from the capillary veffels
again and again, before they pafs through them ; and not only the
mouths of the veins, which arife from thefe capillaries, are fre-
quently feen by microfcopes to regurgitate fome particles of blood
during the ftruggles of the animal ; but a retrograde motion of the
blood in the veins of thefe animals, from the very heart to the extre-
mities of the limbs, is obfervable by intervals during the diftreffes of
the dying creature. Haller, Elem. Phyf. T. i. p. 216. See Sedion
XXIX. 3. 8.

2. Palpitatio cordis. May not the inefFedual and weak unequal
motions of the heart in hyfteric cafes be afcribed to the retrograde
motions of it, which continue for a fliort time, or terminate in fyn-
cope ? See Clafs IV. 3. i, 6.

3. Anhelatia

1 66 DISEASES OF IRRITATION. Glass I. 3. 3.

3. Anhelatio fpafmodica. In fome afthmas may not the difficulty
of refpiration arife from the inverted aftion of the finer branches of
the bronchia, or of the pulmonary artery or vein, like thofe of the
capillaries above defcribed in No. i , of this genus ?

Ihe

Class lIL DISEASE'^IOF SENSATION, 11^67

1^36 Orders and Genera of the Second Clafs of DifeafeSn

GLASS II.

DISEASES OF SENSATION.

O R D O I.

Increafed Senfation.

GENERA.

1. With increafed a£lion of the mufcles.

2. With the produ£tion of new vefTels by internal membranes or

glands with fever.

3. With the produ£lion of new veflels by external membranes or

glands with fever'.

4. With the production of new veflels by internal membranes or

glands without fever. >

5. With the produftion of new veflels by external membranes or

glands without fever.

6. With fever confeqiient to the production of new veflels or fluids.

7. With increafed adtion of the organs of fenfe.

ORDO II.

■ Decreafed Senfation.

GENERA.

1. With decreafed aClions of the general fyftem.

2. With decreafed actions of particular organs,- ,

"bRDO III.

Retrograde Senjit'ive Motions.

GENERA.

1. Of the arterial fyftem.

2. Of the abforbent fyflem.

3. Of the excretory duCts.

1 68

DISEASES OF SENSATION. Class 11. i. i.

Th& Orders^ Genera^ and Species, of the Second Clajs

of Difeafes,

GLASS II.

DISEASES OF SENSATION.

ORDO I.

Increafed Senfatlon»

GENUS I.
With Increafed A£iion of the Mufcku

SPECIES.

I. Degluiitio.

Deglutition.

2. Refpiratio.

Refpiration.

3. Sternutatio,

Sneezing.

4. Anhelitus,

Panting.

5. "Tuffts ebriorum.

Cough of inebriates.

6. Syngultus,

Hiccough.

7. Aflhma humor ale.

Humoral afthma.

8, Ni&itatio fenfitiva.

Winking from pain.

9. Ofcitatio et pandiculation

Yawning and ftretching.

10. Tenefmus.

Tenefmus.

11. Stranguria,

Strangury.

12. Parturitio.

Parturition.

GENUS.

Class 11. i.a. DISEASES OF SENSATION.

i6g

GENUS 11.

M^ifh the Frodu&ion of new Vejfels by internal Membranes or Glands,

with Fever.

SPECIES.

iv Febris fenjitiva irriiata.
z. Ophthalmia interna,

3. Phrenitis*

4. Peripneumonia.

trachealis.

5. Pleuritis,

6. Diaphragmitis,
y. Carditis.

8. Peritonitis^

9. Mefenteritisi

0. Gafiritis,.

1. Enteritisi.
2; Hepatitis..

3. Splenitis.

4. Nephritis..

5. Cyftitis.-

6. Hyjieritis^.

7. Lumbago fen/it ivai .
8.. IfchiaSi

9. Paronychia . interna.

Senfitive irritated fever.
Inflammation of the eye.

of the brain,

of the lungs.

the croup.

of the pleura.

of the diaphragm,

of the heart.

of the peritoneum.

■" of the mefentery.

■ of the ftomach.

of the bowels.

■ of the liver.

— of the Ipleen.

of the kidney,

■— of the bladder.

— of the womb.

of the loins.

of the pelvis.

beneath the nails.

Vol. II,

GENUS

170

DISEASES OF SENSATION.

Class II. 1.3.

GENUS III.

IFlth the ProduB'wn of new Vejfeh by external Membranes or Glands^

with Fever,

SPECIES.

1 . Febrh fenjitlva inirritata.

2. Eryjipelas irritatum.

in'irrltatum.

fenjitlvum.

3. TonJiUitis interna,

^ — JuperJiciaUs,

— '■ inirritata,

4. Parotitis fuppurans.

mutabilis.

felina.

5-
6.

Catarrhus fenfitivus.

■ contagiofus.

— '■ eqmnus et caninus.

7. Peripneumonia fuperjicialie.

8. Pertujfis.

9. Variola dijcreia,

— confluens.

— - — inoculata.

10. Rubeola irritata.

iHirritata.

1 1 . Scarlatina mitis.
maligna.

12. Miliaria fudatoria.

8

Senfitive inirritated fever.
Eryfipelas irritated.

inirritated.

fenfitive.

Angina internal.

— fuperficial.

inirritated.

Mumps fuppurative.

mutable.

of cats.

Catarrh iaflammatorj.

contagious.

among horfes and dogs.

Superficial peripneumony.
Chin-cough.
Small-pox diflinft.

■ confluent.

inoculated.

Meafles irritated.

inirritated.

Scarlet fever mild.

malignant.

Miliary fever fudatory.

; . Miliaria

Class 11. 1.3. DISEASES OF SENSATION.

171

Miliaria irritata.
inirritata.

13. Pejlis.

vaccina.

14. Pemphigus.

15. Varicella.

16. Urticaria.

17. Aptha fenjitiva.

irritata.

inirritata.

1 8 Dyfenteria.

19. Gajiritis fuperjiciahs.

20. Enteritis fupei'Jicialis.

Miliary irritated.
inirritated.

Plague.

of horned cattle.

Bladdery fever.
Chicken-pox.
Nettle rafh.
Thrufli fenfitive.

irritated.

inirritated.

Bloody flux.

Superficial inflam. of the flomach.

of the bowels.

GENUS IV.

With the ProduSlion of new Vejfels by internal Membranes or Glands ,

without Fever.

SPECIES.

I . Ophthalmia fuperjicialis,

lymphatica.

equina.

2'

3-
4-

5-
6.

Pterigion.

Tarjitis palpebrarum.

Hordeolum.

Paronychia fuperjicialis.

Gutta rojea hepatica.

— Jiomatica,

hereditaria.

Ophthalmy fuperficial.

lymphatic.

of horfes.

Eye-wing.

Red eyelids.

Stye.

Whitlow.

Pimpled face hepatic.

ftomatic.

hereditary.

7. Odontitis,

172

DISEASES OF SENSATION. Class II. i,

7. Odontitis,

8. Otitis.

9. Fijiula lacrymaUs.

10. Fi/iula in ano.

1 1 . Hepatitis chronica.

1 2. Scropbulafuppuram,

13. Scorbutus fuppurans.

14. Schirrus fuppurans.

15. Carcinoma.

16. Arthrocele.

17. Arthropuofts.

18. Caries ojjium.

Inflamed tooth.

ear

Fiftula lacrymalls.
Fiftula in ano.
Chronical hepatitis.
Suppurating fcrophula.
Suppurating fcurvy.
Suppurating fchirrus.
Cancer.

Swelhng of the joints.
Suppuration of the joints.
Caries of the bones.

GENUS V.

t

IVith the Produciion of new Veffels by external Membranes or Glands,

•without Fever.

SPECIES.

1 . Gonorrhoea venerea.

2. Syphilis.

3. Lepra.

4. Flephantia/is.

5. Framboefia.

6. Pfora.

7. Pfora ebriorum.

8. Herpes.

9. Zona ignea.
10. Annulus repens.

Clap.

Venereal difeafe.

Leprofy.

Elephantiafis.

Framboefia.

Itch.

Itch of drunkards.

Herpes.

Shingles.

Ring-worm.

ii. 'tinea

Class II. 1.6. DISEASES OF SENSATION.

^13

1 1 . 'Tinea capitis.

12. Crujia ladle a.
I 2. 'Trichoma.

Scald-head.
Milk-cruft.
Plica polonica.

GENUS VI.
With Fever confequent to the Production of new VeJJeh or Fluids.

SPECIES.

I

2

3

4

5
6

7
8

9
10

II

12

14,

15
16

^7

Febris fenjitiva.

« pure clanfo.

a 'Vomica.

ab empyeinate.

mejenterica.

a pure aerato.

a phthi/i.

fcrophulofa.

ifchiadica.

arthropuodica.

a pure contagiofo.

— ■ — variolofa fecundaria.

carcinomatoja.

—— venerea.

afanie contagiofa,

puerpera.

— — — afphacelo.

Senfitive fever.

Fever from concealed matter.

from vomica.

from empyema.

mefenteric.

— - — from aerated matter.

from confumption.

fcrophulous.

from ifchias.

from joint-evil.

from contagious matter.

fecondary of fmall-pox.

cancarous.

venereal.

from contagious fanies.

puerperal.

■ — — from fphacelus.

GENUS

174

DISEASES OF SENSATION. Class II. 2. i.

GENUS VII.

JVith increafed Adion of the Organs ofSenfe.

SPECIES.

1. Delirium febrile.

2. maniacale.

3. ebrietatis.

4. Somnium.

5. Hallucinatio vifus.

6. ■ auditus.

7. Rubor a calore.

8. jiicunditalis.

9. Priapifmus amatorius,
1 o . Di/ientio mamularum.

Delirium of fevers.

maniacal.

of drunkenuefs.

Dreams.
Deception of fight.

of hearinsr.

Blufh from heat.

from joy.

Amorous priapifm.
Diftention of the nipples.

ORDO II.

Decreafed Senfaiion.

GENUS I.

With decreafed ABion of the general Syfein.

1 . Stultitia infenfbilis.

2. I'cedium vitce.

3. Parefsfert/itiva,

SPECIES.

Folly from infenfibility.
Irkfomenefs of life.
. Senfitive debility.

GENUS

Class II. 3. i. DISEASES OF SENSATION.

^75

GENUS II.
JVith decreafed A&ions of particular Organs,

SPECIES.

I. Anorexia,

Want of appetite.

2. Adipfta.

Want of thirft.

3. Impotent ia.

Impotence,

4. St er Hit as.

Barrennefs.

5. Infenjibilitas artuum.

Infenfibility of the limbs.

6. Dyfuria injenjitiva.

Infenfibility of the bladder.'

7. Accumulatio alvina.

Accumulation of feces.

OR DO III.

Retrograde Senjitive Motions.

GENUS I.
Of Excretory DuSis,

Motus retrogrejfus.

1. ureterum.

2. urethrce.

3. duSlus choledoci.

SPECIES.

Retrograde motion.

of the ureters.

of the urethra,

■ ■" of the bile-dud.

/i>

CLASS

Class II. I. r. DISEASES OF SENSATION. 177

CLASS II.

DISEASES OF SENSATION.

■' O R D O I.

Increafed Senfation.

GENUS I.
JVith increafed A£iion of the Mufdesl

The alliens belonging to this genus are thofe which are imme-
diately excited by the fenfations of pain or pleafure, but which are
neither followed by inflammation, nor by convulfion. The former
of which belong to the fubfequent genera of this order, and the latter
to the clafs of voluntary motions.

The criterion between the a6tions, which are the immediate con-
fequence of painful fenfation, and convulfive aftions properly fo called,
confifts in the former having a tendency to diflodge the Simulating
caufe, which induces the painful fenfation ; and the latter being ex-
erted for the purpofe of expending the fenforial power, and thus
dulling or deftroying the general fenfation of the fyftem. See Clafs
III. I.

There is a degree of heat produced in the affecfted part by thefe
fenfitive actions without inflammation, but in much lefs quantity
than when attended by inflammation ; as in the latter there is a pro-
dviftion of new veflels. See Seft. XXXIII. 2, 3.

Some of the fpecies of this genus cannot properly be termed difeafes
in their natural ftate, but become fo by their defe6l or excefs, and are
here inferred to facilitate the explanation of the others.

Vol. II. A a SPECIES.

173 DISEASES OF SENSATION. ClassII. i.j.

SPECIES.

I. Deglutitlo. Swallowing our food is immediately caufed by the
pleafureable fenfation occalioned by its ftimulus on the palate or fauces,
and is acquired long before the nativity of the animal. Afterwards
the pain of hunger previoufly produces the various voluntary exer-
tions to procure the proper material, but the adions of mafticating
and of fwallowing it are effecfled by the fenforial power of fenfation ;
which appears by their not being always controulable by the will, as
when children in vain attempt to fwallow naufeous drugs. See Clafs
IV. I. 3. I. The mafticated food Simulates the palate, which is an
organ of fenfe, into fo much a(flion, as to produce agreeable fenfation ;
'and the mufcles fubfervient to deglutition are brought into adlion by
the fenfation thus produced. The pleafureable fenfation is the proxi-
mate caufe ; the aftion of the fibres of the extremities of the nerves
of tafte is the remote caufe ; the fenforial power of irritation exciting
thefe fibres of the nerves of tafte into increafed adlion is the pre-
remote caufe ; the adion of the mufcles of deglutition is the
proximate efre£t ; the pufhing the food into the ftomach is the
remote efFedl; and the nutrition of the body is the poft-remote
efFed.

Though the mufcles fubfervient to deglutition have their adlions
previoufly aflbciated, fo as to be excited into fynchronous tribes or
fucceffive trains, either by volition, as when we fwallow a difagree-
able drug ; or by fenfation, as when we fwallow agreeable food ; or
by irritation, as when we inattentively fwallow our faliva ; yet do all
thofe three kinds of deglutition belong to the refpe£tive claffes of vo-
lition, fenfation, and irritation ; becaufe the firft links of thefe tribes
or trains of mufcular adlion are excited by thofe fenforial powers, and
the affociated links, which accompany or fucceed them, are excited by

7 the

Class II. I.I. DISEASES OF SENSATION. 179

the combined powers either of volition, or of feufation, or of irrita-
tion, along with that of aflbciation.

2, Refpiratio, Refpiration is immediately caufed by the fenforial
power of fenfation in confequence of the baneful want of vital air ;
and not from the accumulation of blood in the lungs, as that might
be carried on by inhaling azote alone, without the oxygenous part of
the atmofphere. The action of refpiration is thus fimilar to that of
fwallowing our food to appeafe the pain of hunger ; but the lungs
being furrounded with air, their proper pabulum, no intermediate
voluntary exertions are required, as in hunger, to obtain and prepare
the wanted material.

Refpiration is fimilar to flow combuftion ; the oxygenous part of
the atmofphere is received through the moift membranes, which line
the air-cells of the lungs, and uniting with the inflammable part of
the blood generates an acid, probably the phofphoric acid ; a portioa
Cff carbonic acid is likewife produced in this procefs ; as appears by
repeatedly breathing over lime-water, which then becomes turbid.
See Botanic Garden, P. I. Canto I. 1. 401. note.

3. Sternutatio. Sneezing confifts of mufcular adions produced by
the fenforial faculty of fenfation ; and is an effort to diflodge, by-
means of air forcibly impelled through the noflrils, fome material ;
which flimulates the membrane, which lines them, into too o-reat
a£tion, and might thence injure the fenfe of fmell which is diiFufed
on it.

In this operation the too great adion of the vefTels of the mem-
brane of the noflrils is the remote caufe; the fenfation thence induced
is the proximate caufe ; and the mufcular aftions are the proximate
efFedt.

This zdaon. of fneezing frequently precedes common refpiration in
new-born children, but I believe not always ; as like the latter it can-
not have been previoufly acquired in the uterus,

A a 3 It

x8o DISEASES OF SENSATION. Class 11. i. i.

It is produced in fome people by fudden light, as by looking up at
the (ky in a morning, when they come out of a gloomy bed-cham-
ber. It then becomes an affociate adion, and belongs to Clafs IV.

I. 2. 2.

M. M. When it is exerted to excefs it may be cured by fnuffing
ftarch up the noflrils. See Clafs I. i. 2. 13.

4. Anhelitiis, Panting. The quick and laborious breathing of
running people, who are not accuflomed to violent exercife, is occa-
iioned by the too great conflux of blood to the lungs. As the fangui-
ferous fyflem, as well as the abforbent fyftem, is furniflied in many
parts of its courfe with valves, which in general prevent the I'etro-
grade movement of their contained fluids ; and as all thefe veffels, in
fome part of their courfe, lie in contadl: with the mufcles, which are
brought intoadlion in running, it follows that the blood muft be ac-
celerated by the intermitted fwelling of the bellies of the mufcles
movins; over them.

The difficulty of breathing, with which very fat people are imme-
diately affefted on exercife, is owing to the prefTure of the accumu-
lated fat on the veins, arteries, and lymphatics ; and which, by dif-
tending the flcin, occafions it to a6l as a tight bandage on the whole
furface of the body. Hence when the mufcles are excited into quicker
aclion, the progrefs of the blood in the veins, and of the lymph and
chyle in the abforbent fyftem, is urged on with much greater force,
as under an artificial bandage o\\ a limb, explained in Art. IV'. 2. 10.
and in Se£l. XXXIII, 3. 2. Hence the circulation is inftantly quick-
ened to a great degree, and the difficulty of breathing is the confe-
quence of a more rapid circulation through the lungs. The increafed
fecretion of the perfpirable matter is another confequence of this rapid
circulation ; fat people, when at reil, are believed to perfpire lefs
than others, which may be gathered from their generally having more
liquid ftools, more and paler urine, and to their frequently taking lefs

food

Class II. 'i. i. DISEASES OF SENSATION. i8i

food than many thin people ; and laftly, from the pcrfplratlon of fat
people being generally more inodorous than that of lean ones ; but
when corpulent people are put in motion, the fweat ftands in drops
on their ikins, and they " lard the ground" aa they run. The in-
creafe of heat of corpulent people on exercife, is another confequence
of their more rapid circulation, and greater fecretion. See Clafs I.

Other caufes of difficult or quick refpiration will be treated of un-
der Afthma^ Pertuflis, Peripneumony, Tonlillitis.

5. 'Tiijjis ehriorum. Senfitive cough Is an exertion of the mufcles
ufed in expiration excited into more violent adlion by the fenforial
power of fenfation, in confequence of fomething which too power-
fully Simulates the lungs. As the faline part of the fecreted mucus,
when the abforption of it is impeded ; or the too great vifcidity of it,
when the abforption is increafed ; or the too great quantity of the
mucus, when the fecretion is increafed ; or the inflammation of the
membranes of the lungs ; it is an effort to diflodge any of thefe extra-
neous materials.

Of this kind is the cough which attends free-drinkers after a de-
bauch; it confifts of many fhort efforts to cough, with a frequent ex-
puition of half a tea-fpoonful of frothy mucus, and is attended with
confiderable thirft. The thirft is occafioned by the previous diflipa-
tion of the aqueous parts of the blood by fenfible or infenfible perfpira-
tion ; which was produced by the increafed a£lion of the cutaneous
and pulmonary capillaries during the fl;imulus of the wine. In con-
fequence of this an increafed abforption commences to replace this
ixioiflure, and the Ikin and mouth become dry, and the pulmonary
mucus becomes infpifTated ; which fiimulates the bronchia, and is
raifed into froth by the fucceffive currents of air in evacuating it.
This produdlion of froth is called by fome free-drinkers " fpitting
fixpences" after a debauch. This fubfequent thirft, dry mouth-, and

vifcid

iS2 DISEASES OF SENSATION. Class II. i.i,

vlfcid expe£loration ia fome people fuceeeds the fllghteft degree of
intoxication, of which it may be efteemed a criterion. See Clafs IV.

2. I. 8.

As coughs are not always attended with pain, the mufcular aftions,
which produce them, are fometimes excited by the fenforial faculty
of irritation, as in Clafs I. i. 2. 8. I. i. 3. 4. I. i, 4. 3. I. 2. 3. 4.
Coughs are alfo fometimes convulfive, as in Clafs III. i. i. 10. and
fometimes fympathetic, as Clafs IV. 2. i. 7.

M. M. Venefedlion, when the cough is attended with inflamma-
tion. Mucilages. Opium. Torpentia. Blifter.

6. Singultus. Hiccough is an exertion of the mufcles ufed in in-
fpiration excited into more violent a(5lion by the fenforial power of fen-
fation, in confequence of fomething which too powerfully ftimu-
lates the cardia ventriculi, or upper orifice of the flomach. As
when folid food is too haftily taken without fufficient dilution. And
is an effort to diflodge that offenfive material, and pufh it to fome
lefs fenfible part of the ftomach, or into the middle of the contained
aliment.

At the end of fatal fevers it may arife from the acrimony of the
tindigefled aliment, or from a part of the ftomach being already dead,
and by its weight or coldnefs affeding the furviving part with difa-
greeable fenfation. The pain about the upper orifice of the flomach
is the proximate caufe, the too great or too little aftion of the fibres
of this part of the ftomach is the remote caufe, the a£tion of the muf-
cles ufed in infpiration is the proximate effedV, and the repercufilon of
the offending material is the remote effedt.

Hiccough is fometimes fympathetic, occafioned by the pain of
gravel in the kidney or ureter, as in Clafs IV. i. i. 7. and is fome-
times a fymptom of epilepfy or reverie, as in Se6l. XIX. 2.

M. M. Oil of cinnamon from one drop gradually increafed to ten,

on fugar, or on chalk. Opium, Blifter, Emetic,

7. jyihma

ClassII. T. I. DISEASES OF SENSATION-. 1S3

7. AJihma humor ale. The humoral afthma probably confifls in a
temporary anafarca of the lungs, which may be owing to a tempo-
rary defedl of lymphatic abforptioii. Its caufe is neverthelefs at pre-
fent very obfcure, fince a temporary deficiency of venous abforption,
at the extremities of the pulmonary or bronchial veins, might occafiori
a fimilar difficulty of refpiration. See Abortio, Clafs I. 2. i. 14. Or
it might be fuppofed, that the lymph effufed into the cavity- of the
chelt might, by fome additional heat during Deep, acquire an aerial
form, and thus comprefs the lungs ; and on this circumflance the re-
lief, which thefe patients receive from cold air, would be readily ac-
counted for.

The paroxyfms attack the patient in his firft fleep, when the cir-
culation through the lungs in weak people wants the affiftance of the
voluntary power. Clafs I. 2. i. 3. And hence the abforbents of the
lungs are lefs able to fulfil the whole of their duty. And part of the
thin mucus, which is fecreted into the air-cells, remains there un-
abforbed, and occafions the difficult refpiration, which awakes the
patient. And the violent exertions of the mufcles of refpiration,
which fucceed, are excited by the pain of fufFocation, for the purpofe
of pufliing forwards the blood through the comprefi'ed capillaries, and
to promote the abforption of the effufed lymph.

In this the humoral differs from the convulfive afthma, treated of
in Clafs III. i. i. 10. as in that there is probably no accumulated fluid
to be abforbed ; and the violent refpiration is only an exertion for the
purpofe of relieving pain, either in the lungs or in fome diflant part,
as in other convulfions, or epilepfy ; and in this rcfpedl the fits of
humoral and convulfive afth ma efTentially differ from each other, con-
trary to the opinion exprelTed without fufficient confideration in Sedt.
XVIII. 15.

The patients in the paroxyfms both of humoral and convulfive
afthma find relief from cold air, as they generally rile out of bed, and
open the window, and put out their heads ; for the lungs are not

fenfible

1 84 DISEASES OF SENSATION. Class II. r. i.

fenfible to cold, and the fenfe of fufFocation is fomevvhat relieved by
there being more oxygen contained in a given quantity of cold frefli
air, than in the warm confined air of a clofe bed-chamber.

I have feen humoral afthma terminate in confirmed anafarca, and
deftroy the patient, who had been an exceffive drinker of fpirituous
potation. And M. Savage aflerts, that this difeafe frequently termi-
nates in diabetes ; which feems to (hew, that it is a temporary dropfy
relieved by a great flow of urine. Add to this, that thefe paroxyfms
of the afthma are themfelves relieved by profufe fweats of the upper
parts of the body, as explained in Clafs 1. 3. 2. 8. which would coun-
tenance the idea of their being occafioned by congeftions of lymph in
the lungs.

The congeftion of lymph in the lungs from the defeftive abforp-
tion of it is probably the remote caufe of humoral afthma ; but the
pain of fufFocation is the immediate caufe of the violent exertions in
the paroxyfms. And whether this congeftion of lymph in the air-
cells of the lungs increafes during our fleep, as above fuggefted, or
not ; the pain of fufFocation will be more and more diftrefling after
fome hours of fleep, as the fenfibility to internal ftimuli increafes
during that time, as defcribed in Sect. XVIII. 15. For the fame
reafon many epileptic fits, and paroxyfms of the gout, occur during
Heep.

In two gouty cafes, complicated with jaundice, and pain, and fick-
nefs, the patients had each of them a fliivering fit, like the com-
mencement of an ague, to the great alarm of their friends ; both
which commenced in the night, I fuppofe during their fleep ; and
the confequence was a ceflation of the jaundice, and pain about the
ftomach, and ficknefs ; and inftead of that the gout appeared in their
extremities. In thefe cafes I conjefture, that there was a metaflafis
not only of the difeafed a£lion from the membranes of the liver to
thofe of the foot ; but that fome of the new velFels, or new fluids,
which were previoufly produced in the inflamed liver, were tranflated

to

Class II. i. i. DISEASES OF SENSATION. 185

to the feet during the cold fit, by the increafed abforptioii of the he-
patic lymphaticsj and by the retrograde motions of thole of the af-
fe£led hmbs.

This I think refembles in fome refpefts a fit of humoral afthma,
where ftronger motions of the abforbent veffels of the lungs are ex-
cited, and retrograde ones of the correfpondent cutaneous lymphatics;
whence the violent fweats of the upper parts of the body only are
produced ; and for a time the patient becomes relieved by the me-
taftafis and elimination of the offending material by fenfitive exer-
tion. For a further account of this intricate fubjefit fee Clafs III.
I. I. lo.

M. M. To relieve the paroxyfm a tea-fpoonful of ether may be
given mixed with water, with 10 drops of laudanum, to be repeated
three or four times. Venefeition. An emetic. A blifter. After-
wards the. Peruvian bark, with a grain of opium at night, and two or
three of aloes. A flannel Ihirt in winter, but not in fummer. Iffues.
Digitalis ? "

In this fpecies of afthma, there is great reafon to believe, that the
refpiration of an atmofphere, with an increafed proportion of oxygen,
will prove of great advantage ; fome well-obferved and wcll-attefted
cafes of which are publifhed by Dr. Beddoes ; as this purer air invigo-
rates the circulation, and the whole fyftem in confequence, perhaps
not only by its ftinlulus, but by its fupplying the material from which
the fenforial power is extrafted or fabricated. In fpafmodic afthma,
on the contrary, Dr. Ferriar has found undoubted benefit from an at-
mofphere mixed with hydrogen. See Se£t. XVIII. 15. and Clafs III.
I. I. 10.

8. Ni^itatto fenjitiva. Winking of the eyes is performed every

minute, without our attention, for the purpofe of diffufing the tears

over them, which are poured into the eye a little above the external

corner of it, and which are afterwards abforbed by the lacrymal points

Vol. II. B b above

i86 DISEASES OF SENSATION. ClassII. i.s.

above and below the internal corner of it. When this operation is
performed without our attention, it is caufed by the faculty of irrita-
tion, and belongs to Clafs L 1.4. i. but when it is produced by a
flronger ftimulus of any extraneous material in the eye, fo as to caufe
pain, the violent and frequent niclitation is caufed by the faculty of
fenfation.

This difeafe is fometimes produced by the introverlion of the edge
of the lower eyelid, which bends the points of the hairs of the eye-
laih upon the ball of the eye, which perpetually ftimulate it into
painful fenfation. This introverfion of the eyelid is generally owing
to a tumor of the cellular membrane below the edge of the eyelid,
and though a very troublefome complaint may often be cured by the
following fimple means. A little common plafter fpread on thia
linen, about a quarter of an inch long, mull be rolled up fo as to be
about the fize of a crow-quill, this muft be applied immediately be-
low the eyelafh on the out(ide of the eye ; and muft be kept on by
another plafter over it. This will then aft as a flight compreffion
on the tumor under the eyelafli, and will prevent the hairs from
touching the eye-ball. In a week or two the compreffion will di-
minifh the tumor it lies over, and cure this painful deformity.

9. Ofchatio et pandkidath. Yawning and ftretching of the limbs
is produced either by a long inactivity of the mufcles now brought
into aftion, as fometimes happens after fleep, or after liflening a long '
time to a dull narrative ; or it is produced by a too long continued
a£tion of the antagonift mufcles. In the former cafe there is an ac-
cumulation of fenlorial power during the quiefcence of the mufcles
now brought into action ; which probably conftitutes the pain or
wearifomenefs of a continued attitude. In the latter cafe there is an
exhauftion of fenforial power in the mufcles, which have lately been
ading violently, and a confequent accumulation in the mufcles, which
are antagonifts to them, and which were at reft*

Thefe

Class II. 1. 1. DISEASES OF SENSATION. i^y

Thefe involuntary motions are often feen in paralytic linnbs, which
are at the fame time completely difobedient to the will ; and are fre-
quently obfervable in very young children ; and from thence we may
conclude, that thefe motions are learnt before nativity ; as puppies
are feen to open their mouths before the membranes are broken. See
Sear. XVI. 2.

Where thefe motions are obferved in limbs otherwife paralytic, it
is an indication that eleftric Ihocks may be employed with advantage,
as the excitability of the limb by irritation is not extinft, though it
be difobedient both to volition and fenfation.

10. Tenefmus confifts in violent and frequent ineffedual efforts to
^ifcharge the contents of the re6lum, owing to pain of the fphin£ler.
The pain is produced by indurated feces, or by fome acrid material^
as the acidity of indigefted aliment ; and the efforts are attended with
mucus from the pained membrane. The feces mufl fometimes be
taken away by the end of a marrow-fpoon, as cathartics and even,
clyfter will pafs without removing them. It is fometimes caufed by
fympathy with the urethra, when there is a ftone at the neck of the
bladder. See Clafs II. 2, 2. 7. and IV. i. 2. 8.

M. M. Fomentation, an enema with mucilage and laudanum.

The common exclufion of the feces from the redlum is a procefs
limilar to this, except that the mufcles of the fphin6ter ani, and thofe
of the abdomen, which adl along with them by the combined powers
of fenfation and aifociation, are in tenefmus excited by painful fenfa-
tion, and in the latter by a fenfation, which may in fome inflances
be almofl called pleafurable, as relieving us from a painful one in the
exclufion of the feces.

11. Stranguria. Strangury confifts in painful efforts to difcharge
the contents of the urinary bladder. It is generally owing to a Hone

B b 2 ia

r88 DISEASES OF SENSATION. Class II. x. i.

in the fphiniter of the bladder ; or to the inflammation 'of the neck of
it occafioned by cantharides. It is fometlmes caufed by fympathy
with the piles ; and then is liable in women to oecafion convulfions,
from the violence of the pain without inflammation. See Clafs IV,
2. 2. 2. and 3.

M. M. Fomentation clyfter with oil and laudanum, pufh the
ftone back with a bougie ; if from cantharides give half a pint of warm
water every ten minutes. Mucilage of gum arable and tragacanth.

The natural evacuation of the urine is a procefs limilar to this, ex-
cept that the mufcular fibres of the bladder, and the mufcles of the
abdomen, which a6l in concert with them by the combined powers
of fenfation and of aflbciation, are, in the former cafe of flrangury,
excited into adtion by painful fenfation ; and in the latter by a fenfa-
tion, which may almoft be termed pleafurable, as it relieves us from
a previous uneafy one.

The ejeftio feminis is another procefs in fome refpecls (imilar to
ftrangury, as belonging to the fame fenfible canal of the urethra, and
by exciting into a(5^ion the accelerator mufcles ; but in the ftrangury
thefe mufcles are excited into aftion by painful fenfation, and in the
ejection of the femen by pleafiireable ienfation.

12. Parturitto. Parturition is not a diieafe, it is a natural procefs,
but is more frequently unfortunate in high life than amongft the mid-
dle clafs of females ; which may be owing partly to fear, with which
the prlefts of LuoiNA are liable to infpirc the ladies of fafhion to in-
duce them to lie in in town ; and partly to the bad air of London, to
- which they purpofely refort.

There are however other caufes, which render parturition more
dangerous to the ladies of high life ; luch as their greater general de-
bility from negledl of energetic exercl e, their inexperience of the va-
Vialicns of cold and heat, and their feclulioi; from frefh air. To which
ixi-uft be added, that great fource of the deftrudion of female grace
8 and

Class IL r. i. DISEASES OF SENSATION. 189.

and beauty, as well as of female health, the tight flays, and other
bandages, with which they are generally tortured in their early years
by the a£tive folly of their friends, which by difplacing many of the
vlfcera impedes- their adlions, and by compreliing them together pro-
duces adhefions of one part to another, and affedts even the form and'
aperture of the bones of the pelvis, through which, the nafcent child
muft be protruded:^.

As parturition is a natural, not a morbid procefs, no medicine
fliould be given, where there is no appearance of dileafe. The abfurd
cuftom of giving a powerful opiate without indication to all women,
as foon as they are delivered, is, I make no doubt, frequently at-
tended with injurious, and fometimes with fatal confequences. See
Clafs 11. I. 2. 16.

Another thing very injurious to the child, is the tying and cuttings
the navel-ftring too foon ; which fhould always be left till the child
has not only repeatedly breathed, but till all pulfation in the cord
ceafes. As otherwife the child is much weaker than it ought to be;
a part of the blood being left in the placenta, which ought to have
been in the child; and at the fame time the placenta does not fo na-
turally collapfe, and withdraw itfelf from the fides of the uterus, and
is' not therefore removed with fo much fafety and certainty. The
folly of giving rue or rhubarb to new-born, children, and the danger
of feeding them with gruel inflead of milk, is fpoken of in Clafs I.
la 2. 5, and II. I. 2, i6i

ORDO

190 DISEASES OF SENSATION. Class II. i. z.

ORDO I.

Increafed Senfaiion,

GENUS II.

iflth the ProdiiEllon of jiew Vejfels by Internal Membranes or Glands,

with Fever.

In the firfl clafs of difeafcs two kinds of fevers were defcribed, one
from excefs, and the other from defe6l of irritation ; and were in
confequence termed irritative, and inirritative fevers. In this fecond
clafs of difeafes another kind of fever occurs, which is caufed by ex-
cefs of fenfation, and termed in confequence Seniitive Fever. But
there is no fever from defe<fl of fenfation, becaufe the circulation is
carried on in health without our confcioufnefs, that is, without any
fenfation attending it.

But as excefs of fenfation may ex^ifl: with excefs or defeft of irrita-
tion, two other kinds of fever arife from a combination of fenfitive
fever with the irritative, and inirritative ones. Making five kinds
in all.

1. Irritative fever, defcribed in Clafs 1. i. i. i.

2. Inirritative fever. Clafs I. 2. i. i.

3. Senfitive fever. Clafs II. 1.6.1.

4. Senfitive irritated fever. Clafs II. i. 2. i.

5. Senfitive inirritated fever. Clafs II, i. 3. i.

As the fenfitive irritated fever attends all the difeafes enumerated
under the genus about to be defcribed, it is placed at the head of it.
And as the fenfitive inirritated fever accompanies the greatefl number

6 of

Class II. i. 2. DISEASES OF SENSATION. 191

of the fpecies enumerated under the third genus of this order, it i-f
placed at the head of them. And as the fenfitive fever attends the
difeafes of the fixth genus, it is placed at the head of them. But as
every febrile paroxyfm confifts of difordered tribes or trains of affoci-
ated motions, it may be doubted, whether they ought not all to
have been placed in the fourth clafs, amongft the difeafes of affo-
ciation. See Clafs IV. 2. 4. 1 1.

All the fubfequent fpecies of this genus are attended with fenfitive
irritated fever ; there are neverthelefs fome fuperficial inflammations,
which afFeft the fame fituations without much fever, as the fcro-
phulous ophthalmy and fpurious peripneumony, which belong to
other genera.

Inflammation is uniformly attended with the produdlion or fecre-
tion of new fibres conftituting new veffels ; this therefore may be
efteemed its effential charafter, or the criterion of its exiflence. The
extenfion of the old veffels feems rather a confequence than a caufe of
the germination, or pullulation, of thefe new ones ; for the old vef-
fels may be enlarged, and excited with unufual energy, without any
produftion of nev/ ones, as in the blu(h of fliame or of anger.

When thefe new veffels are formed, if they are not reabforbed into
the circulation, they fecrete a new fluid called purulent matter ;
which generally opens itfelf a paffage on the external Ikin, and pro-
duces an ulcer, which either gradually heals, or fpreads, and is the
caufe of hedic fever ; . or they fecrete contagious matter, which has
the property of exciting the fame kind of inflammation, and of pro-
ducing the fame kind of contagious matter, when inferted by inocu-
lation into the flcin of other perfons. Thefe contagious matters form
"ulcers, which either heal fpontaneoufly, or by art ; or continue to
■fpread, and deftroy the patient, by other kinds of he6llc fever.

In this genus there is an increale of the fenforial power of irrita-
tion as well as of feniation ; whence great arterial energ}'' is produced,
and the pulfe becomes ftrong and full, as well as quick ; and the

coats

192 DISEASES OF SENSATION. Class II. 1.2,

coats of the arteries feel hard under the fing;er, being: themfelves
thickened and diftended by ^inflammation. The blood drawn, efpe-
cially at the fecond bleeding, is covered with a tough fize ; which is
probably the mucus from the inflamed internal furface of the arteries,
increafed in quantity, and more coagulable than in its natural' ftat'e ;
the thinner part being more perfeftly abforbed by the increafed a6l ion
of the inflamed abforbents. See Seft. XXXIII. 2. 2. This is ren-
dered more probable, becaufe the hard feel of the pulfe, and the
abundance of coagulable lymph commence, exifl, and ceafe to-
gether.

Great heat is produced from the new chemical combinations arifing
in the fecretion of new fibres, and great pain from the diftention of
old ones, or from their increafed aftion. The increafed quantity of
fenfation from a topical inflammation or phlegmon is the immediate
caufe of the febris fenfitiva irritata, or inflammatory fever ; as when
it arifes from the pain of pleurify, or paronychia ; but generally
an irritative fever precedes this topical inflammation, which occurs
during the hot fit of it ; and then the irritative fever is changed into a
fenfitive irritated fever, by the additional caufe of the fenforial power
of fenfation befides that of irritation.

" SPECIES.

I. Febris fenfitiva irr it at a. Senfitive irritated fever, or 'inflamma-
tory fever. Phlegmafia. A ftrong full pulfe, with inflammation of
the coats of the arteries, conftitutes this difeafe. It originates from
fome topical inflammation, which, if the fever is not fubdued, termi-
nates in fuppuration ; and differs from irritative fever in refpeft to the
painful fenfation which accompanies it. For as pleafurable fenfa-
tion is the caufe of the growth of the new veflfels, and diftention of
the old ones, in the natural enlargement of the body during our in-
fancy ;

Class II. 1.2. DISEASES OF SENSATION. 193

fancy ; fo a painful fenlation is the caufe of the unnatural produftioa
of new veflels, and enlargenient of old ones in inflammatory
difeafes.

When matter is thus formed in any .internal vifcus, or in the cel-
lular membrane, as in the lungs- or liverj ' fo long as this abfcefs re-
mains without admiffion of air, this inflammatory fever is liable to
continue, receiving only temporary relief by bleeding or emetics, or
cathartics ; till the patient, after a month, or two, or three, expires.
But, if air be admitted to thefe internal abfceffes, this kind of fever
is changed into a heftic fever in a (ingle day. It alfo fometimes hap-
pens, that when the abfcefs remains unopened to the air, if the mat-
ter has become putrid, that hedic fever fupervenes, with colliquative
fweats, or diarrhoea j the matter in both cafes is fometimes abforbed,
and the fides of the abfcefs grow together again without an external
aperture. See Clafs II. 1.4. i. and 2. Another termination of in-
flammation is in gangrene, but this belongs to the inflammation of
the external flcin ; as the produftion of purulent matter belongs to
inflammation of the internal or mucous membranes. Thus when
the external ik'in is the feat of inflammation, as in erythema, or ery-
fipelas, and produces fenfitive irritated fever, no colledion of purulent
matter can be formed ; but a material oozes out, and lies upon the
furface, like that in the confluent fmall-pox, and the cuticle at length
peels off", or gangrene fupervenes. It muft be noted, that thefe
kinds of inflammation can exift together ; and fome parts of the cel-
lular membrane may fuppurate at the fame time that the external Ikin
is affefted with erythema, or eryfipelas.

M. M. Venefe£l:ion. Cathartics. Diluents. Cool air. Tor-
pentia. Cold Bath ? See' Seft, XII. 6.

The increafed arterial a£lion in this fenfitive irritated fever is not

Amply owing to the ihcreafed irritability of the arterial fyftem, or to

the flimulus of the diflention of the veffels, but alfo to the increafed

acrimony or pungency of the blood ; which has now fo far changed

Vot.II. Cc its

194 DISEASES OF SENSATION. ClassII. r. 2.

its nature as to become more fluid, more denfe, and to be loaded with
coagulable lymph. Hence it becomes neceflary not only to leffen the
quantity of blood by venefeftion and by cathartics, but alfo to dilute
its acrimony, or pungency, by the introdudion of aqueous and mu-
cilaginous fluids, fuch as barley water, cream and water, fugar and
water, weak broths ; to which may be added fo much of fome ve-
o-etable effential oil, as may render them grateful to the flomach, and
thus promote their abforption, as by infufing parfley or cellery and
turneps in the broth ; or by balm, mint, or fage teas.

The following fpecies of this genus only diftinguifti the fituation of
the part previoufly inflamed, and which is the remote caufe of the
fenfitive irritated, or inflammatory fever, which attends it.

2. Ophthalmia interna. Inflammation of the eye is attended with
the produdlion of new veffels, which fpread over the tunica adjunc-
tiva, and over the cornea j' thefe new veflTels are eafily feen, as they
lie on a white ground, and give ocular demonftration of their pro-
duction in inflammation. When this inflammation of the cornea
fuppurates, it is liable to leave little ulcers, which may be feen be-
neath the furface in the form of little excavations ; and as thefe heal,
they are liable to be covered with an opake fear. This fear, in fome
months or years, is liable to wear away, and become tranfparent,
without the afllflance of any polifliing powder, as of very finely le-
vio^ted slafs, as fome have recommended. But when the cornea is
afFedled through all its thicknefs, the return of its tranfparency be-
comes hopelefs. See Clafs I. 1.3. 14.

In violent degrees of ophthalmy the internal parts, as the retina,
optic artery, iris, ciliary procefs, become inflamed, as well as the ex-
ternal ones ; hence the leaft light admitted to the eye occafions in-
tolerable pain. This curious circumftance cannot be owing to the
a£tion of light on the inflamed veffels of the cornea ; it therefore ihews,
that the extremity of the optic nerve or retina is alfo rendered more

exquifitely

Class II. 1.2. DISEASES OF SENSATION. 195

exquifitely fenfible to light, by partaking of the inflammation ; and L
have been told, that red colours are in thefe cafes fometimes painfully
perceived even in perfedl darknefs. This ftiew^s that the retina is ex>
cited into motion by the ftimulus of light ; and that, v^'hen it is in-
flamed, thefe motions give great pain, like thofe of other inflamed
parts, as the mufcles, or membranes. And fecondly, that the ideas
of colours confift in the motions of the retina ; which ideas occafion
pain, when the extremity of the moving nerve is inflamed.

M. M. Venefe£lion. Cathartics. Diluents. Torpentia. Fre-
quently moiften the eye with cold water by means of a rag. Cool
airy room. Darknefs. When the inflammation begins to decline,
white vitriol gr. vi. in an ounce of water is more efficacious to moif-
ten the eye than folutions of lead. Tinfture of opium diluted. New
veflels from the inflamed tunica adnata frequently fpread like a ^y^s
wing upon the tranfparent cornea, which is then called Pterigium.
To flop the growth of this, the principal veflels fliould be cut
through with a lancet. When the inflammation begins to decline,
after due evacuation any {Simulating material put into the eye in-
creafes the abforption, which foon removes the new red veflels ;
which has given rife to a hundred famous eye-waters, and eye-doc-
tors ; if thefe ftimulating materials are ufed too fbon, the inflamma-
tion is increafed by them. See Se£t. XXXII. 2. 10.

There is another ophthalmia, which attends weak children, and is
generally efl:eemed a fymptom of fcrophula, as defcribed in Clafs IL
1.5. 3. and another, which is of venereal origin, mentioned in
Clafs II. I. 5. 2. both which may be termed ophthalmia fuper-
flcialis.

3. Phrenttis. Inflammation of the brain is attended with into-
lerance of light and found ; which ftiews, that the extremities of the
nerves of thofe fenfes are at the fame time inflamed ; - it is alfb attend-
ed with great pain of the head, with watchfulnefs, and furious de-

C c 2 lirium.

196 DISEASES OF SENSATION. Class II. i. 2,

lirium. The violent efforts, thefe patients are faid fometinncs to exert,
are owing to the increafed fecretion of fenforial power in the brain ;
as all other inflamed glands have a greater circulation of blood paffing
through them, and a greater fecretion in confequence of their pecu-
liar fluids, as in the hepatitis much more bile is generated.

M. M. Venefedion. Cathartics. Torpentia. Foment the head
with cold water for hours together. Or with warm water. Cool
airj room. Afterwards cupping on the occiput. Leeches to the
temples. When the patient is weakened a blifler on the head, and
after further exhauftion five or fix drops of tindure of opium.

4. Perip7ieumonia, Inflammation of the lungs. The pulfe is not
always hard, fometimes foft ; which is probably owing to a degree
of ficknefs or inadlion of the flomach ; with dull pain of the cheft j
refpiration conflantly difficult, fometimes with erecl podure ; the
face bloated and purplifh ; cough generally with moifi: expeftoration,
often ftained with blood.

When the difficulty of refpiration is very great, the patient is not
able to cough ; in this fituation, after copious bleeding, the cough is
liable to return, and is fo far a favourable fymptom, as it fhews fome
abatement of the inflamrnation.

A peripneumony frequently occurs in the chin-cough, and deftroys
the patient, except immediate recourfe be had to the lancet, or to
four or five leeches ; when blood cannot be otherw.ife taken.

The peripneumony is very fatal to young children, efpecially as I
believe it is frequently miftaken for a fpafmodic afthma, or for the
croup, or cynanche trachealis of Cullen. Both which, however,
when they occur, require immediate venefedlion by the lancet or by
leeches, as well as the peripneumony.

The croup is an inflammation of the upper part, and the peripneu-
mony of the lower part of the fame organ, viz. the trachea or wind-
pipe. See Clafs I. 1.3. 4. But as the inflammation is feldom I fup-

pofe

Class II. 1.2. DISEASES OF SENSATION, 197

pofe confined to the upper part of the trachea only, but exifts at the
fame time in other parts of the lungs, and a& no inflammation of the
tonfils is generally perceptible, the uncouth name of cynanche trache-
alis fhould be changed for peripneumonia U-achialis. The method of
cure confifts in immediate and repeated bleeding. A vomit. A grain
of calomel or other mild cathartic. Bathing in fubtepid water, and
in breathing over the fteam of warm water, with or without a little
vinegar in it. And laftly, by keeping the child railed high in bed..

Inflammation of the lungs is alfo liable to occur in the meafles,
and muft be attacked by venefeftion at any time of the difeafe ; other-
wife either a prefent death, or an incurable confumption, is the con-
fequence.

The peripneumony is frequently combined with "inflammation of
the pleura, and fometimes with that of the diaphragm ; either of
thefe may generally be diflinguirtied, not only by the pain which at-
tends inflammation of thefe membranes, but by infpefting the naked
cheft, and obferving whether the patient breathes more by elevating
the ribs, or by depreffing the diaphragm.

A crifis happens in children about the fixth day with much pale
urine, which muft be waited for after evacuations have been ufed, as
far as can be done with fafety ; in this fituation the warm bath
twice a day, and fmall blifters repeatedly in fucceflion, are of peculiar
fervice. .

After the termination of peripneumony a colledlion of coagulable
lymph is frequently left in the cavity of the cheft unabforbed ; or a
common analarca of the lungs occurs from the prefent iuadlion of the
abforbent veffels, which had previoufly been excited too violently.
This difficulty of breathing is cured or relieved by the exhibition of
digitalis. See Art. IV. 2. 8.

M. M. The lancet is the anchor of hope in this difeafe ; which
muft be repeated four or five times, or as often as the fever and dif-
ficulty of breathing increale, which is generally in the evening ; an-

timonials,

198 DISEASES OF SENSATION. Class II. 1.2.

timonials, diluents, repeated fmall blifters about the cheft, mucilage,
pediluvium, warm bath. Is a decoction of feneka-root of ufe ? Do
not neutral falts increafe the tendency to cough by their ftimulus, as
they increafe the heat of urine in gonorrhoea ? Children in every kind
of difficult breathing, from whatever caufe, ftiould be kept as up-
right in bed as may be, and continually watched ; fince, if they flip
down, they are liable to be immediately fufFocated. After the patient
is greatly debilitated, fo that no further evacuation can be admitted,
and the difficult breathing and cough continue, I have given four or
five drops of tincture of opium, that is, about a quarter of a grain of
folid opium, with great advantage, and I believe in feveral cafes I
have faved the patient. A greater quantity of opium in this ftate of
debiUty cannot be ufed without hazarding the life of the perfon.
This fmall quantity of an opiate fhould be given about fix in the
evening, or before the accefs of the evening paroxyfm, and repeated
three or four nights, or longer.

There is a peripneumony with weak pulfe, which may be termed
pen'pneumoma inirritata, as defcribed in Seil. XXVII. 2. which be-
longs to this place. See alfo Superficial Peripneumony, Clafs IL
1.3. 7.

5. Pleurilis. Pleurify. Inflammation of the pleura, with hard
pulfe, pain chiefly of the fide, pungent, particularly increafed during
infpiration ; lying on either fide uneafy, the cough very painful, dry
at the beginning, afterwards moift, often bloody.

One caufe of pleurify is probably a previous adhefion of the lungs
to a part of the pleura, which envelops them. This in many cafes
iias been produced in infancy, by fufFering children to lie too long on
one fide. Or by placing them uniformly on one fide of a fire, or
window, to which they will be liable always to bend themfelves.

When matter is produced during peripneumony or pleurify in one

f»de of the cheft, fo long as it is a concealed vomica, the fever con-

4 tinues,

Class II. i. 2. DISEASES OF SENSATION. 195^

-tinues, if the difeafe be great, for many weeks, and even months ;
and requires oqcafional venefedion, till the patient finks under the
inflammatory or fenfitive irritated fever. But if air be admitted, by a
part of the abfcef& opening itfelf a way into the air-vefFels of the lungs,
a heflic fever, with colliquitive fweats or diarrhoea, fupervenes, and
frequently deftroys the patient ;. or the abfcefs heals the lungs ad-
hering to the pleura,

M. M. The lancet muft be ufed copiouily, and repeated as often
as the pain and difficult refpiration increafe. A blifter on the pained^
part. Antimonial. preparations,^ Diluents. Cool! air. Do neutral
falts increafe the tendency to cough ?■ Pediluvium or femicupium.
frequently repeated.

6. Diaphragmith. Lifiammation of the diaphragm. Pain^ round-
the lower ribs as if girt with a cord. Difficult refpiration performed
only by elevating the ribs and in an ere£t pofture. The corners of
the mouth frequently retradled into a difagreeable fmile, called rifus
Sardonicus.

Thofe animals, which are furniffied with clavicles, or eoUar-boneSs,
act only ufe their foremofl feet as hands, as men, monkies, cats,,
mice, fquirrels, &c. but elevate their ribs in refpiration as well as-
deprefs the diaphragm for the purpofe of enlarging the cavity of the
eheft. Hence an inflammation of the diaphragm is fudden death to*
thofe animals, as horfes and dogs, which can only breathe by de-
preffing the diaphragm ; and is I fuppofe the caufe of the fuddea
death^of horfes that are over-worked ; whereas, in the human animal,
when the diaphragm is inflamed,, fo as to render its motions impof-
fible from the pain they occasion, refpiration can be carried on,
though in a lefs perfe(£t manner, by the intercoftal mufcles in the ele-
vation of the ribs. In pleurify the ribs are kept motionlefs, and the-
refpiration is performed by the diaphragm, as may be readily {.Q^n on.
infpefting the naked cheft, and which is generally a bad fymptom ;

. io-

200 DISEASES OF SENSATION. Class 11. 1.2.

ia the diaphragmitis the ribs are alternately elevated, and deprcffed,
but the lower part of the belly is not feen to move.

M. M. As in pleurify and peripneumony. When the patient be-
comes delirious, and fmiles difagreeably by intervals, and is become
fo weak, that evacuations by the lancet could be uied no further,
and I have almofi: defpaired of my patient, I have found in two or
three inflances, that about five or fix drops of tlnft. thebaic, given
an hour before the evening exacerbation, has had the happieft effeft,
and cured the patient in this cafe, as well as in common peripneu-
mony ; it muft be repeated two or three evenings, fee Clafs II. r.2.4.
as the exacerbation of the fever and difficult refpiration and delirium
generally increafe towards night.

The ftimulus of this fmall quantity of opium on a patient previ-
oufly fo much debilitated, a£ts by increafuig the exertion of the ab-
forbent veflels, in the fame manner as a folution of opium, or any
other flimulant, put on an inflamed eye after the veflTels are previoufly
emptied by evacuations, Simulates the abforbent fyflem, fo as to
caufe the remaining new veflels to be immediately reablorbed.
Which fame ftimulants would have increafed the inflam.mation, if
they had been applied before the evacuations. See Clafs II. i, 2. 2.
Sedl. XXXIII. 3. 1. When the fanguiferous fyftem is full of blood,
the abforbents cannot aft {q powerfully, as the progrefs of their con-
tents is oppofed by the previous fulnefs of the blood- veflels ; whence
ftimulants in that cafe increafe the aftion of the fecerning fyfbem
more than of the abforbent one ; but after copious evacuation this re-
fiftance to the progrefs of the abforbed fluids is removed ; and when
ftimulants are then applied, they increafe the a6lion of the abforbent
fyftem more than that of the fecerning one. Hence opium given
in the commencement of inflammatory difeafes deftroys the patient ;
and cures them, if given in very fmall dofes at the end of inflamma-
tory difeafes.

7. Carditis

Class II. i. 2. DISEASES OF SENSATION. 201

7. Carditis. Inflammation of the heart is attended with un-
equal intermitting pulle, palpitation, pain in the middle of the fler-
num, and conftant vomiting. It cannot certainly be diftinguiftied
from peripneumony, and is perhaps always combined with it.

8. Peritonitis. Inflammation of the peritonaeum is known by
pain all over the abdomen, which is increafed on eredling the body.
It has probably moft frequently a rheumatic origin. See Clafs II.
}. 2. I'j.

9. Me/enteritis. Inflammation of the mefentery is attended with
pains like colic, and with curdled or chyle-like ftools. It is a very
frequent and dangerous difeafe, as the produftion of matter more
readily takes place in it than in any other vifcus. The^confequence
of which, after a hard labour, is probably the puerperal fever,
and in fcrophulous habits a fatal purulent fever, or hopelefs coii-
fumption.

■- M. M. Venefedion. Warm bath. Emollient clyfters.

10. Go/iritis. In inflammation of the ftomach the pulfe is o-ene-
rally foft, probably occafioned by the ficknefs which attends it. The
pain and heat of the ftomach is increafed by whatever is fwallowed,
with immediate rejeftion of it. Hiccough.

This difeafe may be occafioned by acrid or indigeftible matters
taken into the ftomach, which may chemically or mechanically in-
jure its interior coat. There is however a flighter fpecies of inflam-
mation of this vifcus, and perhaps of all others, which is unattended
-by much fever ; and which is fometimes induced by drinking cold
water, or eating cold infipid food, as raw turnips, when the perfon
has been much heated and fatigued by exercife. For vv'hen the fen-
forial power has been diminiflied by great exertion, and the ftomach
has become lefs irritable by having been previoufly Simulated by
much heat, it iboner becomes quiefcent by the application of cold.
Vol. II. D d In

202 DISEASES OF SENSATION. Class XL 1.2.

In coiifequence of this flight inflammation of the flonaach an eruption
of the face frequently enfues by the fenfitive afibciation of this vifcus
with the fltin, which is called a furfeit. See Clafs IV, i. 2. 13, and
II. I. 4. 6. and II. I. 3. 19.

M. M. Venefedion, Warm bath, Blifl:er. Anodyne clyfters.
Almond foap. See Clafs II. i. 3. 17. -

II. Enteritis. Inflammation of the bowels is often attended with-
foft pulfe, probably owing to the concomitant ficknefs ; which pre-
vents fometimes the early ufe of the lancet, to the deftruftion of the
patient. At other times it is attended with ftrong and full pulfe like
other inflammations of internal membranes. Can the feat of the dif-
eafe being higher or lower in the inteftinal canal, that is, above or
below the valve of the colon, produce this difference of pulfe by the
greater fympathy of one part of the bowels with the ftomach than
another ? In enteritis with ftrong pulfe the pain is great about the
navel, with vomiting, and the greateft difficulty in procuring a fl:ool.
In the other, the pain and fever is lefs, without vomiting, and with
diarrhoea. Whence it appears, that the enteritis with hard quick
pulfe differs from Ileus, defcribed in Clafs I. 3. 1.6. only in the ex-
iflence of fever in the former and not the latter, the other fymptoms
generally correfponding ; and, fecondly, that the enteritis with fofter
quick pulfe, differs from the cholera defcribed in Clafs I. 3. i. 5. only
in the exiflence of fever in the former, and not the latter, the other
fymptoms being in general fimilar. See Clafs 11. i. 3. 20.

Inflammation of the bowels fometimes is owing to extraneous in-
digeflible fubilances, as plum-flones, efpeciallj of the damafin,
which has fharp ends. Sometimes to an introfufception of one part
of the intefl:ine into another, and very frequently to a ftrangulated
hermia or rupture. In refpeft to the firfl, I knew an inftance where
a damafin flone, after a long period of time, found its way out of the
body near the groin. I knew another child, who vomited fome
damafin fiiones, which had lain for near twenty hours, and given

great

Class II. 1.2. DISEASES OF SENSATION. aoj

great pain about the navel, by the exhibition of an emetic given in
repeated dofes for about an hour. The fwallowing of plum-ftones
in large quantities, and even of cherry-ftones, is annually fatal to
many children. In refpedl to the introfufccption and hermia, fee
Ileus, Clafs I. 3. i. 6.

M. M. Repeated venefeftion. Calomel from ten to twenty grains
given in fmall pills as in Ileus ; thefe means ufed early in the dlfeafe
generally fucceed. After thefe evacuations a blifter contributes to
ftop the vomiting. Warm bath. Crude mercury. Aloes one grain-
pill every hour will frequently ftay in the ftomach. Glauber's fait
diffolved in pepper-mint water given by repeated fpoonfuls.

When the patient is much reduced, opium in very fmall dofes may
be given, as a quarter of a grain, as recommended in pleurify. If
the pain fuddenly ceafes, and the patient continues to vomit up what-
ever is given him, it is generally fatal ; as it indicates, that a morti-
fication of the bowel is already formed. Some authors have advifed
to join cathartic medicines with an opiate in inflammation of the
bowels, as recommended in colica faturnina. This may fucceed ia
{lighter cafes, but is a dangerous praftice in general ; fince, if the
obftrudlion be not removed by the evacuation, the ftimulus of the
opium is liable to increafe the aftioii of the veffels, and produce
mortification of the bowel, as I think I have feen more than
once.

12. Hepatitis. Inflammation of the liver is attended with ftrong
quick pulfe ; tenfion and pain of the right fide ; often pungent as in
pleurify, oftner dull. A pain is faid to afFe£l the clavicle, and top of
the right flioulder ; with difficulty In lying on the left fide ; difficult
refpiration ; dry cough ; vomiting ; hiccough.

There is another hepatitis mentioned by authors, in which the
fever, and other fymptoms, are wanting, or are lefs violent ; as de-
fcribed in Clafs II, i . 4. 1 1 . and which is probably fometimes relieved

D d 2 by

204 DISEASES OF SENSATION. Class II. 1.2.

by eruptions of the face ; as in thofe who are habituated to the in-
temperate ufe of fermented liquors.

M. M. Hepatic inflammation is very liable to terminate in fup-
puration, and the patient is deftroyed by the continuance of a fever
with fizy blood, but without night-fweats, or diarrhoea, as in other
unopened abfcefles. Whence copious and repeated venefeilion is re-
quired early in the difeafe, with repeated dofes of calomel, and ca-
thartics. Warm bath. Towards the end of the difeafe fmall dofes
of opium before the evening paroxyfms, and laftly the Peruvian bark,
and chalybeate wine, at firft in fmall dofes, as 20 drops twice a day,
and afterwards, if neceflary, in larger. See Art. IV, 2. 6.

Mrs, C. a lady in the laft month of her pregnancy, was feized with
violent hepatitis, with fymptoms both of peripneumony and of pleu-
rify, for it feldom happens in violent inflammations, that one vifcus
alone is afFeiled ; fhe wanted then about a fortnight of her delivery,
and after frequent venefeftion, with gentle cathartics, with fomenta-
tion or warm bath, fhe recovered and was fafely delivered, and both
herfelf and child did well. Rheumatic and eruptive fevers are more
liable to induce abortion.

13. Splenitis. Inflammation of the fpleen commences with tenfion,
heat, and tumour of the left fide, and with pain, which is increafed
by preflure. A cafe is defcribed in Clafs I. 2. 3. 18. where a
tumid fpleen, attended with fever, terminated in fchirrus of that
vifcus.

14. Nephritis. Inflammation of the kidney feems to be, of two
kinds ; each of them attended with difl'erent fymptoms, and different
modes of termination. One of them I fuppofe to be an inflammation
of the external membrane of the kidney, arifing from general caufes
of inflammation, and accompanied with pain in the loins without vo-
miting ; and the other to confift in an inflammation of the interior

8 parts

Class II. 1.2. DISEASES OF SENSATION". 205

parts of the kidney, occafioned by the ftimulus of gravel in the pelvis
of it, which is attended with perpetual vomiting, with pain along
the courfe of the ureter, and retradlion of the teftis on that fide, or
nunfibnefs of the thiaih.

The former of thefe kinds of nephritis is diftinguifhed from lum-
bago by its fituation being more exadlly on the region of the kidney,,
and by its not being extended beyond that part ; after three or four
days I believe this inflammation is liable to change place ; and that a^
herpes or eryfipelas^/ called zona, or fhingles, breaks out about the
loins in its ftead ; at other times it is cured by a cathartic with calo-'
mel, with or without previous venefeftion.

The other kind of nephritis, or inflammation of the interior part
of the kidney, generally arifes from the pain occafioned by the ftimu--
lus of a ftone entering the ureter from the pelvis of the kidney ; and'
which ceafes when the ftone is protruded forwards into the bladder ;;
or when it is returned into the pelvis of the kidney by the retrograde
a-6tion of the ureter. The kidney is neverthelefs inflamed more fre-
quently, though in a lefs degree, from other catifes ; efpecially from-
the intemperate ingurgitation of ale, or other fermented or fpirituous-
liquors. This lefs degree of infi^mmatioii is the caufe of gravel, as
that before mentioned is the effedc of it. The mucus fecreted to lu-
bricate the internal lurface of the uriniferous tubes of the kidney be-
comes fecreted in greater quantity, when- thefe veliels are inflamed ;
and, as the correfpondent ablorbent veffels a£l more energetically at
the lame time, the abforption of its more fluid parts is more power-
full}' effeded ; on both thefe accounts the mucus becomes both-
changed in quality and more indurated. And in this manner flones
are produced on almofi: every mucous membrane of the body ; as in
the lungs, bowels, and even in the 'pericordium, as fome writers
have affirmed. See Clafs I. 1.3.9.

M. M. Venefedion. Ten grains of calomel given in fmall pills,
then im^ufion of fena with oil. Warm bath. Then opium a grain

and

2o6 DISEASES OF SENSATION. Class II. 1.2.

and half. See Clafs I. 1.3. 9. for a further account of the method of

cure.

15. CvJIitis. InflammatioQ of the bladder is attended with tumor
and pain of the lower part of the belly ; with difficult and painful
raifturition; and tenefmus. It generally is produced by the exigence
of a large Itone in the bladder, when in a great degree ; or is produced
by common caufes, when in a {lighter degree.

The ftone in the bladder is generally formed in the kidney, and
pafling dovs'n the ureter into the bladder becomes there gradually in-
creafed in fize ; and this moft frequently by the apportion of concen-
tric fpheres, as may be feen by fawing fome of the harder calculi
through the middle, and poli(hing one furface. Thefe new concre-
tions fuperinduced on the nucleus, which defcended from the kidney,
as defcribed in Clafs I. i. 3. 9. and in the preceding article of this
genus, is not owing to the microcofmic fait, which is often feen to
adhere to the fides of chamber-pots, as this is foluble in warm water,
but to the mucus of the bladder, as it rolls along the internal furface
of it. Now when the bladder is flightly inflamed, this mucus of its
internal furface is fecreted in greater quantity, and is more indurated
by the abforption of its more liquid part at the inftant of fecretion, as
explained in Clafs I. 1.3. 9. and II. 1.2. 14. and thus the flimulus
and pain of a flone in the bladder contributes to its enlargement by
inflaming the interior coat of it.

M. M. Venefedlion, Warm bath. Diluents, Anodyne clyfters.
See Clafs I. i. 3. 9.

16. Hyjieritis. Inflammation of the womb is accompanied with
heat, tenfion, tumor, and pain of the lower belly. The os uteri
painful to the touch. Vomiting. This difeafe is generally produced
by improper management in the delivery of pregnant women. I knew
an unfortunate cafe, where the placenta was left till the next day j

y and

Class II. 1.2. DISEASES OF SENSATION". 207

and then an unflcilful accoucheur introduced his hand, and forcibly
tore it away ; the confequence was a moft violent inflammatory fever,
with hard throbbing pulfe, great pain, very fizy blood, and the
death of the patient. Some accoucheurs have had a pra6lice of intro-
ducing their hand into the uterus immediately after the birth of the
child, to take away the placenta ; which they faid was to fave
time. Many women I believe have been vidlims to this unnatural
pradtice.

Others have received injury, where inflammation has been begin-
ning, by the univerfal praftice of giving a large dofe of opium imme-
diately on delivery, without any indication of its propriety; which,
though a proper and ufeful medicine, where the patient is too feeble,
when given in a fmall dofe, as 10 drops of tindlure of opium, or half
a grain of fohd opium, muft do a proportionate injury, when it is
given improperly ; and as delivery is a natural procefs, it is certainly
more wife to give no medicines, except there be fome morbid lymp-
tom, which requires it ; and which has only been introduced into
cuftom by the ill-employed adivity ^f the Priefts or Prieftefles of
LuciNA ; like the concomitant nonfenfe of cramming rue or rheu-
barb into the mouth of the unfortunate young ftranger, who is thus
fopn made to experience the evils of life. See Clafs II. 1.1.12.
and I. 1.2.5. J"^ ^° fome over-wife beldames force young ducks
and turkeys, as foon as they are hatched, to fwallow a pepper-
corn.

M. M. Venefedion repeatedly ; diluents ; fomentation ; the pa-
tient fhould be frequently raifed up in bed for a fhort time, to o-ive
opportunity of difcharge to the putrid lochia; mucilaginous clyilers.
See Febris Puerpera.

17. 'Lumbago fenfitiv a. Senfitive lumbago. When the extenfive
membranes, or ligaments, which cover the mufcles of the back are

torpid,

2o3 DISEASES OF SENSATION. Class II. 1.2.

torpid, as In the cold paroxyfm of ague, they are attended with pain,
in confequence of the ina£lion of the veffels, which compofe thenn.
When this inafliion continues without a confequent renewal or in-
creafe of activity, the diieafe becomes chronical, and forms the lum-
bago frigida, or irritativa, defcribed in Clafs I. 2.4. 16. But when
this cold fit or torpor of thefe membranes, or ligaments or mufcles of
the back, is fucceeded by a hot fit, and confequent inflammation, a
violent inflammatory fever, with great pain, occurs, preventing the
eredl pofture of the body ; and the afFefted part is liable to fuppurate,
in which cafe a very dangerous ulcer is formed, and a part of one of
the vertebra is generally found carious, and the patient finks after a
long time under the he6tic fever occafioned by the aerated or oxy-
genated matter.

This difeafe bears no greater analogy to rheumatifm than the in-
flammation of the pleura, or any other membranous inflammation ;
and has therefore unjuftly been arranged under that name. It is
diftinguiflied from nephritis, as it is feldom attended with vomiting,
I fuppofe never, except the ureter happens to be inflamed at the fame
time.

The pain fometimes extends on the outfide of the thigh from the
hip to the ankle, heel, or toes, and is then called fciatica ; and has
been thought to confifl in an inflammation of the theca, or covering
of the fciatic nerve, as the pain fometimes fo exaftly attends the prin-
cipal branches of that nerve. See Clafs I. 2. 4. 15. 16.

M. M, Venefedlion repeatedly ; calomel; gentle cathartics; di-
luents ; warm bath ; poultice on the back, confifling of camomile
flowers, turpentine, foap, and opium; a burgundy-pitch plafler. A
debility of the inferior limbs from the torpor of the mufcles, which
had previoufly been too much excited, frequently occurs at the end
of this difeafe ; in this cafe eledtricity, and iiTues on each fide of the
lumber vertebrae, are recommended. See Clafs I. 2. 4. 16.

18. IJchias.

Class 11. 1.2. DISEASES OF SENSATION. 209

18. Jfchias, The ifchias confifts of inflammatory fever, with great
pain about the pelvis, the os coccigis, and the heads of the thigh-
bones, preventing, the patient from walking or ftanding eredl, with
increafe of parn on going to ftool. This malady, as well as the pre-
ceding, has been afcribed to rheumatifin ; with which it feems to
bear no greater analogy, than the inflammations of any other mem-
branes.

The patients are left feeble, and fometimes lame after this difeafe ;
which is alfo fometimes accompanied with great flow of urine, ow-
ing to the defedive abforption of its aqueous parts ; and with confe-
quent thirft occafioned by the want of fo much fluid being returned
into the circulation ; a lodgment of fasces in the reftum fometimes
occurs after this complaint from the leflened fenfibllity of it. See
Clafs I. 2. 4. 15.

M. M. Venefection ; gentle cathartics; diluents ^ fomentation;
poultice with camomile flowers, turpentine, foap, and opium ; af-
terwards the bark. See Clafs I. i. 3. 5.

When this inflammation terminates in fuppuration the matter ge-
nerally can be felt to flu6tuate in the groin, or near the top of the
thigh. In this circumftance, my friend Mr. Bent, Surgeon near
Newcaflile in Staffbrdfliire, propofes to tap the abfcefs by means of a
trocar, and thus as often as neceflary to difcharge the matter without
admitting the air. Might a weak injedion of wine and water, as in
the hydrocele, be ufed with great caution to inflame the walls of the
abfcefs, and caufe them to unite ? See Clafs II. i. 6. 9.

19. Paronychia interna. Inflammation beneath the finger-nail.
The pain occafioned by the inflammatory a6tion and tumor of parts
bound down between the nail on one fide and the bone on the other,
neither of which will yield, is faid to occafion fo much pain as to
produce immediate delirium, and even death, except the parts are di-

VoL, II. E e vided

2IO DISEASES OF SENSATION. Class II. i. 2.

vided by a deep incilion ; which mufl pafs quite through the peri-
ofteum, as the inflammation is faid generally to exift beneath it. This
difeafe is thus refembled by the procefs of toothing in young children ;
where an extraneous body lodged beneath the periofteum induces pain
and fever, and fometimes delirium, and requires to be fet at liberty
by the lancet.

ORDO

Class II. 1.3- DISEASES OF SENSATION. afi

ORDO I.

Increafed Senfat'ion.

GENUS III,

With the ProduBion of new Vejfels by external Membranes or Glands ^

with Fever.

The difeafes of this genus are perhaps all produftive of contagious
matter ; or which becomes fo by its expofure to the air, either
through the cuticle, or by immediate contadl with it; fuch are the
matters of the fmall-pox and meafles. The purulent matter formed
on parts covered from the air by thicker membranes or mufcles, as in
the preceding genus, does not induce fever, and cannot therefore be
called contagious; but it acquires this property of producing fever in
a few hours, after the abfcefs has been opened, fo as to admit the air
to its furface, and may then be faid to confift of contagious miafmata."
This kind of contagious matter only induces fever, but does not pro-
duce other matter with properties fimilar to its own ; and in this re-
fpe(fl it differs from the contagious miafmata of fmall-pox or meafles,
but refembles thofe which have their origin in crowded jails ; for
thefe produce fever only, which frequently deftroys the patient ; but
do not produce other matters fimilar to themfelves ; as appears from
none of thofe, who died of the jail-fever, caught at the famous black
affizes at Oxford, at the beginning of this century, having infedled
their phyficians or attendants.

If indeed the matter has continued fo long as to become putrid^
and thus to have given out air from a part of it, it acquires the power
of producing fever ; in the fame manner as if the ulcer had been
opened, and expofed to the common air j inftances of which are not

E e 2 un frequent.

212 DISEASES OF SENSATION. Class II. i, 3.

unfrequent. And from thefe circumftances it feems probable, that
the matters fecreted by the new veiTels formed in all kinds of phleg-
mons, or puftles, are not contagious, till they have acquired fome-
thingfrom the atmofphere, or from the gas produced by putrefaftion ;
which will account for fome phenomena in the lues venerea, cancer,
and of other contagious fecretions on the fkin without fever, to be
mentioned hereafter. See Clafs II. 1.4. 14.

The theory of contagion has been perplexed by comparing it with
fermenting liquors ; but the contagious material is fhevvn in Sedion
XXXIII. to be produced like other fecreted matters by certain animal
motions of the terminations of the veffels. Hence a new kind of gland
is formed at the terminations of the veflels in the eruptions of the
fmall-pox ; the animal motions of which produce from the blood va-
riolous matter ; as other glands produce bile or faliva. Now if fome
of this matter is introduced beneath the cuticle of a healthy perfon,
or enters the circulation, and excites the extrernities of the blood-
veifels into thofe kinds of difeafed motions, by which it was itfelf
produced, either by irritation or affociatlon, thefe difeafed motions of
the extremities of the veffels will produce other fimilar contagious
matter. See Sedt. XXXIII. 2. 5. and 9. Hence- contagion feems to
be proDa crated two ways; one, by the flimulus of contagious matter
applied to the part, which by an unknown law of nature excites the
ilimulated veffels to produce a fimilar matter ; as In venereal ulcers,
which thus continue to fpread ; or as when variolous matter is In-
ferted beneath the cuticle ; or when it is fuppofed to be abforbed, and
diffufed over the body mixed with the blood, and applied in that
manner to the cutaneous glands. The other way, by which con-
tao-ion feems to be diffufed, is by fome diftant parts fympathlzing or
imitating the motions of the part firft affedled ; as the ftomach and
(kin in the eruptions of the inoculated fmall-pox, or in the bite of a
mad dog ; as treated of in Se6l. XXII. 3.3.

In fome of the difeafes of this genus the pulfe is ftrong, full, and

hardj

Class II. 1.3. DISEASES OF SENSATION. 213

hard, conflitutiag the fenfitive irritated fever, as defcribed in the
preceding genus; as in one kind of eryfipelas, which requires re-
peated venefeQion. In others the arterial aflion is lometimes mo-
derate, fo as to conftitute the fenfitive fever, as in the inoculated
fmall-pox ; where the a£lion of the arteries is neither increafed by the
feniorial power of irritation, as in the lenfitive irritated fever; nor de-
creafed by the defe£l of that power, as in the fenfitive inirritated
fever. But in the o-reateft number of the dileafes of this 2;enus the
arterial a6lion is greatly diminifhed in refpe6l to flrength, and confe-
quentlj the frequency of pulfation is proportionally increafed, as ex-
plained in Sedt. XXXII. 2. i. Which is owing to the deficiency of
the fenforial power of irritation joined with the increafe of that of
fenfation, and thus conftitutes the fenfitive inirritated fever; as in
Scarlatina with gangrenous tonfils.

From this great debility of the zdiion of the arteries, there appears^
to be lefs of the coagulable lymph or mucus fecreted on their internal
furfaces ; whence there is not only a defedl of that buft^or fize upon
the blood, whicb is feen on the furface of that, which is drawn in the
fenfitive irritated fever ; but the blood, as it cools, when it has been
drawn into a bafon, fcarcely coagulates; and is faid to be diiTolved,
and is by fome fuppofed to be in a ftate of a£lual putrefa6lion. See
Sedl. XXXIII. 1. ,3. where the truth of this idea is controverted.
But in the fevers of both this genus and the preceding one great heat
is produced from the chemical combinations in the fecretlons of new
veffels and fluids, and pain or uneafinefs from the diftention of the
old ones ; till towards the termination of the difeafe fenfation ceafesj
as well as irritation, with the mortification of the afFeded parts, and
the death of the patient.

Dyfenterla, as well as tonfillitis and aphtha, are enumerated
amongft the difeafes of external membranes, becaufe they are expofed
either to the atmofpheric air, which is breathed, and fwallowed with
our food and faliva ; or thej are expofed to the inflammable air, or

8 hydrogen,

214 DISEASES OF SENSATION. Class IT. 1.3.

hydrogen, which is generated in the iiiteftines ; both which contri-
bute to produce or promote the contagious quality of thefe fluids ;
as mentioned in Clafs II. i. 5.

It is not fpeaking accurate language, if we fay, that in the difeafes
of this genus the fever is contagious ; fince it is the material produced
by the external membranes, which is contagious, after it has been
expofed to air ; while the fever is the confequence of this contagious
matter, and not the caufe of it. As appears from the inoculated
fmall-pox, in which the fever does not commence, till after fuppura-
tion has taken place in the hioculated arm, and from the difeafes of
the fifth genus of this order, where contagion exifls without fever.
See Clafs II. i. 5. and II. i. 3. i§.

SPECIES.

I. Fehris fetifitiva inirritata. Senfitive inirritated fever. Typhus
gravior. Putrid malignant fever. Jail fever. The immediate caufe
of this difeafe is the increafe of the fenforial power of fenfation, joined
with the decreafe of the fenforial power of irritation ; that is, it con-
fifts in the febris fenfitiva joined with the febris inirritativa of Clafs I.
2. 1. I. as the febris fenfitiva irritata of the preceding genus confifts of
the febris fenfitiva joined with the febris irritativa of Clafs I. 1. i. i.
In both which the word irritata, and inirritata, are defigned to ex-
prefs more or lefs irritation than the natural quantity; and the fame
when applied to fome of the difeafes of this genus.

This fever is frequently accompanied with topical inflammation,
Avhich is liable, if the arterial flrength is not fupported, to end in
fphacelus ; and as mortified parts, fuch as floughs of the throat, if
they adhere to living parts, foon become putrid from the warmth and
moifture of their fituation ; thefe fevers have been termed putrid, and
have been thought to owe their caufe to what is only their confe-
quence.

Ci^AssII. 1.3. DISEASES OF SENSATION. 215

quence. In hot climates this fever is frequently induced by the ex-
halations of ftacjnatino; lakes or marflies, which abound with animal
lubftances ; but which in colder countries produce fevers with debility
only, as the quartan ague, without inflammation.

The fenfitive inirritated, or malignant, fever is alfo frequently
produced by the putrid exhalations and flagnant air in prifons ; but
perhaps moft frequently by conta£l or near approach of the perfons,
who have refided in them. Thefe caufes of malignant fevers contri-
buted to produce, and to fupport for a while, the feptic and antifeptic
theory of them; fee Se£l. XXXIII. 1.3. The vibices or bruifes,
and petechias or purples, were believed to be owing to the diffolved
ftate of the blood by its incipient putrefaftion ; but hydroftatical ex-
periments have been made, which fhew the fizy blood of the patient
in fenfitive irritated or inflammatory fever, with flrong pulfe, is more
fluid, while it is warm, than this uncoagulable blood taken in this
fenfitive inirritated, or malignant fever; from whence it is inferred,
that thefe petechiae, and vibices, are owing to the deficient power of
abforption in the terminations of the veins. See Clafs I. 3. i. 5.

This fenfitive inirritated fever, or typhus gravior, is diftinguifhed
from the inirritative fever, or typhus mitior, in the early ftages of it,
by the colour of the fkin ; v\'hich in the latter is paler, with lefs heat,
owing to the lefs violent action of the capillaries ; in this it is higher
coloured, and hotter, from the greater energy of the capillary a6lion
in the produ£tion of new vcffels. In the more advanced ftate pe-
techia, and the produdion of contagious matter from inflamed mem-
branes, as the aphthae of the mouth, or ujcers of the throat, dil-
tinguifhes this fever from the former. Delirium, and dilated pupils
of the eyes, are more frequent in nervous fevers ; and flupor with
deafnefs more frequent attendants on malignant fevers. See Clafs L
2. 5. 6.

There is another criterion difcernible by the touch of an experi-
enced finger ; and that is, the coat of the artery in inflammatory
4 fevers.

2i6 DISEASES OF SENSATION. Class II. 1.3.

fevers, both thofe attended with ftrength of pulfation, and thefe
with weak pulfation, feels harder, or more like a cord; for the
coats of the arteries in thefe fevers are themfelves inflamed, and are
confequently turgid with blood, and thence are lefs eafily compreffed,
though their pulfations are neverthelefs weak : when the artery is
large or full with an inflamed coat, it is called hard ; and when
fmall or empty with an inflamed coat, it is called fliarp, by many
writers.

M. M. The indications of cure confift, i. In procuring a regur-
gitation of any ofrenfive material, which may be lodged in the long
mouths of the la6leals or lymphatics, or in their tumid glands. 2. To
excite the fyftem into neceifary a6lion by the repeated exhibition of
nutrientia, forbentia, and incitantia ; and to preferve the due eva-
cuation of the bowels. 3. To prevent any unnecefTary expenditure
of fenforial power. 4. To prevent the formation of ulcers, or to
promote the abforption in them, for the purpofe of healing them.

1. One ounce of wine of ipecacuanha, or about ten grains of the
powder, fhould be given as an emetic. After a few hours three or
four grains of calomel fliould be given in a little mucilage, or con-
ferve. Where fomething fwallowed into the ftomach is the caufe of
the fever, it is liable to be arrefted by the lymphatic glands, as the
matter of the fmall-pox inoculated in the arm is liable to be flopped
by the axillary lymphatic gland ; in this fituation it may continue a
day or two, or longer, and may be regurgitated during the operation
of an emetic or cathartic into the ftomach or bowel, as evidently hap-
pens on the exhibition of calomel, as explained in Sedl. XXIX. 7. 2.
For this reafon an emetic and cathartic, with venefe<flion, if in-
dicated by the hardnefs and fulnefs of the pulfe, will very fre-
quently remove fevers, if exhibited on the firft, fecond, or even
third day.

2. Wine and opium, in fmall dofes repeated frequently, but To
that not the leaft degree of intoxication follows, for in that cafe a

greater

Class ir. 1.3. DISEASES OF SENSATION. 217

greater degree of debility is produced from the expenditure of fexi-
lorial power in unnecefTary motions. Many weak patients have been
thus Simulated to death. See Sedl. XII. 7. 8. The Peruvian bark
fhould be given alfo in repeated dofes in fuch quantity only as may
ftrengthen digeftion, not impede it. For thefe purpofes two ounces
of wine, or of ale, or cyder, fhould be given every fix hours j and
two ounces of deco6lion of bark, with two drachms of the tincture
of bark, and fix drops of tindlure of opium, fhould be given alfo
every fix hours alternately; that is, each of them four times in
twenty-four hours. As much rhubarb as may induce a daily evacu-
ation, (hould be given to remove the coUuvies of indigefled materials
from the bowels; which might othcrvvife increafe the diftrefs of the
patient by the air it gives out in putrefadlion, or by producino- a
diaiThoea by its aci-imony ; the putridity of the evacuations are iu
confequence of the total inability of the digeftive powers ; and their
delay in the inteftines, to the inadivity of that canal in reijaecl to its
periftaltic motions.

The quantities of wine or beer and opium, and bark, above men-
tioned, may be increafed by degrees, if the patient feems refreihed
by them; and if the pulfe becomes flower on their exhibition ; but:
this with caution, as I have feen irrecoverable mifchief done by o-i-eater
quantities both of opium, wine, and bark, in this kind of fever; in
which their ufe is to ftrengthen the digeftion of the weak patient,
rather than to ftop the paroxyfms of fever ; but when they are ad-
miniftered in intermittents, much larger quantities are neceffary.

The ftimulus of fmall blifters applied in fucceffion, one every three
or four days, when the patient becomes weak, is of great fervice by
ftrengthening digeftion, and by preventing the coldnefs of the extre-
mities, owing to the fympathy of the Ikin with the flomachj and of
one part of the Ikin with another.

In refpeift to nutriment, the patient fhould be fupplied with wine

and water, with toafled bread, and fugar or fpics in it ; or with

Vol. II, F f fago

2i8 DISEASES OF SENSATION. Class II. 1.3.

fago with. wine; frefli broth with turnips, cellery, parfleyj fruit;
new milk. Tea with cream and fugar; bread pudding, with lemon
juice and fugar ; chicken, fifli, or whatever is grateful to the palate
of the fick perfon, in fmall quantity repeated frequently; with fmall
beer, cyder and water, or wine and water, for drink, which may
be acidulated with acid of vitriol in fmall quantities.

3. All unneceffary motions are to be checked, or prevented. Hence
horizontal pofture, obfcure room, filence, cool air. All the parts
of the fkin, which feel too hot to the hand, fliould be expofed to a
current of cool air, or bathed with cold water, whether there are
eruptions on it or not. Wafh the patient twice a day with cold
vinegar and water, or cold fait and water, or cold water alone, by
means of a fponge. If fome parts are too cold, as the extremities^
while other parts are too hot,, as the face or breaft, cover the cold
parts with flannel, and cool the hot parts by a current of cool air, or
bathinsc them as above.^

4. For the healing of ulcers, if in the mouth, folution of alum In
water about 40 grains to an ounce, or of blue vitriol in water, one
grain or two to an ounce may be ufed to touch them with three or
four times a day. Of thefe perhaps a folution of alum is to be pre-
ferred, as it inftantly takes away the flench from ulcers I fuppofe by
combining with the volatile alcali which attends it. For this purpofe
a folution of alum of an ounce to a pint of water fliould be frequently
injedled by means of a fyringe into the mouth. If there are ulcers
on the external ikin, fine powder of bark feven parts, and ceruffa iu
fine powder one part, fhould be mixed, and applied dry on the fore,,
and kept on by lint, and a bandage.

As floughs in the mouth are frequently produced by the previous
drynefs of the membranes, which line it, this drynefs fhould be.
prevented by frequently moiflening them,, which may be effefted by
injeftion with a fyringe, or by a molft fponge, or laflly in the follow-
ing manner. Place a glafs of wine and water, or of milk and fugar,.

o.a

Class II. 1.3. DISEASES OF SENSATION. 219

on a table by the bedfide, a little above the level of the moutn of the
patient; then, having previoufly moiftened a long piece of narrow"
lifting, or cloth, or flannel, with the fame liquor, leave one end of
it in the glafs, and introduce the other into the mouth of the patienti
which will thus be fupplied with a conftant oozing of the fluid through,
the cloth, which adls as a capillary fyphon.

The vifcid phlegm, which adheres to the tongue, fhould be
coagulated by fome auftere acid, as by lemon-juice evaporated to half
its quantity, or by crab-juice ; and then it may be fcraped off by a
knife, or rubbed off by flannel, or a fage leaf dipped in vinegar, or in
fait and water.

2. 'Eryftpelas, St. j^nthony's fire, may be divided into three kinds,
which differ in their method of cure, the irritated, the inirritated, and
the fenfitive eryfipelas.

Eryjipelas trritatum is attended with increafe of irritation betides
increafe of fenfation ; that is, with ftrong, hard, and full pulfe, which
requires frequent venefeftion, like other inflammations with arterial
flrength. It is diftinguifhed from the phlegmonic inflammations of
the laft genus by its fituation on the external habit, and by the red-
nefs, heat, and tumour not being diftindtly circumfcribed ; fo that the
eye or finger cannot exadlly trace the extent of them.

When the external flcin is the feat of inflammation, and produces
fenfitive irritated fever, no coUedion of matter is formed, as when a
phlegmon is fituated in the cellular membrane beneath the fkin ; but
the cuticle rifes as beneath a blifler-plafler, and becomes ruptured ;
and a yellow material oozes out, and becomes infpiflTated, and lies
ypon its furface ; as is feen in this kind of eryfipelas, and in the con-
fluent fmall-pox ; or if the new veflels are reabforbed the cuticle peels
off in fcales. This difference of the termination of eryfipelatous and
phlegmonic inflamrqatiou feems to be owing in part to the lefs diflen-
fibility of the cuticle than of the cellular membrane, and in part to

F f 2i, , the

22© DISEASES OF SENSATION. Class II. i. _j,

the ready exhalation of the thmner parts of the fecreted fluids through
its pores.

This eryfipelas is generally preceded by a fever for two or three
days before the eruption, which is liable to appear in fome places, as
it declines in others ; and feems frequently to arife from a previous
fcratch or injury of the flcin ; and is attended fometimes with inflam-
flammation of the cellular' membrane beneath the Ikin ; whence a
real phlegmon and colledion of matter becomes joined to the eryfi-
pelas, and either occalions or increafes the irritated fever, which at-
tends it. .

There is a greater fympathy between the external ikin and. the
"meninges of the brain, than between the cellular membrane and;
thofe meninges ; whence eryfipelas is more liable to be preceded or
attended, or fucceeded, by delirium than internal phlegmons. I ex-
cept the mumps, or parotitis, defcribed below ; which is properly an
external gland, as its excretory dud opens into the air. When.
pain of the head or dehrium precedes the cutaneous eruption of the-
face, there is fome reafon to believe, that the primary difeafe is a
torpor of the meninges of the brain ; and that the fucceeding violent,
aftion is transferred to the ikin of the face by fenfitive aflbciation ;.
and that a fimilar fympathy occurs between fome internal membranes
and the Ikin over them, when eryfipelas appears on other parts of the
body. If this circumftance fhould be fupported by further evidence,
this difeafe fhould be removed into Clafs IV. along with the rheu^
matifm and gout. See Clafs IV. i. 2. 17..

This fuppofed retropulfion of eryfipelas on the brain from the fre-
quent appearance of delirium, has prevented the free ufe of the lancet
early in this difeafe to the deftruiSlion of many ; as it has prevented'
the fubduing of the general inflammation, and thus has in the end"
produced the particular one on the brain. Mr. B- — — , a delicate
gentleman about fixty, had an eryfipelas beginning near one ear, and'
extending by degrees over the whole head,. with hard, full, and flrong-

pulfes.

Class II. I.J. DISEASES OF SENSATION. 221

pulfe ; blood was taken from him four or five times in confiderabic
quantity, with gentle cathartics, with calomel, diluents, and cool
air, and he recovered without any iigns of delirium, or inflammation

of the meninges of the brain. Mr. W , a ftrong corpulent man

of inferior life, had eryfipelas over his whole head, with ftrong hard
pulfe : he was not evacuated early in the difeafe through the timidity
of his apothecary, and died delirious. Mrs. F— — had eryfipelas
on the face, without either ftrong or weak pulfe ; that is, with feii''
fitive fever alone, without fuperabundance or deficiency of irritation ;:
and recovered without any but natural evacuations. From thefe
three cafes of eryfipelas on the head it appears, that the evacuations
by the lancet muft be ufed with courage, where the degree of inflam-
mation requires it ; but not where this degree of inflammation is'
fmall, nor in the eryfipelas attended with inirritation, as defcribed
below.

M. M. Venefe£!ion repeated according to the degree of inflam-
mation. An emetic Calomel three grains every other nio-ht. Cooi
air. Diluents, emetic tartar in fmall dofes, as a quarter of a- o-raia'
every fix hours. Tea, weak broth, gruel, lemonade,, neutral falts.
See Se£i:. XII. 6.

Such external applications as carry away the heat of the fkin may
be of fervice, as cold water, cold flour, fnow, ether. Becaufe thefe
applications impede the exertions of the fecerning veflels, which are
now in too great adion; but any applications of the flimulant kind,.
as folutions of lead, iron,, copper, or of alum, ufed early in the dif-
eafe, muR be injurious; as they Simulate the decerning vefiels, as-
well as the abforbent vefiTels, into greater adion ^ exadly as occurs-
when ftimulant eye- waters are ufed too foon. in ophthalmy. See
Clafs 11. I. 2. 2. But as the cuticle peels off in this cafe after the
inflammation ceafes, it differs from ophthalmy ;: and ftimulant appli-
cations are not indicated at all, except where fymptoms of gangrene
appear. For as a new cuticle is formed under the old one, as under

a blifler^

122 DISEASES OF SENSATION. Class II. 1.5..

a blider, the ferous fluid between them is a defence to the new-
cuticle, and (hould dry into a fcab by exhalation rather than be re-
ablbrbed. Hence we fee how greafy or oily applications, and even
how moift ones, are injurious in eryfipelas ; becaufe they prevent the
exhalation of tlie ferous cfFufion between the old and new cuticle, and
thus retard the formation of the latter.

Ervfipelas hilrritalum differs from the former in its being attended
with weak pulfe, and other fymptoms of fenfitive inirritated fever.
The feet and legs are particularly liable to this eryfipelas, which pre-
cedes or attends the fphacelus or mortification of thofe parts. A great
and lono- coldnefs firft afFe£ls the limb, and the eryfipelas on the Ikin
feems to occur in confequence of the previous torpor of the interior
membranes. As this generally attends old age, it becomes more dan-
gerous in oroportion to the age, and alfo to the habitual intemperance,
of the patient in refpe6t to the ufe of fermented or fpirituous

liquor.

When the former kind, or irritaited eryfipelas, continues long, the
patient becomes fo weakened as to be liable to all the fymptoms of
this inirritated eryfipelas ; efpecially where the meninges of the brain
are primarily afFefted. As in that cafe, after two or three efforts have
been made to remove the returning periods of torpor of the meninges
to the external flcin, thofe meninges become inflamed themfelves,
and the patient finks under the difeafe ; in a manner fimilar to that
in old o-outy patients, where the torpor of the liver or flomach is
relieved by affociation of the inflammation of the membranes of the
feet, and then of other joints, and laftly the power of afibciation
ceafingtoaft, but the excefs of fenfation continuing, the liver or
flomach remains torpid, or become themfelves inflamed, and the pa-
tient is deflroyed,

M. M. Where there exifts a beginning gangrene of the extre-
mities, the Peruvian bark, and wine, and opium, are to be given in
large quantities ; fo as to ilrengthen the patient, but not to intoxicate,
6 or

Class II. 1.3. DISEASES OF SENSATION. 223

or to impede his digeftioii of aliment, as mentioned in the firil: fpecies
of this genus. Clafs II. i. 2. i. But where the brain is inflamed or
oppreffed, which is known either by delirium, with quick pulfe ; or
by flupor, and flow refpiration with flow pulfe ; other means muft
be applied. Such as, firft, a fomentation on the head with warm
water, with or without aromatic herbs, or fait in it, fliould be con-
tinued for an hour or two at a time, and frequently repeated. A blifter
may al£b be applied on the head, and the fomentation neverthelefs
occafionally repeated. Internally very gentle ftimulants, as camphor
one grain or two in infulion of valerian. Wine and water or fmall
beer, weak broth. An enema. Six grains of rhubarb and one of
calomel. Afterwards five drops of tindlure of opium, which may be
repeated every fix hours, if it feems of fervice. Might the head be
bathed for a minute with cold water ? or with ether ? or vinegar ?

'Eryjipelas Jenfttivum is a third fpecies, differing only in the kind of
fever which attends it, which is fimply inflammatory, or fenfitive,
without either excefs of irritation, as in the firft variety ; or the defedl
of irritation-, as in the fecond variety: all thefe kinds of eryfipelas are
liable to return by periods in fome people, who have pafl^ed the middle
of life, as at periods of a lunation, or two lunations, or at the
equinoxes. When thefe periods of eryfipelas happen to women, they
feem to fupply the place of the receding catamenia ; when to men,
I have fometimes believed them to be aflbciated with a torpor of the
liver; as they generally occur in thofe who have drank vinous fpirit
exceflively,- though not approbrioufly ; and that hence they fupply
the place of periodical piles, or gout, or gutta rofea.

M. M. As the fever requires no management, the difeafe takes
its progrefs fafely, like a moderate paroxyfm of the gout ; but in this
cafe, as in fome of the former, the eryfipelas does not appear to be a
primary difeafe, and fhould perhaps be removed to the Clafs of
Affociation^

3. Tonfillius^

224 DISEASES OF SENSATION. Class IT. 1.3.

3. "TojifiHhh . Inflammation of the tonfils. The uncouth term
Cynanche has been ufed for difeafes fo diflimilar, that I have divided
them into Tonfillitis and Parotitis ; and hope to be excufed for addino-
a Greek termination to a Latin word, as one of thofe languages may
juftly be conlidered as a dialect of the other. By tonfillitis the in-
flammation of the tonfils is principally to be underftood ; but as ail
inflammations generally fpread further than the part firfl: afFe6led ; fo,
when the fummit of the windpipe is alfo much inflamed, it may be
termed tonfillitis trachealis, or croup. See Clafs I. i. 3. 4. and II. i.
2.. 4. ; and when the fummit of the gullet is much inflamed along
H with the tonfil, it may be called tonfillitis pharyngea, as defcribed in

Dr. CuUen's Nofologia, Genus X. p. 92. The inflammation of the
tonfils may be divided into three kinds, which require diflrerent me-
thods of cure. -

TonJUUtis interna. Inflammation of the internal tonfil. When the
fwelling is fo confiderable as to produce difficulty of breathing, the
fize of the tonfil fliould be diminiflied by cutting it with a proper
lancet, which may either give exit to the matter it contains, or may-
make it lefs by difcharging a part of the blood. This kind of angina
is frequently attended with irritated fever befides the fenfitive one,
w^iich accompanies all inflammation, and fometimes requires vcne-
fedion. An emetic fhould be given early in the difeafe, as by its in-
ducing the retrograde action of the veffels about the fauces during the
iiaufea it occafions, it may eliminate the very caufe of the inflamma-
tion ; which may have been taken up by the abforbents, and ftill
continue in the mouths of the lymphatics or their glands. The pa-
tient fhould then be induced to fwallow fome aperient liquid, an in-
fufion of fenna, fo as to induce three or four evacuations. Gargles
of all kinds are rather hurtful, as the adion of ufing them is liable
to give pain to the inflamed parts ; but the patients find great relief
from frequently holding warm water in their mouths, and putting it
out again, or by fyringing warm water into the mouth, as this adts

like

Class II. 1.3. DISExA^SES OF SENSATION. , 225

like a warm bath or fomentation to the inflamed part. Laflly, fome
mild ftimulant, as a weak foUition of fait and water, or of white vi-
triol and water, may be ufed to wafli the fauces with in the decline
of the difeafe, to expedite the abforption of the new vellels, if ne-
ceflary, as recommended in ophthalmy.

Tonftllitis fuperjicialis . Inflammation of the furfice of the tonfils.
As the tonflls and parts in their vicinity are covered with a membrane,
which, though expofed to currents of air, is neverthelefs confl:antlj
kept.motft by.muicus and fahva, and is liable to difeafes of its furface
like other mucous membranes, as well as to fuppuration of the in-
ternal fubfl:ance of the gland ; the inflammation of its furface is
fucceeded by fmall elevated puflules with matter in them, which foon
difappears, and the parts either readily heal, or ulcers covered with
floughs are left on the furface.

This difeafe is generally attended with only fenfitive fever, and
therefore is of no danger, and may be diftinguiflied with .great cer-
tainty from the dangerous inflammation or gangrene of the tonfils at
the height of the fmall-pox, or fcarlet fever, by its not being attended
with other fymptoms of thofe difeafes. One emetic and a gentle
cathartic is generally fuflicient; and the frequent fwallowing of weak
broth, or gruel, both without fait in them, relieves the patient, and
abfolves the cure. When thefe tumours of the tonfils frequently
return I have fometimes fufpefted them to originate from the ab-
forption of putrid matter from decaying teeth. See Clafs I. 2. 3. 21.
and II. 2. 2. I.

TonJilUtis inirritata. Inflammation of the tonfils with fenfitive
inirritated fever is a fymptom only of contagious fever, whether
attended with fcarlet eruption, or with confluent fmall-pox, or other-
wife. The matter of contagion is generally difluled, not diflblved
in the air ; and as this is breathed over the mucaginous furface of the
tonfils, the contagious atoms are liable to be arrefted by the tonfil ;
which therefore becomes the neft of the future difeafe, like the

Vol.11. G g v inflamed

226 . DISEASES OF SENSATION. Class XL 1.3.

inflamed circle round the inoculated punfture of the arm in fuppofi-
titlous fmall-pox. This fwelling is liable to fuffocate the patient in
fmall-pox, and to become gangrenous in fcarlet fever, and fome other
contagious fevers, which have been received in this manner. The
exlftence of inflammation of the tonfil previous to the fcarlet erup-
tion, as the arm inflames in the inoculated fmall-pox, and fuppurates
before the variolous eruption, fhould be a criterion of the Icarlet fever
beinsT taken in this manner.

M. M. All the means which ftrengthen the patient, as in the fen-
fitive inirritated fever, Clafs II. i. 2» i. As it is liable to continue a
whole lunation or more, great attention fhould be ufed to nourifh the
patient with acidulous and vinous panada, broth with vegetables
boiled in it, fugar, cream, beer ; all vv'hich given frequently will
contribute much to moiften, clean, and heal the ulcufcles, or floughs,
of the throat ; warm water and wine, or acid of lemon, fhould be
frequently applied to the tonfils by means of a fyringe, or by means
of a capillary fyphon, as defcribed in Clafs II. i. 2. i. A flight
folution of blue vitriol, as two grains to an ounce, or a folutiou of
fugar of lead of about fix grains to an ounce, may be of fervice,;
efpecially the latter, applied to the edges of the floughs, drop by drop
by means of a fmall glafs tube, or fmall crow-quill with the end cut
off, or by a camel's-hair pencil or Ipongej to the end of either of
which a drop will conveniently hang by capillary attradion ; as
' folutions of lead evidently impede the progrefs of eryfipelas on the
exterior Ikin, when it is attended with feeble pulfe. Yet a folution
of alum injected frequently by a fyringe is perhaps to be preferred,
as it immediately removes the fetor of the breath, which muft much
injure the patient by its being perpetually received into the lungs by
fefpiration.

4. Parotitis. Mumps, or branks, is a contagious inflammation of

the parotis and maxillary glands, aiid has generally been clafTed under

8 the

Class II. i. 3. DISEASES OF SENSATION. 227

the word Cynanche or Aiigind, to which it bears no analogy. It
divides itfelf into two kindsj which differ in the degree of fever which,
attends them, and in the miethod of cure.

Parotitis fuppurans. The fuppurating mumps is to be diftinguirtied
by the acutenels of the pain, and the fenfitive, irritated, or inflamma-
' tory fever, which attends it.

M. M. Venefeftion. Cathartic with calomel three or four grains
repeatedly. Cool air, diluents. This antiphlogiftic treatment is to
be continued no longer than is neceffary to relieve the violence of the
pain, as the difeafe is attended with contagion, and muft run through
a certain time, like other fevers with contagion.

Parotitis mutabilis. Mutable parotitis. A fenfitive fever only, or
a fenfitive irritated fever, generally attends this kind. And when
the tumor of the parotis and maxillary glands fubfides, a new fwelling
occurs in fome diflant part of the fyflem ; as happens to the hands
and feet, at the commencement of the fecondary fever of the fmall-
pox, ,when the tumor of the face fubfides. This new fwelling in
the parotitis mutabilis is liable to affe£l the teftes in men, and form a
painful tumor, which fliould be prevented from fuppuration by very-
cautious means, if the violence of the pain threaten fuch a termina-
tion ; as by bathing the part with coldifh water for a time, vene-
fedlion, a cathartic ; or by a blifler on the perin^eum, or fcrotum, or
a poultice.

When women are affedled with this complaint, after the fwelling
of the parotis and maxillary glands fubfides, a tumor with pain is liable
to affedl their breafts ; which, however, I have never feen terminate
in fuppuration.

On the retrocefilon of the tumor of the teftes above defcribed, and
I fuppole of that of the breafts in women, a deUrium of the calm kind
is very liable to occur ; which in fome cafes has been the firfl: fymp-
tom which has alarmed the friends of the patient ; and it has thence
been difficult to difcover the caufe of it without much inquiry ; the

G g 3 previous

228 DISEASES OF SENSATION. Class II. i. 3.

previous fymptoms having been fo flight as not to have occafioned
any complaints. In this delirium, if the pulfe will bear it, vene-
feftion fliould be ufed, and three or four grains of calomel, with
fomentation of the head with warm water for an hovir together every
three or four hours.

Though this difeafe generally terminates favourably, confidering
the numbers attacked by it, when it is epidemic, yet it is dangerous
at other times in every part of its progrefs. Sometimes the parotis
or maxillary glands fuppurate, producing ulcers which are difficult
to cure, and frequently deflroy the patient, where there was a
previous fcrophulous tendency. The teftis in men is alio liable to
fuppurate with great pain, long confinement, and much danger; and
laftly the affedion of the brain is fatal to many.

Mr. W. W. had a fwelled throat, which after a few days fubfided.
He became delirious or flupid, in which flate he was dying w-hen I
faw him ; and his friends afcribed his death to a coup de foleil, which
he was faid to have received fome months before, when he was
abroad,

Mr. A. B. had a fwelling of the throat, which after a few days
fubfided. When I faw him he had great ftupor, with flow breath-
ing, atid partial delirium. On fomenting his head with warm water
for an hour thefe fymptoms of ftupor were greatly leflened, and his
opprefled breathing gradually ceafed, and he recovered in one day.

Mr. C. D. I found walking about the lioule in a calm delirium
without ftupor; and not without much inquiry of his friends could
get the previous hiftory of the dileafe ; which had been attended with
parotitis, and Iwelled teftis, previous to the delirium. A few ounces
of blood were taken away, a gentle cathartic was direfted, and his
head fomented with warm water for an hour, with a fmall blifter on
the back, and he recovered in two or three days. ■ '

Mr. D. D. came down from London in the coach alone, fo that
no previous hiftory could be obtained. He was walking about the

houfe

Class II. 1.3- DISEASES OF SENSATION. 229

houfe in a calm delirium, but could give no fenfible anfwers to any-
thing which was propofed to him. His pulfe was weak and quick.
Cordials, a blifter, the bark, were in vain exhibited, and he died in
two or three days. -

Mr. F. F. came from London in the fame manner in the coach.
He was mildly delirious with conliderabla ftupor, and moderate pulfe,
and could give no account of himfelf. He continued in a kind of
cataleptic ftupor, fo that he would remain for hours in any pofture
he was placed, either in his chair, or in bed ; and did not attempt to
fpeak for about a fortnight ; and then gradually recovered. Thefe
two lad cafes are not related as being certainly owing to parotitis, but
as they might probably have that origin.

The parotitis luppuians, or mumps with irritated fever, is at times
epidemic among cats, and may be called parotitis felina; as I have
reafon to believe from the fwelllngs under the jaws, which frequently
fuppurate, and are very fatal to thofe animals. In the village of Hay-
.wood, in Staffbrdfhlre, I remember a whole breed of Perfian cats,
with long white hair, was delfroyed by this malady, alono- with
almoft all the common cats of the neighbourhood ; and as the paro-
titis or mumps had not long before prevaded amongft human beings
in that part ot the country, I recollect being inclined to believe, that
the cats received the infection from mankind ; though in all other
contagious difeafes, except the rabies canlna can be fo called, no dif.
ferent genera of animals naturally communicate infection to each
other ; and 1 am infoimed, that vain efforts have been made to com-
municate the fmall-pox and meafles to fome quadrupeds by inocula*
tion. A dlfeafe of the head and neck dellroyed almoft all the cats in .
Weftphalla. Savage, Nofol. Ciafs X. Art. 30. 8.

5. Catarrhus fenfitivas confifts of an inflammation of the mem-
brane, which lines the noftrlls and fauces. It is attended with lenG-
tive fever alone, and is cured by the fteam of warm water externally,

and

230 DISEASES OF SENSATION. Class II. 1.3.

and by diluents internally, with moderate venefeftion and gentle ca-
thartics. This may be termed catarrhus fenfitiviis, to diftinguifh it
from the catarrhus contagiofus, and is in common language called a
violent cold in the head ; it differs from the catarrhus calidus, or
warm catarrh, of Clafs I. 1.2. 7. in the produ£lion of new veffels,
or inflammation of the membrane, and the confequent more purulent
appearance of the difcharge.

Rancedo catarrhalis, or catarrhal hoarfenefs, is a frequent fymptom
of this difeafe, and is occafioned by the pain or forenefs which attends
the thickened and inflamed membranes of the larynx ; which pre-
vents the mufcles of vocaUity from fufficiently contra£ling the aper-
ture of it. It ceafes with the inflammation, or may be relieved by
the fleam of warm water alone, or of water and vinegar, or of water
and ether. See Paralytic Hoarfenefs, Clafs III. 2. i. 4.

6. Catarrhus contagiofus. This malady attacks fo many at the
fame time, and fp reads gradually over fo great an extent of country,
that there can be no doubt but that it is dilTeminated by the atmo-
fphere. In the year 1782 the fun was for many weeks obfcured by
a dry fog, and appeared red as through a common mift. The ma-
terial, which thus rendered the air muddy, probably caufed the epi-
demic catarrh, which prevailed in that year, and which began far in
the north, and extended itfelf over all Europe. See Botanic Garden,
Vol. II. note on Chunda, and Vol, I. Canto IV. line 294, note ;
and was fuppofed to have been thrown out of a volcano, which much
difplaced the country of Iceland.

In many inftances there was reafon to believe, that this difeafe be-
came contagious, as well as epidemic ; that is, that one perfon might
receive it from another, as well as by the general unfalutary in-
fluence of the atmofphere. This is difficult to comprehend, but may
be conceived by confidering the increafe of contagious matter in the
fmallpox. In that difeafe one particle of contagious matter Simulates

the

Class II. 1.3. DISEASES OF SENSATION. ^31 '

the fkin of the arm iii inoculation into morbid action fo as to produce
a thoufand particles fimilar to itfelf ; the fame thing occurs in catarrh,
a few deleterious atoms Simulate the mucous membrane of the
noftrils into morbid adlions, which produce a thoufand other particles
fimilar to themfelves. Thefe contagious particles difFufed in the air
muft have confifted of animal matter, otherwife how could an animal
body by being Simulated by them produce fimilar particles ? Could
they then have had a volcanic origin, or muft they not rather have
been blown from putrid marflies full of animal matter ? But the
greateft part of the folid earth has been made from animal and veget-
able recrements, which may be difperfed by volcanos. — Future dis-
coveries muft anfwer thefe queftions.

As the fenfitive fever attending thefe epidemic catarrhs is feldom
either much irritated or inirritated, venefe6tion is not always either
clearly indicated or forbid ; but as thofe who have died of thefe
catarrhs have generally had inflamed livers, with confequent fuppu-
ration in them, venefeftion is advifeable, wherever the cough and
fever are greater than common, fo as to render the ufe of the lancet
in the leaft dubious. And in fome cafes a fecond bleeding was ne-
ceffary, and a mild cathartic or two with four grains of calomel; with
mucilaginous fubacid diluents ; and warm fteam occafionally to alle-
viate the cough, finifhed the cure.

The catarrhus contagiofus is a frequent difeafe amongft horfes^and
dogs ; it feems firft to be difleminated amongft thefe animals by
miafmata difFufed in the atmofphere, becaufe fo many of them re-
ceive it at the fame time ; and afterwards to be communicable from
one horfe or dog to another by contagion, as above defcribed. Thefe
epidemic or contagious catarrhs more frequently occur amongft dogs
and horfes than amongfl men ; which is probably owing to the
greater extenfion and fenfibility of the mucous membrane, which
covers the organ of fmell, and is difFufed over their wide noftrils,

and

232 DISEASES OF SENSATION. Class II. 1.5.

atid their large maxillary and frontal cavities. And to this circum-
ftance may be afcribed the greater fatality of it to thefe animals.

Ill refpedl to horfcs, I fufpe£l the fever at the beginning to be of

the fenfitive, irritated, or inflammatory kind, becaufe there is fo

great a difcharge of purulent mucus ; and that therefore they will

bear once bleeding early in the difeafe ; and alfo one mild purgative,

confiftins: of about half an ounce of aloe, and as much white hard

foap, mixed together. They fhould be turned out to grafs both day

and night for the benefit of pure air, unlefs the weather be too cold

(and in that cafe they fhould be kept in an open airy ftable, without

being tied), that they may hang down their heads to facilitate the

difcharse of the mucus from their noftriis. Grafs Ihould be offered

them, or other frefli vegetables, as carrots and potatoes, with mafhes

of malt, or of oats, and with plenty of frefh warm or cold' water

frequently in a day. When fymptoms of debility appear, which may

be known by the colduefs of the ears or other extremities, or when

floughs can be feen on the membrane which lines the noflrils, a

drink confifling of a pint of ale with half an ounce of tincture of

opium in it, given &vtxy fix hours, is likely to be of great utility.

In dogs I believe the catarrh is generally joined with fymptoms of
debility early in the difeafe. Thefe animals fhould be permitted to
go about in the open air, and fhould have conflant accefs to frefh
water. The ufe of being as much as may be in the air is evident,
becaufe all the air which they breathe pafles twice over the putrid
floughs of the mortified parts of the membrane which lines the
noftrils, and the maxillary and frontal cavities ; that is, both during
infpiration and expiration ; and muft therefore be loaded with con-
tagious particles. Frefh nev/ milk, and frefh broth, fliould be given
them very frequently, and they fhould be fuffered to go amongfl: the
grafs, which they fometimes eat for the purpofe of an emetic; and
if pofTible fhould have accefs to a running flream of water. As the

contagious

Class II. r. 3- DISEASES OF SENSATION. 235

contagious mucus of the noftrlls, both of thefe animals and of horfes,
generally drops into the water they attempt to drink. Bit-s of raw
flefli, if the dog will eat them, are preferred to cooked meat ; and
from five to ten drops of tinfture of opium may be given- with advan-
tage, when fymptoms of debility are evident, according to the fize
of the dog, every fix hours. If floughs can be (een in the noftrils,
they fhould be moiftened twice a day, both in horfes and dogs, with
a folution of fugar of lead, or of alum, by means of a fponge fixed
on a bit of whale bone, or by a fyringe. The lotion may be made
by diflblving half an ounce of fugar of lead in a pint of water.

Ancient philofophers feem to have believed, that the contagious
miafmata in their warm climates affe(5led horfes and dogs previous to
mankind. If thofe contagious particles were fuppofed to be difFufed
axnongft the heavy inflammable air, or carbonated hydrogen, of pu-
trid marfhes, as thefe animals hold their heads down lower to the
ground, they may be fuppofed to have received them fooner than
men. And though men and quadrupeds might receive a difeafe from
the fame fource of marfh-putrefa6lion, they might not afterwards be
able to infed: each other, though they might infedl other animals of
the fame genus j as the new contagious matter generated in their
own bodies might not be precifely fimilar to that received ; as hap-
pened in the jail-fever at Oxford, where thofe who took the conta-
gion and died, did not infeft others.

On mules and dogs the infe£lion firfi: began,
And, lail, the vengeful arrows fix'd on man.

Pope's Homer's Iliad, I.

7, Peripneumonia fuperfclalis . The fuperficial or fpurious perip-
neumouy confifts in an inflammation of the membrane, which lines
the bronchia, and bears the fame analogy to the true peripneumony,
as the inflammations of other membranes do to that of the paren-j
chyma, or fubftantial parts of the vifcus, Vv'hich they furround. It
affedls elderly people, and frequently occafions their death ; and
Vol. II. H h exifts

234 DISEASES OF SENSATION. Class II. 1.5.

exifts at the end of the true peripneumony, or along with it ; when
the lancet has not been \ifed fufficiently to cure by reabforbing the
inflamed parts, or what is termed by refolution-.

M. M. Diluents, mucilage, antimonials, warmifh air coiiftantly
changed, venefedion once, perhaps twice, if the pulfe will bear it.
Oily volatile draughts. Balfams ? Neutral falts increafe the ten-
dency to cough. Bliflers in fucceffion about the cheft. Warm
bath. Mild purgatives. Very weak chicken broth without fait in
it. Boiled onions. One grain of calomel every night for a week.
From five drops to ten of tincture of opium at fix every night, when
the patient becomes weak. Digitalis ? See Ciafs II. i. 6. 7.

8. PertuJJts. Tuffis convulfiva. Chin-cough refembles peripneu-
monia fuperficialis in its confifting in an inflammation of the mem-
brane which lines the air-velTels of the lungs ; but differs in the cir-
cumftance of its being contagious ; and is on that account of very
long duration ; as the whole of the lungs are probably not infedted
at the fame time, but the contagious inflammation continues gradually
to creep on the membrane. It may in this refpe£t be compared to
the ulcers in the pulmonary confumption ; but it differs in this, that
in chin-cough fome branches of the bronchia heal, as others become
inflamed.

This complaint is not ufually claffed amongft febrile diforders,
but a fenfitive fever may generally be perceived to attend it during
fome part of the day, efpecially in weak patients. And a peripneu-
mony very frequently fupervenes, and deflroys great numbers of chil-
dren, except the lancet or four or fix leeches be immediately and
repeatedly ufed. When the child has permanent difficulty of breath-
ing, which continues between the coughing fits: unlefs blood be
taken from it, it dies in two, three, or four days of the inflammation
of the lungs. During this permanent difficulty of breathing the
hooping-cough abates, or quite ceafes, and returns again after once

or

Class II. 1.3. DISEASES OF SENSATION. 235

or twice bleeding ; which is then a good fymptom, as the child now
pofleffing the power to cough (hews the difficulty of breathing to be
abated. I dwell longer upon this, becaufe many lofe their lives from
the difficulty there is in bleeding young children ; where the apo-
thecary is old or clumfy, or is not furniChed with a very (harp and
fine-pointed lancet. In this diflrefling fituation the application of
four leeches to one of the child's legs, the wounds made by which
(hould continue to bleed an hour or two, is a fuccedaneum ; and
faves the patient, if repeated once or twice according to the difficulty
of the refpiration.

The chin-cough feems to refemble the gonorrhoea venerea in feveral
circumftances. They are both received by infetJlion, are both dif*-
eafes of the mucous membrane, are both generally cured in four or
fix weeks without medicine. If ulcers in the cellular membrane
under the mucous membrane occur, they are of a phagedenic kind,
and deftroy the patient in both difeafes, if no medicine be ad-
miniftered.

Hence the cure (hould be fimilar in both thefe difeafes ; firft ge-
neral evacuations and diluents, then, after a week or two, I have
believed the following pills of great advantage. The dofe for a child
of about three years old was one fixth part of a grain of calomel, one
fixth part of a grain of opium, and two grains of rhubarb, to be taken
twice a day.

The opium promotes abforption from the mucous membrane, and
hence contributes to heal it. The mercury prevents ulcers from be-
ing formed under the mucous membrane, or cures them, as in the
lues venerea ; and the rhubarb is neceflary to keep the bowels open.

M. M. Antimonial vomits frequently repeated. Mild cathartics.
Cool air. Tincture of cantharides, or repeated blifters ; afterwards
opiates in fmall dofes, and the bark. Warm bath frequently ufed.
The fteam of warm water with a little vinegar in it may be inhaled
twice a day. Could the breathing of carbonic acid gas mixed with

H h 2 atmofpheric

2^6 DISEASES OF SENSATION. Class II. uj.

atmofpheric air be of fervice? Copious venefe£lion, whea a difficulty
of breathing continues between the fits of coughing; otherwife the
cough and the expeftoration ceafe, and the patient is deftroyed.
Ulcers of the lungs fometiaies fupervene, and the phthifis pulmonalis
in a few weeks terminates in death. Where the cough continues
after foine \veeks without much of the hooping, and a fenfitive fever
daily fupervenes, fo as to referable heftic fever from ulcers of th&
lungs ; change of air for a week or fortnight a6ts as a charm, and re-
llores the patient beyond the hopes of the phyfician.

Young children fliould lie with their heads and fhoulders raifed ;
and fhould be conftantly watched day and night ; that when the
cough occurs, they may be held up eafily, fo as to ftand upon their
feet bending a little forwards ; or nicely fupported in that pofture
which they feem to put themfelves into. A bow of whalebone,
about the fize of the bow of a key, is very ufeful to extraft the
phlegm out of the mouths of infants at the time of their coughing;,
as an handkerchief, if applied at the time of their quick infpirations
after long holding their breath, is dangerous, and may fulFocate the
patient in an inflant, as I believe has fometimes happened.

9. Variola dtfcreta. The fmall-pox is well divided by Sydenham
into diftin£l and confluent. The former confifts of diflindl puflules^
which appear on the fourth day of the fever, are circumfcribed and
turgid ; the fever ceafing when the eruption is complete. Headach,
pain in the loins, vomiting frequently, and convulfive fits fometimes,
precede the eruption.

The diftinft fmall-pox is attended with fenfitive fever only, when
very mild, as- in mofl inoculated patients ; or with fenfitive irritated
fever, when the difeafe is greater : the danger in this kind of fmall-
pox is owing either to the tumor and forenefs of the throat about the
height, or eighth day of the eruption ; or to the violence of the fe-
condary fever. For, firft, as the natural difeafe is generally taken

by

Class II. 1.3. DISEASES OF SENSATION. 257

hy particles of the duft of the contagious matter dried and floating in
the air, thefe are liable to be arrefted by the mucus about the throat
and tonfils in their paflage to the lungs, or to the flomach, when thej
are previoufly mixed with faliva in the mouth. Hence the throat
inflames like the arm in inoculated patients ; and this increafing, as
the difeafe advances, deftroys the patient about the height.

Secondly, all thofe upon the face and head come out about the
fame time, namely, about one day before thofe on the hands, and
two before thofe in the trunk ; and thence, when the head is very
full, a danger arifes from the fecondary fever, which is a purulent,
not a variolous fever ; for as the matter from all thefe of the face and
head is reabforbed at the fame time, the patient is deftroyed by the
violence of this purulent fever ; which in the diftintl fmall-pox can
only be abated by venefe6lion and cathartics; but in the confluent
fmall-pox requires cordials and opiates, as it is attended with arterial
debility. See Seft. XXXV. i. and XXXIII. 2. 10.

When the puftules on the face recede, the face fwells; and when
thofe of the hands recede, the hands fwellj and the fame of the feet
in fucceffion. Thefe fwellings feem to be owing to. the abforptioii
of variolous matter, which by its flimulus excites the cutaneous
veflels to fecrete more lymph, or ferum, or mucus, exaftly as hap-
pens by the ftimulus of a blifter. Now, as a bhfler fornetimes pro-
duces flrangury many hours after it has rifen; it is plain, that a part
of the cantharides is abforbed, and carried to the neck of the blad-
der ; whether it enters the circulation, or is carried thither by retro-
grade movements of the urinary branch of lymphatics ; and by parity
of reafoning the variolous matter is abforbed, and fwells the face and
hands by its ftimulus.

Variola confluens. The confluent finall-pox confifls of numerous
puftules, which appear on the third day of the fever, flow together,
are irregularly circumfcribed, flaccid, and little elevated ; the fever

contmuino:

,238 ' DISEASES OF SENSATION. Class II. 1.3.

continuing after the eruption is complete ; convulfions do not pre-
cede this kind of fmall-pox, and are fo far to be efteemed a favourable
fymptom.

The confluent fmall-pox is attended with fenfitive inirritated fever,
or inflammation with arterial debility; whence the danger of this
difeafe is owing to the general tendency to gangrene, with petechias,
or purple fpots, and haemorrhages ; belides the two fources of danger
from the tumor of the throat about the height, or eleventh day of
the eruption, and the purulent fever after that time; which are ge-
nerally much more to be dreaded in this than in the diftindl fmall-pox
defcribed above.

M. M. The method of treatment muft vary with the degree
and kind of fever. Venefeclion may be ufed in the diftind fmall-
pox early in the difeafe, according to the ftrength or hardnefs of the
pulfe; and perhaps on the firft day of the confluent fmall-pox, and
even of the plague, before the fenforial power is exhaufted by the
violence of the arterial adion ? Cold air, and even wafliing or bath-
ing in cold water, is a powerful means in perhaps all eruptive difeafes
attended with fever; as the quantity of eruption depends on the
quantity of the fever, and the adivity of the cutaneous veflels ; which
may be judged of by the heat produced on the fkin ; and which latter
is immediately abated by expofure to external cold. Mercurial puro-es,
as three grains of calomel repeated every day during the eruptive
fever, fo as to induce three or four ftools, contribute to abate in-
flammation ; and is believed by fome to have a fpecific efFedt on the
variolous, as it is fuppofed to have on the venereal contagion.

It has been faid, that opening the pock and taking out the matter
has not abated the fecondary fever; but as I had conceived, that
the pits, or marks left after the fmall-pox, were owing to the acri-
mony of the matter beneath the hard fcabs, which not being able to
exhale eroded the Ikinj and produced ulcers, I directed the faces of

4 two

Class II. 1.3. DISEASES OF SENSATION. 239

two patients in the confluent fmall-pox to be covered with cerate
early in the difeafe, which was daily renewed ; and I was induced to
think, that they had much lefs of the fecondary fever, and were fa
little marked, that one of them, who was a young lady, almoft en-
tirely preferved her beauty. Perhaps mercurial plaflers, or cerates,
made without turpentine in them, might have been more efficacious
in preventing the marks, and efpecially if applied early in the difeafe,
even on the firfl: day of the eruption, and renewed daily. For it ap-
pears from the experiments of Van Woenfel, that calomel or fubli-
mate corrofive, triturated with variolous matter, incapacitates it from
giving the difeafe by inoculation. Calomel or fublimate given as
an alterative for ten days before inoculation, and till the eruptive
fever commences, is faid with certainty to render the difeafe mild by
the fame author, Exper. on Mercury by Van Woenfel, tranflated
by Dr. Fowle, Sgliibury.

Variola inoculata. The world is much indebted to the great dif^
coverer of the good efFedls of inoculation, whofe name is unknown ;
and our own country to Lady Wortley Montague for its intro-
du<5tion into this part of Europe. By inferting the variolous conta-
gion into the arm, it is not received by the tonfils, as generally happens,
I fuppofe, in the natural fmali-poxj whence there is no dangerous
fwelUng of the throat, and as the puftules are generally i&\N and
diftinft, there is feldom any fecondary fever; whence thofe two
fources of danger are precluded ; hence when the throat in inoculated
fmall-pox is much inflamed and fwellcd, there is reafon to believe,
that the difeafe had been previoufly taken by the tonfils in the natural
way.— Which alfo, 1 fuppofe, has generally happened, where the
confluent kind of fmall-pox has occurred on inoculatioru

I have known two inflances, and have beard of others, where the
natural fmall-pox began fourteen days after the contagion had been
received; one of thefe inftances was of a countryman, who went to
a market town many miles from his home, where he faw a perfon

in

240 DISEASES OF SENSATION. Class II. i. 3.

in the fmall-pox, and on returning the fever commenced that day
fortnight : the other was of a child, whom the ignorant mother
carried to another child ill of the fmall-pox, on purpofe to communi-
cate the difeafe to it ; and the variolous fever began on the fourteenth
day from that time. So that in both thefe cafes fever commenced
in half a lunation after the contagion was received. In. the inoculated
fmall-pox the fever generally commences on the feventh day, or after
a quarter of a lunation ; and on this circumflance probably depends
the o-reater mildnefs of the latter. The reafon of which is difficult
t£> comprehend ; but fuppofmg the fads to be generally as above re-
lated, the flower progrefs of the contagion indicates a greater inirri-
tability of the fyftem, and in confequence a tendency to malignant
rather than to inflammatory fever. This difference of the time be-
tween the reception of the infeftion and the fever in the natural and
artificial fmall-pox may neverthelefs depend on its being inferted into
a different feries of veflTels ; or to fome unknown efFedl of lunar pe-
riods. It is a fubjed of great curiofity, and deferves further in-
veftigation.

When the inoculated fmall-pox is given under all the moft favour-
able circumfi:ances I believe lefs than one in a thoufand mifcarry,
which may be afcribed to fome unavoidable accident, fuch as the
patient having previoufly received the infedlion, or being about to be
ill of fome other difeafe. Thofe which have lately mifcarried under-
inoculation, as far as has come to my knowledge, have been chiefly
children at the breafl: ; for in thefe the habit of living in the air has
been confirmed by fo fhort a time, that it is much eafier deftroyed,
than when thefe habits of life have been eflablifhed by more frequent
repetition. See Se6t. XVII. 3. Thus it appears from the bills of
mortality kept in the great cities of London, Paris, and Vienna, that
out of every thoufand children above three hundred and fifty die
under two years old. (Kirkpatrick on Inoculation.) Whence a ftrong
reafon againft oar hazarding inoculation before that age is paffed,

efpecially

Class 11. 1.3. DISEASES OF SENSATION. 241

efpecially in crowded towns; except where the vicinity of the natural
contagion renders it necefl'ary, or the convenience of inoculating a
whole family at a time ; as it then becomes better to venture the lefs
favourable ci re um fiances of the age of the patient, or the chance of
the pain from toothing, than to rilk the infedion in the natural
way.

The moft favourable method confifls in, firft, for a week before
inoculation, reftraining the patients from all kinds of fermented Or
fpirituous liquor, and from animal food j and by giving them from
one grain to three or four of calomel every other day for three times.
But if the patients be in any the leaft: danger of taking the natural in-
fedlion, the inoculation had better be immediately performed, and
this abftinence then began; and two or three gentle purges with ca-
lomel fhould be given, one immediately, and on alternate days. Thefe
cathartics (hould not induce more than two or three ftools. I have
feen two inftances of a confluent fmall-pox in inoculation following a
violent purging induced by too large a dofe of calomel.

Secondly, the matter ufed for inoculation fhould be in a fmall
quantity, and warm, and fluid. Hence it is beft when it can be
recently taken from a patient in the difeafe ; or otherwife it may be
diluted with part of a drop of warm water, fince its fluidity is likely
to occdfion its immediate abforption ; and the wound fliould be made
as fmall and fuperficial as poflible, as otherwife ulcers have been fup-
pofed fometimes to enfue with fubaxillary abfcefles. Add to this,
that the making two pun(5lures either on the fame, or one on each
arm, fecures the fuccefs of the operation in refpedl to communicating
the infeftion.

Thirdly, at the time of the fever or eruption the application of cool
air to thofe parts of the (kin, which are too warm, or appear red, or
are covered with what is termed a ralh, fliould be ufed freely, as well
as during the whole difeafe. And at the fame time, if the feet or

Vol. II. I i hands

242 DISEASES OF SENSATION. Class II. i. 3.

hands are colder than natural, thefe fiiould be covered with flannel.
See Clafs IV. 2. 2. 10.

10. Rubeola irritata, morhiUi. The meafles commence with
fneezing, red eyes, dry hoarfe cough, and is attended with fenfitive
irritated fever. On the fourth day, or a little later, fmall thick
eruptions appear, fcarcely eminent above the ikin, and, after three
days, changing into very fmall branny fcales.

As the contagious material of the fmall-pox may be fuppofed to be
difFufed in the air like a fine dry powder, and mixing with the faliva
in the mouth to infe£l the tonfils in its paflage to the ftomach ; fo
the contagious material of the meafles may be fuppofed to be more
completely diflblved in the air, and thus to impart its poifon to the
membrane of the noftrils, which covers the fenfe of fmell ; whence
a catarrh with fneezing ufliers in the fever ; the termination of the
nafal du£l: of the lacrymal fac is fubje£l to the fame ftimulus and in-
flammation, and affedls by fympathy the lacrymal glands, occafioning
a great flow of tears. See Se<5t. XVI. 8. And the rednefs of the eye
and eyelids is produced in confequence of the tears being in fo great
quantity, that the faline part of them is not entirely reabforbed. See
Sea. XXIV. 2.8.

The contagion, of the meafles, if it be taken a fufficient time be-
fore inoculation, fo that the eruption may commence before the va-
riolous fever comes on, flops the progrefs of the Imall-pox in the
inoculated wound, and delays it till the meafle-fever has finiflied its
career. See Sedl. XXXIII. 2. 9.

The meafles are ufually attended with inflammatory fever with
fl:rong pulfe, and bear the lancet in every ftage of the difeafe. In the
early periods of it, venefeftion renders the fever and cough lefs ; and,
if any fymptoms of peripneumony occur, is repeatedly necefiary ;
and at the decline of the difeafe, if a cough be left after the eruption
8 has

Class II. 1.3. DISEASES OF SENSATION. 243

has ceafed, and the fubfequeut branny fcales are falling off", vene-
fe£tion fluould be immediatelj ufed ; which prevents the danger of
confumption. At this time alfo change of air is of material confe-
quence, and often removes the cough like a charm, as mentioned in
a fimilar fituation at the end of the chin-cous;h.

Rubeola mirritata. Meafles with inirritated fever, or with weak
pulfe, has been fpoken of by fome writers. See London Med. Ob-
ferv. Vol. IV. Art. XI. It has alfo been faid to have been attended
with fore throat. Edinb. Eflays, Vol. V. Art. II. Could the fcarlet
fever have been miftaken for the meafles ? or might one of them have
fucceeded the other, as in the meafles and fmall-pox mentioned in
Sea. XXXIII. 2. 9. ?

From what has been faid, it is probable that inoculation might
difarm the meafles as much as the fmall-pox, by preventing the
catarrh, and frequent pulmonary inflammation, which attends this
difeafe ; both of which are probably the confequence of the imme-
diate application of the contagious mlafmata to thefe membranes.
Some attempts have been made, but a difficulty feems to arife in
giving the difeafe; the blood, I conje£ture, would not infed:, nor
the tears; perhaps the mucous difcharge from the noftrils might fuc-
ceed ; or a drop of warm water put on the eruptions, and fcraped
ofi^ again with the edge of a lancet ; or if the branny fcales were col-
lefted, and moiftened with a httle warm water ? Further experiments -■^'§-

on this fubje£t would be worthy the public attention.

1 1 . Scarlatina mitis. The fcarlet fever exifts with all decrees of
virulence, from a flea-bite to the plague. The infe£bious material
of this difeafe, like that of the fmall-pox, I fuppofe to be diffufed,
not diflTolved, in the airj on which account I fufpeft, that it re-
quires a much nearer approach to the flck, for a well perfon to receive
the infection, than in the meafles; the contagion of whicTi I believe
to be more volatile, or difFufible in the atmofphere. But as the

I i 2 contagious

244 DISEASES OF SENSATION. Class II. 1.3.

contagious mlafmata of fmall-pox and fcarlet fever are fuppofed to be
more fixed, they may remain for a longer time in clothes or furni-
■' ture; as a thread dipped in variolous matter has given the dileafe by
inoculation after having been expofed many days to the air, and after
having been kept many months in a phial. This alfo accounts for
the flow or fporadic progrefs of the fcarlet fever, as it infeds others
at but a very fmall diftance from the fick ; and does not produce a
quantity of pus-like matter, like the fmail-pox, which can adhere to
the clothes of the attendants, and when dried is liable to be (hook off
in the form of powder, and thus propagate the infedlion.

This contagious powder of the fmall-pox, and of the fcarlet fever,
becomes mixed with faliva in the mouth, and is thus carried to the
tonfils, the mucus of which arrefts Ibme particles of this deleterious
material; while other parts of it are carried into the ftomach, and
are probably decompofed by the power of digeftion; as feems to
happen to the venom of the viper, when taken into the flomach.
Our perception of bad taftes in our mouths, at the fame time that we
perceive difagreeable odours to our noftrils, when we inhale very bad
air, occafions us to fpit out our faliva ; and thus, in fome inftances,
to prcferve ourfelves from infe£tion. This has been fuppofed to ori-
ginate from the fympathy between the organs of tafte and fmell ; but
any one who goes into a fick room clofe fhut up, or into a crowded
afl'embly-room, or tea-room, which is not iufficiently ventilated, may
eafily mix the bad air with the laliva on his tongue fo as. to tafle it ;
as 1 have myfelf frequently attended to.

Hence it appears that thefe heavy infectious matters are more liable
to mix with the faliva, and inflame the tonfils, and that either before
or at the commencement of the fever; and this is what generally
happens in the fcarlet fever, always L fuppoie in the malignant kind,
and very frequently in the mild kind. But as this infeclion may be
taken by other means, as by the fkin, it alfo happens in the moft
mild kind, that there is no inflammation of the tonfils at all ; in the

fame

Class IL 1.3- DISEASES OF SENSATION. 245

fame manner as there is generally no inflammation of the tonfils in
the inoculated fmall-pox.

In the mild fcarlatina on the fourth day of the fever the face fwells
a little, at the fame time a florid rednefs appears on various parts of
the fkin, in large blotches, at length coalefcing, and after three days
changing into branny Icales.

M. M.. Cool air. Fruit. Lemonade. Milk and Vi^ater.

Scarlatina maligna. The malignant fcarlet fever begins with in-
flamed tonfils ; which are fucceeded by dark drab-coloured floughs
three or five lines in diameter, flat, or beneath the furrounding fur-
face ; and which conceal beneath them fpreading gangrenous ulcers.
The fvi^ellings of the tonfils are fenfible to the eye and touch exter-
nally, and have an elaftic rather than an oedematous feel, like parts in
the vicinity of gangrenes. The pulfe is very quick and weak, with
delirium, and the patient generally dies in a few days ; or if he re-
covers, it is by flow degrees, and attended with anafarca.

M. M. A vomit once. Wine. Beer. Cyder. Opium. Bark,
in fmall repeated dofes. Small fucceflive blifl:ers, if the extremities
are cooler than natural. Cool air on the hot parts of the flcin, the
cool extremities being at the fame time covered. Iced lemonade.
Broth. Cuftards. Milk. Jellies. Bread pudding. Chicken.
Touch the ulcers with a dry fponge to abforb the contagious matter,
and then with a fponge filled with vinegar, with or M'ithout fugar of
lead diflTolved in it, about fix grains to an ounce ; or with a very little
blue vitriol diflblved in it, as a grain to an ounce ; but nothing fo in-
ftantaneoufly correfts the putrid fmell of ulcers as a folution of alum,
about half an ounce to a pint of water, which fliould be a little
warmifli, and injedled into the fauces gently by means of a fyringe.
Thefe ihould be repeated frequently in a day, if it can be done eafily,
and without fatigue to the child. A little powder of bark taken fre-
quently into the mouth, as a grain or two, that it may mix with the

faliva.

246 DISEASES OF SENSATION. Class IL 1.3.

faliva, and thus frequently Simulate the dying tonfils. Could a warm
bath made of decofiioa of bark, or a cold fomentation with it, be of
fervice ? Could oxygene gas mixed with common air ftimulate the
languid fyftem ? Small ele£lric fhpcks through the tonfils every hour?
ether frequently applied externally to the fwelled tonfils ?

As this difeafe is attended with the greateft degree of debility, and
as flimulant medicines, if given in quantity, fo as to produce more
than natural warmth, contribute to expend the already too much ex-
haufted fenforial power ; it appears, that there is nothing fo necef-
fary to be nicely attended to, as to prevent any unneceflary motions
of the fyflem ; this is beft acconiplifhed by the application of cold to
thofe parts of the flcin, which are in the leaft too hot. And fecondly,
that the exhibition of the bark in fuch quantity, as not to opprefs the
flomach and injure digeftion, is next to be attended to, as not being
liable to increafe the aftions of the fyflem beyond their natural quan-
tity; and that opium and wine fhould be given with the greateft cau-
tion, in very fmall repeated quantity, and fo managed as to prevent,
if poffible, the cold fits of fever; which probably occur twice iti
25 hours, obeying the lunations like the tides, as rncntioned in Se6t.
XXXII. 6. that is, I fuppofe, the cold periods, and confequent ex-
acerbations of fever, in this malignant fcarlatina, occur twice in a
lunar day; which is about ten minutes lefs than 25 houj'S ; fo that i|i
the commencement of one cold fit be marked, the commencement of
the next may be expe61:ed, if not difturbed by the exhibition of wine
or opium,, or the application of blifiers, to occur in about twelve hours
and a half from the commencement of the former.; .or if not prevented
by large dofes of the bark.

No one could do an zd: more beneficial to fociety, or glorious to
himfelf, than by teaching rrjankind . how to inoculate this fatal dif-
eafe; and thus to deprive it of its malignity. Matter might be taken
frorp the ulcers in the throat, which would probably convey the con-
tagion. Or warm water might be put on the eruption, and fcraped

off

Class II, i. 3. DISEASES OF SENSATION. 247

ofF again by the edge of a lancet. Thefe experiments could be attend-
ed with no danger, and fhould be tried for the public benefit, and the
honour of medical fcience.

12. Miliaria. Miliary fever. ,An eruption produced by the
warmth, and more particularly by the ftimulus of the points of the
wool in flannel or blankets applied to the fkin, has been frequently
obferved ; which, by cool drefs, and bed-clothes without flannel, has
foon ceafed. See Clafs I. 1-2.3. This, which maybe called ot///-
aria fudatoria, has been confounded with other miliary fevers, and
has made the exiftence of the latter doubted. Two kinds of eruptions
I have feen formerly attended with fever, but did not fufficiently
mark their progrefs, which I conceived to be miliary eruptions, one
with arterial ftrength, or with fenfitive irritated fever, and the other
with arterial debility, or with fenfitive inirritated fever.

In the former of thefe, or miliaria irritata, the eruptions were
diflinft and larger than the fmall-pox, and the fever was not fub-
dued without two or three venefedions, and repeated cathartics with
calomel.

The latter,, or miliaria inirritata. Was attended with great arterial
debility ; and during the courfe of the fever pellucid points appeared
within the flcin, particularly on the foft parts of the fingers. And,
in one patient, whom I efteemed near her end, I well recoiled to
have obferved round pellucid globules, like what are often feen on
vines in hot-houfes, no larger than the fmalleft pins' heads, adhere
to her neck and bofom ; which were hard to the touch, but were
eafily rubbed off. Thefe difeafes, if they are allied, do not differ
more than the kinds of fmall-pox; but require many further obfer-
vations.

Thd eruption fo often icen. on children in the cradle, and called by
the nurles red-gum, and which is attended with fome degree of fever,
I fuiped to be produced by too great warmth, and the contad of flan-
nel

248 DISEASES OF SENSATION. Class II. 1.3.

nel next their tender fkins, like the miliaria fudatoria ; and like that
requires cool air, cool clothes, and linen next their Ikin.

13. Peftis. The plague, like other difeafes of this clafs, feems to
-be fometimes mild, and fometimes malignant ; according to the tef-
timony of different writers. It is faid to be attended with inflamma-
tion, with the greatefl arterial debility, and to be very contagious,"
attended at an uncertain time of the fever with buboes and carbuncles.
Some authors affirm, that the contagion of the plague may be re-
peatedly received, fo as to produce the difeafe ; but as this is contrary
to the general analogy of all contagious difeafes, which are attended
with fever, and which cure themfelves fpontaneoufly; there is reafon
to fufped, that where it has been fuppofed to have been repeatedly
received, that fome other fever with arterial debility has been mif-
laken for it, as has probably univerfally been the cafe, when the
fmall-pox has been faid to have been twice experienced.

M. M. Venefeftion has been recommended by fome writers on the
firft day, where the inflammation was fuppofed to be attended with
fufficient arterial ftrength, which might perhaps fometimes happen,
;as the bubo feems to be a fuppuration ; but the carbuncle, or anthrax,
is a gangrene of the part, and thews the greateft debility of circu-
lation. Whence all the means before enumerated in this genus of
difeafes to fupport the powers of life are to be adminiftered. Cur-
rents of cold air, cold water, ice, externally on the hot parts of the
ilcin.

The methods of preventing the fpreading of this difeafe have been
much canvaiTed, and feern to confift in preventing all congregations
of the people, as in churches, or play-houfes ; and to remove the
fick into tents on fome airy common by the fide of a river, and fupply
•them with frefh food, both animal and vegetable, with beer and wine
in proper quantities, and to encourage thofe who can, dally to wafh

both their clothes and themfelves.

■ ' . The

Class II. r. 3. DISEASES OF SENSATION. 249

The pejils vaccina, or difeafe amongft the cows, which affli£ted
this illand about half a century ago, feeins to have been a contagious
fever with great arterial debility ; as in fome of them in the latter
ftage of the difeafe, an emphyfema could often be felt in fome parts,
which evinced a confiderable progrefs of gangrene beneath the Ikin.
In the fen(itive inirritated fevers of thefe animals, I fuppofe about
fixty grains of opium, with two ounces of extradl of oak-bark, every
fix hours, would fupply them with an efficacious medicine ; to which
inight be added thirty grains of vitriol of iron, if any tendency to
bloody urine fliould appear, to which this animal is liable. The me-
thod of preventing the infeftion from fpreading, if it (hould ever
again gain accefs to this ifland, would be immediately to obtain an
order from government to prevent any cattle from being removed,
which were found within five miles of the place fuppofed to be in-
fe£led, for a few days; till the certainty of the exiftence of the pef-
tilence could be afcertained, by a committee of medical people. As
foon as this was afcertained, all the cattle within five miles of the
place fhould be immediately flaughtered, and confumed within the
circumfcribed diftridt ; and their hides put into lime-water before pro-
per infpedlors.

14. Pemphigus is a contagious difeafe attended with bladdery erup-
tions appearing on the fecond or third day, as large as filberts, which
remain many days, and then efFufe a thin ichor. It feems to be
either of a mild kind with fenfitive fever only, of which I have {t&xx
two inftances, or with irritated, or with inirritated fever, as appears
from the obfervations of M. Salabert. See Medical Comment, by Dr.
Duncan, Decad. II. Vol. VI.

15. Varicella. Chicken-pox is accompanied with fenfitive fever,
puftules break out after a mild fever like the fmall-pox, feldom fup-
purate, and generally terminate in fcales without fears. I once faw a

Vol. II. K k hdy.

230 DISEASES OF SENSATION. Class II. 1.3.

lady, who mlfcarryed during this difeafe, though all her children had
it as (lightly as ufual. It fometimes leaves fears or marks on the
(kin.- This difeafe has been miftaken for the fmall-pox, and inocu-
lated for it ; and then the fmall-pox has been fuppofed to happen
twice to the fame perfon. See Tranf. of the College London. It is
probable that the pemphigus and urticaria, as well as this difeafe,
have formerly been difeafes of more danger ; which the habit of in-
numerable generations may have rendered mild, and will in procefs
of time annihilate. In the fame manner as the fmall-pox, venereal
difeafe, and rickets, feem to become milder or lefs in quantity every
half century. While at the fame time it is not improbable, that
other new difeafes may arife, and for a feafon thin mankind !

16. Urticaria. Nettle-rafh begins v/ith mild fenfitive fever, which
is fometimes fcarcely perceptible. Hence this eruption has been
thought of two forts, one with and the other without fever. Oa
the fecond day red fpots, like parts (lung with nettles, are feen ;
which almoft vani(h during the day, and recur in the evening with
the fever, fucceeded in a few days by very minute fcales. See Tranf.
of the College, London.

I "I. Aphtha. Thrufh. It has been doubted, whether aphtha or
thru(h, which confifts of ulcers in the mouth, (hould be enumerated
amongft febrile difeafes ; and whether thefe ulcers are always fymp-
tomatic, or the confequence rather than the caufe of the fevers which
attend them. The tongue becomes rather fwelled ; its colour and
that of the fauces purplifh ; (loughs or ulcers appear firfl: on the throat
and edges of the tongue, and at length over the whole mouth. Thefe
floughs are whitifli, fometimes diftinft, often, coalefcing, and remain
an uncertain time. Cullen. I (hall concifely mention four cafes of
aphtha, but do not pretend to determine whether they were all of
them fymptomatic or original difeafes,

7 • Aphtha

Class 11. 1.3. DISEASES OF SENSATION. 251

Aphtha fenjitiva. A lady during pregnancy was frequently feized
■with ulcers on her tongue and cheeks, or other parts of the mouth,
without much apparent fever ; which continued two or three weeks,
and returned almoft every month. The thrufh in the mouths of
young children feems to be a fimilar difeafe. Thefe ulcers refemble
thofe produced in the fea-fcurvy, and have probably for their caufe
an increafed adlion of the fecerning fyftem from Increafed fenfation,
with a decreafed adion of the abforbent fyftem from decreafed irrita-
tion. See Clafs I. 2. i, 14.

M. M. Solutions of alum, of blue vitriol. Powder of bark taken
frequently into the mouth in very fmall quantity. See Clafs II.

Aphtha Irritata. Inflammatory aphtha. A cafe of this kind is
related under the title of fuppurative rheumatifm. Clafs IV.
2. I. 16.

Aphtha Inirritata. Sloughs or ulcers of the mouth, attended with
fenfitive fever with great arterial debility. They feem to fpread
downwards from the throat into the ftonniach, and probably through
the whole inteftinal canal, beginning their courfe with cardialgia, and
terminating it with tenefmus ; and might perhaps be called an eryfi-
pelas of this mucous membrane.

M. M. Cool air. A fmall bllfter on the back. Bark. Wine.
Opium in fmall repeated quantities. Soap neutralizes the gaftric acid
without effervefcence, and thus relieves the pain of cardialgia, where
the ftomach is afFedled. Milk alfo deftroys a part of this acid. In-
fufion of fage leaves two ounces, almond foap from five grains to ten,
with fuc^ar and cream, is generally both agreeable and ufeful to thefe
patients. See I. 2. 4. 5.

Where the ftomach may be fuppofed to be excoriated by poifons
containing acid, as fublimate of mercury or arfenic ; or if it be other-
wife inflamed, or very fenfible to the ftimulus of the gaftric acid j or
where it abounds with acidof any kind, as in cardialgia ; the exhibi-

K k 2 tion

252 DISEASES OF SENSATION. Class II. i. 3,

tion of foap is perhaps a preferable manner of giving alcali than any
other, as it decompofes in the ftomach without effervelcence ; while
the cauftic alcaU is too acrid to be adminiflered in ftich cafes, and the
mild alcali produces carbonic gas. If a drop of acid of vitriol be put
on cap paper, it will be long before it deftroys the paper ; but if a
drop of mild alcali be added, a fudden efFervefcence arifes, and the
paper is inftantly deftroyed by the efcape of the fixed air ; in the fame
manner as lumps of folid lime are broken into powder by the efcape
of the fleam produced from the water, which is poured on them.
This fhews why a fucceflion of acid and of alcaline cauftics fooner
deftroys a part, than either of them applied feparately.

18. Dyfenteria. Bloody-flux is attended with fenfitive fever gene-
rally with arterial debility j with frequent mucous or bloody ftools ;
which contain contagious matter produced by the membranes of the
inteftines ; the alimentary excrement being neverthelefs retained ;
with griping pains and tenefmus.

M. M. Emetics. Antimonials. Peruvian bark. Opium and ca-
lomel of each a grain every night. Bolus armeniic. Earth of alum.
Chalk. Calcined hartfhorn. Mucilage. Bee's wax mixt with yolk
of egg. Cerated glafs of antimony. Warm bath. Flannel clothing
next to the Ikin. Large clyfters with opium. With ipecacuanha,
with fmoke of tobacco ? Two dyfenteric patients in the fame ward
of the infirmary at Edinburgh quarrelled, and whipped each other
with horfewhips a long time, and were both much better after it,
owing perhaps to the exertion of fo much of the fenforial power of
•volition ; which, like real infanity, added excitement to the whole
fyflem.

The prevention of this contagion mufl confift principally in ventila-
tion and cleanlinefs ; hence the patients fhould be removed into cot-
tages diftant from each other, or into tents ; and their f£eces buried as
foon as may be ; or conveyed into a running ftream ; and themfelves

fhould

Class II. 1.3. DISEASES OF SENSATION. 253

fhould be wafhed with cold or warm water after every evacuation.
For the contagious matter confifts in the mucous or purulent dif-
charse from the membrane which lines the inteftines ; and not from
the febrile perfpiration, or breath of the patients. For the fever is
only the confequence and not the caufe of contagion ; as appears
from Genus the Fifth of this Order, where contagion exifls without
fever. .

19. Gajiritls fuperficialis. Superficial inflammation of the ftomach.
An eryfipelatous inflammation of the ftomach is mentioned by Dr.
Cullen from his own obfervations ; which is diftinguiflied from the
inflammatory gaftritis by lefs pain and fever, and by an eryfipelatous
rednefs about the fauces. Does thisdifeafe belong to aphtha ?

2.0. Enteritis fuperJiciaUs. Superficial inflammation of the bowels
is alfo mentioned by Dr. Cullen from his own obfervation under the
name of enteritis erythematica ; and is fald to be attended with lefs
pain and fever, without vomiting, and with diarrhoea, May not this-
difeafe be referred to aphtha, or to dyfentery ?

"^

ORBO

254 DISEASES OF SENSATION. Class II. 1.4.

ORDO I.

Increafed Sefifatmt.

GENUS IV.

With the Produ£Jion of new Fejfels by internal Membranes or Qlands^

without Fever.

Where inflammation is produced in a fmall part, which has not
oreat natural fenfibility, the additional fenfation does not produce an
increafed adion of the arterial fyftem ; that is, the aflbciated motions
which are employed in the circulation of the blood, thofe for inftance
of the heart, arteries, glands, capillaries, and their correfpondent
veins, are not thrown into increafed adion by fo fmall an addition of
the fenforial power of fenfation. But when parts, which naturally
poflefs more fenfibility, become inflamed, the quantity of the fenforial
power of fenfation becomes fo much increafed, as to affedl the aiToci-
ated motions belonging to the circulation, occafioning them to pro-
ceed with greater frequency ; that is, a fever is induced. This is
well exemplified in the internal and fuperficial paronychia, one of
which is attended with great pain and fever, and the other with little
pain and no fever. See Clafs II. i. 2. 19. and II. i. 4. 5.

From hence it appears, that the fenfitive fever is an accidental con-
fequence of the topical phlegmon, or inflammation, and not a caufe
of it ; that it is often injurious, but never falutary ; and fhould there-
fore always be extinguifhed, as foon as may be, either by the lancet
and cathartics, and diluents, and cold air, when it is of the irritated
kind J or by the bark, opium, cool air, and nutrientia, when it is of
the inirritated kind.

SPECIES.

Class ir. 1.4. DISEASES OF SENSATION. 255

SPECIES.

I. Ophthalmia fuperficialis. As the membranes, which cover the
eye, are excluded from the air about one third part, of the twenty-
four hours j and are moiftened by perpetual niftitation during the
other fixteen ; they may be confidered as internal membranes ; and
from the analogy of their inflammation to that of other internal mem-
branes, it is arranged under this genus ; whilft the tonfillitis is
efteemed an inflammation of an external r^iembrane, becaufe currents
of air are perpetually pafling both day and night over the fauces.

The fuperficial ophthalmy has generally been efteemed a fymptom
of fcrophula, when it recurs frequently in young perfons ; but is
probably only a concomitant of that difeafe, as a fymptom of general
debility ; ramifications of new red veffels, and of enlarged old ones,
are fpread over the white part of the eye ; and it is attended with lefs
heat, lefs pain, and lefs intolerance of light than the ophthalmia in-
terna, defcribed in Clafs II. i. 2. 2. It occurs in thofe of feeble cir-
culation, efpecially children of a fcrophulous tendency, and feems to
arife from a previous torpor of the veffels of the tunica albuginea from
their being expofed to cold air ; and from this torpor being more liable
to occur in habits, which are naturally inirritable ; and therefore
more readily fall into quiefcence by a fmaller dedudliion of the flimulus
of heat, than would affedl ftronger or, more irritable habits ; the con-
fequence of this torpor is increafed a£lion, which produces "pain in the
eye, and that induces inflammation by the acquifition of the additional
fenforial power of fenfation.

Ophthalmia lymphatica is a kind of anafarca of the tunica adnata; in
this the veffels over the fclerotica, or white part of the eye, rife confi-
derably above the cornea, which they furround, are lefs red than in the
ophthalmia fuperficialis, and appear to be fwelled by an accumulation

of

256 DISEASES OF SENSATION. Class II. 1.4.

of lymph rather than of blood ; It is probably owing to the temporary
obftru£tion of a branch of the lymphatic fyftem.

M. M. If the pain be great, venefeilion by leeches on the tem-
ple, or cutting the temporal artery, and one purge with three or four
grains of calomel (hould be premifed. Then the Peruvian bark twice
a day. Opium from a quarter to half a grain twice a day for fome
weeks. Bathe the eye frequently with cold water alone, or with
cold water, to a pint of which is added half an ounce of fait. White
vitriol fix grains dilTolved in one Ounce of water ; a drop or two to be
put between the eyelids twice a day. Take very fmali electric
fparks from the eyes every day for a fortnight. Bathe the whole head
with fait and water made warm every night for fome months. Send
fuch children to a fchool near the fea for the convenience of fea-bath-
ing for many months annually; fuch fchools are to be found in or near
LiverpooL

When a child is affljited with an inflamed eye of this kind, he
Ihould always fit with his back to the window or candle ; but it is
generally not neceflary to cover it, or if the uneafy fenfation of light
makes this proper, the cover fhould fland off from the eye, fo as not
much to exclude the cool air from it. As covering an eye unnecefla-
rily is liable to make that eye weaker than the other, from its not
being fufficiently ufed, and thence to produce a fquinting for ever
afterwards.

Neverthelefs, when the pain is great, a poultice muft be applied to
keep the eyes moift, or a piece of oiled filk bound lightly over them.
Or thus, boil an egg till it is hard, cut it longitudinally into two he-
mifpheres, take out the yolk, few the backs of the two hollow
hemifpheres of the white to a ribbon, and bind them over the eyes
every night on going to bed ; which, if nicely fitted on, will keep
the eyes raoift without any difagreeable preflure. See Clafs I.
I. 3. 14.

Ophthalmia

Class II. i. 4. DISEASES OF SENSATION. 257

Ophthalmia equina. An inflammation of this kind is liable to affeft
the eyes of horfes ; one caufe of which is owing to a filly cuflom of
cutting the hair out of horfes' ears ; by which they are not only liable
to take cold at the ear, but grafs feeds are liable to fall into their ears
from the high racks in flables ; and in both cafes the eye becomes
inflamed by fympathy. I once direfted the temporal artery of a horfe
to be opened, who had frequent returns of an inflamed eye ; and I
believed it was of elTential fervice to him ; it is probable that the ar-
tery was afterwards contrafted in the wounded part, and that thence
lefs ialood was derived to the eye : the haemorrhage was flopped by
two perfons alternately keeping their fingers on the orifice, and after-
wards by a long bandage of broad tape.

2. Pterigien. Eye-wing. A fpot of inflammation fometimes
begins on the infide of the lower eyelid, or on the tunica albuginea,
and fpreads an intertexture of red veffels from it, as ft-om a center,
which extend on the white part of the eye, ?nd have the appearance
of the wing of a fly, from whence its name.

M. M. Cut the ramifications of vefTels again and again with the
point of a lancet clofe to the center of inflammation.

3. 'Tarjiiis palpebrarum. Inflammation of the edges of the eyelids.
This is a difeafe of the glands, which produce the hairs of the eye-
lafhes, and is frequently the caufe of their falling off. After this in-
flammation a hard fear-like ridge is left on the edge of the eyelid,
which fcratches and inflames the eyeball, and becomes a very trouble-
fome difeafe.

The Turkifli ladies are faid to colour the edge of the eyelafh with
crude antimony in very fine powder, which not only gives luftre to
the eye, as a diamond fet on a black foil, but may prevent extraneous
light from being refledled from thefe edges into the eye, and thus
lerve the purpofe of the black feathers about the eyes of fwans, de-
VoL. II, LI fcribed

258 DISEASES OF SENSATION. Class II. 1.4."

fcribed in Se6t. XXXIX. 5. i. and nnay alfo prevent the edges of the
eyelids from being inflamed by the frequent ftimulus of tears on
them. Black lead in fine powder might be better for all thefe
purpofes than antimony, and might be put on with, a camel's hair
brufli,

M. M. Mercurial ointment fmeared at night on the edges of the
eyelids. Burnt alum fixty grains, hog's greafe half an ounce, well
rubbed into an ointment to be fmeared on them in the night. Cold
water frequently in the day. See Clafs II. i. 1.8.

4. Hordeolum. Stye. This inflammation begins either on or near
the edges of the eyelids, or in the loofe ikin of them, and is fome-
times very flow either in coming to fuppuration or in difperfing.
The flcin beneath the lower eyelid is the moft frequent feat of this
tumor, which fometimes never fuppurates at all, but becomes an in-
cyfted tumor : for as this fl<.in is very loofe for the purpofe of admit-
ting great motion to the eyelid, the abforbent power of the veins
feems particularly weak in this part ; whence when any perfon is
weakened by fatigue or otherwife, a darker fliade of colour is {eea
beneath the eyes ; which is owing to a lefs energetic a6lion of the ab-
forbent terminations of the veins, whence the currents of dark or
venous blood are delayed in them. This dark fhade beneath the eyes,
when it is permanent, is a fymptom of habitual debility, or inirritabi-
lity of the circulating fyflem. See Clafs I. 2. 2. 2.

M. M. Smear the tumors with mercurial ointment, moiften them
frequently with ether. To promote their fuppuration they may be
wounded with a lancet, or flit down the middle, or they may be cut
out. A cauftic leaves a large fear.

Paronychia fuperficialts . Whitlow. An inflammation about the
ifoots of the nail beneath the fliin, which fuppurates without fever,
and fometimes deflroys the nail j which is however gradually repro-
duced.

Class II. 1.4. DISEASES OF SENSATION. 259,

duced. This kind of abfcefs, though not itfelf dangerous, has given
opportunity for the inoculation of venereal matter in the hands of ac-
coucheurs, and of putrid matter from the diffetlion of difeafed
bodies ; and has thus been the caufe of difeafe and death. When
putrid matter has been thus abforbed from a dead body, a livid line
from the finger to the fu'elled gland in the axilla is faid to be vifible ;
which fhews the inflammation of the abforbent veffel along its whole
courfe to the lymphatic gland ; and death has generally been the con-
(fequence.

M. M. In the common paronychia a poultice is generally fuffici-
ent. In the abforption of putrid matter rub the whole hand and arm
with mercurial ointment three or four times a day, or perpetually.
Could the fwelled axillary gland be exfeded ? In the abforption of
venereal matter the ufual methods of cure in fyphilis rnufl be admi-
iiiflered, as in Clafs II. i. 5. i.

6. Gutta rafea. The rofy «5op dn the face is of three kinds.
Firft, the gutta rofea hepatica, or the red pimples on the faces of
drunkards, which are probably a kind of crifis, or vicarious inflam-
mation, which fucceeds, or prevents, a torpor of the membranes of
the liver. This and the fucceeding fpecies properly belong to Clafs
IV. I. 2. 14.

Secondly, the pimpled face in confequence of drinking cold water,
or eating cold turnips, or other infipid food, when much heated with
exercife ; which probably arifes from the fympathy between the fkin
of the face and the ftomach ; and may be called the gutta rofea Jioma-
tlca. Which is diftinguifhed from the former by the habits of the
patient in refpe6t to drinking ; by the colour of the eruptions beino-
kfs deep ; and by the patient continuing generally to be troubled with
Ibme degree of apepfia. See Clafs I. 3. i. 2. I knew a lady, who had
long been affli6ted with pain about the region of the ftomach ; and,
on drinking half a pint of vinegar, as a medicine, ftie had a breaking

L 1 3 out

z6o . DISEASES OF SENSATION. Class II. 1.4.

out commenced on her face ; which remained, and flie became free
from the. pain about the ftomach. Was this a ftomachic, or an hepa-
tic difeafe ?

Thirdly, there is a red face, which confifts of fmaller pimples
than thofe above mentioned ; and which is lefs hable to fuppurate ;
and which feems to be hereditary, or at leaft has no apparent caufe
like thofe above mentioned ; which may be termed gutia rofea here-
ditaria, or puniSla rofea.

Mrs. S. had a pimpled face, which I believe arofe from potation of
ale. She applied alum in a poultice to it, and had foon a paralytic
ftroke, which difabled her on one fide, and terminated in her
death.

Mrs. L. had a red pimpled face, which feemed to have been de-
rived from her mother, who had probably acquired it by vinous po-
tation ; fhe applied a quack remedy to it, which I believe was a fo-
lution of lead, and was feized with epileptic fits, which terminated
in palfy, and deftroyed her. This fhews the danger of ufing white
paint on the face, which is called bifmuth, but is in reality white lead
or ceruffa.

Mr. Y had acquired the gutta rofea on his nofe, and applied a

faturnine folution on it for a few nights, and was then feized with
paralylis on one fide of his face ; which however he gradually re-
covered, and has fince acquired the gutta rofea on other parts of his

face.

Thefe fatal effefts were probably caufed by the difagreeable fenfa-
tion of an inflamed- liver, which ufed before to be relieved of the
fympathetic adion and confequent inflammation of the fkin of the
face, which was now prevented by the ftronger flimulus of the appli-
cation of calx of lead. The manner in which difagreeable fenfa-
tions induce epilepfy and palfy is treated of in Clafs III. In feme
cafes where habitual difcharges, or eruptions, or ulcers are flop-
ped, a torpor of the fyftem may follow, owing to the want of the

accuflomed

Class II. 1.4. DISEASES OF SENSATION. 261

accuftomed quantity of fenfation or irritation. See Clafs I. 1.2. 9.
and 11. I. 5. 6. In both thefe fituations fome other flimulus (hould
be ufed to fupply the place of that which is taken away ; which may
either be perpetual, as an ifflie ; or periodical, as a cathartic repeated
once a fortnight or month.

Mifs W. an elegant young lady of about twenty, applied a mer-
curial lotion to her face, which was covered with very fmall red
points ; which feemed to have been not acquired by any known or
avoidable means ; (he was feized with inflammation of her liver, and
after repeated bleeding and cathartics recovered, and in a few weeks
the eruption appeared as before.

M. M. Five grains of calomel once a month, with a cathartic,
five grains of rhubarb and a quarter of a grain of emetic tartar every
night for many weeks. With this preparation mercurial plafterSj
made without turpentine, and applied every night, and taken off
every morning', will fometimes fucceed, and may be ufed with fafety.
But bliftering the face all over the eruption, beginning with a part,
fucceeds better than any other means, as I have more than once
experienced. — Something like this is mentioned in the Letters of
Lady Mary Wortiey Montague, who bliftered her face with balfam.
of Mecca.

Mrs. F. had for many years had a difagreeably looking eruption on^
her chin, after a cathartic with calomel, (he was advifed to blifter her
-whole chin ; on the healing of the blifler a i&w eruptions again ap--
peared, which ceafed on the application of a fecond blifter. She took-
rhubarb five grains, and emetic tartar a quarter of a grain every night
for many weeks.

Mifs I^ a young lady about eighteen, had tried variety of advice
for pimples over the greateft part of her face in vain. She took the
above medicines internally, and bliftered her face by degrees all over
and became quite beautiful. A fpot or two now and then appeared,
and oa this account ihe frequently flept with parts of her face covered
8 with.

i6z DISEASES OF SENSATION. Class II. 1.4.

with mercurial plafter, made without turpentine, which was held 011
by a pafteboard malk, and taken off in the mornings ; if any part of
the plafter adhered, a little butter or oil deftroyed the adhefion.

7. Odontitis. Inflammatory tooth-ach is occafioned by inflamma-
tion of the membranes of the tooth, or a caries of the bone itfelf.
The gum fometimes fuppurates, otherwife a fvvelling of the cheek
fucceeds by aflociation, and thus the violence of the pain in the
membranes of the tooth is relieved, and frequently cured ; and when
this happens the difeafe properly belongs to Clafs IV, as it fo far
refembles the tranflations of morbid alliens in the gout and rheumar
tifm.

At other times the tooth dies without caries, efpecially in people
about fixty years of age, or before j and then it flimulates its in-
volving membrane, like any other extraneous fubftance. The mem-
brane then becomes inflamed and thickened, occafioning fome pain,
and the tooth rifes upwards above the reft, and is gradually pufhed
out whole and undecayed; on its rifing vip a pus-like mucus is feeu
difcharged from the gum, M'hich furrounds it ; and the gum feems
to have left the tooth, as the fangs or roots of it are in part
naked.

M. M. Where the tooth is found it can only be faved by evacu-
ations by venefedion, and a cathartic ; and after its operation two
.grains of opium, a blifter may alfo be ufed behind the ear, and ether
applied to the cheek externally. In flighter cafes two grains of opium
with or without as much camphor may be held in the mouth, and
fufFered to diffolve near the afFe£ted tooth, and be gradually fwallow-
ed.' See Clafs I. 2.4.12. Odontalgia may be diftinguifhed from
otitis by the application of cold water to the affected tooth ; for as
the pain of common tooth-ach is owing to torpor, whatever decreafes
ilimulus adds to the torpor and confequent pain ; whereas the pain
of an inflamed tooth being ceafed by the increafed adlion of the
6 membranes

Class II. 1.4- DISEASES OF SENSATION. 263

membranes of it is in fome meafure alleviated by the application
of cold.

8. Otitis. Inflammation and confequent fuppuration of fome mem-
branes of the internal ear frequently occur in children, who fleep in
cold rooms, or near a cold wall, without a night-cap. If the bones
are affefted, they come out in a long procefs of time, and the child
remains deaf of that ear. But in this cafe there is generally a fever
attends this inflammation ; and it then belongs to another genus.

M. M. A warmer night-cap. Warmifh water fhould be gently
fyrlnged into the ear to keep it clean twice a day ; and if it does not
heal in a week, a little fpirit of wine fhould be added ; firft about a
fourth part, and it fhould be gradually increafed to half reftified fpirit
and half water : if it continues long to difcharge matter with a very
putrid fmell, the bones are injured, and will in time find their exit,
during which time the ear fhould be kept clean by filling it with a
weaker mixture of fpirit of wine and water ; or a folution of alum in
water; which maybe poured into the ear, as the head is inclined,
and fhook out again by turning the head, two or three times morning
and evening. See Clafs IL i. 4. 10.

9. Fijlula lacrymalis. The lacrymalfack, with its pundla lacry-
malia and nafal du£l, are liable to be deflroyed by fuppuration with-
out fever ; the tears then run over the eyelids, and inflame the edges
of them, and the cheeks, by their perpetual moifture, and faline acri-
mony.

M. M. By a nice furgical operation a new aperture is to be made
from the internal corner of the eye into the noftril, and a filver tube
introduced, which fupplies the defe6l by admitting the tears to pafs
again into the noflril. See Melanges de Chirurgie par M, Pouteau ;
who thinks he has improved this operation.

10. Fijlula

c64 DISEASES OF SENSATION. Class IL i. 4.

10. Fijiula in ano. A mucous dilcharge from the anus, called by
lome white piles, or matter from a fuppurated pile, has been^mif-.
taken for the matter from a concealed fitlula. A bit of cotton wool
applied to the fundament to receive the matter, and renewed twice a
day for a week or two, fhould always be ufed before examination with
the probe. The probe of an unlkilful empyric fometimes does more
harm in the loofe cellular membrane of thefe parts than the original
ulcer, by making a fiftula he did not find The cure of a fiftnla in
ano of thofe, who have been much addifted to drinking fpirituous
liquor, or who have a tendency to pulmonary confumption, is fre-
quently of dangerous confequence, and is fucceeded by ulcers of the
lungs, and death.

M. M. Ward's pafte, or 20 black pepper-corns taken after each
meal twice a day ; the pepper-corns fhould be cut each into two or
three pieces. The late Dr. Monro of Edinburgh afferted in his lec-
tures, that he had known a fiftula in ano cure§ by injeding firft a
mixture of redified fpirit of wine and water ; and by gradually in-
creafin* the fl:ren2;th of it, till the patient could bear redlified fpirit
alone ; by the daily ufe of which at length the fides of the fiftula be-
came callous, and ceafed to difcharge, though the cavity was left.
A French furgeon has lately affirmed, that a wire of lead put in at
the external opening of the ulcer, and brought through the re6l:um,
and twifted together, will gradually wear itfelf through the gut, and
thus effeft a cure without much pain. The ends of the leaden wire
muft: be twifted more and more as it becomes loofe. Or, laftly, it
muft be laid open by the knife.

1 1. V'ljlida urethrce. Where a ftri£lure of the urethra exifts, from
whatever caufe, the patient, in forcing the ftream of urine through
■the ftrufture, diftends the urethra behind it ; which after a time is
liable to burft, and to become perforated ; and fome of the urine is
pufhed into the cellular membrane, occafioning fiftulas, which fome-
times'

Glass II. 1.4. DISEASES OF SENSATION. 265

times have large furfaces producing much matter, which is prefled
out at the time of making water, and has been miftaken for a catarrh
of the bladder ; thefe fiftulas fometimes acquire an external opening
in the perinasum, and part of the urine is difcharged that way.

Can this matter be diftlngulflied from mucus of the bladder by the
criterion delivered in Clafs II. i. 6. 6 ?

M. M. The perpetual ufe of bougies, either of catgut or of coart-
chouc. The latter may be had at No ^Jt Red-lion ftreet, Holborn,
London. The former are eafily m.ade, by moiftening the catgut,
and keeping it ftretched till dry, and then rounding one end with a
pen-knife. The ufe of a warm bath every day for near an hour, at
the heat of 94 or 96 degrees, for two or three months, I knew to be
uncommonly fuccefsful in one cafe ; the extenfive fiftulas completely
healing. The patient fhould introduce a bougie always before he
makes water, and endeavour to make it as (lowly as pofTible. See
Clafs I. 2. 3. 24.

12. Hepatitis chronica. Chronical inflammation of the liver. A
colleftion of matter in the liver has frequently been fouiid on dlffec-
tion, which was not fufpe6led in the living fubjeft. Though there
may have been no certain figns of fuch a coUedion of matter, owing
to the infeniibility of the internal parts of this vifcus ; which has thus
neither been attended with pain, nor induced any fever ; yet there
may be in fome cafes reafon to fufpedt the exiftence of fuch an ab-
fcefs ; either from a fenfe of fulnefs in the right hypochondre, or
from tranfient pains fometimes felt there, or from pain on prefllire,
or from lying on the left fide, and fometimes from a degree of fenfi-
tive fever attending it.

Dr. Saunders fufpe£ls the acute hepatitis to exifl in the inflamma-
tion of the hepatic artery, and the chronical one in that of the vena
portarum. Treatife on the Liver. Robinfon. London.

Vol. II. Mm ^ 3- Scrophula

266 DISEASES OF SENSATION. Class II. 1.4.

13. Scrophula fuppurans. Suppurating fcrophula. The indolent
tunnors of the lynnphatic glands are hable, after a long time, to re-
gain their fenfibility; and then, owing to their former torpor, an in-
creafed adlion of the veffels, beyond what is natural, with inflamma-
tion, is the confequence of their new life, and fuppuration fucceeds.
This cure of fcrophula generally happens about puberty, when a new
energy pervades the whole fyftem, and unfolds the glands and organs
of reprodudlion.

M. M. See.Clafs I. 2. 3. 21. Where fcrophulous ulcers about the
neck are difficult to heal, Dr. Beddoes was informed, in Ireland,
that an empyric had had fome fuccefs by inflaming them by an appli-
cation of wood forrel, oxalis acetofella, the leaves of which are
bruifed in a mortar, and applied on the ulcers for two or three days,
and then fome more lenient application is ufed.

A poor boy, about twelve years old, had a large fcrophulous ulcer
on one lide of the cheft beneath the clavicle, and another under his
jaw ; he was diredled, about three weeks ago, to procure a pound of
dry oak-bark from the tanners, and to reduce it to fine powder,
and to add to it one ounce of white lead in fine powder, and to cover
the ulcers daily with it, keeping it on by brown paper and a bandage.
He came to me a iew minutes ago, to fliew me that both the ulcers
are quite healed. The conftant application of linen rags, moiftened
with a folution of an ounce of fugar of lead in a pint of water, I think
.1 have feen equally efficacious.

14. Scorbutus fuppurans. In the fea-fcurvy there exifts an ina£livlty
of venous abforption, whence vibices and petechias, and fometimes
ulcers. As the column of blood prefling on the origins of t-he veins
of the lower extremities, when, the body is erect, oppofes the afcent
of the blood in them, they are more frequently liable to become en-
larged, and to produce varixes, or vibices, or, laftly, ulcers about
the legs, than on the upper parts of the body. The expofure to

cold

Class II. 1.4. DISEASES OF SENSATION. 267

cold is believed to be another caufe of ulcers on the extremities ; as
happens to many of the poor in winter at Lifbon, who fleep in the
open air, without {lockings, on the fteps of their churches or palaces.
See Clafs I. 2. i. 15.

M. M. A bandage fpread with plafter to cover the whole limb
tight. Rags dipped in a folution of fugar of lead. A v/arm flannel
flocking or roller. White lead and oak bark, both in fine powder.
Horizontal reft.

15. Sctrrhus fuppurans. When a fcirrhus afFe£ls any gland of no
great extent or fenfibility, it is, after a long period of time, liable to
fuppurate v.'ithout inducing fever, like the indolent tumors of the
conglobate or lymphatic glands above mentioned ; whence colleftions
of matter are often found after death both in men and other animals ;
as in the liver of fwine, which have been fed with the grounds of
fermented mixtures in the diftilleries. Another termination of fcir-
rhus is in cancer, as defcribed below. See Clafs I. 2. 3. 22.

I

6. Carcinoma. Cancer. When a fchirrous tumor regains its fenfibi

o

lity by nature, or by any accidental hurt, new veffels fhoot amongft
the yet infenfible parts of it, and a new fecretion takes place of a very
injurious material. This cancerous matter is abforbed, and induces
fwelling of the neighbouring lymphatic glands ; which alfo become
fchirrous, and afterwards cancerous.

This cancerous matter does not feem to acquire its malignant or
contagious quality, till the cancer becomes an open ulcer ; and the
matter fecreted in it is thus expofed to the air. Then it evidently
becomes contagious, becaufe it not only produces he£tic fever, like
common matter in ulcers open to the air ; but it alfo, as it becomes
abforbed, fwells the lymphatic glands in its vicinity ; as thofe of the
axilla, when the open cancer is on ttje breafl. See Clafs 11. 1.3.

Hence exfedion before the cancer is open is generally a core ; but

M m 2 , after

i68 DISEASES OF SENSATION. Class II. 1.4.

after the matter has been expofed to the air, it is feldom of fervice ;
as the neighbouring lymphatic glands are ah'eady infecled. I have
obferved fome of thefe patients after the operation to have had dif-
cafed livers, which might either have previoufly exifted, or have been
produced by the fear or anxiety attending the operation.

Erofion with arfenic, after the cancer is become an open ulcer,
has o-enerally no better efFeft than exfeftion, but has been fuccefsful
before ulceration. The beft manner of uling arfenic, is by mixing
one o-rain with a dram of lapis calaminaris, and ftrewing on the can-
cer fome of the powder every day, till the whole is deftroyed.

Cancers on the face are faid to arife from the periofleum, and that
unlefs this be deftroyed by the knife, or by cauftics, the cancer cer-
tainly recurs. After the cancer becomes an open ulcer of fome extent,,
a purulent fever fupervenes, as from other open ulcers, and gradually
deftroys the patient. See Clafs 11. 1.6. 13.

Two very interefting cafes have been lately publiftied by Dr. Ew-
art, of Bath, in which carbonic acid gas, or fixed air, was kept con-
ftantly in contact with the open cancerous ulcers of the breaft ; which
then healed like other common ulcers. This is rather to be afcribed
to the exclufion of oxygen, than to any fpecihc virtue in the carbonic
acid. As in common ulcers the matter does not induce he£lic fever,
till it has been expofed to the air, and then probably united with
oxygen.

The manner of applying the fixed air, is by including the cancer in
one half or hemifphere of a large bladder ; the edges are made to ad-
here to the Ikin by adhefive plafter, or perhaps a mixture of one part
of honey with about twenty parts of carpenter's glue might better
fuit fome tender ikins. The bladder is then kept conftantly filled
with carbonic acid gas, by means of a pipe in the neck of it ; and
the matter let out at a fmall aperture beneath.

I'

Arthrocek.

Class ir. 1.4. ' DISEASES OF SENSATION. 2^9

17. Arthrocele. Swelling of the joints feems to have its remote
caufe in the fbftnefs of the bones, for they could not fvvell unlefs
they were prcvioufly foftened, fee Clafs I. 2. 2. 12. The epiphyfes, or
ends of the bones, being naturally of a loofer texture, are moft liable
to this difeafe, and perhaps the cartilages and capfular ligaments may
alfo become inflamed and fwelled along with the heads of the bones.
This malady is liable to diflort the fingers and knees, and is ufually
called gout or rheumatifm ; the former of vvhich is liable to difable
the fingers by chalk- ftones, and thence to have fomewhat a fimilar
appearance. But the arthrocele, or fwelling of the joints, afFe£ls people
who have not been intemperate in the ufe of fermented or fpirituous
liquors ; or who have not previoufly had a regular gout in their feet ;
and in both thefe circumflances differs from the gout. Nor does it
accord with the inflammatory rheumatifm, as it is not attended with
fever, and becaufe the tumors of the joints never entirely fubfide.
The pain or fenfibility, which the bones acquire, when they are in-
flamed, may be owing to the new veflels, which fhoot in them in
their foft ftate, as well as to the diftention of the old ones.

M. M. Half a grain of opium twice a day, gradually increafed to
a grain, but not further, for many months. Thirty grains of powder
of bark twice a day for many months. Ten grains of bone-afhes, or
calcined hartfliorn, twice a day, with decoftion of madder ? Soda
phofphorata ?

18. Arthropuojls. Joint-evil. This differs from the former, as
that never fuppuratesj thefe ulcers of the joints are generally efteemed
to arife from fcrophula ; but as fcrophula is a difeafe of the lymphatic
or abforbent fyfi:em, and this confifts in the fuppuration of the mem-
branes, or glands, or cartilages about the joints, there does not
feem a fufficient analogy to authorize their arrangement under the
fame name.

The white fwelling of the knee, when it fuppurates, comes under

this

270 DISEASES OF SENSATION. Class II. 1.4.

this fpecies, with variety of other ulcers attended with carious
bones.

19. Caries ojjimn. A caries of the bones maybe termed a fuppura-
tion of them ; it differs from the above, as it generally is occafioned
by fome external injury, as in decaying teeth ; or by venereal virus,
as in nodes on the tibia ; or by other matter derived to the bone in
malignant fevers ; and is not confined to the ends of them.

The feparation of the dead bone from the living is a work of fome
time. See Sed. XXXIII. 3. i.

ORDO

Class II. 1.5. DISEASES OF SENSATION. 271

ORDO I.

Increqfed Senfation.

GENUS V.

With the Production of new Vejfels by external Membranes or Glands.,

without Fever.

The ulcers, or eruptions, which are formed on the external fkin,
or on the mouth or throat, or on the air-cells of the lungs, or on the
inteftines, all of which are more or lefs expofed to the conta£l of the
atmofpheric air, which we breathe, and which in fome proportion
we fwallow with our food and faliva ; or to the contact of the inflam-
mable air, or hydrogen, which is fet at liberty by the putrefying ali-
ment in the inteftines, or by putrefying matter in large abfceffes ;
all of them produce contagious matter ; which, on being inoculated
into the Ikin of another perfon, will produce fever, or a limilar
difeafe.

In fome cafes even the matter formed beneath the fkin becomes in
fome degree contagious, at leaft fo much fo as to produce fever of
the he£lic or malignant kind, as foon as it has pierced through"
the (kin, and has thus gained accefs to fome kind of air ; as the
frefli pufs of a common abfcefs ; or the putrid pus of an abfcefs,
which has been long confined ; or of cancerous ulcers. ^

From this analogy there is reafon to fufpedt, that the matter of all
contagious difeafes, whether with or without fever, is not infe£tious
till it has acquired fomething from the air ; which, by oxygenating
the fecreted matter, may probably produce a new acid. And fecond-
ly, that in he£lic fever a part of the purulent matter is abforbed ; or
8 afts

272 DISEASES OF SENSATION. Class II. 1.5.

adls on the furface of the ulcer ; as variolous matter afFe£ts the ino-
culated part of the arm. And that hedic fever is therefore caufed by
the matter of an open ulcer; and not by the fenfation in the ulcer
independent of the aerated pus, which lies 'on it. Which may ac-
count for the venereal matter from buboes not giving the infedion,
according to the experiments of the late Mr. Hunter, and for fome
other phenomena of contagion. See Variola difcreta, Clafs IL

I-3-9-

SPECIES.

1. Gonorrhoea venerea. A pus-like contagious material difcharged
from the urethra after impure cohabitation, with fmarting or heat on
making watery which begins at the external extremity of the urethra,
to which the contagious matter is applied, and where it has accefs to
the air.

M. M. In this ftate of the venereal difeafe once venefeftion, with
mild cathartics of fenna and manna, with mucilage, as almond emul-
iion, and gum arable, taken for two or three weeks, abfolve the cure.
Is camphor of ufe to relieve the ardor urins ? Do balfams increafe or
leflen the heat of urine ? Neutral falts certainly increafe the fmarting
in making water, by increafing the acrimony of the urine.

Can the difcharge from the urethra be foon flopped by faturnine
inje£lions, or mercurial ones, or with folution of blue vitriol, at
firfl: very dilute, and gradually made flronger ? And .at the fame time
left the fyphilis, or general difeafe, (hould fupervene, the patient
might take a quarter of a grain of corrofive fublimate of mercury twice
a day, as direded below ?

2. Syphilis, Venereal difeafe. The contagion fhews itfelf in ul-
cers on the part firfl inoculated, as chancres ; ulcers on the tonfils

fucceed.

Class II. 1.5. DISEASES OF SENSATION. 273

fucceed, with eruption on the flcin, efpecially about the roots of the
hair; afterwards on other parts of the fkin, terminating in dry fcabs;
and laflly, with pain and fwelling of the bones.

The corona veneris, or crown of Venus, confifls of the eruptions
at the roots of the hair appearing moft round the forehead ; which is
occafioned by this part being moi;e expofed to the air ; which we ob-
ferved, at the beginning of this genus, either produces or increafes
the virulence of contagious matter. But it is difficult to conceive
from this hiftory, why the throat fliould be firft afFe6led; as it cannot
be fuppofed, that the difeafe is fo often taken by the faliva, like the
fmall-pox, though this may fometimes occur, perhaps very often.
The connexion between the genitals in men and the throat, is treated
of in ClafsIV. I. 2.7. Hydrophobia.

M. M. A quarter of a grain of corrofive fublimate of mercury,
taken thrice a day for five or fix weeks, made into a pill with bread-
crumbs, or diffolved in a fpoonful of brandy and water, is a very ef-
ficacious and almoft certain cure. When it does not fucceed, it is
owing either to the drug being bad, or to its having precipitated from
the brandy, or from its being fpoiled in the pill by long keeping.
Opium contributes much to expedite the cure both of the fimple go-
norrhoea, and of venereal ulcers, by increafing abforption both from
the mucous membrane, and from the furface of ulcers.

2- Lepra. Leprofy. Leprofy of the Greeks. The fkin is rough
with white branny fcales, which are full of chinks ; often moift be-
neath, and itching. The fcales on the head or arms of fome drink-
ing people are a difeafe of this kind. The perfpirable matter defigned
for the purpofe of lubricating the external fkin is fecreted in this dif-
eafe in a too vifcid ftate, owing to the inflammation of the fubcuta-
neous veffels ; and, as the abforbents zdc too ftrongly at the fame
time, a vifcid mucus is left adhering to the furface of the fkin.
' In the leprofy of the Jews, defcribed in the thirteenth and four-
VoL. II. N n teenth

274 DISEASES OF SENSATION. Class II. i. 5.

teenth chapters of Leviticus, the depreflion of the fore beneath the
furface of the Ikin, and the hairs in it becoming white, feem to have
been the principal circumftances, which the prieft was diredled to at-
tend to for the purpofe of afcertaining the difeafe.

M. M. Effence of antimony from 20 drops to 100 twice or thrice
a day, with half a pint of decodiion of elm-bark ; or tinflure of can-
tharides from 20 to 60 drops four times a day j or fublimate of mer-
cury, with much diluting fluid. Acid of vitriol ? Perhaps the cure
chiefly depends on much dilution with water, from two to four pints
a day, in which elm-bark, or pine-buds, or juniper-tops, may be
boiled. Bath or Buxton water drank in large quantities. Warm
bath. Oil-lkin bound on the part to confine the perfpirable matter.
Ointment of tar and fuet ; or poultice for two or three days, and then
cerate with lapis calaminaris. Diet of raifins and bread. Abflinence
from wine, beer, and all fpirits.

4. Elephantia/is. Leprofy of the Arabs. A contagious difeafe j
the flcin is thickened, wruikled, rough, unduous, deftitute of hair,
without any fenfation of touch in the extremities of the limbs-; the
face deformed with tubercles ; the voice hoarfe, and with a nafal
tone. Cullen.

5. Framhoe/ia. Yaws is faid to be contagious and hereditary.
It principally afFedls the negroes in the- Weft Indies* Edinb. Effays,
Vol. VI.

6. Pfory. Itch. A contagious prurient eruption. There are
two kinds of itch, that which appears between the fingers, and un-
der the joints of the knees and elbows ; and that which feldom is (eQu.
in thefe places, but all over the other parts of the body. The latter
is feldom thought to be the itch, as it does not eafily infedt even a
bedfellow, and refifts the ufual means of cure by brimftone.

If

Class II. 1.5. DISEASES OF SENSATION. " 275

If the itch be cured too haftily by rubbing mercurial or arfenical
preparations over the whole body, or on too great a part of it, many
bad fyoiptoms are produced ; as weaknefs of digeftion, with pale
bloated countenance, and tendency to dropfy. I have twice feen
St, Vitus's dance occur from the ufe of a mercurial girdle ; and once
a fwelled liver. I have a!fo feen a fwelled fpleen and Iwelled legs
from the external ufe of arfenic in the cure of the itch. And very
numerous and large phlegmons commonly fucceed the too hafty cure
of it by other means.

There does not appear a flrift analogy between the haily cure of
the itch, and the retrocefiion of the puftles in the fecondary fever of
the fmall-pox ; becaufe in that the abforption of the matter is evinced
by the fwelling of the face and hands, as the puftles recede, as ex-
plained in Clafs II. I. 3. 9. Variola difcreta. And a fever is produced
by this abforption; neither of which happen, when the puflies of the
itch are deftroyed by mercury or arfenic.

Nor can thefc inconveniences, which occur on the too hafty cure
of the itch, be explained by thofe which follow the cure of fome
kinds of gutta rofea, Clafs II. i . 4. 6. as in thofe the eruptions on the
face were an alTociated difeafe with inflammation of the liver or flo-
roach, which they were accuftomed to relieve; whereas the itch
is not known to have had any previous catenation with other
difeafes.

In, the itch there exifts not only great irritation in the production of
the puftles, but great fenfation is caufed by their acrimony afterwards ;
infomuch that the pain oF itching, without the interrupted fmarting
occafioned by fcratching, would be intolerable. This great excite-
ment of the two fenforial powers of irritation and fenfation is fo great,
when the pullles are difFnfed over the whole furface of the body, that
a torpor fucceeds the fudden ceafing of it ; which affeds thofe parts of
the fyftem, which were moft catenated with the new motions of the

N n 2 ikin,

276 DISEASES OF SENSATION. Class II. 1.5.

fkin, as the ftomach, whence indigeftion and flatulency; or which
are generally moft liable to fall into torpor, as the numerous glands,
which form the liver. Whence the difeafes confequent to the hafty
cure of the itch are difeafes of debility, as tumid vifcera, cedematous
fwellings, and St. Vitus's dance, which is a debility of affociation.
In the fame manner indigeflion, with green evacuations, are faid to
follow an injudicious application of ceruffa to flop too haftily the exfu-
dation behind-the ears of children, Clafs I. i. 2. 9. And dropfies are
liable to fucceed the cure of old ulcers of the legs, which have long
ftimulated the fyftem.

M. M. The iize of a large pea, of an ointment confifling of one
part of white precipitate of mercury to fix parts of hogs' lard well tri-
turated together, to be rubbed on a part of the body every night, and
wafhed off with foap and water next morning, till every part is clear-
ed ; with lac fulphuris twenty grains to be taken every morning in-
wardly. Warm faline bath, with white vitriol in it. Flowers of
fulphur mixed with thick gruel, with hogs fat. With either of
which the body may be fmeared all over.

7. Pfora ebrkrum. Elderly people, who have been much addicted
to fpirituous drinks, as beer, wine, or alcohol, are liable to an erup-
tion all over their bodies ; which is attended with very afHi£ting itch-
ing, and which they probably propagate from one part of their bodies
to another with their own nails by fcratching themfelves. I faw fatal
efFe(3:s in one fuch patient, by a too extenfive ufe of a folution of lead ;
the eruption difappeared, he became droplical, and died ; I fuppofe from
the too fuddenly ceafing of the great ftimulus caufed by the eruptions
over the whole fkin, as in the preceding article.

M. M. The patient fhould gradually accuftom himfelf to half his

ufual quantity of vinous potation. The warm bath, with one pound

of fait to every three gallons. Mercurial ointments on fmall parts of

7 the

Class II. 1.5. DISEASES OF SENSATION, 277

the Ikin at a time. A grain of opium at night inftead of the ufual po-
tation of wine or beer.

8. Herpes. Herpes confills of gregarious fpreading excoriations,
which are fucceeded by branny fcales or fcabs. In this difeafe there
appears to be a deficient abforption of the fubcutaneous mucus, as
well as inflammation and increafed fecretion of it. . For the fluid not
only excoriates the parts in its vicinity by its acrimony, but is very
faline to tbe tafl:e, as fome of thefe patients have afTured me ; I be-
lieve this kind of eruption, as well as the tinea, and perhaps all other
cutaneous eruption, is liable to be inoculated in other parts of the body
by the finger-nails of the patients in fcratching themfelves.

It is liable to aff^edt the hands, and to return at diftant periods ; and
is probably a fecondary difeafe, as well as the zona ignea, or Ihingles,
defcribed below.

M. M. Poultice the eruption with bread and milk, or raw carrots '
grated, for two or three whole days, to dilute or receive the dif-
charged fluid, and abate the inflammation; then cover the parts
with frefh cerate mixed with lapis calaminaris. On the parts not ex-
coriated mercurial ointment, made of one part of white calx of mer-
cury and fix of hogs' fat. Internally, after venefe£tion, gentle re-
peated cathartics. Laflly, the bark. Acid of vitriol. Bolus Arme-
nize, or teftacia. Antimonials. Deco£lion of interior bark of elm.

9. Zona ignea. Shingles. This eruption has been thought a fpe-
cies of herpes by fome writers, and by others a fpecies of eryfipelas.
Yellow or livid veficles appear, producing a corrofive ichor, which- is
fometimes attended with a degree of fever. It is faid to infeft fome-
times the thorax and ribs, but its mofl: general fituation is on the
fimall of the back, over one kidney, extending forward over the courfe
of one of the ureters.

There is reafon to fufpecl, that this alfo Is a fecondary or iympa-

thetic

278 DISEASES OF SENSATION. Class II. i. 5.

thetic dlfeafe, as well as the preceding one ; but future obfervations
are required, before it can be removed to the fourth clafs, or difeafes
of affociation. In three patients I have been induced to beheve, that
the eruption on the loins vi^as a tranflation of inflammation from the
external membrane of the kidney to the fkin. They had, for a day
or two before the appearance of the eruption, complained of a dull
pain on the region of one kidney, but w^ithout vomiting ; by which
it vvas diftinguifhed n'om nephritis interna, or gravel ; and without
pain down the outfide of the thigh, by which it was diftinguifhed
from fciatica. In other fituations the fhingles may fympathize with
other internal membranes, as in a cafe publifhed by Dr. Ruflel (De
Tabe Glandulari), where the retroceffion of the (hingles was fucceed-
.ed by a ferious dyfpnaea.

M. M. Venefeiflion, if the pulfe is ftrong. Calomel three or four
grains, very mild repeated cathartics. Poultice for a few days, then
cerate of lapis calaminaris, as in herpes. A grain of emetic tartar
diffolved in a pint of water, and taken fo as to empty the ftomach and
inteftines, is laid much to haften the cure ; compreffes foaked in a
faturnine folution are recommended externally on the eruption ; and
cerate where there are ulcerations, Defanet's Surgical Journal, Vol.
■II. p. 378. If this be a vicarious difeafe, it fliould continue half a
lunation ; left, on its ceafing, the bad habits of motion of the primary
difeafe fhould not have been fo perfedly diflevered, but that they may
recur.

ID. Annulus repem. Ring-worm. A prurient eruption formed in
a circle, afFeding children, and would feem to be the work of infers,
according to the theory of Linnaeus, who afcribes the itch and dyfen-
tery to microfcopic animalcula. Thefe animalctila are probably the
effed, and not the caufe, of thefe eruptions ; as they are to be ittw in
.all putrefcent animal fluids. The annular propagation of the ring-
-worm, and its continuing to enlarge its periphery, is well accounted
^ for

Class ir. 1.5. DISEASES OF SENSATION. 279

for by the acrimony of the ichor or faline fluid eroding the fkia
in its vicinity,

M, M. Cover the eruption daily with ink. With white mercurial
ointment, as defcribed above in herpes. With folution of white vi-
triol ten scrains to an ounce. Thefe metallic calces ftimulate the ab-
forbents into ftronger adion, whence the fluid has its faline part re-
abforbed, and that before it has accefs to the air, which probably
adds to its acrimony by oxygenating it, and thus producing a new
acid.

II. 'Tinea. Scald head. This contagious eruption afFe£ls the
roots of the hair, and is generally mofl virulent around the edges of
the hair on the back part of the head ; as the corona veneris appears
mofl: on the edges of the hair on the forepart of the head ; for in
thefe parts the eruption about the roots of the hair is moft expofed to
the external air, by which its acrimony or noxious quality is in-
creafed.

The abforption of the matter thus oxygenated fwells the lympha-
tics of the neck by its ftimulus, occafioning many little hard lumps
beneath the feat of the eruption ; when this happens, the fooner it is
cured the better, left the larger lymphatics of the neck fhould become
aff^edled..

M. M. The art of curing thefe eruptions confifts, firft, in abating
the inflammation, and confequent fecretion of a noxious material.
Secondly, to prevent its accefs to the air, which fo much increafes
its acrim'ony. And thirdly, to promote the abforption of it, before
it has been expofed to the air ; for thefe purpofes venefe(flion once,
and gentle cathartics, which promote abforption by emptying the
blood-veflels. Next poultices and fomentations, with warm water,
abace inflammation by diluting the faHne acrimony of the fecreted
fluid, and abating the painful lenfation. Afterwards cerate joined
with fome metallic calx, as of zinc or lead, or folution of lead, mer-

- cury.

28o DISEASES OF SENSATION. Class 11. 1.5.

cuiy, or copper, or iron, which may ftimulate the abforbent fyflem
into ftronger adlion.

Cover the Ihaved head with tar and fuet, and a bladder ; this, by
keeping the air from the fecreted fluid, much contributes to its mild-
ncfs, and the friraulus of the tar increafes its abforption. Seethe
three preceding fpecies of this genus.

12. Crujla la'Bea. Milk-cruft is a milder difeafe than tinea, af-
fe£ling the face as well as the hairy fcalp of very young children. It
is not infedlious, nor liable to fwell the lymphatics in its vicinity like
the tinea.

M. M. Cover the eruption with cerate made with lapis calaminaris,
to be renewed every day. • Mix one grain of emetic tartar with forty
grains of chalk, and divide into eight papers, one to be taken twice
a day, or with magnefia alba, if ftools are wanted. The child fhould
be kept cool and much in the air,

13. Trichoma. Plica polonica. A contagious difeafe, in which
the hair is faid to become alive and bleed, forming inextricable knots
or plaits of great length, like the fabled head of Medufa, with into-
lerable pain, fo as to confine the fufFerer on his bed for years.

ORDO

Class IL 1.6. DISEASES OF SENSATION. 281

OR DO I.

Increajed Seiifat'ton.

GENUS VI.
With Fever confequent to the Produdiion of new Vejfels or Fluids.

SPECIES.

I. Fcbrh fenjltlva. Senfitive fever, when unmixed with either ir-
ritative or inirritative fever, may be diftinguifhed from either of them
bj the lefs comparative diminution of mufcular ftrength ; or in other
words, from its being attended with lefs diminution of the fenforial
power of irritation. An example of unmixed fenfitive fever may ge-
nerally be taken from the pulmonary confumption ; in this difeafe
patients are feen to walk about with eafe, and to do all the common
offices of life for weeks, and even months, with a pulfe of 1 20 flrokes
in a minute ; while in other fevers, whether irrigated or inirritated,
with a pulfe of this frequency, the patient generally lies upon the bed,
and exerts no mufcular efforts without difficulty.

The caufe of this curious phenomenon is thus to be underflood ; in
the fenfitive fever a new fenforial power, viz. that of fenfation, is
fuperadded to that of irritation ; which in other fevers alone carries
on the increafed circulation. Whence the power of ii^ritation is not
much more exhaufted than in health ; and thofe mufcular motions,
which are produced in confequence of it, as thofe which are exerted
in keeping the body upright in walking, riding, and in the per-
formance of many cuftomary aftions, are little impaired. For an ac-
VoL. II. ' O o count

282 DISEASES OF SENSATION. Class IL i. 6.

count of the irritated fenfitive fever, fee Clafs IL 1.2. i. ; for the in-
irritated fenfitive fever, Clafs II. i. 3. 1. IV. 2. 4. 1 1.

2. Fein's a pure claufo. Fever from iiiclofed matter is generally of
the irritated fenfitive kind, and continues for many weeks, and even
months, after the abfcefs is formed ; but is diftinguiflied from the
fever from aerated matter in open ulcers, becaufe there are feldom
any night-fvveats, or colliquative diarrhoea in this, as in the latter.
The pulfe is alfo harder, and requires occafional venefe£lion, and ca-
thartics, to abate the inflammatory fever ; which is liable to increafe
again every three or four days, till at length,- unlefs the matter has
an exit, it deftroys the patients In this fever the matter, not having
been expofed to the air, has not acquired oxygenation ; in which a
new acid, or fome other noxious property, is produced ; which adts-
like contagion on the conftitution inducing fever-fits, called hedic
fever, which terminate with fweats or diarrhoea ; whereas the mat-
ter in the clofed abfcefs is either not abforbed, or does not fo affedl
the circulation as to produce diurnal or he£tic fever-fits \ but the
ftimulus of the abfcefs excites fo much fenfatbn as to induce perpe-
tual pyrexia, or inflammatory fever, without .fuch marked remiffions.
Neverthelefs there fometimes is no fever produced, when the matter
is lodged in a part of little fenfibility, as in the liver \ yet a white pus-
like fediment in thofe cafes exifts I believe generally in the urine,
with occafional wandering pains abo_ut the region of the liver or
cheft. ,

3. Vomica. An abfcefs in the lungs is fometimes produced after
peripneumony, the cough and fhortnefs of breath continue in lefs
degree, with difficulty in lying on the well fide, and with fenfitive
irritated fever, as explained in the preceding article.

The occafional increafe of fever, with hard pulfe and fizy blood, in
thefe patients, is probably owing to the inflammation of the walls of

6 the

Class II. 1.6. DISEASES OF SENSATION. 283

the vomica ; as it is attended with difficulty of breathing, and re-
quires venefeaion. Mr. B , a child about {even years old, lived

about five weeks in this fituation, with a pulfe from 150 to 170 in a
minute, without fvveats, or diarrhoea, or fediment in his water, ex-
cept mucus occafionally ; and took fufficient nouriHiment durino- the
•whole time.' The blood taken was always covered with a ftrono-
cupped fize, and on his death three or four pints of matter were
found in one fide of the chefl ; which had probably, but lately, been
effrifed from a vomica. This child was frequently induced to fwino-,
both in a reciprocating and in a rotatory fvving, without any apparent
abforption of matter ; in both thefe fvvings he exprefled pleafure, and
did not appear to be vertiginous.

M. M. Repeated emetics. Digitalis ? Perfeverance in rotatory
fwinging. See Clafs II. i. 6. 7.

Mr. i. had laboured fome months under a vomica after a peripneu-
mony, he was at length taken with a catarrh, which was in fome
•degree endemic in March 1795, which occafioned him to fneeze
much, during which a copious haemorrhage from the lungs occurred,
and he fpit up at the fame time half a pint of very fetid matter, and
recovered. Hence errhines maybe occafionally ufed with advantao-e.

4, Empyema. When the matter from an abfcefs in the luno-s
finds its way into the cavity of the cheft, it is called an empyema.
A fervant man, after a violent peripneumony, was feized with fymp-
toms of empyema, and it was determined, after fome time, to per-
form the operation ; this was explained to him, and the ufual means
were employed by his friends to encourage him, " by advifing him
not to be afraid." By which good advice he conceived fo much fear,
■ that he ran away early next morning, and returned in about a week
quite well. Did the great fear promote the abforption of the matter,
like the ficknefs occafioned by digitalis ? Fear renders the external
Ikin pale ; by this continued decreafe of the adion of the abforbents

O o 2 of

284 DISEASES OF SENSATION. Class II. 1.6.

of the flcin might not thofe of the lungs be excited into greater ac-
tivity ? and thus produce increafed pulmonary abforption by reverfe
fympathy, as it produces pale urine, and even flools, by direft fym-
pathy ?

M. M. Digitalis ?

5. Febris Mefenterica. Fever from matter formed in the mefentery
is probably more frequent than is fufpeded. It commences with pain
in the bowels, with irritated fenfitive fever ; and continues many
weeks, and even months, requiring occalional venefedion, and mild
cathartics ; till at length the continuance of the pyrexia, or inflam-
matory fever, deftroys the patient. This is an affediion of the lym-
phatic glands, and properly belongs to fcrophula; but as the mat-
ter is not expofed to the air, no hedic fever, properly fo called, is
induced.

6. Febris a pure aerato. Fever from aerated matter. A great col-
leftion of matter often continues a long, time, and is fometimes to-
tally abforbed, even from venereal buboes, without producing any
diforder in the arterial fyllem. At length, if it becomes putrid by its
delay, and one part of the matter thus becomes aerated by the air
given aut by the other part ; or if the ulcer has been opened, fo that
any part of it has been expofed to the air for but one day, a hedlis
fever is produced. Whence the utility arlfes of opening large abfcefles
by ietons, as in that cafe little or no hedic fever is induced.; becaufe
the matter is fqueezed out by the fide of the fpongy threads of cotton,
and little or no air is admitted ; or by tapping the abfcefs with a trocar,
as mentioned in ifchias, Clafs II. i. 2. 18.

In this fever the pulfe is about 120 in a minute, and its acceis is
generally in an evening, and fometimes about noon alfo, with, fweats
or purging towards morning, or urine with pus-hke fediment ; and
the patients bear this fever better than any other with fo quick a

pulfe ;

Class II. 1.6. DISEASES OF SENSATION. 285

pulfe ; and laflly, when all the matter from a concealed ulcer is ab-
forbed, or when an open ulcer is healed, the he£tic fever cea(es»
Here the abforbed matter is fuppofed to produce the fever, and the
diarrhoea, fweats, or copious muddy urine, to be (imply the confe-
quence of increafed fecretion, and not to confift of the purulent mat-
ter, which was fuppofed to be abforbed from the ulcer. See Sudor
calidus, Clafs I. 1.2.3. .

The adion of the air on ulcers, as we have already (hewn, in-
creafes the acrimony of the purulent matter, and even converts it
into a weaker kind of contagious matter ; that is, to a material in-
ducing fever. This was afcribed to the union of the azotic part of
the atmofphere with the effufed pus in Sed. XXVIII. 2. but by con-
templating more numerous fads and analogies, 1 am now induced to
believe, that it is by the union of oxygen with it; firft, becaufe oxy-
gen fo greedily unites with other animal fubftances, as the blood,
that it will pafs through a moift bladder to combine with it, accord-
ing to the experiment of Dr. Prieftley. Secondly, becaufe the poi-
fons of venomous creatures are fuppofed to be acids of different kinds,,
and are probably formed by the contad of air after their fecretion..
And laflly, becaufe the contagious matter from other ulcers, as in
itch, or fmall-pox, are formed on external membranes, and are pro-
bably combinations of animal matter and oxygen, producing other
new acids; but further experiments mull: determine this queflion.

It was thought a fubjed of confequence by the ^fculapian Society
at Edinburgh, to find a criterion which fhould dlflinguiOi pus from
mucus, for the purpofe of more certainly difcovering the prefence of
ulcers in pulmonary difeafes, or in the urinary paflages. For this
purpofe that fociety offered their firfl gold medal, which was con-
ferred on the late Mr. Charles Darwin, in the year 1778, for his ex-
periments on this fubjed. From which he deduces the following
conclufions :

" I. Pus

286 DISEASES OF SENSATION. Class IL 1.6.

" I. Pus and mucus are both fokible In the vitriolic acid, though
in very different proportions, pus being much the lefs loluble.

2. The addition of water to either of thefe compounds decom-
pofes it; the mucus thus feparated, either fvvims on the mixture, or
forms large fiocci in it ; whereas the pus falls to the bottom, and
forms on agitation a uniform turbid mixture.

3. Pus is difFufible through a diluted vitriolic acid, though mucus
is not; the fame occurs with water, or a folution of fea fait.

4. Nitrous acid diffolves both pus and mucus j water added to the
iblution of pus produces a precipitate; and the fluid above becomes
clear and green ; while water and the folution of mucus form a dirty
coloured fluid.

5. Alkaline lixivium diffolves (though fometimes with difficulty)
mucus, and generally pus.

6. Water precipitates pus from fuch a folution, but does not
mucus.

7. Where alkaline lixivium does not diffolve pus, it ftill dif-
tiriguifhes it from mucus ; as it then prevents its diffufion through
water.

8. Coagulable lymph is neither foluble in diluted nor concentrated
vitriolic acid.

9. Water produces no change on a folution of ferum in alkaline
lixivium, until after long flanding, and then only a very flight fedi-
ment appears.

10. Corrofive fubllmate coagulates mucus, but does not pus.
From the above experiments it appears, that ftrong vitriolic acid

and water, diluted vitriolic acid, and cauftic alkaline lixivium and
water will ferve to difiinguifh pus from mucus; that the vitriolic
acid can feparate it from coagulable lymph, and alkaline lixivium
from ferum.

And hence, when a perfon has any expe£lorated material, the

com-

Class II. 1.6. DISEASES OF SENSATION. 287

compofition of which he wiflies to afcertain, let him diffolve it in vi-
triolic acid, and in cauftic alkaline lixivium ; and then add pure water
to both folutions : and if there is a fair precipitation in each, he may
be affured that fome pus is prefent. If in neither a precipitation oc-
curs, it is a certain teft, that the material is entirely mucus. If the
material cannot be made to diffolve in alkaline lixivium by time and
trituration, we have alfo reafon to believe that it is pus." Experi-
ments oh Pus and Mucus. Cadell. London.

7. Phthijis pulmonalis. In pulmonary confumption the fever is
generally fuppofed tobe the confequence of the flimulus of abforbed
matter circulating in the blood-vefTels, and not fimply of its ftimukis
on their extremities in the furface of the ulcers ; as mentioned in
Clafs II. I. 5. and Clafs II. i. 3. 9. The ulcers are probably fome-
times occafioned by the putrid acrimony of effufed blood remainino- in
the air-cells of the lungs after an haemoptoe. See Clafs I. 2. 1.9.
The remote caufe of confumption is ingenioufly afcribed by Dr. Bed-
does to the hyper- oxygenation of the blood, as mentioned Sedioa
XXVIII. 2.

As the patients liable to confumption are of the inirritable tempera-
ment, as appears by the large pupils of their eyes ; there is reafon to
believe, that the hasmoptoe is immediately occafioned by the deficient
abforption of the blood at the extremities of the bronchial vein; and.
that one difficulty of healing the ulcers is occafioned by the deficient
abforption of the fluids effufed, into them. See Sed. XXX. i„,
and 2.

The difficulty of healing pulmonary ulcers may be owing, as its
remote caufe, to the inceffant motion of all the parts of the luno-s ;
whe«ice no fcab, or indurated mucus, can be formed fo as to adhere
on them. Whencethefe naked ulcers are perpetually expofed to the
aftion of the air on their furfaces, converting their mild purulent'
matter into a contagious ichor; which not only prevents them from

healing,.

2?58 • DISEASES OF SENSATION. Class II. i. 6,

healing, but by its a6lion on their circumferences, like the matter of
itch or tinea, contributes to fpread them wider. See the preceding
article, and Seft. XXXIII. 2. 7. where the pulmonary phthifis is
fuppofed to be infefflious.

This acidifying principle is found in all the metallic calces, as in
lapis calaminaris, which is a calciform ore of zinc ; and in cerufla,
■which is a calx of lead ; two materials which are powerful in healing
excoriations, and ulcers, in a fliort time by their external application.
How then does it happen, that the oxygen in the atmoiphere fliould
prevent puhxionary ulcers from healing, and even induce them to
fpread wider; and yet in its combination with metals, it fhould faci-
litate their healing ? The healing of ulcers conlifts in promoting the
abforption of the fluids effufed into them, as treated of in Se6lioa
XXXIII. 3. 2. Oxygen in combination with metals, when applied
iti certain quantity, produces this effeft by its ftimulus ; and the me-
tallic oxydes not being decompofed by their contact with animal
matter, no new acid, or contagious material, is produced. So that
the combined oxygen, when applied to an ulcer, fimply I fuppofe
promotes abforption in it, like the application of other materials of
the articles forbentia or incitantia, if applied externally; as opium,
bark, alum. But in the pulmonary ulcers, which cannot protedt
themfelves from the air by forming a fcab, the uncombined oxygen
of the atmofphere unites with the purulent matter, converting it into
a contagious ichor ; which by infe6lion, not by erofion, enlarges the
ulcers, as in the itch or tinea; which might hence, according to Dr.
Beddoes's ingenious theory of confumption, be induced to heal, if ex-
pofed to an atmofphere deprived of a part of its oxygen. This I hope
future experiments will confirm, and that the pneumatic medicine
will alleviate the evils of mankind in many other, as well as in this
moft fatal malady.

M. M. Firfl:, the refpiration of air lowered by an additional quan-
tity of azote, or mixed with fome proportion of hydrogen, or of car-
bonic

Class II. i. 6. DISEASES OF SENSATION. 2S9

bonic acid air, may be tried ; as defcribed in a late publication of
Dr. Beddoes 011 the medicinal ufe of fadlitious airs. Johnfon, London.
Or laftly, by breathing a mixture of one tenth part of hydro-carbo-
nate mixed with comm.on air, according to the difcovery of Mr. Watt,
which has a double advantage in thefe cafes, of diluting the oxygen
of the atmofpheric air, and inducing ficknefs, which increafes pul-
monary abforption, as mentioned below. An atmofphere diluted
with fixed air (carbonic acid) might be readily procured by fetting
tubs of new wort, or fermenting beer, in the parlour and lodging-
room of the patient. For it is not acids floating in the air, but the
•oxygen or acidifying principle, which injures or enlarges pulmonary
iilcers by combining with the purulent matter.

Another cafy m.ethod of adding carbonic acid gas to the air of a
room, would be by means of an apparatus invented by Mr. Watt,
and fold by Bolton and Watt at Birmingham, as defcribed in Dr.
Beddoes' Treatife on Pneumatic Medicine. Johnfon, London. It
confifts of an iron pot, with an arm proje£ting, and a method of let-
ting water drop by flow degrees on chalk, which is to be put into the
iron pot, and expofed to a moderate degree of heat over a common
fire. By occafionally adding more and more chalk, carbonic acid gas
might be carried through a tin pipe from the arm of the iron pot to
any part of the room near the patient, or from an adjoining room. In
the fame manner a diffufion of folution of flowers of zinc might be
produced and breathed by the patient, and would be likely much to
contribute to the healing of pulmonary ulcers ; as obferved by Mr.
Watt. See the treatife above mentioned.

Breathing over the vapour of cauftic volatile alkali might eafily be
managed for many hours in a day ; which might neutralize the acid
poilbn formed on pulmonary ulcers by the conta£l of oxygen, and
thus prevent its deleterious quality, as other acids become lefs cauf-
tic, when they are formed into neutral falts with alkalis. The vola-
VoL.II. . Pp tile

290 DISEASES OF SENSATION. Class 11. 1.6,

tile fait fliould be put into a tin canifier, with two pipes like horns
from the top of it, one to fuck the air from, and the other to adnnit it.

Secondly, the external ulcers in fcrophulous habits are pale and.
flabby, and naturally dliinclined to heal, the oepofition of fluids in
them being greater than the abforptlon ; thefe ulcers have their ap-
pearance immediately changed by the external application of metallic
calxes, and the medicines of the article Sorbentia, fuch as cerufFa and
the bark in fine powder, fee Clafs L 2. 3. 21. and are generally healed
in a fhort time by thefe means. Induced by thefe obfervations, I wiflied
to try the external application of fuch powders to ulcers in the iunes,
and conftrudted a box with a circulating brufli in it, as defcribed in
the annexed plate ; into this box two ounces of fine powder of Peru-
vian bark were put, and two drams of ceruffa in fine powder ; on
whirling the central brufh, part of this was raifed into a cloud of
powder, and the patient, applying his mouth to one of the tin pipes
rifi.ng out of the box, inhaled this powder twice a day into his lungs..
I obferved it did not produce any cough or unealinefs. This patient
was in the lafl flage of confumption, and was foon tired of the expe-
riment, nor have I had fuch patients as I wifhed for the repetition of
it. Perhaps a fine powder of manganefe, or of the flowers of zinc,
or of lapis calaminaris, might be thus applied to ulcers of the lungs
with greater advantage ? Perhaps air impregnated with flowers of
zinc in their moft comminuted flate, might be a better way of apply-
ing this powder to the lungs, as difcovered by Mr. Watt. See Dr.
Beddoes on Pneumatic Medicine. Johnfon.

Thirdly, as the healing of an ulcer confifl:s in producing a tendency,
to abforption on its furface greater than the depofition on it; fee Se6l,
XXXIII. 3. 2. other modes of increafing pulmonary abforption,
which are perhaps more manageable than the preceding ones, may be
had recourfe to ; fuch as by producing frequent naufea or ficknefs.
See Sedt. XXIX. 5, i. and Art. IV. 2. The great and fudden ab-
forption.

Cla/s II. 1.6. J. pa^e 9^0.

TubliJ/i/d by J.Jo/iiison .•i'.Fnii/.f C/unvli Yard Marfh.^iKni^l,,

€lassII. 1.6. DISEASES OF SENSATION. 291^

forption of fluid from the lungs in the anafarca pulmonum by the
ficknefs induced by the exhibition of digitalis, aftoniflies thofe who
have not before attended to it, by emptying the fwelled iimbs, and
removing the difficulty of breathing in a (tw hours.

The mofl: manageable m.ethod of ufing digitalis is by making a fa-
turated tincture of it, by infufing two ounces of the powder of the
leaves in a mixture of four ounces of redified fpirit of wine, and four
ounces of water. Of this from 30 to 60 drops, or upwards, from a
two-ounce phial, are to be taken twice in the morning part of the
day, and to be fo managed as not to induce violent ficknefs. If fick-
nefs neverthelefs comes on, the patient mull: for a day or two omit
the medicine ; and then begin it again in reduced dofes.

Mr. , a young man about twenty, with dark eyes, and large

•pupils, who had every fymptom of pulmonary ulcers, I believed to
have been cured by digitalis, and publiflied the cafe in the Tranfac-
tions of the College, Vol. III. But about two years afterwards I

heard that he relapfed and died. Mr. L , a corpulent man, who

had for fome weeks laboured under a cough with great expedloration,
with quick pulfe, and difficulty of breathing, foon recovered by the
ufe of digitalis taken twice a day ; and though this cafe might probably
be a peripneumonia notha, or catarrh, it is here related as ftiewino-
the power of pulmonary abforption excited by the ufe of this
drug.

Another method of inducing ficknefs, and pulmonary abforption
n\ confequence, is by failing on the fea ; by which many confump-
tive patients have been faid to have received their cure j which has
been erroneoufiy afcribed to fea-air, inftead of fea-ficknefs ', whence
many have been fent to breathe the fea-air on the coafts, who mio^ht
have done better in higher fituations, where the air probably contains
3efs oxygen gas, which is the heaviefl: part of it. See a Letter from
Dr. T. G. below.

A third method of inducing ficknefs, and confequent pulmonary

P p 2 abforption^

292 DISEASES OF SENSATION. Class II. 1.6.

abforptlon, is by the vertigo occafioned by fwinging ; which has
lately been introduced into praftice by Dr. Smith, (Effay on Pulmo-
nary Confumption), who obferved that by fwinging the he£lic puHe
became flower, which is explained in Clafs IV. 2. i. 10. The ufual
way of reciprocating fwinging, lik-e the ofcillations of a pendulum,
produces, a degree of vertigo in thofe, who are unufed to it ; but to
give it greater effeft, the patient fhould be placed in a chair fufpended
from the ceiling by two parallel cords in conta£t with each other, the
chair fhould then be forcibly revolved 20 or 40 times one way, and
fufFered to return fpontaneoufly ; which induces a degree of ficknefs
in moft adult people, and is well worthy an exa£l and pertinacious
trial, for an hour or two, three or four times a day for a month.

The common means of promoting abforption in ulcers, and of
thickening the matter in confequence, by taking the bark and opium
internally, or by metallic falts, as of mercury, fteel, zinc, and cop-
per, in fmall quantities, have been repeatedly ufed in pulmonary
confumption; and may have relieved fome of the fymptoms. As
inercury cures venereal ulcers, and as pulmonary ulcers refcmble
them in their not having a difpofition to heal, and in their tendency
to enlarge themfelves, there were hopes, from analogy, that it might
have fucceeded. Would a folation of gold in aqua regia be worth
trying ? When vinegar is applied to the lips, it renders them inftant-
ly pale, by promoting the venous abforption ; if the whole Ikin vi'as
moiftened with warmifh vinegar, would this promote venous abforp-
tion in the lungs by their fympathy with the Ikin ? The very abfte-
mious diet on milk and vegetables alone is frequently injurious.
Flefti-meat once a day, with fmall wine and water, or fmall beer, is
preferable. Haifa grain of opium twice a day, or a grain, 1 believe
to be of great ufe at the commencement of the difeafe, as appears
from the fubfequent cafe.

Mifs , a delicate young lady, of a confumptive family, when

fhe was about eighteen, had frequent cough, with quick pulfe, a
8 pain

CLASsir. 1.6. DISEASES OF SENSATION. 293

pain of her fide, and the general appearances of a beginning confump-
tion. She took about five drops of laudanum twice a day in a faline
draught, which was increafed gradually to ten. In a few weeks {he
recovered, was afterwards married, bore three or four children, and
then became confumptive and died.

The following cafe of hereditary confumption is related by a phy-
fician of great ability and very extenfive pra£tice ; and, as it is his
own cafe, abounds with much nice obfervation and ufeful knowledge;
and, as it has been attended with a favourable event, may give con-
folation to many, who are in a fimilar fituation ; and fliews that
Sydenham's recommendation of riding as a cure for confumption is
not fo totally ineffedual, as is now commonly believed.

" J. C. aged 27, with black liair, and a ruddy complexion, was
fubje£l to cough from the age of puberty, and occafionally to fpitting
of blood. His maternal grandfather died of confumption under thirty
years of age, and his mother fell a vi£lim to this difeafe, with which
fhe had long been threatened, in her 43d year, and immediately after
(he ceafed to have children. In the fevere winter of 1 783-4, he was
much afflifted with cough ; and being expofed to intenfe cold, in the
month of February he was feized with peripneumony. The difeafe
was violent and dangerous, and after repeated bleedings as well as
blifterings, which he fupported with diiSculty, in about fix weeks
he was able to leave his bed. At this time the cough was fevere,
and the expe(^oration difficult. A fixed pain remained on the left
fide, where an iffue was inferted ; regular hedic came on every day
about an hour after noon, and every night heat and refllefiiiefs took
place, fucceeded towards morning by general perfpiration.

The patient, having formerly been fubjed to ague, was flruck
with the resemblance of the febrile paroxylm, with what he had ex-
perienced under that difeafe, and was willing to flatter himfelf it
might be of the fame nature. He therefore took bark in the interval
of fever, but with an increafe of his cough, and this requiring vene-

feftion.

. 294 DISEASES OF SENSATION. Class 11. r.^.

ffiftion, the blood was found highly iiifiammatoiy. The vaft quan-
tity of blood which he had loft from time to time, produced a difpo-
Ction to fainting, when he refumed the upright pofture, and he was
therefore obliged to remain almoft conftantly in a recumbent pofition.
Attempting to ride out in a carriage, he was furprifed to find that he
could fit upright for a confiderable time, while in motion, without
inconvenience, though, on ftopping the carriage, the difpofition to
fainting returned.

At this time, having prolonged his ride beyond the ufual length,
he one day got into an uneven road at the ufual period of the recur-
rence of the hedic paroxyfms, and that day he miffed it altogether.
This circumftance led him to ride out daily in a carriage at the time
the febrile acceflion might be expe6led, and fometimes by this
'^ means it was prevented, fometimes deferred, and almoft always

mitigated.

This experience determined him to undertake a journey of fome
length, and Brifloi being, as is ufual in fuch cafes, recommended,
. . he fet out on the 19th of April, and arrived there on the 2d of May.

During the greater part of this journey (of 175 miles) his cough was
fevere, and being obliged to be bled three different times on the road,
he was no longer able to fit upright, but at very fliort intervals,
and was obliged to lie at' length in the diagonal of a coach. The
hedic paroxyfms were not interrupted during the journey, but thej
were irregular and indiftind, and the falutary effe£bs of exercife, or
rather of geftation, were impreffed on the patient's mind.

At Briftol he fiayed a month, but reaped no benefit. The weather
was dry and the roads dufty ; the water infipid and inert. He at-
tempted to ride on horfeback on the downs, but was not able to bear
the fatigue for a diftance of more than a hundred yards. The necef-
fity of frequent bleedings kept down his ftrength, and his hedlic pa-
roxyfms continued, though lefs fevere. At this time, fufpeding
ihat his cough was irritated by the weft-winds bearing the vapour

from

CiAss IL I. 6.- DISEASES OF SENSATIO^rv 295:

from the fea, he refolded to try the efFe£ls of an inland iitnation, and
fet.ofFfor Matlock in Derbyfhire.

During the journey he did.not findthe improvement he expefled,
but the nightly perfpirations began to diniinifh ; and the extraordinary
fatigue he experienced proceeded evidently from his travelling in a
poft-chaife, vi'here he could not indulge in a recumbent pofitlon.
The weather at Briftol had been hot, and the earth arid and dufty.
At Matlock, during the month of June 1784, there was almofi: a;
perpetual drizzle, the foil was wet, and the air moid and cold,-
Here, however, the patient's cough began to abate, and at intervals--
be, found. an opportunity, of riding more or lefs on horfeback* From'
two or three hundred yards at a time, he got to ride a mile without*
flopping ; and at length he was able to fit on horfeback during a rid©
from Mafon's Bath to the village of Matlock along the Dervvent, and"
round on the oppofite banks, by the works of Mr. Arkwright, back-
to the houfe whence he flarted, a diftance of five miles. On dif-
mounting, however, he was feized with diliquium, and foon after
the ftrength he had recovered was loft by an attack of the haemorrhoids
of the moft painful kind, and. requiring much lofs of blood from tho
parts affedled,.

On refiedlion, it appeared that .the only benefit received by the pa»
tient was during motion, and continued motion could better be ob-'
tained in thecourfe of a journey than during his refidence at any par-
ticular place. This, and other circuniftances of a private but painful
nature, determined him to fet out from Matlock on a journey to Scot-
land. The weather v/as now much improved, and during the jour-
ney he recruited his ftrength. Though as yet he could not fit up-
right at reft for half an hour together without a difpofition to giddi-
nefs, dimnefs of fight, and deliquium, he was able to fit upright
under the motion of a poft-chaife during a journey of from 40 to 70
miles daily, and his appetite, began to improve. Still his cough con=*
3. ' tinucdjj

296 DISEASES OF SENSATION. Class II. 1.6.

tinned, and his hedlic flufliings, though the chills were much abated
and very irregular.

The falutary efFefts of motion being now more ftriking'than ever,
he purchafed a horfe admirably adapted to a valetudinarian in Dum-
friesfhire, and being now able to fit on horfeback for an hour to-
gether, he rode out feveral times a dayo He fixed his refidence for a
few weeks at Moffat, a village at the foot of the mountains whence
the Tweed, the Clyde, and the Annan, defcend in different direc-
tions ; a fituation inland, dry, and healthy, and elevated about three
hundred feet above the furface of the fea. Here his flrength reco-
vered daily, and he began to eat animal food, which for feveral
months before he had not tafted. Perfevering in exercife on horfe-
back, he gradually increafed the length of his rides, according to his
ftrength, from four to twenty miles a day ; and returning on horfe-
back to Lancafhire by the lakes of Cumberland, he arrived at Liver-
pool on the firfl of September, having rode the laft day of his journey
forty miles.

The two inferences of mofl importance to be drawn from this nar-
rative, are, firft, the extraordinary benefit derived from geflation in
a carriage, and fliU more the mixture of geftation and exercife on
horfeback, in arrefling or mitigating the he6lic paroxyfm ; and fe-
condly, that in the florid confumption, as Dr. Beddoes terms it, an
elevated and inland air is in certain circumflances pecuHarly falutary ;
■while an atmofphere loaded with the fpray of the fea is irritating and
noxious. The benefit derived in this cafe from exercife on horfe-
back, may lead us to doubt whether Sydenham's praife of this re-
medy be as much exaggerated as it has of late been fuppofed. Since
the publication of Dr. C. Smyth on the effefts of fwiiiging in lower-
ing the pulfe in the he6lic paroxyfm, the fubjeil of this narrative has
repeated his experiments in a great variety of cafes, and has con-
£rmed them. He has alfo repeatedly feen the heftic paroxyfm pre-
vented.

Class II. 1.6. DISEASES OF SENSATION. 297

vented, or cut fhort, by external ablution of the naked body with
tepid water.

So much was his power of digeflion impaired or vitiated by the
immenfe evacuations, and the long continued debility he underwent,
that after the cough was removed, and indeed for feveral years after
the period mentioned, he never could eat animal food without heat
and flufhing, with frequent pulfe and extreme drowfinefs. If this
drowfinefs was encouraged, the fever ran high, and he awoke from
difturbed fleep, wearied and deprefled. If it was refolutely refilled
by gentle exercife, it went off in about an hour, as well as the in-
creafed frequency of the pulfe. This agitation was however fuch as
to incapacitate him during the afternoon for fludy of any kind. The
fame effedls did not follow a meal of milk and vegetables, but under
this diet his ftrength did not recruit ; whereas after the ufe of animal
food it recovered rapidly, notwithftanding the inconvenience already
mentioned. For this inconvenience he at laft found a remedy in the
ufe of coffee immediately after dinner, recommended to him by. his
friend Dr. Percival. At firft this remedy operated like a charm, but
by frequent ufe, and indeed by abufe, it no longer pofFeifes its origi-
nal efficacy.

Dr. Falconer, in his Diflertation on the Influence of the Paffions
and Affedions of the Mind on Health and Difeafe, fuppofes that the
cheerfulnefs which attends heftic fever, the ever-fpringing hope,
which brightens the gloom of the confumptive patient, increafes the
difeafed anions, and haftens his doom. And hence he is led to en-
quire, whether the influence of fear might not be fubflituted in fuch
cafes to that of hope with advantage to the patient ? This queftion I
ihall not prefume to anfwer, but it leads me to fay foraething of the
flate of the mind in the cafe juft related.

The patient, being a phyfician, was not ignorant of his dano-er
which fome melancholy circumftances ferved. to imprefs on his mind.
It has already been mentioned, that his mother and grandfather died
Vol. II. Q^q of

298 DISEASES OF SENSATION. Class II. 1.6.

of this difeafe. It maybe added, that in the year preceding that on
which he himfelf was attacked, a fifter of his was carried off by con-
fumptioa in her i 7th year ; that in the fame winter in which he fell
ill, two other fifters were feized with the fame fatal diforder, to
which one of them fell a viftim during his refidence at Briftol, and
that the hope of bidding a lafl adieu to the other was the immediate
caufe of his journey to Scotland, a hope which, alas! was indulged
in vain. The day on which he reached the end of his journey, her
remains were committed to the duft ! It may be conjeftured from
thefe circumftances, that whatever benefit may be derived from the
apprehenlion of death, muft in this cafe have been obtained. The
expeftation of this iffue was indeed for fome time fo fixed that it
ceafed to produce much agitation ; in conformity to that general law
of our nature, by which alraoft all men fubmit with compofure to a
fate that is forefeen, and that appears inevitable. As however the
proo-refs of difeafe and debility feemed to be arrefled, the hope and the
love of life revived, and produced, from time to time, the obferva-
tions and the exertions already mentioned.

Wine and beer were rigoroufly abftained from during fix months
of the above hiftory; and all the blood which was taken was even to
the lafl bufFy." Feb. 3, 1795.

8. Febr'is fcrophulofa. The hectic fever occafioned by ulcers of the
lymphatic glands, when expofed to the air, does not differ from that
attending pulmonary confumption, being accompanied with night-
fweats and occafional diarrhcea.

, M. M. The bark. Opium internally. Externally cerufTa and
bark in fine powder. Bandage. Sea-bathing. See Clafsl. 2. 3. 21.
and 11. 1.4. 12.

9. Febris ifchiadica. A he6lic fever from an open ulcer between
the mufcles of the pelvis, which differs not from the preceding. If

7 the

Class II. 1.6. DISEASES OF SENSATION. , 299

the matter in this fituation lodges till part of it, I fuppofe, becomes
putrid, and aerates the other part ; or till it becomes abforbed from
fome other circumftance ; a fimilar he£lic fever is produced, with
iiight-fweats, or diarrhcEa.

Mrs. , after a lying in, had pain on one fide of her loins,

which extended to the internal part of the thigh on the fame fide.
No flu£luation of matter could be felt ; flie became hedlic with copi-
ous night-fweats, and occafional diarrhoea, for four or five weeks ;
and recovei-ed by, I fuppofe, the total abforption of the matter, and
the reunion of the walls of the abfcefs. See Clafs II. 1.2. 18.

10. Febris Arthropuodlca. Fever from the matter of difeafed joints.
Does the matter from fuppurating bones, which generally has a very
putrid fmell, produce hedic fever, or typhus? See Clafs II. i.
4. 16.

11. Febris a pure contagiofo. Fever from contagious pus. When
the contagious matters have been produced on the external habit, and
in procefs of time become abforbed, a fever is produced in confequence
of this reabforption ; which differs with the previous irritability or in-
irritability, as well as with the fenfibility of the patient.

\z. Febris varioloja fecundaria. Secondary fever of fmall-pox. In
the diftindl fmall-pox the fever is of the fenfitive irritated or inflam-
matory kind ; in the confluent fmall-pox it is of the fenfitive inirri-
tated kind, or typhus gravior. In both of them the fwelling of the
face, when the matter there begins to be abforbed, and of the hands,
when the matter there begins to be abforbed, Ihew, that it flimulates
the capillary veffels or glands, occafioning an increafed fecretion
greater than the abforbents can take up, like- the a£tion of the can-
tharides in a blifter ; now as the application of a blifter on the Ikin
frequently occafions the ftrangury, which fhews, that fome part of

Q^q a the

300 DISEASES OF SENSATION. Class II. 1.6.

the canthaiides is abforbed; there is reafoii to conclude, that a part of
the matter of fmall-pox is abforbed, and thus produces the fecondary
fever. See Clafs II. i, 3. 9. And not fimply by its fcimulus on the
furface of the ulcers beneath the fcabs. The exfudation of a yellow
fluid from beneath the confluent eruptions on the face before the
height is fpoken of in Clafs II. i. 3. 2.

The material thus abforbed in the fecondary fever of fmall-pox dif-
fers from that of open ulcers, as it is only aerated through the elevated
cuticle ; and fecondly, becaufe there is not a conftant fupply of frefli
matter, when that already in the puftules is exhaufted, either by ab-
forption, or by evaporation, or by its induration into a fcab. Might
not the covering the face afliduoufly and exa6tly with plafl:ers, as v/ith
cerate of calamy, or with minium plafter, by precluding the air from
the puftules, prevent their contra£ling a contagious, or acefcent, or
fever-producing power ? and the fecondary fever be thus prevented
entirely. If the matter in thofe puftules on the face in the confluent
fmall-pox were thus prevented from oxygenation, it is highly probable,
both from this theory, and from the fadls before mentioned, that the
matter would not erode the fltin beneath them, and by thefe means
no marks or fears would fucceed.

13. Febris carcinomatofa. Fever from the matter of cancer. In a
late publication the pain is faid to be relieved, and the fever cured,
and the cancer eradicated, by the application of carbonic acid gas, or
fixed air. See Clafs II. 1.4. 16.

14. Febr'is venerea. From the abforption of the matter from vene-
real ulcers and fuppurating bones. See Syphilis, II. i. 5. 2.

M. M. Any mercurial calx. Sarfaparilla ? Mezereon ?

15. Febris a f ante putrida. Fever from putrid fanies. When parts
of the body are deftroyed by external violence, as a bruife, or by mor-
tification,

Cl-assII. 1.(5. " DISEASES OF- SENSATION. :oi

tification, a putrefa<51ion loon fucceeds ; as they are kept in that de-
-gree of warmth and moifture by their adhefion to the living parts of
the bodv, which moft forwards that procefs. Thus the floughs of
mortified parts of the tonfils give fetor to the breath in fome fevers;
the matter from putrefying teeth, or other fuppurating bones, is par-
ticularly offenfive ; and even the fcurf, which adheres to the tongue, .
frequently acquires a bitter tafte from its incipient putridity. This
material differs from thofe before mentioned, as its deleterious property
depends on a chemical rather than an animal procefs,

l6.- Febris puerpera. Puerperal fever. It appears from fome late
diffe^lions, which have been publifhed, of thofe women who have
died of the puerperal fever, that matter has been formed in the omen-
tum, and found in the cavity of the abdomen, with fome blood or
fanies. Thefe parts are fuppofed to have been injured by the exer-
tions accompanying labour ; and as matter in this vifcus may have
been produced without much pain, this difeafe is not attended with
arterial ftrength and hard full pulfe like the inflammation of the ute-
rus ; and as the fever is of the inirritative or typhus kind, there is
reafou to believe, that the previous exhauftion of the patient during
labour may contribute to its produftion j as well as the abforption of
a material not purulent but putrid ; which is formed by the delay of
extravafated or dead matter produced by the bruifes of the omentum,
or other vifcera, in the efforts of parturition, rather than by purulent
matter, the confequence of fuppuration. The pulfe is generally
about I 20 when in bed and in the morning ; and is increafed to 134,
or more, when the patient fits up, or in the evening paroxyfm. The
pulie of all very weak patients increafes in frequency when they fit
up ; becaufe the expenditure of fenforial power neceffary to preferve
an ereft pofture deduds fo much from their general ftrength ; and
hence the pulfe becomes weaker, and in confequence quicker. See
Se6l. XII. 1.4,

In

30^ DISEASES OF SENSATION. Class II. 1.6.

In this fever time muft be allowed for the abforption of the matter.
Very large and repeated quantities of the bark, by preventing fuffici-
ent food from being taken, as bread, and wine, and water, 1 have
thought has much injured the patient ; for the bark is not here given
as in intermittent fevers to prevent the paroxyfm, but fimply to
flrengthen the patient by increafing the power of digeftion. About
two ounces of deco6lion of bark, with four drops of laudanum, and a
dram of fweet fpirit of vitriol, once in fix hours, and a glafs of wine
between thofe times, with panada, or other food, I have thought of
moft advantage, with a fmall blifter occafionally.

Where not only the flomach but alfo the bowels are much diftend-
ed with air, fo as to found on ftriking them with the fingers, the cafe
is always dangerous, generally hopelefs ; which is more fo in propor-
tion to the quicknefs of the pulfe. Where the bowels are diftended
two drops of oil of cinnamon fhould be given in the panada three or
four times a day.

1 7. Febris afphaceh. Fever from mortification. This fever from
abforption of putrid matter is of the inirritative or typhus kind. See
the preceding article.

M. M. Opium and the bark are frequently given in too great quan-
tity, fo as to induce confequent debility, and to opprefs the power of
digeftion.

ORDO

Class 11. i. 7. DISEASES OP SENSATION. 303

ORDO I.

Increafed Senfat'ion.

GENUS VII.
JVith increafed AB'ion of the Organs of Senfe.

SPECIES.

I. Delirium febrile. Paraphrofyne. The ideas in delirium confift
of thofe excited by the fenfation of pleafure or pain, which precedes
them, and the trains of other ideas aflbciated with thefe, and not of
thofe excited by external irritations or by voluntary exertion. Hence
the patients do^ot know the room which they inhabit, or the peo-
ple who furround them ; nor have they any voluntary exertion, where
the delirium is complete ; fo that their efforts in walking about a room ■
or riling from their bed are unfteady, and produced by their catena-
tions with the immediate affedlions of pleafure or pain. See Sedlion
XXXIII. 1.4.

By the above circumftances it is diftinguiflied from madnefs, in
which the patients well know the perfons of their acquaintance, and
the place where they are ; and perform all the voluntary actions with
fleadinefs and determination. See Se£t. XXXIV. 2. 2.

Delirium is fometimes lefs complete, and then a new face and louder
voice ftimulate the patient to attend to them for a few moments; and
then they relapfe again into perfed delirium. At other times a deli-
rium affecls but one fenfe, and the perfon thinks he fees things which
do not exift ; and is at the fame time fenfible to the queftions which
are alked him, and to the tafte of the food which is offered to him.

This

304 DISEASES OF SENSATION. Class II. i. 7.

This partial delirium is termed an hallucination of the difordered
organ ; and may probably arife from the origin of one nerve of fenfe
being more liable to inflammation than the others ; that is, an exube-
rance of the fenforial power of fenfation may affedl it; which is there-
fore thrown into adtion by {lighter fenfitive catenations, without being
obedient to external ftimulus, or to the power of volition.

The perpetual flow of ideas in delirium is owing to the fame clr-
cumftance, as of thofe in our dreams ; namely, to the defeat or pa-
ralyfis of the voluntary power ; as in hemiplagia, when one iide of
the body is paralytic, and thus expends lefs of the fenforial power,
the limbs on the other iide are in conftant motion from the exube-
rance of it. Whence lefs fenforial power is exhaufted in delirium,
than at other times, as well as in. fleep ; and hence in fevers with
great debility, it is perhaps, as well as the ftupor, rather a favourable
circumfiance ; and when removed by numerous blifters, the death of
the patient often follows the recovery of his underftanding. See Clafs
I. 2. 5. 6. and I. 2. 5. 10.

Dehrium in difeafes from inirritability is fometimes preceded by a
propenfity to furprife. See Clafs I. i. 5. 12.

M. M. Fomentations of the fhaved head for an hour repeatedly.
A blifl:er on the head. Rifing from bed. Wine and opium, and
fometimes venefeftion in fmall quantity by cupping, if the ftrength-
of the arterial fyftem will allow it.

2. Delirium maniacale. Maniacal delirium. There is another kind
of delirium, defcribed in Se£t. XXXIH. 1.4. which has the increafe
of pleafureable or painful fenfation for its caufe, without any diminu-
tion of the other fenforial powers r but as this excites the patient to
the exertion of voluntary adions, for the purpofe of obtaining the ob-
jeft of his pleafureable ideas, or avoiding the object of his painful ones,
fuch as perpetual prayer, when it is of the religious kind, it belongs

tO;

Class II. i. 7. ' DISEASES OF SENSATION. 303

to the infanities defcribed In Clafs III. 1.2. i, and is more properly
termed hallucinatio maniacalis.

3. D'tllrium ebrietatls. The drunken delirium is in nothing dif-
ferent from the delirium attending fevers except in its caufe, as from
alcohol, or other poifons. When it is attended with an apople£lic
ftupor, the pulfe is generally low ; and venefedlion I believe fome-
times deftroys thofe, who v^^ould otherwife have recovered in a few
hours.

M. M. Diluting Kquids. An emetic.

4. Somnium. Dreams conflitute the moft complete kind of deli-
rium. As in thefe no external irritations are attended to, and the
power of volition is entirely fufpended ; fo that the fenfations of plea-
fure and pain, with their aflbclations, alone excite the endlefs trains
of our fleeping ideas ; as explained in Sedt. XVIII. on Sleep.

^. Hallucinaiio vifus. Deception of fight. Thefe vifual hallucina-
tions are perpetual in our dreams ; and fometimes precede general de-
lirium in fevers ; and fometimes belong to reverie, and to Infanity.
See Clafs III. 1.2. i. and 2. and muft be treated accordingly.

Other kinds of vifual hallucinations occur by moon-light ; when
objeds are not feen fo diftln6lly as to produce the ufual ideas aflbci-
ated with them, but appear to us exadlly as they are feen. Thus the
trunk of a tree appears a flat furface, inftead of a cylinder as by day,
and we are deceived and alarmed by feeing things as they really are
feen. See Berkley on Vlfion.

6. Hallucinatio auditus. Auricular deception frequently occurs la
dreams, and fometimes precedes general delirium in fevers ; and fome-
times belongs to vertigo, and to reverie, and to infanity. See Se6l.
XX. 7. and Clafs 111. i. 2. i. and 2.

Vol. II. R r 7. Rubor

^o6 DISEASES OF SENSATION, Class IL u 7.

7. Rubor a calore. The blufh from heat is occafioned by, the in-
creafed a6lion of the cutaneous veflels iti confequence of the increafed
feufation of heat. See Clafs I. i. 2. i. and 3.

8. Rubor jucunditatis. The bl\i(h of joy is owing to the increafed
action of the capillary arteries, alpng vyith that of every nnoying veffel
in the body, from the increafe of pleafurable fenfatioa.

9. Priapifmus amatorlus. Amatorial priapifm. The blood is poured
into the cells of the corpora cavernofa much fafter than it can be re-
abforbed by the vena penis, owing in this cafe to the pleafurable {tw-^
fation of love increafing the arterial adion. See Clafs I. i. 4. 6.

10. Dtflent'io mcmmlarum. The teats of female animals, when they
give fuck, become rigid and erected, in the fame manner as in the
laft article, from the pleafurable fenfatioa of the love of the mother
to her offspring. Whence the teat may properly be called an orgau
of fenfe. The nipples of men do the fame when rubbed with the
hand. See Clafs I. i. 4. 7.

ORDO

Glass 11. 2.1. DISEASES OF SENSATION. 307

6'RE)6 ii.

Decreafed Senfatton.

GENUS 1.

Of the General Syjlem.

SPECIES.

1. Stultlt'ta infenfibilis. Folly from infenfibility. The pleafure or
pain generated in the fyftem is not fufficient to promote the ufual ac-
tivity either of the fenfual or mufcular fibres.

2. Taediumvitce. Ennui. Irkfomenefs of life. The pain of lazinefs
has been thought by fome philofophersto be that principle of adion,
which has excited all our induftry, and diftinguifhed mankind from
the brutes of the field. It is certain that, where the ennui exifls, It is
relieved by the exertions of our minds or bodies, as all other painful
fenfations are relieved j but it depends much upon our early habits,
whether we become patient of lazinefs, or inclined to aftivity, during
the remainder of our lives, as other animals do not appear to be af-
fedted with this malady ; which is perhaps lefs owing to deficiency of
pleafurable fenfation, than to the fuperabundancy of voluntary power,,
which occafions pain in the mufcles by its accumulation ; as appears
from the perpetual motions of a fquirrel confined in a cage.

3. Parejtsfen/ttiva, Weaknefs of the whole fyflem from infenfi-
bility.

Rr2 ORDO

3o8 DISEASES OF SENSATION. Class II. a. 2,

ORDO II.

Decreafed Senfatlon,

GENUS II.

Of Particular Organs.

SPECIES.

I. Anorexia. Want of appetite. Some elderly people, and thole
debilitated by fermented liquors, are liable to lofe their appetite for
animal food ; which is probably in part owing to the deficiency of
gaftric acid, as well as to the general decay of the fyftem : elderly
people will go on years without animal food; but inebriates foon fink,
when their digeftion becomes fo far impaired. Want of appetite is
fometimes produced by the putrid matter from many decaying teeth
being perpetually mixed with the faliva, and thence alFedting the
organ of tafte, and greatly injuring the digeftion.

M. M. Fine charcoal powder diffufed in warm water held in the
mouth frequently in a day, as in Clafs I. 1.4. 4. or folution of
alum in water. Extraft the decayed teeth. An emetic. A blifter.
Chalybeates. Vitriolic acid. Bile of an ox infpiffated, and made into
pills ; 20 grains to be talcen before dinner and fupper. Opium half a
grain twice a day.

Ail the ftrength we poflefs is ultimately derived from the
food, which we are able to digeft ; whence a total debility of
the fyftem frequently follows the want of appetite, and of the

power

Class II. 2. 2. DISEASES OF SENSATION. 309

power of digeftion. Some young ladies I have obferved fo fall
into this general debility, fo as but juft to be able to walk about j
which I have fometimes afcribed to their voluntary fafting, when
they believed themfelves too plump ; and who have thus loft both
their health and beauty by too great abftinence, which could never
be reftored.

I have feen other cafes of what may be termed anorexia epi-
leptica, in which a total lofs of appetite, and of the power of
digeftion, fuddenly occurred along with epileptic fits. Mifs B. a
girl about eighteen, apparently very healthy, and rather plump, was
feized with fits, which were at firft called hyfterical ; they occurred
at the end of menftruation, and returned very frequently with total
lofs of appetite. She was relieved by venefeftion, blifters, and opi-
ates ; her ftrength diminiftied, and after fome returns of the fits,
Ihe took to her bed, and has furvived 15 or 20 years j (he has ia
general eaten half a potato a day, and feldom fpeaks, but retains
her fenfes, and had many years occafional returns of convulfion.
I have feen two fimilar cafes, where the anorexia, or want of
appetite, v/as in lefs degree ; and but juft fo much food could
be digefted, as fupplied them with fufficient ftrength to keep from
the bed or fofa for half the day. As well as I can recolledl:, all
thefe patients were attended with weak pulfe, and cold pale fkin ;
and received benefit by opium, from a quarter of a grain to a grain
four times a day. See Clafs III. i. i. 7. and III. i. 2. i. and
III. I. 2. 20.

2. Adipjia. Want of thirft. Several of the inferior people, as
farmers wives, have a habit of not drinking with their dinner
at all, or only take a fpoonful or two of ale after it. I have
frequently obferved thefe to labour under bad digeftion, and debi-
lity in confequence ; which I have afcribed to the too great ftimulus

of

3IO ■'- DISEASES OF SENSATION. Class II. 2. 2.

of folid food undiluted, deftroylng in procefs of tiijie the irritability of
the flomach.

3. Impotentia (agenefia). Impotency much feldomer happens to the
male fax than fterility to the female fex. Sometimes a temporary
impotence occurs from bafhfulnefs, or the interference of fome vo-
luntary exertion in the produ£lion of an efFeft, which fhould be per-
formed alone by pleafurable fenfation.

One, who was foon to be married to a lady of fuperior condition
to his own, exprefled fear of not fucceeding on the wedding night ;
he was advifed to take a grain of opium before he went to bed,
and to accuftom himfelf to fleep with a woman previoufly, but
not to enjoy her, to take off his bafhfulnefs ; which fucceeded to
his wifh.

M. M. Chalybeates. Opium. Bark. Tin6ture of cantharides.

4. Stenlitas. Barrennefs. One of the ancient medical writers
afferts, that the female fex become pregnant with moft certainty
at or near the time of menftruation. This is not improbable, fince
thefe monthly periods' feem to referable the monthly venereal or-
gafm of fome female quadrupeds, which become pregnant at thofe
times only ; and hence the computation of pregnancy is not often
erroneous, though taken from the laft menftruation. Sec Se6tion
XXXVI. 7.. 3.

M. M. Opium a grain every night. Chalybeates in very fmall dofes.
Bark. Sea-bathins;.

w

5. Infenjibihtas w'tuum. As in fome paralytic limbs. A great
inlenlibility fometiraes accompanies the torpor of the Ikin in cold

fits

Class II. 3.2. DISEASES OF SENSATION. ^ti

fits of agues. Sotn'e parts have retained the feiife of heat, but not
the fenie of touch. See Sed. XVI. 6,

M.. M. Friaiou with flannel. A blifter. Warrtith.

6. Dy fur'ia tnjenjitwa. Infenfability of the bladder. A dafficul'ty
or total inability tO; make water atteiads fome fevers with great debit-
lity, owing to the infenfibility or inirritability of the bladder. This
is a dangerous but not always a fatal lymptom.

M. M. Draw off the water with a catheter. Aflifl: the patient'
in the exclufion of it by compreffing the lower parts of the abdomen
with the hands. Wine two ounces, Peruvian bark one dram in
decoftion^ every three hours alternately. Balfam of copaiva. Oil
of almonds, with as much camphor as can be dilTolved in it, ap-
plied as a liniment rubbed on the region of the bladder and peri-
neeum, and repeated every four hours, was ufed in this difeafe with
fuccefs by Mr, Tatham. Med. Comment. 1791, p. 213.

7. Accumulatio alv'ina. An accumulation of feces in the reiTtum,
occafioned by the torpor, or infenfibility, of that bowel. But as
liquids pafs by thefe accumulations, it differs from the conftipatio
alvi, which is owing to too great abforptlon of the alimentary
canal.

Old milk, and efpecially when boiled, is liable to induce this
kind of coftivenels in fome grown perfons ; which is probably owing
to their not poileffing fufficient gaftric acid to curdle and digeft it ;
for as both thefe procefles require gaftric acid, it follows, that a
greater quantity of it is neceffary, than in the digeftion of other ali-
ments, which do not previoufly require being curdled. This ill
digefted milk not fufficiently ftimulating the redtum, remains till it
becomes a too folid mafs. On this account milk feldom agrees with
thole, who are fubjedl to piles, by inducing coftivenefs and large
flools.

8 M.M. Extraa

312 DISEASES OF SENSATION. Class II. 2. 2.

M. M. ExtracSt the hardened fcybala by means of a marrow-fpoon ;
or by a piece of wire, or of whale-bone bent into a bow, and intro-
duced. Injedlions of oil. Caftor oil, or oil of almonds, taken by the
mouth. A large clyfter of fmoak of tobacco. Six grains of rhubarb
taken every night for many months. Aloes. An endeavour to
eftablifh a habit of evacuation at a certain hour daily. See Clafs I.

ORDO

Class II. 3. i. DISEASES OF SENSATION. 313

OR DO III.

Retrograde Senjit'tve Motions.

GENUS I.
Of 'Excretory DuSis,

The retrograde aftion of the cefophagus in ruminating animals,
when they bring up the food from their firft ftomach for the purpofe
of a fecond maftication of it, may probably be caufed by agreeable
fenfation ; fimiiar to that which induces them to fwallovv it both be-
fore and after this fecond maflication ; and then this retrograde a£lion
properly belongs to this place, and is erroneoufly put at the head of
the order of irritative retrograde motions. Clafs 1. 3. i. i.

SPECIES.

I. Ureterum motus retrogre/fus. When a ftone has advanced intO'
the ureter from the pelvis of the kidney, it is fometimes liable to be
returned by the retrograde motion of that canal, and the patient ob-
tains fallacious eafe, till the ftone is again pufhed into the ureter.

2.. Urethra motus retrogrejjus. There have been inftances of bou-
gies being carried up the urethra into the bladder mod: probably by
an inverted motion of this canal ; for which fome hav-e undergone an
operation fimiiar to that for the extradion of a ftone.. A cafe is re-
lated in fome medical publication, in which a catgut bougie was car-
ried into the bladder, and after remaining many weeks, was voided

Vol. 1L S.f. giece—

3 14 DISEASES OF SENSATION. ClassILj. i.

piece-meal iii a femi-diffolved ftate. Another cafe is related of a
French officer, who ufed a leaden bougie ; which at length found its
way into the bladder, and w^s, by injeding crude mercury, amalga-
mated and voided.

In the fame manner the infe£lion from a fimple gonorrhoea is pro-
bably carried further along the courfe of the urethra ; and fmall ftones
frequently defcend fome way into the urethra, and are again carried
up into the bladder by the inverted action of this canal.

^. Du£ius ehokdochl motus retrogrejfus. The concretions of bile,
called gall-flones, frequently enter the bile-dud, and give violent
pain for fome hours ; and return again into the gall-bladder, by the
retrograde adion of this dud. May not oil be carried up this dud,
when a gall-flone gives great pain, by its retrograde fpafmodic adion?
See Clafs I. 1.3. 8.

M, M. Opium a grain and half.

tJje

Class III. DISEASES OF VOLITION. 31 j

llje Orders a?id Genera of the Third Clafs of Difeafes.

CLASS m.

DISEASES OF VOLITION.

OR DO L

Increafed Volition,

GENERA.

1. With increafed adlions of the mufcles.

2. With increafed aflions of the organs of fenfe,

ORDO II.

Decreafed Volition.

GENERA.

1. With decreafed adlions of the mufcles,

2. With decreafed adions of the organs of fenfa

S f 2 The

it6

DISEASES OP VOLITION. CtAss III, 1. 1.

The Orders^ Ge7iera^ a?id Species, of the Third Clafi

of Dfeafes.

GLASS III.

DISEASES OF VOLITION.

ORDO I.

Increafed VoUtioti.

GENUS I.

With Increafed Anions of the Mufcleu

SPECIES.

1. faElitatiQ.

2. 'Tremor febrilis,

3. Clamor*

4. Kifus.

5. Convulfio.
debilis.

6, dolorifca,

7. Epilepfia.

8. dolor if c a.

9. Somnambulifnus.

10. Afthma convulfvum.

1 1 , __.=_=, dolor if aim.

Reftleffnefs.
Febrile trembling.
Screaming.
Laughter.
Convulfion.

weak,
painful.

Epilepfy.

■ painful.

Sleep-walking.
Afthma convulfive.
painful.

12. Stridor

Class III. 1,3. DISEASES OF VOLITION.

1 2, Stridor dentium.
j^. 'Tetanus trifmus.

14, — . dolortficus.

15. Hydrophobia.

Gnafhing of the teeth.
Cramp of the jaw.

— painful.

Dread of water.

sn

GENUS II.

With increafed ASiions of the Organs of Senfe,

SPECIES.

1. Mania mutabilis,

2. Studium inane.

3- J^igili<^'

4. Erotomania.

5. Amor fui.

6. Nojialgia.

7. Spes religiofa.

8. Superbiajlemmatis,

9. Ambitio.

10. Mceror.

1 1 . "Tixdium vita.

1 2. Dejiderium pulchritudinis,

13. Pauper tatis timor.

14. Let hi timor,

15. Orci timor,

16. Satyr iajisf,

17. Ira.

18. Rabies.

19. C;V/^2.

Mutable madnefs.
Reverie.
Watchfulnefs.
Sentimental love.
Vanity.

Defire of home.
Supeftitious hope.
Pride of family.
Ambition.
Grief.

Irkfomenefs of life,
Lrofs of beauty.
Fear of poverty.
■ of death.

of hell.

Luft.

Anger.

Rage.

Depraved appetite.

20. Cacojitiat

;i8

DISEASES OF VOLITION. Class III. 2.1.

20.. Cacojltla,

21.

24.

?5'

Syphilis imaginaria,
Pfora tmaginaria.
Tabes imaginaria.
Sympathia aliena.
Educatio heroica.

Averfion to food.
Imaginary pox*

itch.

tabes.

Pity.

Heroic education.

ORDO II.

Decreajed Fo lit ion.

GENUS I.
JVith decreafed ABions of the Mufcies,

SPECIES.

I.

Laffitudo.

Fatigue.

Vacillatio fenilis.

See-faw of old age.

3-

Tremor fenilis.

Tremor of old age.

4.

Brachionim paralyjts.

Palfy of the arms.

5-

Raiicedo paralytica.

Paralytic hoarfenefs.

6.

Fejicce urinaria par alyjis.

Palfy of the bladder.

Re£li paralyjts.

Palfy of the reftum.

8.

Pare/is voluntaria.

Voluntary debility.

9-

Catalepfis,

Catalepfy.

10.

Hemiplegia.

Palfy of one fide.

II.

Paraplegia,

Palfy of the lower limbs.

12.

Somnus.

Sleep.

13-

Incubus.

Night- mare.

[4. Lethargus.

Class III. 2. 3. DISEASES OF VOLITION.

14. Lethargus.

15. Syncope epilepti&a.

16. Apoplexia.

I 7. Mors afngare^

Lethargy.
Epileptic fainting.
Apoplexy.
Death from cold.

3'9

GENUS II.
With decreafed Anions of the Organs of Senfe.

1. RecolleBionis ja&ura.

2. Stultitia voluntaria.

3. Credulitas,

SPECIES.

Lofs of recolle£tion»
Voluntary folly.
Credulity.

CLAS

Class III. i.i. DISEASES OF VOLITION, 321

*

CLASS III.

DISEASES OF VOLITION.

ORDO L

Increafed Volition.

GENUS I.

Increafed A£lions of the Mufcks.

We now flep forward to confider the difeafes of volition, that fu-
perior faculty of the fenforium, which gives us the power of reafon,
and by its facility of action diftinguifhes mankind from brute animals ;
which has efFedled all that is great in the world, and fuperimpofed the
works of art on the fituations of nature.

Pain is introduced into the fyftem either by excefs or defedl of the
a£tion of the part. (Se£l. IV. 5.) Both which circumftances feem
to originate from the accumulation of fenforial power in the afFedled
organ. Thus when the flcin is expofed to great cold, the aflivity of
the cutaneous veffels is diminished, and in confequence an accumula-
tion of fenforial power obtains in them, becaufe they are ufually ex-
cited into inceffant motion by the flimulus of heat, as explained iia
Se£l. XII. 5. 2. Contrarywife, when the veJTels of the (kin are ex-
pofed to great heat, an excefs of fenforial power is alfo produced in
them, which is derived thither by the increafe of flimulus above what
is natural.

This accounts for the relief which is received in all kinds of pain

by any violent exertions of our mufcles or organs of fenfe ; which may
Vol. II. ^ J. . . j.^^^

323 DISEASES OF VOLITION. Class III. i. r..

thus be in part afcribed to the exhauftion of the fenforial power by
fuch exertions. But this relief is in many cafes fo inftantaneous, that
it feems neverthelefs probable, that it is alfo in part owing to the dif-
ferent manner of progreflion of the two fenforial powers of fenfatioti^
and volition ; one of them commencing at fome extremity of the fen-
forium, and being propagated towards the central parts of it ; and
the other commencing in the cential parts of the fenforium, and
being propagated towards the extremities of it ; as mentioned in Se6t.
XL 2.1.

Thefe violent voluntary exertions of our mufcles or ideas to relieve
the fenfation of pain conftitute convulfions and madnefs ; and are dif-
tingiiifhed from the mufcular aftions owing to increafed fenfation, as
in fneezing^ or coughing, or parturition, or ejedtio feminis, becaufe
they do not contribute to diflodge the caufe, but only to prevent the
fenfation of it. In two cafes of parturition, both of young womea
with their firfl child, I have feen general convullions occur from ex-
Gefs of voluntary exertion, as above defcribed, inftead, of the aftions
of particular mufcles, which ought to have been excited by fenfation^
for the exclufion of the fetus. They both became infenfible, and,
died after fome hours ; from one of them the fetus was extracted iu*
vain. I have heard alfo of general convulfions being excited inflead of;
the a£lions of the mufculi. acceleratores in the ejedio feminism which
terminated fatally. See Clafs III. 1.1.7.

Thefe violent exertions are moll: frequently excited in confequenec
of thofe pains,, which originate from defeft of the adion. of the part.
See Seel. XXXIV. i. and 2. The pains from excefs and defedl of the.
aftion of the part are diftinguifhable from each other by the former
being attended with increafe of heat in the pained part, or of the
whole body J while the latter not only exift without increafe of heat
in the pained part, but are generally attended with coldnefs of the ex-
tremities of the body.

As fooii as thefe violent adions of our mufculai^ or fenfual fibres

for

Class III. i. i. DISEASES OF VOLITION.

3^1

for the purpofe of relieving pain ceafe to be exerted, the pain recurs ;
whence the reciprocal contraftion and relaxation of the mufcles in con-
vulfion, and the intervals of madnefj. Otherwife thefe violent ex-
ertions continue, till fo great a part of the fenforial power is exhauft-
ed, that no more of it is excitable by the faculty of volition ; and a
temporary apoplexy fucceeds, with fnoring as in profound deep ;
which fo generally terminates epileptic fits.

When thefe voluntary exertions become fo connected with certain
difagreeable fenfations, or with irritations, that the effort of the will
cannot retrain them, they can no longer m common language be
termed voluntary; but neverthelefs belong to this clafs, as they are
produced by excefs of volition, and may ftill not improperly be
called depraved voluntary adions. See Se£t. XXXI V. i. where many
motions in common language termed involuntary are fhewn to de-
pend on excefs of volition.

When thefe exertions from excefs of volition, which in common
language are termed involuntary motions, either of mind or body, are
perpetually exerted in weak conflitutions, the pulfe becomes quick ;
which is occafioned by the too great expenditure of the fenforial
.power in thefe unceafing modes of activity. In the fame manner as
in very weak people in fevers, the pulfe femetimes increafes in fre-
■quency to i4oflrokes in a minute, when the patients {land up or
endeavour to walk ; and fubfides to i lo, when they lie down again
in their beds. Whence it appears, that when a very quick pulfe ac-
companies convuifion or infanity, it limply indicates the weakn^fs of
the patient ; that is, that the expenditure of fenforial power is too
great for the fupply of it. But if the (Irength of the patient is not
previoufly exhaufted, the exertions of the mufcles are attended with
temporary increafe of circulation, the reciprocal fwellings and elonga-
tions of their bellies pufh forwards the arterial blood, and promote the
abforption of the venous blood ; whence a temporary iiKreafe of fecre-
tion and of heat, and a flronger pulfe.

T t 2 SPECIES.

324 DISEASES OF VOLITION. Class III. i. i.

SPECIES.

I. Jaiiitat'io, Reftleffnefs. There is one kind of reftleffnefs at-
tending fevers, which confifts in a frequent change of pofture to re-
lieve the uneafinefs of the preffure of one part of the body upon an-
other, when the fenfibility of the fyftem, or of fome parts of it, is
increafed by inflammation, as in the lumbago ; which may fometimes
be diftinguifhed in its early ftage by the inceffant defire of the patient
to turn himfelf in bed. But there is another reftleffnefs, which ap-
proaches towards writhing or contortions of the body, which is a
voluntary effort to relieve pain ; and may be efteemed a (lighter
kind of convulfion, not totally unreftrainable by oppofite'or counter-
afting volitions.

M. M. A blifter. Opium. Warm bath.

2. Tremor febrHis. Reciprocal convulfions of the fubcutaneous
mufcles, originating from the pain of the fenfe of heat, owing to de-
feat of its ufual ftimulus, and confequent accumulation of fenforial
povver in it. The aftual deficiency of heat may exift in one part of
the body, and the pain of cold be felt moft vividly in fome other part
affociated with it by fenfitive fympathy. So a chillnefs down the
back is firft attended to in ague-fits, though the difeafe perhaps com-
mences with the torpor and confequent . coldnefs of fome internal
vifcus. But in whatever part of the fyftem the defe£l of heat exifts,
or the fenfation of it, the convulfions of the fubcutaneous mufcles
exerted to relieve it are very general ; and, if the pain is flill greater,
a chattering of the teeth is added, the more fuddenly to exhauft the
fenforial power, and becaufe the teeth are very fenfible to cold.

Thefe convulfive motions are neverthelefs reftrainable by violent
voluntary counteradion ; and as their intervals are owing to the pain

of

Class III. i. i. DISEASES OF VOLITION. 325

of cold being for a time relieved by their exertion, they may be com-
pared to laughter, except that there is no interval of pleafure pre-
ceding each moment of pain ia this as in the latter.
M. M. See I. 2. 2. i.

3. Clamor. Screaming from pain. The talkative animals, as
dogs, and Avine, and children, fcream mofl, when they are in pain,
and even from fear;, as they have ufed this kind of exertion from
their birth moft frequently and moft forcibly ; and can therefore
fooner exhauft the accumulation of fenforial power in the afFefted
mufcular or fenfual organs by this mode of exertion; as defcribed in
Sedt. XXXI v. I. 3. This facility of relieving pain by fcreaming is
the fource of laughter, as explained below.

4. Rifus. The pleafurable fenfations, which occafion laughter, are
perpetually paffing into the bounds of pain ; for pleafure and pain are
often produced by different degrees of the fame ftimulus ; as warmth,
light, aromatic or volatile odours, become painful by their excefs ;
and the tickling on the foles of the feet in children is a painful fenfa-
tion at the very time it produces laughter. When the pleafurable
ideas, which excite us to laugh, pafs into pain, we ufe fome exertion,
as a fcream, to relieve the pain, but foon flop it again, as we are un-
willing to lofe the pleafure ; and thus we repeatedly begin to fcream,
and ftop again alternately. So. that in laughing there are three ftages,
firft of pleafure, then pain, then an exertion to relieve that pain. See
Sea. XXXIV. 1.3.

Every one has been in a fituation, where fome ludicrous circum-
ftance has excited him to laugh ; and at the fame time a fenfe of de-
corum has forbid the exertion of thefe interrupted fcreams ; and then
the pain has become fo violent, as to occafion him to ufe fome other
great aftion, as biting his tongue, and pinching himfelf, in lieu of the
reiterated fcreams which conftitute laughter.

O'

5. Convuljio,

326 DISEASES OF VOLITION. Class III. i.i.

5. Convulfio, Convulfion. When the pains From defe£l or excefs
of motion are more diftreffing than thofe already defcribed, and are
not relievable by fuch partial exertions, as in fcreaming, or laughter,
more general convullions occur ; which vary perhaps according to the
fituation of the pained part, or to fome previous afTociations formed b}'-
the early habits of life. When thefe convuliive motions bend the
body forwards, they are termed emprofthotonoi^ when they bend it
backward, they are termed opifthotonoi. They frequently fucceed
each other, but the opifthotonoi are generally more violent ; as the
mufcles, which erefc the body, and keep it eredl, are naturally in
more conftant and more forcible adion than their antagonifts.

The caufes of convuhion are very numerous, as from toothing in
children, from worms or acidity in their bowels, from eruption of
the diftind fmall-pox, and laftly, from breathing too long the air of
an unventilated bed-room. Sir G. Baker, in the Tranfadions of the
College, defcribed this difeafe, and deteded its caufe ; where many
children in an orphan-houfe were crowded together in one chamber
without a chimney, and were almofl all of them afFedted with con-
vulfion ; in the hofpital at Dublin, many died of convulfions before
the real caufe was underilood. See Dr. Beddoes's Guide to Self-pre-
fervation. In a large family, which I attended, where many female
fervants flept in one room, which they had contrived to render inac-
ceffible to every blaft of air ; I faw four who were thus feized with
convulfions, and who were believed to have been afFefted by fym-
pathy from the firft who fell ill. They were removed into more
airy apartments, but were fome weeks before they all regained their
perfedt health.

Convulfion is diftinguifhed from epilepfy, as the patient does not
intirely lofe all perception during the paroxyfm. Which only fhews,
that a lefs exhauftion of fenforial power renders tolerable the pain-s
which caufe convulfioii, than thofe which ^caufe epilepfy. The hy-
:ileric convulfions are diftinguifhed from thofe, owing to other caufes,

.3 i^y

ClassIII. I. T. DISEASES OF VOLITION. 327

by the prefence of the expedation of death, which precedes and fuc-
ceeds them, and generally by a flow of pale urine ; thefe convulfions
do not conflantly attend the hyfteric difeafe, but are occaiionally fu-
perinduced by the dlfagreeable fenfation arifing from the torpor or in-
verfion of a part of the alimentary canal. Whence the convulfioii
of laughter is frequently fufficient to reftrain thefe hyfteric pains,
which accounts for the fits of laughter frequently attendant on this
4ifeafe.

M. M. To remove the peculiar pain which excites the convulfions.
Venefeftion. An emetic. A cathartic with calomel. Warm-bath.
Opium in large quantities, beginning with fmaller ones. Mercurial
friiStions,. Ele£l-ricity. Cold-bath in the paroxyfm ; or cold afper-
iion. See Memoirs of Med. Society, Lon.. V. 3* p. 147. a paper by
Dr. Currie.

Convuljto debills. The convulfions of dying animals, as of thofe
which are bleeding to death in the flaughter-houfe, are an effort to
relieve painful fenfation, either of the wound which occafions their
death, or of faintuefs from want of due dlftention of the blood-veflels.
Similar to this in a lefs degree is the fubfultus tendinum, or flarting of
the tendons, in fevers with debility; thefe aflions of the mufcles are
too weak to move the limb, but the belly of the acting mufcles is
leen to fwell, and the tendon to be ftretched. Thefe weak convul-
fions, as they are occafioned by the difagreeable fenfation of faintnefs
from inanition, are fymptoms of great general debility, and thence
frequently precede the general convulfions of the adl of dying. See a
cafe of convulfion of a mufcle of the arm, and of the fore-arm, with-
out moving the bones to which they were attached, Sedl, XVII. i. 8,
See twitchings of the face, Clafs IV. 3. 2. 2.

6, Convuljio dolor'tfca, Raphanla. Painful convulfion* In this
difeafe the mufcles of the arras and legs are exerted to relieve the

pains

328 DISEASES OF VOLITION. ClassIII. i. i.

pains left after the rheumatifm in young and delicate people ; it re-
curs once or twice a-day, and has been miftaken for the chorea, or
St. Vitus's dance ; but differs from it, as the undue motions in that
difeafe only occur, when the patient endeavours to exert the natural
ones ; are not attended with pain ; and ceafe, when he lies down
:without trying to move : the chorea, or dance of St. Vitus, is often
introduced by the itch, this by the rheumatifm.

It has alfo been improperly called nervous rheumatifm ; but is dif-
tinguiftied from rheumatifm, as the pains recur by .periods once or
twice a day ; whereas in the chronic rheumatifm they only occur on
moving the afFeded mufcles. And by the warmth of a bed the pains
of the chronic rheumatifm are increafed, as the mufcles or membranes
then become more fenfible to the ftimulus of the extraneous muca-
ginous material depofited under them. Whereas the pains of the ra-
phania, or painful convulfion, commence with coldnefs of the
part, or of the extremities. See Rheumatifmus chronicus, Clafs I,

I. 3. 12.

The pains which accompany the contractions of the mufcles in
this difeafe, feem to-arife from the too great violence of thofe con-
tractions, as happens in the cramp of the calf of the leg ; from which
they differ in thofe being fixed, and thefe being reiterated contradlions.
Thus thefe convulfions are generally of the lower limbs, and recur at
periodical times from fome uneafy fenfation from defe£l of action, like
other periodic difeafes ; and the convulfions of the limbs relieve the
original uneafy painful fenfation, and then produce a greater pain
from their own too vehement contradlions. There is however an-
other way of accounting for thefe pains, when they fucceed the acute
rheumatifm; and that is by the coagulable lymph, which may be
left ftill unabforbed on the membranes ; and which may be in too
fmall quantity to affe£t them with pain in common mufcular exertions,
but may produce great pain, when the bellies of the mufcles fwell to
a larger bulk in violent action.

4 ' ' M. M. Vene-

Class III. i. r. DISEASES OF VOLITION. " 529

M. M. Venefedtion. Calomel. Opium. Bark. One grain 6f
Calomel and one of opium for ten fucceifive nights. A bandage fpread
with emplaftrum de minio put tight on the affe6led part.

7. JLp'tlepfia is originally induced, like other convulfions, by a volun-
tary exertion to relieve fome pain. This pain is mofi: frequently
about the pit of the ftomach, or termination of the bile-dud ; and in
lome cafes the torpor of the ftomach, which probably occafioned the
epileptic fits, remains afterwards, and produces a chronical anorexia;
of which a cafe is related in Clafs II. 2. 2. i. There are inftances of
its beginning in -the heel, of which a cafe is puWiflied by Dr. Short,
in the Med. Eflays, Edinb. I once faw a child about ten years old,
who frequently fell down in convulfions, as (lie v\'as running about
in play; on examination a wart was found on one ancle, which was
ragged and inflamed ; which was diredled to be cut off, and the fits
never recurred.

When epilepfy firfl: commences, the patients are liable to utter one
fcream before they fall down ; afterwards the convulfions fo immedi-
ately follow the pain, which occafions them, that the patient does not
recoUeit or feem fenfible of the preceding pain. Thus in laughter,
when it is not exceffive, a perfon is not confcious of the pain, which
fo often recurs, and caufes the fucceflive fcreams or exertions of
laughter, which give a temporary relief to it.

Epileptic fits frequently recur in fleep from the increafe of fenfibi-
lity at that time, explained in Sedl. XVIII. 14. \\\ two fuch cafes,
both of young women, one grain of opium given at night, and con-
tinued many months, had fuccefs ; in one of them the opium was
omitted twice at difi-erent times, and the fit recurred on both the
nights. In the more violent cafe, defcribed in Se6l. XVIII. 15, opiurrl
had no efi-ecl, "^

Epileptic fits generally commence with fetting the teeth, by which
means the tongue is frequently wounded ; and with rolling the eye-
balls in every kind of diredion ; for the mufcles which fufpend the
Vol. II. U u jaw.

330 - DISEASES OF VOLITION, Cla^ss IIL i. i.

jaw, as well as thofe which move the eyes, are in perpetual motioa
during our waking hours; and yet continue fubfervient to voli-
tion ; hence their more facile and forcible a£lions for the purpafe
of relieving pain by the exhauflioa of fenforial power. See Seftiou
:XXXIV. 1.4.

Epileptic convulfions are not attended with the fear of death, as in
the hyfteric difeafe, and the urine is of a ftraw colour. However it
muft be noted, that the difagreeable fenfations in hyfleric difeafes
fometimes are the caule of true epileptic convulfions, of lyncope, and
of madnefs.

The pain, which occafions fome fits of epilepfy, is felt for a time
in a dlflant part of the fyftem, as in a toe or heel ; and is faid by the
patient gradually to afcend to the head, before the general convullions
commence. This afcending lenfation has been called aura epileptica,
and is faid to have been prevented from affefting the head by a tight
bandage round the limb. In this malady the pain, probably of fome
torpid membrane, or difeafed tendon, is at firft only fo great as to in-
-duce flight fpafms of the mufcular fibres in its vicinity ; which flight
fpafms ceafe on the numbnefs introduced by a tight bandage; when
no bandage is applied, the pain gradually increafes, till generally con-
vulfions are exerted to relieve it. The courfe of a lymphatic, as when
poifonous matter is abforbed ; or of a nerve, as in the fciatica, may,
by the fympathy exifting between their extremities and origins, give
aa idea of the afcent of an aura or vapour.

In difficult parturition it fometimes happens, that general convul-
fions are excited ro relieve the pain of labour, infl:ead of the exertions
of thofe mufcles of the abdomen and diaphragm, which ought to for-
ward the exclufion of the child. See Clafs III, 1,1. That is, in-
ftead of ^he particular mufcular adtions, which ought to be excited by
fenfation'ito remove the offending caufe, general convulfions are pro-
duced b/ the povv'er of volition, which ftill the pain, as in common
epilepfy, without removing the caufe ; and, as the parturition is not
thus promoted, the convulfions continue, till the fenforial power is
8 totally

Class III. r. I. DISEASES OF VOLITION. 331

totally exhaufled, that is, till death. In patients affli(5ted with epi-
lepfy from other caufes, I have feen the moft violent convulfiohs recur
frequently during pregnancy without niifcarriage, as they did not tend
to forward the exclufion of the fetus.

M. M. Venefe£tion. A large dofe of opium. Delivery.

The later in life epileptic fits are firft experienced, the more dan-
gerous they in ay be efteemed in general ; as in thefe cafes the caufe
has generally been acquired by the habits of the patient, or by the de-
cay of fome part, and is thus probably in an increafing flate. Where-
as in children the changes in the fyftem, as they advance to puberty,
fometimes removes the caufe. So in toothing, fits of convulfion with
flupor frequently occur, and ceafe when the tooth advances ; but

this is not to be expefted in advanced life. Sir , about fixty

years of age, had only three teeth left in his upper jaw, a canine
tooth, and one on each fide of it. He was feized with epileptic fits,
with pain commencing in thefe teeth. He was urged to have them
extracted, which he delayed too long, till the fits were become ha-
bitual, and then had them extra6ted in vain, and in a few months
funk under the difeafe. . ~

Mr. F , who had lived intemperately, and had been occafion-

ally affected with the gout, was fuddenly feized with epileptic fits ;
the convulfions were fucceeded by apoplectic fnoring ; from which
he was, in about 20 minutes, difturbed by frefli convulfions, and
had continued in this fituation above four-and-twenty hours. About
eight ounces of blood were then taken from him ; and after having
obferyed, that the apopledtic's torpor continued about 20 minutes, I
direded him to be forcibly raifed up in bed, after he had thus -lain
about fifteen minutes, to gain an interval between the termination of
the fleep, and the renovation of convulfion. In this interval he was
induced to fvvallow- forty drops of laudanum, Tw-enty more were
given him in the fame manner in about half an hour, both which
evidently fliortened the convulfion fits, and the confequent ftupor ;
he then took thirty more drops, which for the prefent removed the

U u 2 fits.

2^2 DISEASES OF VOLITION. Class III. i. i,

fits. He became rather infane the next day, and after about
three more days loft the infanlty, and recovered his ufual ftate of
ijealth.

The cafe mentioned in Seft, XXVil. 2. where the patient was left
after epileptic fits with a fufFufion of blood beneath the tunica ad-
jxindiva of the eye, was in almoft every refpedl fimilar to the pre-
cedins, and fubmitted to the fame treatment. Both of them fufFered
frequent relapfes, which were relieved by the fame means, and at
length periftied, I believe, by the epileptic fits.

In thofe patients, who have not been fubje(ft to epilepfy before they
have arrived to about forty years of age, and who have been intem-
perate in refpeit to fpirituous potation, 1 have been induced to believe,
that the fits were occafioned by the pain of a difeafed liver; and this
became more probable in one of the above fubjefts, who had ufed means
to repel eruptions on the f^ice ; and thus by fome frimulant applica-
tion had prevented an inflammation taking place on the Ikin ot the
face in (lead of on fome part of the liver. Secondly, as in thefe cafes
infanity had repeatedly occurred, which could not be traced from an he-
reditary fource; there is reafon to believe, that this as well as the epi-
leptic convulfions were caufed by fpirituous potation ; and that this
therefore is the original fource both of epilepfy and of inlanity in thofe
families, which are afflifted with them. This idea however brings fome
confolation with it ; as it may be inferred, that in a few lobar generations
thefe difeafes may be eradicated, which othervvife deftroy the family.

M. M. Venefedlion. Opium. Bark. Steel. Arfenic. Opium
one grain twice a day for years together. See the preceding
article.

8. Fjpikpf.a dohrifica. Pai-nful epilepfy. In the common epilepfy
the convulfions are immediately induced, as foon as the dilagreeable
fenfation, which caufes them, commences ; but in this the pain con-
tinues long with cold extremities, gradually increafmg for two or
three hours, till at length convulfions or madnefs fcome on ; which

terminate

Class III. I. I. DISEASES OF VOLITION. 333

terminate the daily paroxjfm, and ceafe themfelves in a little time
afterwards.

This difeafe fometimes originates from a pain about the lower edge
of the -liver, fometimes in the temple, and fometimes in the puden-
dum ; it recurs dail^^ for five or fix weeks, and then ceafes for feveral
inonths- The pain is owing to defe£l of a£lion, that is, to the ac-
cumulation of lenforial power in the part, which probably fympathizes
with fome other part, as explained in Se 61, XXXV. 2. XII. 5. 3. and
Glafs II.- I. 1. II.. and IV. 2. 2. 3.

It is the moft painful malady that human nature is liable to ! — See
Seft. XXXIV. 1.4.

Mrs. C- was feized every day about the fame hour with violent

pain on the right fide of her bowels about the fituation of the lower
e-dge of the liver, without fever, which increafed for an hour or two,
till it became totally intolerable. After violent fcreaming fhe fell into
convulfions, which terminated fometimes in fainting, with or with-
out ftertor, , as in common epilepfy ; at other times a tempory infanity
fupervened ; which continued about half an hour, and the fit ceafed*
Thefe paroxyfms had returned daily for two or three weeks, and were
at length removed bylarge dofes of opium, like the fits of reverie or
fomnambulat-ion. About half an hour before the expelled return of
the fit three or four grains of opium were exhibited, and then tindure
of opium was given in warm brandy and water about 20 or 30 drops
every half hour, till the eyes became fomewhat inflamed, and the
nofe began to itch, and by the fharp movements of the patient, or
quick fpeech, an evident intoxication appeared ; and then it generally
happened that the pain ceafed. But the efi^e£ls of this large dofe of
opium was- fucceeded by perpetual ficknefs and efforts to vomit, with
great general debility all the. fucceeding day.

The rationale of this temporary cure from the exhibition of opium
and vinous fpirit depends on the great expenditure of fenforial power
in the increafed adions of all the irritative motions, by the ftimulus
of fuch large quantities of opium and vinous fpirit; together with the

produflioa

334 DISEASES OF VOLITION. Class IIL i. i.

prodiuftlon of much fenfatlon, and many movements of the organs of
fenfe or ideas in confequence of that fenfation; and laftly, even the
motions of the arterial fyftem become accelerated by this degree of in-
toxication, all which foon exhaufled fo much fenforial power as to
relieve the pain ; which would otherwife have caufed convulfions or
Jnfanity, which are other means of expending fenforial power. The
general debility on the fucceeding day, and the particular debility of
the flomach, attended in confequence with ficlaiefs and frequent ef-
forts to vomit, were occafioned by the fyftem having previoufly been
fo ftrongly Simulated, and thofe parts in particular on which the
opium and wine more immediately ailed. This ficknefs continued
fo many hours as to Ijreak the catenation of motions, which had daily
reproduced the paroxyfm ; and thus it generally happened, that the
whole difeafe ceafed for fome weeks or months from one great intoxi-
cation, a circumftance not eafily to be explained on any other
theory.

The excefs or defeat of motion in any part of the lyftem occafions
the prodtiftion of pain in that part, as in Sed:. XII. i. 6. This defe6l
or excefb of fibrous a£lion is generally induced by excefs or defe£l of
the ftimulus of objedts external to the moving organ. But there is
another fource of exceffive fibrous aftion, and confequent pain, which
is from excefs of volition, which is liable to affeft thole muicles, that
have weak antagonifls ; as thofe which fupport the under jaw, and
clofe the mouth in biting, and thofe of the calf of the leg ; which are
thus liable to fixed or painful contra6llons, as in trihnus, or locked
jaw, and in the cramp of the calf of the leg; and perhaps in fome
colics, as in that of Japan : thefe pains, from contradlion arifing from
excefs of volition in the part from, the want of the counteradion of
antagonift mufcles, may give occafional caufe to epileptic fits, and
may be relieved in the fame way, either by exciting irritative and
fenfitive motions by the ftimulus of opium and wine ; or by convul-
fions or infanity, as defcribed above, which are only different methods
of exhaufting the general quantity of fenforial power.

Confidering

Class III. i. i. DISEASES OF VOLITION. 335

Confidering the great refemblance between this kind of painful
epilepfy and the colic of Japan, as defcribed by Kenafer ; and that
that difeafe was faid to be cured by acupunfture, or the prick of a
needle ; I direded fome very thin fteel needles to be made about three
inches long, and of fuch a temper, that they would bend double
rather than break ; and wrapped wax thread over about half an inch
of the blunt end for a handle. One of thefe needles, when the pain
occurred, was pufhed about an inch into the painful part, and the
pain inftantly ceafed ; but I was not certain, whether the fear of the
patient, or the ftimulus of the punfture, occafioned the ceflation of
pain ; and as the paroxyfm had continued fome weeks, and was then
declining, the experiment was not tried again. ,The difeafe is faid to
be very frequent in Japan, and its feat to be in the bowels, and that
the acupundlure eliminates the air, which is fuppofed to diftend the
bowel. But though the aperture thus made is too fmall to admit of
the eduftion of air ; yet as the ftimulus of fo fmall a pundiure may
either excite a torpid part into action, or caufe a fpafmodic one to
ceafe to a£t ; and laftly, as no injury could be likely to enfue. from
fo fmall a perforation, I fhould be inclined at fome future time to give
this a fairer trial in fimilar circumftances.

Another thing worth trial at the commencement of this deplorable
difeafe would be eledricity, by paffing ftrong Ihocks through the
painful part ; which, whether the pain was owing to the inadion of
that part, or of fome other membrane aflbciated with it, might fti-
mulate them into exertion j or into inailivity, if owing to ^xed pain-
ful contraftion.

And laftly, the cold bath, or afperfions with cold water on the af-
fefted part, according to the method of Dr. Currie in the Memoirs of
a Med. Soc. London, V. iii. p. 147, might produce great efFedl at
the commencement of the pain. Neverthelefs opium duly admi-
niftered, fo as to precede the expefted paroxyfm, and in fuch dofes,
given by degrees, as to induce intoxication, is principally to be de-
pended upon in this deplorable malady. To which fhould be added,

that

335 DISEASES OF VOLITION. Class III. f. i.

that if venefeftion can be previoufly performed, even to but few-
ounces, the efFe£l of the opium is much more certain ; and ftill more
fo, if there be time to premife a brifk cathartic, or even an emetic.
The efFe6l of increafed ftimulus is fo much"greater after previous de-
fe£l of ftimulus ; and this is ftill of greater advantage where the caufe
of the difeafe happens to conlift in a material, which can be abforbed.
See Art. IV. 2. 8.

M. M. Venefedlion. An emetic. A cathartic. Warm bath.
Opium a grain every half hour. Wine. Spirit of wine. If the pa-
tient becomes intoxicated by the above means, the fit ceafes, and vio-
lent vomitings and debility fucceed on the fubfequent day, and prevent
a return. Blifters or fmapifms on the fmall of the leg, taken off
when they give much pain, are of ule in {lighter convulfions,
Acupundure. Electricity. Afperfion with cold. water on the pain-
ful part.

9. Somnambulifmus. Sleep-walking is a part of reverie, or ftudiort?
inane, defcribed in Sedt. XIX. In this malady the patients- have
only the general appearance of being afleep in relpedt to their inatten-
tion to the ftimulus of external objefts, but, like the epilepfies above
defcribed, it confifts in voluntary exertions to relieve pain. The
mufdles are fubfervient to the will, as appears by the patient's vvalk-
ino- about, and fometimes doins; i:he common ofSces of life. The
ideas of the mind alfo are obedient to the will, becaufe their difcourfe
is confifl:e*it, though they anfvver imaginary queftions. The writa-
tive ideas of external objedts continue in this malady, becaule the pa-
tients do not run againft the furniture of the room ; and when they
aoply their volition to their organs of fenfe, they become fenfi ble of
the objefts they attend to, but not otherwife, as general lenfation is
deftroyed by the violence of their voluntary exertions. At the fame
time the fenfations of pleafure in confequence of ideas excited by vo-
lition are vividly experienced, and other ideas feem to be excited by
tbefe pleafurable fenfations, as appears in the cafe of Mafter A. Se£t.

XXXIV,

ClassIII. 1. I. DISEASES OF VOLITION. y^j

XXXIV. 3. I., where a hiftory of a hunting fcene was voluntarily
recalled, with all the pleaiurable ideas which attended it. In melan-
choly madnefs the patient is employed in voluntarily exciting one
idea, with thofe which are connedted with it by voluntary affoeiations
only, but not fo violently as to exclude the ftimuli of external objefts.
In reverie variety of ideas are occafionally excited by volition, and
thofe which are connedled with them either by fenfitive or voluntary
affoeiations, and that fo violently as to exclude the ftimuli of external
objefts. Thefe two fituations of our fenfual motions, or ideas, re-
femble convulfion and epilepfy; as in the former the ftimulus of ex-=
ternal objeds is ftill perceived, but not in the latter. Whence this
difeafe, fo far from being conne£led with fleep, though it has by uni-
verfal miftake acquired its name from it, arifes from excefs of voli-
tion, and not from a fufpenfion of it ; and though, like other kinds of
epilepfy, it often attacks the patients in their deep, yet thofe two^
whom I faw, were more frequently feized with it while awake, the
fleep-walking being a part of the reverie. See Sedt. XIX. and XXXIVj,
3. 'and Clafs II. i. 7. 4. and III. i. 2. 18.

M. M. Opium in large dofes before, the expecfled paroxyfm.

io. Afthma convidfivum. The fits of convulfive afthma return at
periods, and are attended with cold extremities, and fo far refemble
the accefs of an intermittent fever ; but, as the lungs are not fenfible
to the pain of cold, a fhivering does not fucceed, but inftead of it
violent efforts of refpiration ; which have no tendency, as in the
humoral afthma, to diflodge any offending material, but only to re-
lieve the pain by exertion, like the fhuddering in the beginning of
ague-fits, as explained Clafs III. i. i. 2.

The infenfibility of the lungs to cold is obfervable on going into
frofty air from a warm room ; the hands and face become painfully
cold, but no fuch fenfation is excited in the lungs j which is another
argument in favour of the exiftence of a peculiar fet of nerves for the

Vol. II. X x ^ purpofe

338 DISEASES OF VOLITION. Class III. r. i.

purpofe of perceiving the univerfal fluid matter of heat, m which all
things are immerfed. See Se6t. XIV. 6. Yet are the lungs never-
thelefs very fenfible to the deficiency of oxygen in the atmofphere,
as all people experience, when they go into a room crowded with
company and candles, and complain, tliat it is fo clofe, they can
fcarcely breathe; and the fame in fome hot days in fummer.

There are two difeafes, which bear the name of afthma. The
firft is the torpor or inability of the minute veffels of the lungs, con-
fifting of the terminations of the pulmonary and bronchial arteries and
veins, and their attendant lymphatics j in this circumftance it re-
fembles the difficulty of breathing, which attends cold bathing. If
this continues long, a congeftion of fluid in the air-cells fucceeds, as
the abforbent aftions ceafe completely before the fecerning ones ; as
explained in Clafs I. i. 3.^3. And the coldnefs, which attends the
in'a£tion of thefe vefTels, prevents the ufual (Quantity of exhalation.
Some fits ceafe before this congeftion takes place, and in them no vio-
lent fweating nor any expuitioa of phlegm occurs. This is the hu~
moral aflhma, defcribed at Clafs II. i. i. 7,

The fecond kind of aflhma confiils in the convulfive aftions in
confequence of the difagreeable fenfations thus induced ; which in
fome fits of aflhma are very great, as appears in the violent efforts to
raife the ribs, and to de^refs the diaphragm, by lifting the flioulders,
Thefe, fo long as they contribute to remove the caufe of the difeafe,
are not properly convulfions, but exertions immediately caufed by
fenfation ; but in this kind of aflhma they are only efforts to relieve
pain, and are frequently preceded by other epileptic convulfions.

Thefe two kinds of aflhmas have fo many refembling features, and
are fo frequently intermixed, that it often requires great attention to
diflingulfh them ; but as one of them is allied to anafarca, and the
other to epilepfy, we (hall acquire a clearer idea of them by com-
paring them^with thofe diforders, A criterion of the humoral or hy=
dropic aflhma is, that it is relieved by copious fweats about the head
3 ^li^

Class III. 1. 1. DISEASES OF VOLITION. 339

and breafi:, which are to be afcribed to the fenfitive exertions of the
pulmonary veffels to reheve the pain occafioned by the anafarcous
conge'ftion in the air-cells ; and which is elFected by the increafed ab-
forption of the mucus, and its elimination by the retrograde action of
thofe lymphatics of the Ikin, whofe branches communicate with the
pulmonary ones ; and which partial fweats do not eafily admit of any
other explanation. See Clafs I. 3. 2. 8. Another criterion of it is,
that it is generally attended with fwelled legs, or other fymptoms of
anafarca. A criterion of the convulfive afthma may be had from the
abfence of thefe cold clammy fweats of the upper part of the body
only, and from the patient having occafionally -been fubjeft to coa-
vulfions of the liinbs, as in the common epilepfy.

It may thus frequently happen, that in the humoral afthma fomc
exertions of the lungs may occur, which may not contribute to dif-
charge the anafarcous lymph, but may be efforts flmply to relieve
pain ; befides thofe efforts, which produce the increafed abforptioa
and elimination of it ; and thus we have a bodily difeafe refembling in
this circumftance the reverie, in which both fenfitive and voluntary
motions are at the fame time, or in fucceflion, excited for the pur-
pofe of relieving pain.

It may likewife fometimes happen, that the difagreeable fenfation,
occalioned by the congeftion of lymph in the air-cells in the humoral
or hydropic afthma, may induce voluntary convulfions of the refpira-
tory organs only to relieve the pain, without any fenfitive anions of
the pulmonary abforbents to abforb and eliminate the congeftion of
ferous fluid ; and thus the fame caufe may occafionally induce either
the humoral or convulfive afthma.

The humoral afthma has but one remote caufe, which is the torpor
of the pulm.onary veffels, like that which occurs on going into th$
cold bath ; or the want of abforption of the pulmonary lymphatics to
take up the lymph effufed into the air-cell. Whereas the convulfive
afthma, like other convulfions, or epilepfies, may be occafioned by

X X 2 paiu

340 DISEASES OF VOLITION. Class III. i. r.

pain in altnoft any remote part of the fyftem. But in Tome of the
adult patients in this difeafe, as in many epHepfies, I have fufpeded
the remote caufe to be a pain of the liver, or of the biliary dudls.

The aflhmas, which have been induced in conlequence of the re-
cefs of eruptions, efpecially of the leprous kind, countenance this
opinion. One lady I knew, who for many years laboured under an
a^hma, which ceafed on her being afflifled with pain, fwelling, and
diftortion of fome of her large joints, which were efteemed gouty^
but perhaps erroneouily. And a young man, whom I faw yefterday^
was feized with ailhma on the retroceffion, or ceafnig of eruptions 0:1.
his face.

The convulfive afthma, as well as- the hydropic, aremore liable ta
return in hot weather ; which may be occafioned by the lefs quantity
of oxygen exifting in a given quantity of warm' air, than of cold^
which can be taken into the lungs at one infpiration... They are both
moft liable to occur after the firft flecp, which is therefore a general
criterion of alihma. The caufe of this is explained in Sed. XVIII. 15.
and applies to both of them, as our fenfibility to internal uneafy fenfa-
tion increafes during fleep...

When children are gaining teeth, long before they appear, the pain
of the gums often induces convuKions. This pain is relieved in fome
by fobbing and fcreaming ;. but in.others a laborious refpiration is ex^
erted to reheve the pain ; an-d this conftitutes the true afthma convul-
fjvum. In other children again general convullionSj or epileptic pa-,
roxylms, are induced for this purpofe; which, like other epilepfiesj
btecome eftabliOied by habit,, and recur before the irritation has time
to produce the painful fenfation, which originally caufed them...

The afthma convulfivam is alfo- fometimes induced by worms, or
by acidity in the ftoraachs of children, _and by other: painful fenfations
in adults ; in whom it is generally called nervous afthma,. and is oftea
joined with ether epileptic fymptoms.

This afthma is diftinguiftied from the peripneum.ouy, and frona

Class III. i. r. DISEASES OF VOLITION. 341

the croup, hy the prefence of fever in the two latter. It is diftiii-
guifhed from the humoral afthma, as in that the patients are more
liable to run to the cold air for relief, are more fubjedl to cold extre-
mities, and experience the returns of it more .frequently after their
flrft fleep. It is diflinguifhed from the hydrops thoracis, as that has
no intervals, and the patient fits conftantly upright, and the breath is
colder ; and, where the pericardium is.affe£led, the pulfe is quick and
unequal. See Hydrops Thoracis, I. 2. 3. 14.

M. M. Venefeclion once. A cathartic with calomel once. Opium.
AflafcEtida. Warm bath. If the caufe can be detefted, as in toothinsr
or worms, it fhould be removed. As this fpecies of afthma is fo li-
able to recur during fleep, like epileptic fits, as mentioned in Se6lion
XVlil. 15. there was reafon to believe, that the refpiration of an at-
mofphere mixed with hydrogen, or any other innocuous air, which
might dilute the oxygen, would be ufeful in- preventing the parox-
yfms by decreafing the fenfibility of the fyrtem. This, I am informed
by Dr. Beddoes, has been ufed with . decided fuccefs by Dr. Ferriac,
See eiafsll. 1. i. 7.

II. jfflh'ma dohnjicum. Angina peilorls. The painful afthma
was firft defcribed by Dr. Heberden in the Tranfadions of the Col-
lege; its principalfymptoms confift in a pain about the middle of the
fternumi or rather lawer, on zvtxy increafe of pulmonary or mufcu-
lar exertion, as in walking fafter than ufual, or going quick up a hill:,
or even up flairs ; with great difficulty of breathing, fo as to occafion
the patient inftantly to fl:op. . A pain in the arms about -the infertion
of the tendon of the peroral mufcle generally attends, and 'a defire of
refting by hanging on a door or branch of a tree by the arms is
fometimes obferved. Which is -explained in Clafs 1. 2. 3. 14. and in
Se£t. XXIX. 5. 2.

Thefe patients generally die fuddenly; and on examining the tho-
rax no certain caufe, or feat, of the difeafe has been detected ;. fome

have

342 DISEASES OF VOLITION. Class III. i. i.

have fuppofed the valves of the arteries,- or of the heart, were imper-
fedl ; and others that the accumulation of fat about this vifcus or the
lungs obftrud:ed their due action ; but other obfervations do not accoud
with thefe fuppofitions.

Mr. W , an elderly gentleman, was feized with afthma during

the hot part of laft fummer ; he always waked from^ his firfl fleep with
difficult refpiration, and pain in the middle of his fternum, and after
about an hour was enabled to fleep again. As this had returned for
a,bout a fortnight, it appeared to me to be an afthma complicated with
the difeafe, which Dr. Heberden has called angina pedloris. It was
treated by venele£lion, a cathartic, and then by a graiii of opium
given at going to bed, with ether and tinfture of opium vx • -n the
pain or afthma recurred, and laftly with the bark, but w_as icveral
days before it was perfe6bly fubdued.

This led me to conceive, that in this painful afthma the diapi)ra;:m,
as well as the other mufcles of refpiration, was thrown into coiu'ul-
five action, and that the fibres of this mufcle not having proper- anta-
gonifts, a painful fixed fpafm of it, like that of the mufcles ir, ihe calf
of the leg in the cramp, might be the caufe of death in the angina
peSorls, which I have thence arranged under the name of painful
afthma, and leave for further inveftigation.

From the hiftory of the cafe of the late much lamented John
Hunter, and from the appearances after death, the cafe feems to have
been of this kind, complicated with vertigo and confequent affeciion
of the ftomach. The remote caufe feems to have arifen from oftifi-
cations of the coronary arteries ; and the immediate cr.ufe of his death '
from fixed fpafm of the heart. Other hiftories and diffedlions are ftiU
required to put this matter out of doubt ; as it is poftible, that either
a fixed fpafm of the diaphragm, or of the heart, which are both fur-
niflied with but weak antagonifts, may occafioa fudden death j and
-thefe may conftitcite two diftincfl difeafes.

Four patients I have now in my recolledion, all of whom I be-
lieved

Class HI. i. i. DISEASES OF VOLITION. 343

lieved to labour under the angina pedoris in a great degree ; which
have all recovered, and have continued well three or four years by
the ufe, as I believe, of iflues on the infide of each thigh ; which
were at firll large enough to contain two peafe each, and afterwards
but one. They took befides fome flight antimonial medicine for a
while, and were reduced to half the quantity or ftrength of their ufuai
potation of fermented liquor.

The ufe of femoral iffues in angina pedloris was firft recommended
by Dr. Macbride, phyfician at Dublin, Med. Obferv. & Enquir.
Vol. VI. And 1 was further induced to make trial of them, not only
becaufe the means which I had before ufed were inadequate,
but from the ill effeSt I once obferved upon the lungs, which
fucceeded the cure of a fmall fore beneath the knee ; and argued
converfely, that iflues in the lower limbs might affiil, a difficult re-
fpiration.

Mrs. L , about fifty, had a fmall fore place about the fize of

half a pea on the infide of the leg a little below the knee. It had dif-
charged a pellucid fluid, which flie called a ley- water, daily for four-
teen years, with a great deal of pain i on which account file applied
to a furgeon, who, by means of bandage and a faturnine application,
foon healed the fore, unheedful of the confequences. In lefs than two
months after this I faw her with great difficulty of breathing, which
with univerfal anafarca foon defl;royed her.

The theory of the double effedt of iflues, as above related, one ia
relieving by their prefence the afthma dolorificum, and the other in
producing by its cure an anafarca of the lungs, is not eafy to explain.
Some fimilar effeds from cutaneous eruptions and from bliflers are
mentioned in Clafs I. i. 2. 9. In thefe cafes it feems probaWe, that
the pain occafioned by iflues, and perhaps the abforption of a fmall
quantity of aerated purulent matter, ftimulate the whole fyflem into
greater energy of adlion, and thus prevent the torpor which is the
beginning of fo many difeafes. In confirmation of this effedl of pain

on

344 " 'DISEASES OF VOLITION. -Class III. i. r.

on the fyflem, I remember the cafe of a lady of ati ingenious and ac-
-tive mind, who, for many of the latter years of her life, was perpe-
rtiially fubjecl to great pains of her head from decaying teeth. When
all her teeth were gone, fhe became quite low fpirited, and melan-
.choly in the popular fenfe of that word, and after a year or two be-
came univerfally dropfical and died.

M. M. Iflues in the thighs. Five grains of rhubarb, and one fixth
of a grain of emetic tartar every night for fome months, with or
without half a grain of opium. No ftronger liquor than fmall beer,
or wine diluted with twice its quantity of water. Since I wrote the
above I have feen two cafes of hydrops thoracis, attended with pain
in the left arm, fo as to be miftakeu for afthma dolorificum, in
which femoral iflues, though applied early in the difeafe, had no
efFeft.

12. Stridor denthun. The clattering of the teeth on going into
cold water, or in the beginning of ague-fits, is an exertion along with
the tremblings of the Ikin to relieve the pain of cold. The teeth and
Ikin being more fenfible to cold than the more internal parts, and
more expofed to it, is the reafon that the mufcles, which ferve
them, are thrown into exertion from the pain of cold rather than
thofe of refpiration, as in {creaming from more acute pain. Thug
the poet,

Put but your toes into cold water.
Your correfpondent teeth will clatter.

Frigr.

-In more.acute pains the'jaws are gnaflied together with great vehe-
mence, infomuch that fometimes the teeth are faid to have been
broken by the force. See Se£l. XXXIV. i. 3. In thefe cafes fome-
thing fliould be offered to the patient to bite, as a towel, otherwife
they are liable to tear their own arms, or to bite their attendants, as I
have witnefled in the painful epileply.

13. 'Tetanus

Class III. 1. 1. DISEASES OF VOLITION. 345

13. Tetanus trifmns. Cramp. The tetauu^ confiils of a fixed
fpafcn of almoft all the mufcles of the body ; but the trifmus, or
locked jaw, is the moft frequent difeafe of this kind. It is generally-
believed to arife from fympathy with an injured tendon. In one cafe
where it occurred in confequen.ee of a broken ankle from a fall from a
horfe, it was preceded by evident hydrophobia. Amputation was ad-
vifed, but not fubmitted to; two woands were laid into one with
fciflbrs, but the patient died about the feventh day from the accident.
In this cafe the wounded tendon, like the wounds from the bite of a
mad dog, did not produce the hydrophobia, and then the locked jaw,
till feveral days after the accident*

I twice witnefled the locked jaw from a pain beneath the fternum,
about the part where it is complained of in painful afthma, or angina
pe(9:oris, in the fame lady at fome years diftance of time. The laflr
time it had continued two days, and fhe wrote her mind, or exprefled
herfelf by figns. On obferving a broken tooth, which made a fmall
aperture into her mouth, I rolled up fiv^ grains of opium like a worm
about an inch long, and introducing it over the broken tooth, pufhed
it onward by means of a fmall crow-quill ; as it diflblved I obferved
fhe fwallowed her faliva, and in lefs than half an hour, flie opened her
mouth and converfed as ufual.

Men are taught to be a(ha«ied of fcreaming from pain in their early
years ; hence they are prone to exert the mufcles of the jaws inftead,
which they have lear-nt to exert frequently and violently from their
infancy,} whence the locked jaw. This and the following fpafm have
no alternate relaxations, like the preceding ones ; which is perhaps
owing, firft, to the weaknefs of their antagonift mufcles, thofe which
elevate the jaw being very ilrong for the purpofe of biting and mafti-
cating hard fubftances, and for fupportiug the under jaw, with very
■weak antagonift mufcles ; and fecondly, to their not giving fufficient
relief even for a moment to the pain, or its preceding irritation, which
■excited them.

Vol. II. ^ Y y M. M. Opium

346 DISEASES OF VOLITION. Class III. i. r.

M. M. Opium in very large quantities. Mercurial ointment ufed
extenfivcly. Electricity. Cold bath. Dilate the wound, and fill it
with lint moiflened with fpirit of turpentine; which inflames the
wound, and cures or prevents the convulfions. See a cafe, Tranfadl.
of American Society, ^ol. ri. p. 227.

Wine in large quantities in one cafe was more fuccefsful than opi-
um ; it probably inflames more, which in this difeafe is defirable.
Between two or three ounces of bark, and from a quart to three pints
of wine a day, fucceeded better than opium. lb.

14. T^etanus dolorijicus. Painful cramp. This kind of fpafm moft
frequently attacks the calf of the leg, or mufcles of the toes ; it often,
precedes paroxyfms of gout, and appears towards the end of violent
diarrhoea, and from indigeftion, or from acid diet. In thefe cafes it
feems to fympathize with the bowels, but is alfo frequently produced
by the pain of external cold, and to the too great previous extenfion of
the mufcles, whence fome people get the cramp in the extenfor muf-
cles of the toes after walking down hill, and of thofe of the calf of
the leg after walking up a fteep eminence. For the reafon why thefe
cramps commence in fleep, fee Se£l. XVIII. 15.

The mufcle in this difeafe contra£ts itfelf to relieve fome fmaller
pain, either from irritation or aflbciation,. and then falls into great pain
itfelf, from the too great a£lion of its own fibres. Hence any mufcle,.
by being too vehemently exerted, falls into cramp, as in fwimming
too fordjJDly in water, which is painfully cold ; and a fecondary pain is
then induced by the too violent contradlion of the mufcle ; though the
pain, which was the caufe of the contraftion^ ceafes. Which ac-
counts for the continuance of the contradion, and difiinguifhes this
difeafe from other convulfions, which are relaxed and exerted alter-
nately. Hence whatever may be the caufe of the primary pain, which
occafions the cramp of the calf of the leg, the fecondary one is re-
lievable by {landing up, and thus by the weight of the body on the

n toes

Class III. i.r. DISEASES OF VOLITION-. 347

toes forcibly extending the contraded mufcles. For the caufe, which
induces thefe mufcles of the calf of the leg to fail into more violent
contradion than other fpafmodic mufcles, proceeds from ttie weaknefs
of their antagonift mufcles ; as they are generally extended again after
aftion by the weight of the body on the balls of the toes. See the
Drecedino; article. •

M. M. Rub the legs with camphor diffolved in oil, and let the pa-
tient wear ftockings in bed. If a foot-board be put at the bed's feet,
and the bed be fo inclined, that he will reft a little with his toes
againft the foot-board, that prefTure is faid to prevent the undue con-
tradions of the mufculi gaftrocnemii, which conftitute the calf of the
leg. In gouty patients, or where the bowels are affefted with acidity,
half a grain of opium, and fix grains of rhubarb, and fix of chalk,
every night. Fleffi-meat to fupper. A little very weak warm fpirit
and water may be taken for prefent relief, when thefe cramps are very
troublefome to weak or gouty patients.

15. Hydrophobia. Dread of water generally attending canine mad-
nefs. I was witnefs to a cafe, where this difeafe preceded the locked
jaw from a wound in the ankle, occafioned by a fall from a horfe ; as
mentioned in the preceding article. It came on about the fixth day
after the accident ; when the patient attempted to fwallow fluids, he
became convulfed all over from the pain of this attempt, and fpurted
them out of his mouth with violence. It is alfo faid to happen in
fome hyfterical cafes. Hence it feems rather the immediate confe-
quence of a pained tendon, than of a contagious poifon. And is fo
far analogous to tetanus, according with the opinions of Dodor Rufch
and Dodtor Percival.

In other refpeds, as it is produced by the faliva of an enraged ani-
mal inftilled into a wound, it would feem analogous to the poifon of
venomous animals. And from the manner of its accefs fo long
after the bite, and of its termination in a fliort time, it would

Y y 2 feem

348 DISEASES OF VOLITION. Class III. i. r.

feem to refemble the progrefs of contagious fevers. See Sedl. XXIL

3- 3-

If the patient was bitten in a part, which could be totally cut

away, as a finger, even after the hydrophobia appears, it is probable

it might cure it ; as I fufpedt the caufe ftill remains in the wounded

tendon, and not in a diffufed infedtion tainting the blood. Hence

there are generally uneafy fenfations, as cold or numbnefs, in the old

cicatrix, before the hydrophobia commences. See a cafe in Medical

Communications, Vol.11, p. 190.

If the difeafed tendon could be inflamed without cutting it out, as
by cupping, or cauftic, or blifler after cupping, and this in the old
wound long fince healed, after the hydrophobia commences, might
prevent the fpafms about the throat. As inflaming the teeth by the
ufe of mercury is of ufe in fome kinds of hemicrania. Put fpirit of
turpentiue on the wound, wafh it well. See Clafs I. 3. 1. 1 1. IV. I.
2. 7.

M. M. Wine, mufk, oil, internally. Opium, mercurial ointment^
ufed extenlively. Mercurial fumigation. Turpeth mineral. To fa-
livate the patient as foon as poffible. Exfedlion or a cauftic on the
fear, even after the appearance of hydrophobia. Put a tight bandage
on the limb above the fear of the old wound to benumb the pained
tendon, however long the wound may have been healed. Could a
hollow catheter of elaftic gum, coartchouc, be introduced into the
cefophagus by the mouth or noflril, and liquid nourishment be thus
conveyed into the ftomach ? See Default's Journal, Cafe I. where, in
an ulcer of the mouth, fuch a catheter was introduced by the noftril,
and kept in the oefophagus for a month, by which means the patient
was nourifhed and preferved.

It is recommended by Dr. Bardfley to give oil internally by a fimi-
lar method contrived by Mr. John Hunter. He covered a probano-
with the fkin of a fmall eel, or the gut of a lamb or cat. It was tied
up at one end above and below the fponge, and a flit made above the

upper

Class III. i. i. DISEASES OF VOLITION. 349

upper ligature; to the other end of the eel-fkin or gut was fixed a
bladder and pipe. The probang thus cov^ered, was introduced into the
flomach, and the liquid food or medicine was put into the bladder and.
fqueezed down through the eel-lkin. Menn. of Society at Manchefter.
See Clafs I. 2. 3. 25.

Dr. Bardfley has endeavoured to prove, that dogs never experience
the hydrophobia, or canine madnefs, without having been previoufly
bitten or infefted ; and fecondly, that the difeafe in this fpecies of
animal always fhews itfelf in five or fix weeks ; and concludes from
hence, that this dreadful malady might be annihilated by making all
the dogs in Great Britain perform a kind of quarantine, by fhutting
them up for a certain number of weeks. Though the difeafe from
the bite of the mad dog is perhaps more analogous to thofe from the
wounds inflidted by venomous animals than to thofe from other con-
tagious matter, yet thefe obfervations are well worthy further atten-
tion i which the author promifeSs

ORDO

2S0 DISEASES OF. VOLITION. . Class III. 1.2.

O R D O I.

Increafed Volition.

GENUS II.
frith Increafed Anions of the Organs of Senfe.

' In every fpecies of madnefs there is a peculiar idea either of defirc
or averfion, which is perpetually excited in the mind with all its
connedions. In Ibme conftitutions this is conneded with pleafurable
ideas without the exertion of much mufcular adion, in others it pro-
duces violent mufcular aclion to gain or avoid the obje6t of it, in others
it is attended with defpair and ina6tion. Mania is the general word for
the twoformer of thefe, and melancholia for the latter; but the fpecies
of them are as numerous as the defires and averfions of mankind.

In the prefent age the pleafurable iiifanities are moft frequently in-
duced by fuperftitious hopes of heaven, by fentimental love, and by
perfonal vanity. The furious infanities by pride, anger, revenge,
fufpicion. And the melancholy ones by fear of poverty, fear of death,
and fear of hell ; with innumerable others.

Quicquid agunt homines, votum, timor, ira, voluptas,
Gaudia, dlfcurfus, noftri efl farrago libelli.

JuvEN. I. 85.

This idea, however, which induces madnefs or melancholy, is ge-
nerally untrue ; that is, the obje6l is a miftaken fad. As when a
patient is perfuaded he has the itch, or venereal difeafe, of which he
has no fymptom, and becomes mad from the pain this idea occafions,
,So that the objed of madnefs is generally a delirious idea, and thence

cannot

Class III. 1.2. DISEASES OF VOLITION. 351

cannot be conquered by reafon ; becaufe it continues to be excited by
painful fenfation, which is a flronger flimulus than volition. Moft
frequently pain of body is the caufe of convulfion, which is often
however exchanged for madnefs ; and a painful delirious idea is moil:
frequently the caufe of madnefs originally, but fometimes of convul-
fion. Thus I have feen a young lady become convulfed from a fright,
and die in a few days ; and a temporary madnefs frequently terminates
the paroxyfms of the epilepfia dolorifica, and an infanity of greater
permanence is frequently induced by the pains or br'uifes of partu-
i^ition.

Where the patient is debilitated a quick pulfe fometimes attends
infane people, which is neverthelefs generally only a fymptom of the
debility, owing to the too great expenditure of fenforial power ; or of
the paucity of its produdion, as in inirritative, or in fenfitive inirritated
fever. See III. i. i.

But neverthelefs where the quick pulfe is permanent, it fhews the
prefence of fever ; and as the madnefs then generally arifes from the
difagreeable fenfations attending the fever, it is fo far a good fymp-
tom ; becaufe when the fever is cured, or ceafes fpontaneoufly, the
infanity mofl frequently vanifhes at the fame time.

The ftimulus of fo much volition fupports infane people under va-
riety of hardfhips, and contributes to the cure of difeafes from debility,
as fometimes occurs towards the end of fevers. See Seil. XXXIV.
2. 5. And, on the fame account, they bear large dofes of medicines
to procure any operation on them ; as emetics, and cathartics, which,
before they produce their effed in inverting the motions of the fto-
raach in vomiting, or of the abforbents of the bowels in purging,
mufl: firft weaken the natural a6lions of thofe organs, as fliewn in
Sea. XXXV. I. 13.

From thefe confiderations it appears, that the indications of cure
muft confifh in removing the caufe of the pain, whether it arifes from
a delirious idea, or from a real fa6l, or from bodily difeafe ; or fe-

- condly.

352 DISEASES OF VOLITION. Class III. 1.2.

cendly, if this cannot be done, by relieving the pain in confequence
of fuch idea or difeafe. The firft is fometimes efFeded by prefenting
frequently in a day contrary ideas to (hew the fallacy, or the too
great eftimation, of the painful ideas. 2dly. By change of place, aud
thus prefenting the ftimulus of new objefts, as a long journey.
3dly. By producing forgetfulnefs of the idea or objeft, which caufes
their pain ; by removing all things which recal it to their minds ;
and avoiding all converfation on fimilar fubje£ls. For I fuppofe no
difeafe of the mind is fo perfedlly cured by other means as by forget-
fulnefs.

Secondly, the pain in confequence of the ideas or bodily difeafes
above defa'ibed is to be removed, firft, by evacuations, as venefec-
tion, emetics, and cathartics; and then by large dofes of opium, or
by the vertigo occafioned by a circulating fwing, or by a fea- voyage,
•which, as they affefl the organs of fenfe as well as evacuate the fto-
mach, may contribute to anfwer both indications of cure.

Where maniacs are outrageous, there can be no doubt but coercion
isnecefTary; which may be done by means of a flraight waiftcoat ;
which difarms them without hurting them ; and by tying a handker-
chief round their ankles to prevent their efcape. In others there can
be no doubt, but that confinement retards rather than promotes their
cure ; which is forwarded by change of ideas in confequence of change
of place and of obje£ls, as by travelling or failing.

The circumftances which render confinement neceflary, are firft,
if the lunatic is liable to injure others, which muft be judged of by
the outrage he has already committed, zdly. If he is likely to injure
himfelf ; this alfo muft be judged of by the defpondency of his mind,
if fuch exifts. 3dly. If he <:annot -take care of his affairs. Where
<none of thefe circumftances exift, there (hould be no confinement.
For though the miftaken idea continues to exift, yet if no actions are
produced in confequence of it, the patient cannot be called infane, he
C3.n only be termed dehrious. If every one, who pofteffes miftaken

ideas.

Glass III. 1.2. DISEASES OF VOLITION, ^53

ideas, or who puts falfe eftimates on things, was liable to confine-
ment, I know not who of my readers might not tremble at the fight
of a madhoufc !

The mofl convenient dlftrlbution of infanities will be into general,
as mania mutabilis, fludium inane, and vigilia ; and into partial in-
fanities. Thefe lafl again may be fubdivided into defires and aver-
fions, many of which are fucceeded by pleafarable or painful ideas,
by fury or dejeftion, according to the degree or violence of their ex-
ertions. Hence the analogy between the infanities of the mind, and
the convulfions of the mufcles defcribed in the preceding genus, is
curioufly exaft. The convulfions without ftupor, are either jufl fuf-
ficient to obliterate the pain, which occafions them ; or are fucceeded
by greater pain, as in the convulfio doloriflca. So the exertions in
the mania mutabilis are either juft fufficient to allay the pain which
occafions them, and the patient dwells comparatively in a quiet ftate;
or thofe exertions excite painful ideas, which are fucceeded by furious
difcourfes, or outrageous adlions. The fludium inane, or reverie,
refembles epilepfy, in which there is no fenfibility to the ftimuli of
external objefts. Vigilia, or watchfulnefs, may be compared to the
general writhing of the body; which is juft a fufficient exertion to
relieve the pain which occafions It. Erotomania may be compared to
trifmus, or other mufcular fixed fpafm, without much fubfequent
pain ; and mseror to cramp of the mufcles of the leg, or other fixed
fpafm with fubfequent pain. All thefe coincidences contribute to
fliew, as explained in Se6t. III. 5, that our ideas are motions of the
immediate organs of fenfe obeying the fame laws as our mufcular
motions.

The violence of acliou accompanying Infanlty depends much on
the education of the perfon; thofe who have been proudly educated
with unreftrained pafiions, are liable to greater fury; and thofe,
whofe education has been humble, to greater defpondency. Where
the delirious Idea, above defcribed, produces pleafurable fenfations, as
Vol. II. Z z in

354 DISEASES OF VOLITION. Class III. 1.2.

in perfonal vanity or religious enthufiafm ; it is almoft a pity to fnatch
them from their fool's paradife, and reduce them again to the com-
mon lot of humanity ; left they fliould complain of their cure, like
the patient defcribed in Horace,

' — — Pol ! me occldillis, amici,

Non fefvaftis, ait, cui fie extorta voluptas,
Et demptus per vim mentis gratiffimus error !

The dlfpofition to infanity, as well as to convulfion, is believed to
be hereditary ; and in confequence to be induced in thofe families
from flighter caufes than in others. Convulfions have been (hewn to
have been moft frequently induced by pains owing to defe£l of ftimu-
lus, as the fhuddering from cold, and not from pains from excefs of
flimulus, which are generally fucceeded by inflammation. But in-
fanities are on the contrary generally induced by pains from excefs of
ftimulus, as from the too violent adions of our ideas, as in commoa
anger, which is an infanity of fiiort duration; for infanities generally,
though not always, arife from pains of the organs of fenfe ; but con-
vulfions generally, though not always, from pains of the membranes
or glands. And it has been previoufly explained, that though the
membrane and glands, as the flomach and Ikin, receive great pain
from want of ftimulus ; yet that the organs of fenfe, as the eye and
ear, receive no pain from defedc of ftimulus.

Hence it follows, that the conftitutions moft liable to convulfion,
are thofe which moft readily become torpid in fome part of the fjf-
tem, that is, which poffefs lefs irritability ; and that thofe moft liable
to infanity, are fuch as have excefs of fenfibility ; and laftly, that
thefe two circumftances generally exift in the fame conftitution ; as
explained in Se£l. XXXI. 2. on Temperaments. Thefe obfervations
explain why epilepfy and infanity frequently fucceed or reciprocate
with each other, and why inirritable habits, as fcrophulous ones, are
liable to infanity, of which I have known fome inftances.

6 . Id

Class III. 1.2. DISEASES OF VOLITION. 355

In many cafes however- there is no appearance of the difpofition to
epilepfy or infanity of the parent being tranfmitted to the progeny.
Firft, where the infanity has arifen from fome violent difappoint-
ment, and not from intemperance in the ufe of fpirituous liquors.
Secondly, where the parent has acquired the infanity or epilepfy by
habits of intoxication after the procreation of his children. Whrch
habits I fuppofe to be the general caufe of the difpofition to infanity in
this country. See Clafs III. i. r. 7.

As the difpofition to gout, dropfy, epilepfy, and infanity, appears
to be produced by the intemperate ufe of fpirituous potation, and is ia
all of them hereditary; it feems probable, that this difpofition gradu-
ally increafes from generation to generation, in thofe families which
continue for many generations to be intemperate in this refpeft ; till
at length thefe difeafes are produced ; that is, the irritability of the
fyftem gradually is decreafed by this powerful flimulus, and the fen-
fibllity at the fame time increafed, as explained in Seft. XXXI. i. and
2. This difpofition is communicated to the progeny, and becomes
flill increafed, if the fame ftimulus be continued, and fo on by a
third and fourth generation ; which accounts for the appearance of
epilepfy in the children of fome families, where it was never known
before to have exifted, and could not be afcribed to their own intem-
perance. A parity of reafoning fhews, that a few fober generations
may gradually in the fame manner reflore a due degree of irritability
to the family, and decreafe the excefs of fenfiblllty.

From hence it would appear probable, that fcrophuia and dropfy
are difeafes from inirrltability ; but that in epilepfy and infanity an ex-
cefs of fenfiblllty is added, and the two faulty temperaments are thus
conjoined.

Zz 2 SPECIES.

•6 DISEASES OF VOLITION. Class III, 1.2.

SPECIES.

I. Mania mutahUis. Mutable madnefs. Where the patients are
liable to miftake ideas of fenfation for thofe from irritation, that is,
imaginations for realities, if cured of one fource of infanity, they are
liable in a few months to find anotlier fource in fome new miftaken
or imaginary idea, and to a<5l from this new idea. The idea belongs
to delirium, when it is an imaginary or miftaken one ; but it is the
voluntary adtions exerted in confequence of this miflakea idea, M'hich
conftitute infanity.

In this difeafe the patient is liable carefully to conceal the obje6l of
his defireor averfion. But a confl:ant inordinate fufpicioii of all peo-
ple, and a careleffnefs of cleanlinefs, and of decency, are generally
concomitants of madnefs. Their defigns cannot be counteraded, tillr
you can inveftigate the delirious idea or objedl of their infanity ; but
as they are generally timid, they are therefore lefs to be dreaded.

Z. Z. called a young girl, one of his maid-fervants, into the par-
lour, and, with cocked piftols in his hands, ordered her to ftrip her-
felf naked; he then infpefted her with fome attention, and difmiffed
her untouched. Then he flripped two of his male fervants in the
fame manner, to the great terror of the neighbourhood. After he
was fecurcd, with much difficulty he was perfuaded to tell me, that
he had got the itch, and had examined fome of his fervants to find
out from whom he had received it ; though at the fame time there
was not a fpot to be feen on his hands, or other parts. The outrages
in confequence of this falfe idea were in fome meafure to be afcribed
to the pride occafioned by unreftrained education, affluent wealth, and
dignified family.

Madnefs is fometimes produced by bodily pain, particularly I be-
lieve of a difeafed liver, like convulfion and epilepfy ; at other times
7 it

Class HI. i. 2. DISEASES OF VOLITION.

ZSI

it is caufed by very painful ideas occafioned by external circumflances,
as of grief or difappointment ; but the moft frequent caufe of infanity
arifes from the pain of fome imaginary or miftaken idea ; which may
be termed hallucinatio maniacalis. This hallucination of one of the
fen fes is often produced in an inftant, and generally becomes gradually
weakened in procefs of time, by the perpetual ftimulus of external
obje6ls, or by the fucceffions of other catenations of ideas, or by the
operations of medicines; and when the maniacal hallucination ceafes,
or Is forgotten, the violent exertions ceafe, which were in confequence
of it, and the difeafe is cured.

Mr. , a clergyman, about forty years of age, who was

rather a weak man, happened to be drinking wine in jocular company,
and by accident fwallowed a part of the feal of a letter, which he had
juft then received j one of his companions feeing him alarmed, cried
out in humour, " It will feal your bowels up." He became melan-
choly from that inftant, and in a day or two refufed to fwallow any
kind of nourifliment. On being prefled to give a reafon for this re-
fufal, he anfwered, he knew nothing would pafs through him. A
cathartic was given, which produced a great many evacuations, but
he flill perfifted, that nothing pafled through him ; and thouo-h he
was frightened into taking a little broth once or twice by threats, yet
he foon ceafed intirely to fwallow any thing, and died in confequence
of this infane idea.

Mifs , a fenfible and ingenious lady, about thirty, faid flie had

feen an angel -, who told her, that (he need not eat, though all others
were under the neceffity of fupporting their earthly exiftence by food.

After fruitlefs perfuafions to take food, fhe ftarved herfelf to death.

It was propofed to fend an angel of an higher order to tell her, that
now fhe muft begin to eat and drink again ; but it was not put into
execution.

Mrs. , a lady between forty and fifty years of age, imagined

that fhe heard a voice fay to her one day, as fhe was at her toilet,

" Repent,

358 DISEASES OF VOLITION. Class III. i. z,

" Repent, or you will be damned." Fronn that moment flie be-
came melancholy, and this hallucination afFeded her in greater or lefs
degree for about two years ; {lie then recovered perfedlly, and is now
a cheerful old woman.

Mrs. , a farmer's wife, going up flairs to drefs, found the

curtains of her bed drawn, and on undrawing them, (he believed that
fhe faw the corpfe of her fifter, who was then ill at the diftance of
twenty miles, and became from that time infane ; and as her fifler
died about the time, fhe could not be produced to counterafl:
the infane hallucination, but fhe perfeilly recovered in a few
months.

Mrs. , a mofl elegant, beautiful, and accomplifhed lady,

about twenty-two years of age, had been married about two months
to an elegant, polifhed, and affluent young man, and it was well
known to be a love-match on both fides. She fuddenly became me-
lancholy, and yet not to fo great a degree, but that fhe could com-
mand herfelf to do the honours of her table with grace and apparent
cafe. After many days intreaty, flie at length told me, that fhe
thought her marrying her hufband had made him unhappy ; and
that this idea fhe could not efface from her mind day or night. I
withftood her being confined, as fome had advifed, and propofed a
fea-voyage to her, with expectation that the ficknefs, as well as
change of objefts, might remove the infane hallucination, by intro-
ducing other energetic ideas ; this was not complied with, but fhe
travelled about England with her friends and her hufband for many
months, and at length perfedlly recovered, and is now I am informed
in health and fpirits.

Thefe cafes are related to fhew the utility of endeavouring to in-
vefligate the maniacal idea, or hallucination ; as it may not only ac-
quaint us with the probable defigns of the patient, from whence may-
be deduced the neceflity of confinement ; but alfo may fome time lead
to the mofl effedual plan of cure.

I jreceived

Class III. r. 2. DISEASES OF VOLITION. 359

I received good information of the truth of the following cafe,
which was publiflied a few years ago in the newfpapers. A young
farmer in Warwickfhire, finding his hedges broke, and the flicks
carried away during a frofty feafon, determined to watch for the
thief. He lay many cold hours under a hay-flack, and at length an
old woman, like a witch in a play, approached, and began to pull up
the hedge ; he waited till flie had tied up her bottle of flicks, and
was carrying them ofF, that he might convidl her of the theft, and
then fpringing from his concealment, he feized his preywith violent
threats. After fome altercation, in which her load was lert upon the
ground, fhe kneeled upon her bottle of flicks, and railing her arms
to heaven beneath the bright moon then at the full, fpoke to the
farmer already fhivering with cold, " Heaven grant, that thou never
mayefl know again the blefiing to be warm." He complained of
cold all the next day, and wore an upper coat, and in a few days an-
other, and in a fortnight took to his bed, always faying nothing
made him warm, he covered himfelf with very many blankets, and
had a fieve over his face, as he lay ; and from this one infane idea he
kept his bed above twenty years for fear of the cold air, till at length
he died.

M. M. As mania arifes from pain either of our mufcles or organs of
fenfe, the arts of relieving pain mufl conftitute the method of cure;
See Sedl. XXXIV. 3. 4. Venefe£lion. Vomits of from five grains
to ten of emetic tartar, repeated every third morning for three or four
times ; with folution of gum-ammoniac, and foluble tartar, fo as to
purge gently every day. Afterwards warm bath for two or three
hours a day. Opium in large dofes. Bark. Steel.

Dr. Binns gave two fcruples (40 grains) of folid opium at a dofe,
and twenty grains four hours afterwards ; which reflored the patient.
Dr. Brandreth gave 400 drops of laudanum to a maniac in the greatefl
poflible furor, and in a few hours he became calm and rational. Med, .
Commeiit. for 1 79 1, p. 384.

Urognojik^

360 DISEASES OF VOLITION. Class III. i. 2,

Prognojllc,

The temporary quick pulfe attending fome maniacal cafes is {imply
a fymptom of debilit}'-, and is the confequence of too great exertions;
but a permanent quick pulfe fhews the prelence of fever, and is fre-
quently a falutary fign ; becaufe, if the life of the patient be fafe,
when the fever ceafes, the infanity generally vaniflies along with it,
as mentioned above. In this cafe the kind of fever muft dire6t the
method of curing the infanity; which mufl confift of moderate eva-
cuations and diluents, if the pulfe be ftrong ; or by nutrientia, bark,
and fmall dofes of opium, if the pulfe be weak.

Where the caufe is of a temporary nature, as in puerperal infanity,
there is reafon to hope, that the difeafe will ceafe, when the bruifes,
or other painful fenfations attending this ftate, are removed. In thefe
•cafes the child fhould be brought frequently to the mother, and ap-
plied to her breaft, if fhe will fuffer it, and this whether Ihe at firft
attends to it or not ; as by a few trials it frequently excites the
ftorge, or maternal afFeftion, and removes the infanity, as I have
witneffed.

When the madnefs is occafioned by pain of the teeth, which I be-
lieve is no uncommon cafe, thefe muft be extrafted ; and the cure
follows the extinftion of the pain. There is however fome difficulty
in detedling the delinquent tooth in this cafe, as in hemicrania, unlefs
by its apparent decay, or by fome previous information of its pain
baving been complained of; becaufe the pain of the tooth ceafes, as
ibon as the exertions of infanity commence.

When a perfon becomes infane, who has a family of fmall children
to folicit his attention, the prognoftic is very unfavourable; as it
Hiews the maniacal hallucination to be more powerful than thofe ideas
wliich generally intereft us the moft.

2. Studium

Class III. I. 2. DISEASES OF VOLITION. 361

2. Studium inane. Reverie confifts of violent voluntary exertions
of ideas to relieve pain, with all the trains or tribes connefted with
them by fenfations or affociations. It frequently alternates with epi-
leptic convulfions ; with which it correfponds, in refpeft to the in-
^enfibiHty of the mind to the ftimuli of external objefts, in th&
fame manner as madnefs correfponds with common convulfion, iij.
the patient's pofleffing at the fame time a fenfibiUty of the flimuli of
external objects.

Some have been reported to have been involved in reverie fo per-
fectly, as not to have been difturbed by tlie difcharge of a cannon ;
and others to have been infenfible to torture, as the martyrs for reli-
gious opinions ; but thefe feem more properly to belong to particular
infanities than to reverie, like noftalgia and erotomania.

Reverie is diftinguifhed from madnefs as defcribed above ; and from
delirium, becaufe the trains of ideas are kept conliflent by the power
of volition, as the perfon reafons and deliberates in it. Somnambu-
iifmus is a part of reverie, the latter confifting in the exertibns of the
locomotive mufcles, and the former of the exertions of the organs of
fenfe ; fee Clafs I. i. i. 9. and Se6l. XIX. both which are mixed, or
alternate with each other, for the purpofe of relieving pain.

When the patients in reverie exert their volition on their organs of
fenfe, they can occafionally perceive the ftimuli of external objecfts,
as explained in Se£l. XIX. And in this cafe it refembles fome-
times an hallucination of the fenfes, as there is a mixture of fa<3: and
imagination in their difcourfe ; but may be thus diftinguiflied : hallu-
cinations of the fenfes are allied to delirium, and are attended gene-
rally with quick pulfe, and other fymptoms of great debility ; but
reverie is without fever, and generally alternates with convullions ;
and fo much intuitive analogy (fee Sedl. XVH. 3. 7.) is re-
tained in its paroxyfms, as to preferve a confiftency in the trains
of ideas.

Mifs G , whofe cafe is related in Se£l. III. 5. 8. faid, as I

Vol. II. 3 A once

362 DISEASES OF VOLITION. Class III. 1.2.

once fat by her, " My head is fallen off, fee it is rolled to that corner
of the room, and the little black dog is nibbhng the nofe off." Oa
my walking to the place which fhe looked at, and returning, and
atfuring her that her nofe was unhurt, {he became pacified, though I
was doubtful whether (he attended to me. See Clafs III. i. 1.9. and
Clafs III. I. 2. 2.

M. M. Large dofes of opium given before the expelled paroxyfm,
as in epilepfia dolorifica, Clafs III. 1.1.8.

The hallucinatio fludiofa, or falfe ideas in reverie, differ from ma-
niacal hallucinations above defcribed, as no infane exertions fucceed,
and in the patients whom I have feen they have always been totally
forgotten, when the paroxyfm was over.

Mafter , a fchool-boy about twelve years old, after he came

out of a convulfion fit and fat up in bed, faid to me, " Don't you fee
my father standing at the feet of the bed, he is come a long way 011
foot to lee me." I anfwered, no: " What colour is his coat ?" He
replied, " A drab colour." " And what buttons r" " Metal ones,"'
he anfwered, and added, " how fadly his legs are fwelled." In a
few minutes he faid, with apparent furprife, " He is gone," and re.-
turned to his perfe£l mind. Other cafes are related in Se£l. XIX.
and XXXIV. 3. and in Clafs II L 1.2.2, with further obfervations
on this kind of hallucination ; which however is not the.caufe of re-
verie, but conftitutes a part of it,, the caufe being generally fome un-
eafy fenfation of the body.

3. VigJlia. Watchfulnefs confifls in the unceaiing exertion of vo-
lition ; which is generally caufed by fome degree of pain either of
mind or of body, or from defeit of the ufual quantity of plealurable
fenfation ; hence if thofe, who are accuflomed to wLne at night, take
tea inftead, they cannot ileep. The fame happens from want of foKd
food for fupper, to thole who are accuftomed to ufe it ; as in thefe
cafes there is pain or defe£l of pleafure in. the flomach.

Sometimes

Glass III. 1.2. DISEASES OF VOLITION. 363

Sometimes the anxiety about flceping, that is the defire to fleep,
prevents fleep ; which confifts in an abolition of defire or will.
This may fo far be compared to the impediment of fpeech defcribed
in Se£t. XVII., i. 10. as the interference of the will prevents the ef-
fedl defired.

Another fource of watchfulnefs may be from the too great fecre-
tion of fenforial power in the brain, as in phrenzy, and as fometimes
happens from the exhibition of opium, and of wine ; if the exhauftion
of fenforial power by the general adlions of the fyftem occafioned by
the ftiraulus of thefe drugs can be fuppofed to be lefs than the inciisafed
fecretlon of it. , .

M. M. I. Solid food to fupper. Wine. Opium. Warm bath.
2. The patient (hould be told that his want of fleep is of no confe-
quence to his health. 3. Venefe6lion by cupping. Abflinence from
wine. 4. A blifter by ftimulating the fkin, and rhubarb by Simu-
lating the bowels, will fometimes induce fleep. Exercife. An uni-
form found, as of a paufing drop of water, or the murmur of bees.
Other means are defcribed in Se£t. XVIII. 20.

4. Erotomania. Sentimental love. Defcribed in its excefs by ro-
mance-writers and poets. As the obje£l of love is beauty, and as our
perception of beauty confifl:s in a recognition by the fenfe of vifion of
thofe objeds, which have before infpired our love, by the pleafure
they have afforded to many of our fenfes (Se£t. XVI. 6) ; and as brute
animals have lefs accuracy of their kiii^e, of vifion than mankind (ib.) ;
we fee the reafon why this kind of love is not frequently obfervable
in the brute creation, except perhaps in fome married birds, or in the
affeftion of the mother to her offspring. Men, who have not had
leifure to cultivate their tafl:e for vifible objeds, and who have not
read the works of poets and romance- writers, are lefs liable to fenti-
mental love ; and as ladies are educated rather with an idea of being
ch^jfen, than of choofing; there are many men, and more women,

3 A 2 who

364 DISEASES OF VOLITION. Class III. 1.2.

\yho have not much of this Infanity ; and are therefore more eafily
induced to marry for convenience or intereft, or from the flattery of
one fex to the other.

In its fortunate gratification fentimental love is fuppofed to fupply
the pureft fource of human feUcity; and from the fuddennefs with
which many of thofe patients, defcribed in Species I. of this genus»
were feized with the maniacal hallucination, there is reafon to be-
lieve, that the mod violent fentimental love may be acquired in a
moment of time, as reprefented by Shakefpeare in the beginning of
his Romeo and Juliet.

Some have endeavoured to make a diftindlion between beauty and
grace, and have made them as it were rivals for the poiTeffion of the
human heart ; but grace may be defined beauty in adtion ; for a fleep-
ing beauty cannot be called graceful in whatever attitude flie may re-
cline ; the mufcles mufl be in a6llon to produce a graceful attitude,
and the limbs to produce a graceful motion; But though the obje6t
of love is beauty, yet the idea is neverthelefs much enhanced by the
imagination of the lover ; which appears from this curious circum-
flance, that the lady of his paffion feldom appears fo beautiful to the
lover after a few months feparatlon, as his ideas had painted her in his
abfence ; and there is, on that account, always a little diiappolnt-
ment felt for a minute at their next interview from this hallucinatioiv
of his ideas.

This paflion of love produces reverie in its firfl: ftate, v/hich exer-
tion alleviates the pain of it, and by the afiiftance of hope converts it
into pleafure. Then the lover feeks folitude, left this agreeable re-
verie ihould be interrupted by external ftimuli, as defcribed by
Virgil.

'£}'

Tantum inter denfas, umbrofa cacumina, fagos
Affidue veniebat, ibi hsec incondita folus
Monllbus et fylvis Audio jaftabat inani.

Whea

Class III. 1.2. DISEASES OF YOLITION. s^5

When the pain of love is fo great, as not to be relieved by the e)^-
ertions of reverie, as above defcribed ; as when it is mifplaced on an.
objeft, of which the lover cannot poffefs himfelf; it may ftill be
countera£led or conquered by the floic phllofophy, which ftrips all
things of their ornaments, and inculcates " nil admirari." Of which
leflbns may be found in the meditations of Marcus Antoninus. The
maniacal idea is faid in fome lovers to have i)een weakened by the
a6lion of other very energetic ideas ; fuch as have been occafioned by
the death of his favourite child, or by the burning of his houfe, or by
his being (hipwrecked. In thofe cafes the violence of the new idea
for a while expends fo much fenforial power as to prevent the exer-
tion of the maniacal one ; and new catenations fucceed. On this
theory the lover's leap, fo celebrated by poets, might eifeO: a cure, if
the patient efcaped with life.

The third ftage of this difeafe I fuppofe is irremediable ; when a
lover has previoufly been much encouraged, and at length meets with
negleft or difdain j the maniacal idea is fo painful as not to be for a
moment relievable by the exertions of reverie, but is inflantly follow-
ed by furious or melancholy infanity ; and fuicide, or revenge, have
frequently been the confequence. As was lately exemplified in Mr,
Hackman, who (hot Mifs Ray in the lobby of the playhoufe. So the
poet defcribes the paffion of Dido,

Moriamur inultse ? —

At moriamur, ait, — fic, fic, juvat ire fub umbras !

The /lory of Medtea feems to have been contrived by Ovid, who
was a good judge of the fubje6l, to reprefent the favage madnefs oc-
caiioned by ill-requited love. Thus the poet,

Earth has no rage like love to hatred turn'd,
Nor hell a fury like a woman fcorn'd.

DrydeNo

5. ^mar

366 DISEASES OF VOLITION. Class III. i. %.

/ 5. Amor Jul. Vanity confiftsof an agreeable reverie, and is well ri-
diculed in the ftory of Narciffus, who lo long contemplated his own
beautiful image in the water, that he died from neglett of taking fuf-"
t-enance. I once faw a handfome young man, who had been fo much
flattered by his parents, that his vanity rofe fo near to infanity, that
one niight difcern by his perpetual attention to himlelf, and the dif-
ficulty with which he arranged his converfation, that the idea of him-
felf intruded itfelf at every comma or paufe of his difcourfe. In this
degree vanity mufl afford great pleafure to the pofleflor ; and when
it exifts within moderate bounds, may contribute much to the hap-
pinefs of focial life.

My friend Mr. once complained to me, that he was much

troubled with baflifulnefs in company, and believed that it arofe from
his want of perfonal vanity ; on this account he determined on a jour-
Bey to Paris, vi'hen Paris was the center of politenefs; he there
learnt to drefs, to dance, and to move his hands gracefully in con-
verfation ; and returned a moft confummate coxcomb. But after a
very few years he relapfed into rufticity of drefs and manners.

M. M. The cure of vanity may be attempted by excefs of flattery,
v/hich will at length appear ridiculous, or by its familiarity will ceafe
to be defired. I remember to have heard a ftory of a nobleman ia
the court of France, when France had a court, who was fo difagree-
ably vain in converfation, that the king was pleafed to direct his cure,
which was thus performed. Two gentlemen were diredled always
to attend him, one was to fland behind his chair, and the other at a
refpedful diflance before him ; whenever his lord/hip began to fpeak,
one of them always pronounced, *' Lord Gallimaufre is going to fay
the beft thing in the world." And, as foon as his lordfhip had done
fpeaking, the other attendant pronounced, " Lord Gallimaufre has
fpoken the beft thing in the world," Till in a few vi'eeks this noble
lord was fo difgufted with praile that he ceafed to be vain ; and his
jnajefty difmifled his keepers.

6. Nojlalgiaa

Class III. 1.2. DISEASES OF VOLITION. 367

6. Nojlalg'ia. Maladie de Pais. Calenture. An unconquerable
define of returning to one's native country, frequent in long voyages,
in which the patients become fo infane as to throw themfelves into
the fea, miftaking it for green fields or meadows. The Swifs are
faid to be particularly liable to this difeafe, and when taken into fo-
reign fervice frequently to defert from this caufe, and efpecially after
hearing or finging a particular tune, which was ufed in their village
dances, in their native country, on which account the playing or
finging this tune was forbid by the punifliment of death. Zwin-

gerus.

Dear is that flied, to which his foul conforms,
And dear that hill, which lifts him to the ftorms.

Goldsmith..

7. Spes reUglofa. Superftitious hope. This maniacal hallucination
in its milder ftate produces, like fentimental love, an agreeable reve-
rie ; but when joined with works of fupererogation, it has occafioned
many enormities. In India devotees confign themfelves by vows to
mod painful and uncealing tortures, fuch as holding up their hands,
till they cannot retraft them ; hanging up by hooks put into the
thick fkin over their (houldcrs, fitting upon fharp points, and other
felf torments. While in our part of the globe fafting and mortifica-
tion, as flagellation, has been believed to pleafe a merciful deity! The
ferenity, with which many have fuffered cruel martyrdoms, is to be
afcribed to this powerful reverie.

Mr. , a clergyman, formerly of this neighbourhood, began

to bruife and wound himfelf for the fake of religious mortification,
and pafled much time 111 prayer, and continued whole nights alone
in the church. As he had a wife and f<:imily of fmall children, I be-
lieved the cale to be incurable ; as otherwife the affeftion and employ-
iTient in his family connexions would have oppofed the beginning of
this infanity. He was taken to a madhoufe without efFe£b, and after

he

368 DISEASES OF VOLITION. Class III. i. 2.

he returned home, continued to beat and bruife himfelf, and by this
kind of mortification, and by fometimes long fafting, he at length
became emaciated and died. I once told him in converfation, that.
" God was a merciful being, and could not delight in cruelty, but
that I fuppofed he worfhipped the devil." He was ftruck with this
idea, and promifed me not to beat himfelf for three days, and I be-
lieve kept his word for one day. If this idea had been frequently
forced on his mind, it might probably have been of fervice,

"When thefe works of fupererogation have been of a public nature,
what cruelties, murders, maiTacres, has not this infanity introduced
hito the world ! — A commander, who had been very aftive in leading
and encouraging the bloody deeds of St. Bartholomew's tlay at Paris,
on confeiling his fins to a worthy ecclefiafiiic on his death-bed, was
alked, " Have you nothing to fay about St. Bartholomew ?" " Oa
that day," he replied, " God Almighty was obliged to me !" —
The fear of hell is another infauity, which will be fpoken of
below.

8. Siiperhla jlemmahs. Pride of family has frequently formed a
maniacal hallucination, which in its mild flate has confifled in agree-
able reverie, but when it has been fo painful as to demand homage
from others, it has frequently induced infane exertions. This infanity
feems to have exifted in the flourifhing ftate of Rome, as now all
over Germany, and is attacked by Juvenal with great feverity, a fmali
part of which I fhall here give as a method of cure. Sat. 8.

Say, what avails the pedigree, that brings
Thy boafted line from heroes or from kings ;
Though many a mighty lord, in parchment roU'd,
Name after name, thy coxcomb hands unfold ;
Though wreathed patriots crowd thy marble halls,
Or fleel-clad warriors frown along the walls ;
While on broad canvas in the gilded frame
All virtues flourilh, and all glories flame?—

Say,'

CxASsIII. 1.2. DISEASES OF VOLITION. '369

Say, — If ere noon with idiot laugh you lie
Wallowing in wine, or cog the dubious die^
Or adl unfhamed, by each indignant buft,

The midnight orgies of promilcuous lufl ! ■

Go, lead mankind to Virtue's holy flirine,
With morals mend them, and with atts refine,
Or lift, with golden chara£ters unfurl'd,
The flag of peace, and ftill a warring world !— •
— So (hall with pious hands immortal Fame
Wreathe all her laurels round thy honour'd name.
High o'er thy tomb with chiflel bold engrave,
*' The truly noble are the good and brave."

9. Ainbit'io. Indrdinate delire of fame. A careleffnefs about the
opinions of others is faid by Xenophoa to be the fource of impu-
dence ; certainly a proper regard for what others think of us fre-
quently incites us to virtuous adlions, and deters us from vicious ones ;
and increafes our happinefs by enlarging our fphere of fympathy, and
hy flattering our vanity.

Abfl:ra£l what others feel, what others think,
All pleafures ficken, and all glories fink.

Pope.

When this reverie of ambition excites to conquer nations, or to
enfiave them, it has been the fource of innumerable wars, and the
occafion of a great devaftation of mankind. Caefar is reported to have
boafted, that he had deftroyed three millions of his enemies, 'and one
million of his friends.

The works of Homer ate fuppofed to have done great injury to
mankind by infpiring the love of military glory. Alexander was faid
to fleep with them always on his pillow. How like a mad butcher
amid a flock of fheep appears the hero of the Iliad, in the following
fine lines of Mr. Pope, which conclude the twentieth book.

Vol. IL 3 B His

370 DISEASES OF VOLITION. Class III, 1.3.

His fiery courfers, as the cliariot rolls,
Tread down whole ranks, and crufli out heroes' fouls ;
Dafli'd from their hoofs, as o'er the dead they fly.
Black bloody drops the fmoaking chariot dye ; —
The fpiky wheels through heaps of carnage tore,
And thick the groaning axles dropp'd with gore ;
High o'er the fcene of death Achilles flood,
All grim with duft, all horrible with blood ;
Yet Hill infatiate, flill with rage on flame,
Such is the lufl; of never dying fame!

The cure mufl be taken from moral writers. Woolafton fays,
Cffifar conquered Pompey ; that is, a man whofe name confifted of
the letters C. ae. f. a. r. conquered a long time ago a man, whofe
mme confifted of the letters P. o. m. p. e. y. and that this is all that
remains of either of them. Juvetial alfo attacks this mode of iiifanity.
Sat. X. 166.

— I, demens, et faevas curre per alpes,.
Ut pueris placeas, et declamatio fias !

Which is thus tranflated by Dr. Jobnfon,

And left a name, at which the world grew pale.
To point a moral, or adorn a tale I

10. Meeror. Grief. A perpetual voluntary contemplation of al!
the circumftances of fome great lofs, as of a favourite child. In ge-
neral the painful ideas gradually decreafe in energy, and at length the
recolleftion becomes more tender and lefs painful. The letter of Sul-
picius to Cicero on the lofs of his daughter is ingenious. The ex-
ample of David on the lofs of his child is heroic.

A widow lady was left in narrow circumftances with a boy and a
girl, tvi'o beautiful and lively children, the one fix and the other
feven years of age ; as her circumftances allowed her to keep but one

maid"

Class'IU. I. 2. DISEASES OF VOLITION. >;!

maid-fervant, thefe two children were the fole attention, employ-
ment, and confolation of her lifej (he fed them, dreffed them, fiept
with them,, and taught them herfelf ; they were both fnatched from
her by the gangrenous fore throat in one week : fo that Ihe loft at
once all that employed her, as well as all that was dear to her. For
the firft three or four days after their death, when any friend vifited
her, fhe fat upright, with her eyes wide open, without fliedding
tears, and afFeded to fpeak of indifferent things. Afterwards flie be-
gan to weep much, and for fome weeks talked to her friends of no-
thing elfe but her dear children. But did not for many years, even
to her dying hour, get quite over a gloom, which was left upon her
countenance. '

In violent grief, when tears flow, it is efteemed a good fymptom ;
becaufe then the aftions caufed by fenfitive aflbciation take the place of
thofe caufed by volition ; that is, they prevent the voluntary exer-
tions of ideas, or mufcular adlions, which conftitute infanity.

The fobbing and fighing attendant upon grief are not convulfivc
movements, they are occafioned by the fenforial power being fo ex-
pended on the painful ideas, and their connexions, that the perfon
neglecls to breathe for a time, and then a violent ligh or fob is necef-
fary to carry on the blood, which opprefles the pulmonary veffels,
which is then performed by deep or quick infpirations, and laborious
expirations. Sometimes neverthelefs the breath is probably for a
while voluntarily held, as an effort to relieve pain. The palenefs
and ill health occaiioned by long grief is fpokeii of in Clafs IV.
2. I. 9.

The melioration of grief by time, and its being at length even
attended with pleafure, depends on our retaining a diftindl idea of the
lofl objeft, and forgetting for a time the idea of the lofs of it. This
pleafure of grief is beautifully defcribed by Akenfide. Pleafures of
Imagination, Book II. 1. 680.

3B 2 — — -Afk

373 DISEASES OF VOLITION. Class III. i. 2.

-Afk the faithful youth,

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

So often fills his anns ; fo often draws

His lonely footfleps at the filent hour

To pay the mournful tribute of his tears?

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

Sliould ne'er feduce his bofom to forego

That facred hour ; when, ftealing from the noifc

Of care and envy, fvveet remembrance foothes

"With Virtue's kindeft looks his acliing breaft,

And turns his tears to rapture.

M. M. Confolation is beft fupplied by the Chriftiaii dodlrine of a,
happy immortality. In the pagan religion the power -of dying was
the great confolation in irremediable diftrefs. Seneca fays, " no one
need be unhappy unlefs bj^ his own fault." And the author of Tele-
machus begins his work by faying, that Calypfo could not confole
herfelf for the lofs of UlylTes, and found herfelf unhappy in being, im-
mortal. In the firft hours of grief the methods of confolation ufed
by uncle Toby, in Triftram Shandy, is probably the befl ; "he fat
down in au arm chair by the bed of hia diilreffed friend, and faid no-
thing."

1 1. 'Tced'mm vita. The inanity of fublunary things has afforded a
theme to philofophers, moralifts, and divines, from the earlieft re-
cords of antiquity ; '* Vanity of vanities !" fays the preacher, " all is
vanity !" Nor is there any one, I fuppofe, who has paffed the meri-
dian of life, who has not at fome moments felt the nihility of all
things. ' •

Wearinefs of life in its moderate degree has been efteemed a motive
to adlion by fome philofophers. See Se£l. XXXIV. 2. 3. But in
thofe men, who have run through the ufual amufements of life
early in rcfped to their age ; and who have not induftry or ability to

cultivate

Class III. 1.2. DISEASES OF VOLITION. ^73

cultivate thofe fciences, which afford a perpetual fund of novelty,
and of confequent entertainment, are liable to become tired of life, as
they fuppofe there is nothing new to be found in it, that can afford
them pleafure ; like Alexander, who is faid to have (hed tears, becaufe
he had not another world to conquer.

Mr. , a gentleman about fifty, of polifhed manners, who

in a few months afterwards deftroyed himfelf, faid to me one day,
*' a ride out in the morning, and a warm parlour and a pack of cards
in the afternoon, Is all that life affords." He was perfuaded to have
an iffue on the top of his head, as he complained of a dull head-ach,
which being unfkilfully managed, deftroyed the pericranium to the
fize of an inch in diameter; during the time this took in healing, he
was indignant about it, and endured life, but foon afterwards fhot
himfelf.

Mr. , a gentleman of Gray's Inn, fome years ago was pre-
vailed upon by his friends to difmifs a miftrefs, by whom he had a
child, but who was fo great a termagant and fcold, that Ihe was be-
lieved to ufe him very ill, and even to beat him. He became melan-
choly in two days from the want of his ufual flimulus to aftion,.
and cut his throat on the third fo completely, that he died immedi-
ately.

Mr. Anfon, the brother to the late Lord Anfon, related to me the
following anecdote of the death of Lord Sc — '■ — . His Lordfliip fent
to fee Mr. Anfon on the Monday preceding his death, and faid,
*' You are the only friend I value in the world, I determined there-
fore to acquaint you, that I am tired of the infipidity of life, and in-
tend to-morrow to leave it." Mr. Anfon faid, after much converfa-
tion, that he was obliged to leave town till Friday, and added, " As
you profefs a friendfhip for me, do me this laft favour, I entreat you, ,

live till I return." Lord Sc believed this to be a pious artifice to

gain time, but neverthelefs agreed, if he fhould return by four
o'clock on that day. Mr. Anfon did not return till five, and found,

by

374. DISEASES OF VOLITION. Class III. 1.2,

by the countenances of the domeftics, that the deed was done. He
v.'ent into his chamber aad found the corpfe of his friend leaning over
the arm of a gi eat chair, with the piftol on the ground by him, the
ball of which had been difcharged into the roof of his mouth, and
pafled into his brain.

Mr. and Mr. , two young men, heirs to confiderable

fortunes, fliot themfelves^at the age of four or five and twenty, with-
out their friends being able to conjecSlure any caufe for thofe rafh ac-
tions. One of them I had long known to exprefs himfelf with dif-
latisfadion of the world ; at eighteen years of age he complained,
that he could not entertain himfelf; he tried to ftudy the law at Cam-
bridge, and afterwards went abroad for a year or two by my advice ;
but returned diflatisfied with all things. As he had had an eruption
for fome years on a part of his face, which he probably endeavoured
to remove by external applications; I was induced to afcribe his per-
petual ennui to the pain or difagreeable fenfation of a difeafed liver.
The other young gentleman fliot himfelf in his bed-room, and I was '
informed that there was found written on a fcrap of paper on his
table, " I am impotent, and therefore not fit to live." From
whence there was reafon to conclude, that this was the halluclnatio
maniacalis, the delirious idea, which caufed him to deftroy him-
felf. The cafe therefore belongs to mania mutabilis, and not to ta;-
dium vitae.

M. M. Some reftraint in exhaufting the ufual pleafures of the world
early in life. The agreeable cares of a matrimonial life. The culti-
vation of fcience, as of chemiftry, natural philofophy, natural hiftory,
which fupplies an inexhauftible fource of pleafurable novelty, and re-
lieves ennui by the exertions it occafions.

In many of thefe cafes, whence irkfomenefs of life has been the
oftenfible caufe of fuicide, there has probably exifted a maniacal hal-
lucination, a painful idea, which the patient has concealed even to his
dying hour ; except where the mania has evidently arifen from here-
ditary

Class III, 1.2. DISEASES OF VOLITION. 375

ditary or acquired difeafe of the membranous or glandular parts of the
fy ftem .

12. Piilchitudinis dejtderlum. The lofs of beauty, either by difeafe,
as by the Imall-pox, or by age, as life advances, is fometimes pain-
fully felt by ladies, who have been much flattered on account of
it. There is a curious cafe of this kind related in Le Sage's
Bachelor of Salamanca, which is too nicely defcribed to be totally
imaginary.

In this fituation fome ladies apply to what are termed cofmetics
under various names, which crowd the newfpapers. Of thefe the
white has deftroyed the health of thoufands ; a calx, or magiftery, of
bifmuth is fuppofed to be fold in the fhops for this purpofe ; but it is
either, I am informed, in part or entirely white lead or cerufla. The
pernicious effedls of the external ufe of thofe faturnine applications are
fpoken of in gutta rofea, Clafs II. i. 4. 6. The real calx of bifmuth
would probably have the fame ill efFe6t» As the red paint is prepared
from cochineal, which is an animal body, lefs if any injury arifes from
its ufe, as it only lies on the Ikin like other filth.

The tan of the fkin occalioned by the fun may be removed by
lemon juice evaporated by the fire to half its original quantity, or by
diluted marine acid ; which cleans the cuticle, by eroding its furface,.
but requires much caution in the application ; the marine acid muft
be diluted with water, and when put upon the hand or face, after a
fecond of time, as foon as the tan difappears, the part mufl be wafhed
with a wet towel and much warm water. Freckles lie too deep for
this operation, nor are they in general removeable by a blifter,, as I
once experienced. See Clafs I. 2. 2. 9.

It is probable, that thofe materials which flain filk, or ivory,
might be ufed to ftain the cuticle, or hair, permanently ;, as they are
all animal fubftances. But I do not know, that any trials of this kind
have been made on the ikin. I endeavoured in vain, to whiten the

back

376 DISEASES OF VOLITION. Cla&s III. i. 2,

back of my heuKi by marine acid oxygenated by manganefe, which {o
iiiftautly whitens cotton.

The cure therefore mull: be fought from moral writers, and the
cultivation of the graces of the mind, which are frequently a more
valuable pofleffioa than celebrated beauty.

13. Patiperfatts t'lmor. The fear of poverty is one kind of avarice ;
it is liable to affedl people who have left off a profitable and aflive
bufitiefs ; as they are thus deprived of their ufual exertions, and are
liable to obferve the daily expenditure of money, without calculating
the fource from whence it flows. It is alfo liable to occur with a

fudden and unexpefted increafe of fortune. Mr. , a furgeon,

about fifty years of age, who was always rather of a parfimonious
difpofition, had a large houfe, with a fortune of forty thoufand
pounds, left him by a diflant relation ; and in a few weeks became
infane from the fear of poverty, lamenting that he fhould die in a
jail or workhoufe. He had left off a laborious country bufinefs, and
the daily perception of profit in his books ; he alfo now faw greater
expences going forwards in his new houfe, than he had been ac-
cuftomed to obferve, and did not fo diftindlly fee the fource of fupply;
which feems to have occafioned the maniacal hallucination. — This
idea of approaching poverty is a very frequent and very painful difeafe,
fo as to have induced many to become fuicides, who were in good
circumilances ; more perhaps than any other maniacal hallucination ,1
except the fear of hell.

The covetoufnefs of age is more liable to affe£t fingle men, than
thofe who have families j though an accumulation of wealth would
feem to be more defirable to the latter. But an old man in the
former fituation, has no perfonal connedlions to induce him to open
his purfe; and having loft the friends of his youth, and not eafily
acquiring' new ones, feels himfelf alone in the world; feels himfelf
unprotedled, as his ftrength declines, and is thus led to depend for
6 ' afiiftance

Class III. i. 2. DISEASES OF VOLITION. 2,11

affiftance o\\ money, and on that account wiflies to accumulate it.
Whereas the father of a family has not only thofe connedlions, which
demand the frequent expenditure of money, but feels a confolation in
the friendship of his children, when age may render their good offices
neceflary to him.

M. M. I have been well informed of a medical perfon in good cir-
circumflances in London, who always carries an account of his af-
fairs, as debtor and creditor, in his pocket-book ; and looks over it
frequently in a day, when this difeafe returns upon him ; and thus,
by counterafting the maniacal hallucination, wifely prevents the in-
creafe of his infanity. Another medical perfon, in London, is faid
to have cured himfelf of this difeafe by ftudying mathematics with
great attention ; which exertions of the mind relieved the pain of the
maniacal hallucination.

Many moral writers have ftigmatlfed this infanity ; the covetous,
they fay, commit crimes and mortify themfelves without hopes of re-
ward ; and <thus become miferable both in this world and the next.
Thus Juvenal :

Cum furor baud dubius, cum fit manifefta phrenitlsj
Ut locuples moriaris, egenti vivere fato !

The covetous man thouglit he gave good advice to the fpendthrift,
when he faid, " Live like me," who well anfwered him,

' ■■" Like youj Sir John ?
" That I can do, when all-I have is gone !"

Pope.

14. Leth'i tlmor. The fear of death perpetually employs the
thoughts of thefe patients ; hence they are devifing new inedicines,
and applying to phyfician-s and quacks without number. It is con-
founded with hypochondriafis, Clafs L 2. 3. 9, in popular converfa-
tion, but is in reality an infanity.

Vol, II. 3 C A young

378 DISEASES OF VOLITION. Class III. 1.2.

A young gentleman, whom I advifed to go abroad as a cure for
this difeafe, aflured me, that during the three years he was in Italy
and France he never pafled a quarter of an hour without fearing he
Ihould die. But has now for above twenty years experienced the
contrary.

The fufferers under this malady are generally at once difcoverable
by their telling you, amidit an vinconne(5led defcriptloii of their com-
plaints, that they are neverthelefs not afraid of dying. They are alfo.
eafily led to complain of pains in almoft any part of the body, and are
thus foon difcovered.

M. M. As the maniacal hallucination has generally arifen in early
infancy from fome dreadful account of the ftruggles and pain of dying,.
I have fometimes obferved, that thefe patients have received great
confolation from the inftances I have related to them of people dying
without pain. Some of thefe, which I think curious, I fhall con-
cifely relate, as a part of the method of cure.

Mr. , an elderly gentleman, had fent for me one whole day

before I could attend him ; on my arrival he faid he was glad to fee
me, but that he was now quite well, except that he was weak, but
had had a pain in his bowels the day before. He then lay in bed
with his legs cold up to the knees, his hands and arms cold, and his

pulfe fcarcely difcernible, and died in about fix hours. Mr. ,

another gentleman about fixty, lay in the aft of dying, with difficult
refpiration like groaning, but in a kind of ftupor or coma vigil, and
every ten or twelve minutes, while I fat by him, he waked, looked
up, and faid, *' who is it groans fo, I am fure there is fomebody
dying in the room," and then funk again into a kind of fleep. From
thefe two cafes there appeared to be no pain in the ad of dying, which
may afford confolation to all, but particularly to thofe who are afflidt-
ed with the fear of death.

15. Ord

Class III. 1.2. DISEASES OF VOLITION. 379

1 5. Orci thnor. The fear of hell. Many theatric preachers among
the Methodifts fuccefsfuUy infpire this terror, and Uve comfortably
upon the folly of their hearers. In this kind of madnefs the poor
patients frequently commit fuicide ; although they believe they run
headlong into the hell, which they dread ! Such is the power of ora-
tory, and fuch the debility of the human underftanding !

Thofe, who fuffer under this infanity, are generally the rnoH: in-
nocent and harmlefs people ; who are then liable to accufe themfelves
of the greateft imaginary crimes, and have fo much intelledual
cowardice, that they dare Hot reafon about thofe things, which they
are direfted by their priefts to believe, however contradi£lory to hu-
man apprehenlion, or derogatory to the great Creator of all things.
The maniacal hallucination at length becomes fo painful, that the
poor infane flies from life to become free from it.

M. M. Where the intelledual cowardice is great, the voice of
reafon is inefFedlual ; but that of ridicule may fave many from
thofe mad-making dodors ; though it is too weak to cure thofe,
who are already hallucinated. Foot's Farces are recommended for
this purpofe.

16. Safyriajts. An nngovernable defirc of venereal indulgence.
The remote caufe is probably the flimulus of the femen ; whence
the phallus becomes diftended with blood by the arterial propulfion of
it being more ftrongly excited than the correfpondent venous abforp-
tion. At the fame time a nev/ fenfe is produced in the other termi-
nation of the urethra ; which, like itchiag, requires fome exterior
frlftion to facilitate the removal of the caufe of the maniacal aftions,
which may probably be increafed in thofe cafes by fome aflbciated
hallucinations of ideas. It differs from priapifmus chronicus in the
defire of its appropriated object, which is not experienced in the
latter, Clafs I. 1.4. 6, and from the priapifmus amatorius, Clafs 11.

3 C 3 1.7.

300 DISEASES OF VOLITION. Class III. 1.2-

1. 7. 9. In the maniacal adlons ia confequence of defire. The furor
uterius, or nymphomania, is a fimilar difeafe.

M. M. Venefedion. Cathartics. Torpentia, Marriage.

17. Ira. Anger is caufed by the pain of offended pride. We are
not angry at breaking a bone, but become quite infane from the
fmalleft ftroke of a whip from an inferior. Ira furor brevis. Anger is
not only itfelf a temporary madnefs, but is a frequent attendant on
other infanities, and as, whenever it appears, it diftinguiflies in-
fanity from delirium, it is generally a good lign in fevers with-
debility.

An injury voluntarily infli£led on us by others excites our exertions
of felf-defence or of revenge againil: the perpetrator of it ; but anger
does not fucceed in any great degree unlefs our pride is offended ; this
idea is the maniacal hallucination, the pain of which fometimes pro-
duces fuch violent and general exertions of our mufcles and ideas, as
to dlfappoint the revenge we meditate, and vainly to exhaufl: our fen-
forial power. Hence angry people, if not further excited by dif-
agreeable language, are liable in an hour or two to become humble,
and forry for their violencCj and willing to make greater conceflions
than required.

M. M. Be filent, when you feel yourfelf angry. Never ufe loud
oaths, violent upbraidings, or ftrong expreflions of countenance, or
gefticulations of the arms, or clenched fifls ; as thefe by their former
aflbciations with anger will contribute to increafe it. I have been told
of a fergeant or corporal, who began moderately to cane hisfoldiers,
when they were awkward in their exercil'e, but being addidled to
fwearing and coarfe language, he ufed foon to enrage himfelf by his
own expreffions of anger, till toward the end he was liable to beat the
delinquents unmercifully,

1 8, Rabies^

Class III. r. 2. DISEASES OF VOLITION. 381

18. Rabies. "Rage. A define of biting others, moft frequently at-
tendant on canine maJnefs. Animals in great pain, as in the colica fa-
turnina, are faid to bite the ground tliey lie upon, and even their
own flefh. I have feen patients bite the attendants, and even their
own arms, in the epilepfia dolorifica. It feems to be an exertion to
relieve pain, as explained in Se6t. XXXIV. i. 3. The dread of water
in hydrophobia is occafioned by the repeated painful attempts to fwal-
low it, and is therefore not an eflential or original part of the difeafe
called canine madnefs. See Clafs III. i. i. 15.

There is a mania reported to exifl: in fome parts of the eaft, in
which a man is faid to run a muck ; and thefe furious maniacs are
believed to have induced their calamity by unlucky gaming, and af-
terwards by taking large quantities of opium ; whence the pain of
defpair is joined with the energy of dj-unkennefs ; they are then faid
to fally forth into the moft populous flreets, and to wound and flay
all they meet, till they receive their own death, which they defire to
procure without the greater guilt, as they fuppofe, of fuicide.

M. M. When there appears a tendency to bite in the painful epi-
lepfy, the end of a rolled up towel, or a wedge of foft; wood, Ihould
be put into the mouth of the patient. As a bullet is faid fometimes to
be given to a foldier, who is to be feverely flogged, that he may by
biting it better bear his puniftiment.

19, Citta. A defire to fwallow indigeftib'le fubftances. I once
faw a young lady, about ten years of age, who filled her flomach
with the earth, out of a flower-pot, and vomited it up with fmall
ftories, bits of wood, and wings of infedls amongft it. She had the
bombycinous complexion, and looked like a chlorotic patient, though
fo young ; this generally proceeds from an acid in the ftomach.

M. M. A vomit. Magnefia alba. Armenian bole. Rhubarb.
Bark. Steel, A blifter. See Clafs I, z, 4. 3,

20. Cacofitla,

382 DISEASES OF VOLITION. Class III. 1. 2.

20. Cacojltla. Averfion to food. This may arife, without difeafe
of the ftomach, from conne£ling naufeous ideas to our ufual food, as

by calling a ham a hog's a . This madnefs is much inculcated

by the ftoic philofophy. See Antoninus' Meditations. See two cafes
of patients who refufed to take nourifhment, Clafs III. i. 2. i,

Averfions to peculiar kinds of food are thus formed early in life by
aflbciation of fome maniacal hallucination with them. I remember a
child, who on tafting the griftle of flurgeon, alked what griftle was.^
And being told it was like the divifion of a man's nofe, received an
ideal hallucination ; and for twenty years afterwards could not be per-
fuaded to tafte fturgeon.

The great fear or averfion, which fome people experience at the
. fight of fpiders, toads, crickets, and the like, have generally had a
fimilar origin.

M. M. Affociate agreeable ideas with thofe which difgufl: ; as call
a fpider ingenious, a frog clean and innocent ; and reprefs all expref-
fions of difguft by the countenance, as fuch exprefllons contribute to
preferve, or even to increafe, the energy of the ideas aflbciated with
them ; as mentioned above in Species j 7. Ira.

21. Syphilis imaginaria. The fear that they are infefted with the
venereal difeafe, when they have only deferved it, is a very common
infanity amongft modeft young men ; and is not to be cured without
applying artfully to the mind ; a little mercury mufi be given, and
hopes of a cure added weekly and gradually by interview or corre-
fpondence for fix or eight weeks. Many of thefe patients have been
repeatedly falivated without curing the mind J

22. Pfora imaginaria. I have twice feen an imaginary itch, and
twice an imaginary diabsetes, where there was not the leafi: veilige of
either of thofe difeafes, and once an imaginary deafnefs, where the
patient heard perfectly welL In all thefe cafes the hallucinated idea

7 is

Class Iir. 1.2. DISEASES OF VOLITION. 383

is fo powerfully excited, that it is not to be changed fuddenly by oc-
cular fenfation, or reafon. Yet great perfeverance in the frequently
prefenting contrary ideas will fometimes flowly remove this halluci-
nation, or in great length of time oblivion, or forgetfulliefs, performs
a cure, by other means in vain attempted.

23. Tabes hnaglnar'ia. This imaginary difeafe, or hallucination,
is caufed by the fuppofed too great frequency of parting with the
femen, and had long impofed upon thephyficianas well as the patient,
till Mr. John Hunter firft endeavoured to fhew, that in general the
morbid efFeds of this pollution was in the imagination ; and that thofe
were only liable to thofe efFe(3;s in general, who had been terrified by
the villainous books, which pretend to prevent or to cure it, but
which were purpofely written to vend fome quack medicine. Moft
of thofe unhappy patients, whom I have feen, had evidently great
impreffion of fear and felf- condemnation on their minds, and mio-ht
be led to make contradiftory complaints in almoft any part of the
body, and if their confeffions could be depended on, had not ufed this
pollution to any great excefs.

M. M. I. Affure them if the lofs of the femen happens but twice
a week, it will not injure them. 2. Marry them. The laft is a cer-
tain cure ; whether the difeafe be real or imaginary. Cold partial
bath, and aftringent medicines frequently taken, only recal the mind
to the difeafe, or to the delinquency ; and thence increafe the imagi-
nary effedts and the real caufe, if fuch exifts. Mr. deftroyed

himfelf to get free from the pain of fear of the fuppofed ill confe-
quences of felf-pollution, without any other apparent difeafe ; whofe
parents I had in vain advifed to marry him, if poffible.

24. Sympathia al'iena. Pity. Our fympathy with the pleafures
and pains of others diftinguifhes men from other animals ; and is pro-
bably the foundation of what is termed our moral iQi\iQ ; and the

fource

384. DISEASES OF VOLITION. Class III. i. a.

fource of all our virtues. See Se6l. XXII. 3. 3. When our fympa-
thy with thofe miferies of mankind, which we cannot alleviate, rifes
to excefs, the mind becomes its own tormentor ; and we add to the
aggregate fum of human mifery, which vi'e ought to labour to dimi-
nifh ; as in the following eloquent lamentation from Akenfide's Plea-
fures of Imagination, Book II. 1. 200,

-Dark,

As midnight florms, the fcene of human things

jAppear'd before me; deferts, burning fands.

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

And defolation blading all the wefl;

With rapine and with murder. Tyrant power

Here fits enthroned in blood ; the baleful charms

Of fuperflition there infeft the fkies,

And turn the fun to honor. Gracious Heaven !

What is the life of man? Or cannot thefe,

Not thefe portents thy awful will fufSce ?

That, propagated thus beyond their fcope.

They rife to aft their cruelties anew ■ -

In my affll6led bofom, thus decreed

The univerfal fenfitive of pain,

The wretched heir of evils not its own !

A poet of antiquity, whofe name I do not recolleit, is faid to have
w^ritten a book defcribing the miferies of the world, and to have de-
flroyed himfelf at the conclufion of his talk. This fympathy, with
all fenfitive beings, has been carried fo far by fome individuals, and
even by whole tribes, as the Gentoos, as not only to reftrain them
from killing animals for their fupport, but even to induce them to
permit infedls to prey upon their bodies. Such is however the con-'
dition of mortality, that the firft law of nature is, *' Eat or be eaten."
We cannot long exift without the deflrudion of other animal or ve-
getable beings, either in their mature or their embryon ftate. Unlefs
the fruits, which furround the feeds of fome vegetables, or the honey

ftolen

Class III. i. z. DISEASES OF VOLITION. 385

ftolen from them by the bee, may be faid to be an exception to this
alTertion. See Botannic Garden, P. I. Cant. 1. 1. 278. Note. Hence,
from the neceffity of our nature, we may be fuppofed to have a right
to kill thofe creatures, which we want to eat, or wliich want to eat
us. But to deftroy even infeifls wantonly fliews an unreflefting
mind or a depraved heart.

Neverthelefs mankind may be well divided into the felfifh and the
focial ; that is, into thofe whofe pleafures arife from gratifying
their .appetites, and thofe whofe pleafures arife from their fympa-
thlzing with others. And according to the prevalence of thefe op-
pofing propenfities we value or diflike the poffeflbr of them.

In conduiSling the education of young people, it is a nice matter to
infpire them with fo much benevolent fympathy, or compaffion, as
may render them good and amiable ; and yet not fo much as to make
them unhappy at the fight of incurable diftrefs. We (hould endea-
vour to make them alive to fympathize with all remediable evils, and
at the fame time to arm them v/ith fortitude to bear the fight of fuch
irremediable evils, as the accidents of life muil: frequently prefent be-
fore their eyes. About this I have treated more at large in a plan for
the conduft of a boarding fchool for ladies, which I intend to publi(K
in the courfe of the next year.

'2^. Educalio hero'ica. From the kinds and degrees of infanities al-
ready enumerated, the reader will probably recolle£l many more from
his own obfervation ; he will perceive that all extraordinary exertions
of voluntary aftion in confequence of fome falfe idea or hallucination,
which ftrongly afFe£ls us, may philofophically, though not popularly,
be termed an infinity; he will then be liable to divide thefe voluntary
exertions into difagreeable, pernicious, deteftable, or into meritorious,
-delegable, and even amiable, infanities. And will laftly be induced
to conceive, that a good education confifts in the art of producing
sCuch happy hallucinations of ideas, as may be followed by fuch vo-
VoL. II. 3 D luntary

386 DISEASES OF VOLITION. Class III. 1.2.

luntaiy exertions, as may be termed meritorious or amiable in-
fanities.

The old man of the mountain in Syria, who governed a fmall na-
tion of people called Aflaffines, is recorded thus to have educated thofe
of his army who were defigned to aflafiinate the princes with whom
he was at war. A young man of natural activity was chofen for the
purpofe, and thrown into a deep fleep by opium mixed with his food ;
he was then carried into a garden made to reprefent the paradife of
Mahomet, with flowers of great beauty and fragrance, fruits of deli-
cious flavor, and beautiful houries beckoning him into the fhades.
After a while, on being a fecond time ftupified with opium, the
young, enthufiaft was reconveyed to his apartment; and on the next
day was aflured by a prieft, that he was defigned for fome great ex-
ploit, and that by obeying the commands of their prince, immortal
happinefs awaited him.

Hence it is eafy to collect how the firft impreffions made on us by
accidental circumftances in our infancy continue through life to bias
our afFedlions, or miflead our judgments. One of my acquaintance
can trace the origin of his own energies of adlion from fome fuch re-
mote fources ; which juftifies the obfervation of M. Roufleau, that
the feeds of future virtues or vices are oftener fown by the mother,
than the tutor.

ORDO

Class III. 2.1. DISEASES OF VOLITION. 387

ORDO IL

Decrea/ed Volition.

GENUS I. ■
JVith decreafed ABions of the Mufcks,

Our mufcles become fatigued by long contradion, and ceafe for a
time to be excitable by the will ; owing to exhauftion of the fenforial
power, which refides in them. After a fhort interval of relaxation
the mufcle regains its power of voluntary contra<£lion ; which is pro-
bably occalioned by a new fupply of the fpirit of animation. In
weaker people thefe contradions ceafe fooner, and therefore recur
more frequently, and are attended with fhorter intervals of relaxation,
as exemplified in the quicknefs of the pulfe in fevers with debility,
and in the tremors of the hands of aged or feeble people.
. After a common degree of exhauftion of the fenforial power in a
mufcle, it becomes again gi^adually reftored by the reft of the mufcle;
and even accumulated in thofe mufcles, which are moft frequently
ufed ; as in thofe which conftitute the capillaries of the Ikin after
having been rendered torpid by cold. But in thofe mufcles, which
are generally obedient to volition, as thofe of locomotion, though
their ufual quantity of fenforial power is reftored by their quiefcence,
or in fleep (for fleep affedls thefe parts of the fyftem only), yet but
little accumulation of it fucceeds. And this want of accumulation of
the fenforial power in thefe mufcles, which are chiefly fubfervient to
volition, explains to us one caufe of their greater tendency to paralytic
afFe£lion,

3 D 2 , It

388 DISEASES OF SENSATION. ClassIII. 2. r.

It mufl be obferved, that thofe parts of the fyftem, which have
been for a time quiefcent from want of ftimulus, as the veffels of the
Ikin, when expofed to cold, acquire an accumulation of fenforial
power during their inactivity ; but this does not happen at all, or in
much lefs quantity, from their quiefcence after great expenditure of
fenforial power by a previous exceffive flimulus, as after intoxication.
In this cafe the mufcles or organs of fenfe gradually acquire their na-
tural quantity of fenforial power, as after fleep ; but not an accumu-
lation or fuperabundance of it. And by frequent repetitions of ex-
hauftion by great flimulus, thefe veffels ceafe to acquire their whole
natural quantity rf fenforial power ; as in the fchirrous flomach, and
fchirroiis liver, occafioned by the great and frequent ftimulus of
vinous fpirit ; which may properly be termed irritative paralyfis of
thofe parts of the fyftem.

In the fame manner in common palfies the ina£lion of the paralytic
mufcle feems not to be owing to defedl of the ftimulus of the will^
but to exhauftion of fenforial power. Whence it frequently follows
great exertion, as in Se6l. XXXIV. 1..7. Thus fome parts of the
fyftem may ceafe to obey the will, as in common paralyfis ; others
may ceafe to be obedient to fenfation, as in the impotency of age;
others to irritation, as in fchirrous vifcera ; and others to aflbciation^
as in impediment of fpeech ; yet though all thefe may become inex-
citaMe, or dead, in refpe6l to that kind of ftimulus,. which has pre-
vioufly exiiaufted them, whether of volition, or fenfation, or ir-
ritation, or affociation, they may ftill in many cafes be excited by
the others .v

SPECIES.

Class III. 2. i. DISEASES OF VOLITION. 389

SPECIES.

1. Lajfitudo. Fatigue or wearinefs after much voluntary exertion.
From the too great expenditure of fenforial power the mufcles are
with difficulty brought again into voluntary contraftion ; and ieem
to require a greater quantity or energy of volition for this purpofe.
■At the fame time they fttU remain obedient to the flimulus of agree-
able fenfation, as appears in tired dancers finding a renovation of their
aptitude to motion on the acquifition of an agreeable partner ; or
from a tired child riding on a gold-headed cane, as in Se<3:. XXXIV,
2. 6. Thefe mufcles are likewife ftill obedient to the fenforial power
of aflbciation, becaufe the motions, when thus excited, are performed
in their defigned diredions, and are not broken into variety of gefti-
culation, as in St. Vitus^s dance.

A laffitude likewife frequently occurs with yawning at the begin-
ning of ague-fits; where the production of fenforial power in the
brain is lefs than its expenditure. For in this cafe the torpor may
either originate in the brain, or the torpor of fome diftant parts of the
fyflem may by fympathy afFedt the brain, though in. a lefs propor-
tionate degree than the parts primarily aifefted.

2. Vacillat'iG feiiUh. Some elderly people acquire a fee-faw motion
of their bodies from one fide to the other, as they fit, like the ofcilla-
tion of a pendulum. By thefe motions the mufcles, which preferve
the perpendicularity of the body, are alternately quiefcent, and ex-
erted ; and are thus lefs liable to fatigue or exhauftion. This there-
fore relembles the tremors of old people above mentioned, and not
thofe fpafmodic movements of the face or limbs, which are called
tricks, defcribed in Clafs IV. 3. 2. 2. which originate from excefs of

fenforial

390 DISEASES OF VOLITION. Class III. 2. i.

fenforial power, or from efforts to relieve difagreeable fenfation, and
are afterwards continued by habit,

3. Tremor fenilis. Tremor of old age confifts of a perpetual trem-
bling of the hands, or of the head, or of other mufcles, when they
are exerted; and is erroneoufly called paralytic; and feems owing to
the fmall quantity of animal power refiding in the mufcular fibres.
Tliefe tremors only exift when the affeded mufcles are excited into
a(Slion, as in lifting a glafs to the mouth, or in writing, or in keep-
ing the body upright ; and ceafe again, when no voluntary exertion
is attempted, as in lying down. Hence thefe tremors evidently ori-
ginate from the too quick exhauftion of the leflened quantity of the
fpirit of animation. So many people tremble from fear or anger, when
too great a part of the fenforial power is exerted on the organs of {^enie,
fo as to deprive the mufcles, which fupport the body ered, of their
due quantity.

4. Brachwrum paralyjts. A numbnefs of the arms is a frequent
fymptom in hydrops thoracis, as explained in Clafs I. 2. 3. 14. and
in Se6l. XXIX. 5. 2. ; it alfo accompanies the afthma dolorificum,
Clafs III. I. I. II. and is owing probably to the fame caufe in both.
In the colica faturnina a paralyfis affeds the wrifts, as appears on the
patient extending his arm horizontally with the palm downwards, and
is often attended with a tumor on the carpal or metacarpal bones. See
Clafs IV. 2. 2. iQ.

Mr. M , a miner and well-finker, about three years ago, loft

the power of contracting both his thumbs; the balls or mufcles of the
thumbs are much emaciated, and remain paralytic. He afcribes his
difeafe to immerfing his hands too long in cold water in the execution
of his bufinefs. He fays his hands had frequently been much be-
-numbed before, fo that he could not without difficulty clench them ;

but

Class III. 2. I. DISEASES OF VOLITION. 391

but that they recovered their motion, as foon as they began to glow,
after he had dried and covered them.

In this cafe there exifted two injurious circumftances of different
kinds ; one the violent and continued aftion of the mufcles, which
deftroys by exhaufting the fenforial power ; and the other, the appli-
cation of cold, which deftroys by defeat of ftimulus. The cold feems
to have contributed to the paralyfis by its long application, as well as
the continued exertion ; but as during the torpor occafioned by the
expofure to cold, if the degree of it be not fo great as to extinguifii
life, the fenforial power becomes accumulated ; there is reafon to be-
lieve, that the expoiing a paralytic limb to the cold for a certain time,
as by covering it with fnow or iced water for a few minutes, and
then covering it with warm flannel, and this frequently repeated,
might, by accumulation of fenforial power, contribute to reflore it
to a ftate of voluntary excitability. As this accumulation of fen-
forial power, and confequent glow, feems, iu the prefent cafe,
feveral times to have contributed to reftore the numbnefs or inability
of thofe mufcles, which at length became paralytic. See Clafs I.
a. 3.21.

M. M. Ether externally. Fridlon. Saline warm bath. Elec-
tricity. ,

5. Kaucedo paralytica. Paralytic hoarfenefs confifts in the almoft
total lofs of voice, which fometimes continues for months, or even
years, and is occafioned by inability or paralyfis of the recurrent
nerves, which ferve the mufcles of vocality, by opening or clofing
the larynx. The voice generally returns fuddenly, even fo as to
alarm the patient* A young lady, who had many months been af-
fedted with almoft a total lofs of voice, and had in vain tried variety
of advice, recovered her voice in an inftant, on fome alarm as (he was
dancing at an aflembly. Was this owing to a greater exertion of voli-
7 tion

392 DISEASES OF VOLITION. Class JII. 2. i.

lion than ufual? like the dumb young man, the fon of Croefus, who
is related to have cried out, when he law his father's life endangered
by the Ivvord of his enemy, and to have continued to fpeak ever af-
terwards. Two young ladies iu this complaint feemed to be cured by
eledric fliocks palled through the larynx every day for a fortnight.
See Raucedo catarrhalis, Clafs 11. i. 3. 5.

M. M. An emetic. Eleftric (hocks. Muftard-feed, a large fpoon-
ful fwallowed whole, or a little bruifed, every morning. Valerian,
Burnt fponge. Blifters on each fide of the larynx. Sea-bathing. A
gargle of deco£lion of feneca. Fridion. Frequent endeavours to
Ihout and fing.

•o'

6. Vejicce urinaria paralyjls. Paralyfis of the bladder is frequently
a fymptom in inirritative fever; in this cafe the patient makes no
■water for a day or two j and the tumor of the bladder diftended with
urine may be feen by the fliape of the abdomen, as if girt by a cord
below the navel, or diftinguifhed by the hand. Many patients in
this fituation make no complaint, and fuffer great injury by the inat-
tention of their attendants ; the water muft be drawn off once or
twice a day by means of a catheter, and the region of the bladder
gently preffed by the hand, whilfl the patient be kept in a fitting or
ereft pofture.

M. M. Bark. Wine, Opium, a quarter of a grain every fix hours.
Balfam of copaiva or of Peru. Tindlure of cantharides 20 drops twice
a day, or repeated fmall blifters.

;•. KeEl't paralyjis. Palfy of the re^lum. The redium inteftinum,
"like the urinary bladder in the preceding article, poffefliss voluntary
power of motion ; though thefe volitions are at times uncontrollable
by the will, when the acrimony of the contained feces, or their bulk,
liimulate it to a greater degree. Hence it happens, that this part is

liable

Class III. 2. I. DISEASES OF VOLITION. 393

liable to lofe its voluntary power by paralyfis, but is ftill liable to be
flimulated into aftion by the contained feces. This frequently occurs
in fevers, and is a bad fign as a fymptom of general debility ; and it
is the fenfibility of the mufcular fibres of this and of the urinary
bladder remaining, after the voluntarity has ceafed, which occafions
thefe two refervoirs fo foon to regain, as the fever ceafes, their obe-
dience to volition; becaufe the paralyfis is thus (hewn to be lefs
complete in thofe cafes than in common hemiplegia ; as in the latter
the fenfe of touch, though perhaps not the fenfe of pain, is generally
deftroyed in the paralytic limb.

M. M. A fponge introduced within the fphinder ani to prevent the
conftant difcharge, which fhould have a firing put through it, 'by
which it may be retraced.

8. Parefis voluntarla. Indolence ; or inaptitude to voluntary ac-
tion. This debility of the exertion of voluntary efforts prevents the
accomphfliment of all great events in life. It often originates from a
miftaken education, in which pleafure or flattery is made the imme-
diate motive of ad:ion, and not future advantage ; or what is termed
duty. This obfervation is of great value to thofe, who attend to the
education of their own children. I have feen one or two young
married ladies of fortune, who perpetually became uneafy, and be-
lieved themfelves ill, a week after their arrival in the country, and
continued fo uniformly during their ftay ; yet on their return to Lon-
don or Bath immediately loft all their complaints, and this repeatedly;
which I was led to afcribe to their being in their infancy furrounded
with menial attendants, who had flattered them into the exertions
they then ufed. And that in their riper years, they became torpid for
want of this ftimulus, and could not amufe themfelves by any vo-
luntary employment ; but required ever after, either to be amufed by
other people, or to be flattered into adivity. This I fuppofe, in the
other fex, to have fupplied one fource of ennui and fuicide.

Vol. II. 3 E 9. Catalepjis.

394 DISEASES OF VOLITION. ClassIII. 2. i.

9. Catalepjis is fometimes ufed for fixed fpafmodic contradions or
tetanus, as defcribed in Seft. XXXIV. i. 5. and in Clafs III. i. i, i^.
but is properly limply an inaptitude to mufcular motion, the limbs
remaining in any attitude in which they are placed. One patient,
whom I faw in this fituation, had taken much mercury, and appear-
ed univerfally torpid. He I'at in a chair in any pofture he was put,
and held a glais to his mouth for many minutes without attempting
to drink, or withdrawing his hand. He never fpoke, and it was at
firfb neceflary to compel him to drink broth ; he recovered in a few
weeks without relapfe.

10. Hemiplegia. Palfy of one fide confifts in the total difobedience
©f the affeiled mufcles to the power of volition. As the voluntary
motions are not perpetually exerted, there is little fenforial power ac-
cumulated during their quiefcence, whence they are lefs liable to re-
cover from torpor, and are thus more frequently left paralytic, or
difobedient to the power of volition, though they are fometimes ftill
alive to painful fenfation, as to the prick of a pin, and to heat ; alfo
to irritation, as in flretching and yawning ; or to eleftric fhocks.
Where the paralyfis is complete the patient feems gradually to learn
to ufe his limbs over again by repeated efforts, as in infancy ; and,
as time is required for this purpofe, it becomes difficult to know,
whether the cure is owing to the efFedt of medicines, or to the re-
peated efforts of the voluntary power.

The difpute, whether the nerves decuflate or crofs each other be-
fore they leave the cavities of the fkuU or fpine, feems to be decided
in the affirmative by comparative anatomy ; as the optic nerves of
fome fifh have been fhewn evidently to crofs each other ; as feen by
Haller, Elem. Phyfiol. t. v. p. 349. Hence the application of blif-
ters, or of ether, or of warm fomentations, fhould be on the fide of
the head oppofite to that of the affefted mufcles. This fubjed fhould
neverthelefs be nicely determined, before any one fhould trepan for

the

Class III. 2. i. DISEASES OF VOLITION. 395

the hydrocephalus internus, when the difeafe is (hewn to exlft only
on one (ide of the brain, by a fquinting affedling but one eye ; as
propofed in Clafs I. 2. 5. 4. Dr. Sommering has fhewn, that a true
decuffation of the optic nerves in the human fubjed aflually exifts,
Elem. of Phyfiology by Blumenbach, tranflated by C. Caldwell,
Philadelphia. This further appears probable from the oblique direc-
tion and infertion of each optic nerv«, into the fide of the eye
next to the nofe, in a diredl line from the oppofite fide of the
brain.

The vomiting, which generally attends the attack of hemipleo-ia,
is mentioned in Se£l. XX. 8. and is fimilar to that attending vertio-o
in fea-ficknefs, and at the commencement of fome fevers. Black
- flools fometimes attend the commencement of hemiplegia, which is
probably an efFufion of blood from the biliary dudt, where the liver is
previoufly afFedted ; or fome blood may be derived to the inteftines by
its efcaping from the vena cava into the receptacle of chyle durino- the
diflrefs of the paralytic attack; and may be conveyed from thence
into the inteftines by the retrograde motions of the ladleals ; as pro-
bably fometimes happens in diabaetes. See Se£t. XXVII. 2. Palfy
of one fide of the face is mentioned in Clafs II. 1.4. 6. Paralyfis of
the la(£teals, of the liver, and of the veins, which are defcribed in
Sea. XXVIII. XXX. and XXVII. do not belong to this clafs, as they
are not difeafes of voluntary motions.

M. M. The eledlric fparks and fhocks, if ufed early in the difeafe,
are frequently of fervice. A purge of aloes, or calomel. A vomit.
Blifter. Saline draughts. Then the bark. Mercurial ointment or
fublimate, where the liver is evidently difeafed ; or where the gutta
rofea has previoufly exifted. Sudden alarm. Frequent voluntary ef-
forts. Externally ether. Volatile alcali. Fomentation on the head.
Fridlion. When children, who have fuffered an hemiplegia, beo-in
to ufe the affefted arm, the other hand fhould be tied up for half an
hour three or four times a day ; which obhges them at their play to

3 E 2 ufc

396 DISEASES OF VOLITION. Class III. 2. i.

ufe more frequent voluntary efforts with the difeafed lin:ib, and thus
fooner to reftore the diffevered aflTociations of motion.

Dr. J. Alderfon has lately much recommended the leaves of rhus
toxicoclendon (fumach), from one gr. to iv. of the dried powder to be
taken three or four times a day. ElTay on Rhus Toxic. Johnfon,
London, i 793. But it is difficult to know what medicine is of fer-
vice, as the movements of the mufcles muft be learned, as in infancy,
by frequent efforts.

II. Paraplegia. A palfy of the lower half of the body divided ho-
rizontally. Animals may be conceived to have double bodies, one
half in o-eneral refembling fo exadlly the other, and being fupplied
with feparate fets of nerves ; this gives rife to hemiplegia, or palfy of
one half of the body divided vertically ; but the paraplegia, or palfy of
the lower parts of the fyftem, depends on an injury of the fpinal
marrow, or that part of the brain which is contained in the vertebrse
of the back ; by which all the nerves fituated below the injured part
are deprived of their nutriment, or precluded from doing their proper
offices ; and the mufcles, to which they are derived, are in confe-
quence difobedient to the power of volition.

This fometimes occurs from an external injury, as a fall from an
e&inence; of which I faw a deplorable inflance, where the bladder
and redtum, as well as the lower limbs, were deprived of fo much of
their powers of motion, as depended on volition or fenfation ; but I
fuppofe not of that part of it, which depends on irritation. In the
fame manner as the voluntary mufcles in hemiplegia are fometimes
brought into aftiori by irritation, as in ftretching or pendiculation,
defcribed in Se£l. VII. i. 3.

But the moft frequent caufe of paraplegia is from a protuberance of
one of tke fpinal vertebrae ; which is ov/ing to the innutrition or foft-;
nefs of bones, defcribed in Clafs I. 2. 2. 17. The cure of this de-
plorable difeafe is frequently effe^Hied by the ftimulus of an ifTue placed

on

Class III. 2. r. DISEASES OF VOLITION. 397

on each fide of the prominent fpine, as firft publifhed by Mr. Pott.
The other naeans recommended in foftnefs of bones ihould alfo be at-
tended to; both in refpedl to the internal medicines, and to the me-
chanical methods of fupporting, or extending the fpine ; which lad,
however, in this cafe requires particular caution.

12. Somnus. In fleep all voluntary power is fufpended, fee Se£t.
XVIII. An unufual quantity of fleep is often produced by weaknefs.
In this cafe fmall dofes of opium, wine, and bark, may be giverv
with advantage. For the periods of fleep, fee Cjafs IV. 2. 4. i.

The fubfequent ingenious obfervations on the frequency of the
pulfe, which fometiraes occurs in fleep, are copied from a letter of
Dr. Currie of Liverpool to the author.

" Though reft in general perhaps renders the healthy pulfe flower,
yet under certain circumftances the contrary is the truth. A full
meal without wine or other ftrong liquor does not increafe the fre-
quency of my pulfe, while I lit upright, and have my attention en-
gaged. But if I take a recumbent pofture after eating, my pulfe
becomes more frequent, efpecially if my mind be vacant, and I be-
come drowfy; and, if I flumber, this ' increafed frequency is more
confiderable with heat and flufliing.

- " This I apprehend to be a general truth. The obfervation may-
be frequently made upon children ; and the reftlels and feverifli nights
experienced by many people after a full fupper are, I believe, owing
to this caufe. The fupper occafions no inconvenience, whilfl: the
perfon is upright and awake ; but, when he lies down and begins to
fleep, efpecially if he does not perfpire, the fymptoms above men-
tioned occur. Which may be thus explained in part from your prin-
ciples. When the power of volition is aboliflied, the other fenforial
aftions are increafed. In ordinary fleep this does not occafion in-
creafed frequency of the pulfe ; but where fleep takes place during
the procefs of digefuon, the digefliion itfelf goes on with increafed ra-
pidity.

398 DISEASES OF VOLITION. Class III. 2. i.

pidity. Heat is excited in the fyftem fafter than it is expended; and
operating on the fenfitive adlions, it carries thenx beyond the limita-
tion of pleafure, producing, as is common in fiich cafes, increafed
frequency of pulfe.

" It is to be obferved, that in fpeaking of the heat generated under
thefe circumftances, I do not allude to any chemical evolution of heat
from the food in the procefs of digeftion. I doubt if this takes place
to any confiderable degree, for I do not obferve that the parts incum-
bent on the ftomach are increafed in heat during the moft hurried di-
geftion. It is on fome parts of the furface, but more particularly on
the extremities of the body, that the increafed heat excited by digef-
tion appears, and the heat thus produced arifes, as it fhould feem,
from the fympathy between the ftomach and the veflels of the ikin.
The parts moft affeded are the palms of the hands and the foles of
the feet. Even there the thermometer feldom rifes above 97 or 98
degrees, a tenaperature not higher than that of the trunk of the body;
but three or four degrees higher than the common temperature of
thefe parts, and therefore producing an uneafy fenfation of heat, a
fenfation increafed by the great fenfibility of the parts affedled.

" That the increafed heat excited by digeftion in fleep is the caufe
of the accompanying fever, feems to be confirmed by obferving, that
if an increafed expenditure of heat accompanies the increafed genera-
tion of it (as when perfpiration on the extremities or furface attends
this kind of fleep) the frequent pulfe and fluftied countenance do not
occur, as I know by experiment. If, during the feverifti fleep al-
ready mentioned, I am awakened, and my attention engaged power-
fully, my pulfe becomes almoft immediately flower, and the fever
gradually fubfides."

From thefe obfervations of Dr. Currie it appears, that, while in

common fleep the aftions of the heart, arteries, and capillaries, are

ftrengthened by the accumulation of fenforial power during the fuf-

penfion of voluntary a£lion, and the pulfe in confequence becomes

4 fuller

Class III. 2.1. DISEASES OP VOLITION. 399

fuller and (lower ; in the feverlfh deep above defcribed the a£lions of
the heart, arteries, and capillaries, are quickened as well as flreno-th-
ened by their confent with the increafed a6tions of the flomach, as
well as by the flimulus of the new chyle introduced into the circula-
tion. For the ftomach, and all other parts of the fyftem, being
more fenfible and more irritable during fleep, Se£l. XVIII. 15. and
probably more ready to ad from aflbciation, are now exerted with
greater velocity as well as ftrerrgth, conftituting a temporary fever of
the fenfitive irritated kind, refembling the fever excited by wine in
the beginning of Intoxication ; or in fome people by a full meal in their
waking hours. Seft. XXXV. i.

On waking, this increafed fenfibility and irritability of the {ydem
ceafes by the renewed exertions of volition ; in the fame manner as
more violent exertions of volition deflroy greater pains ; and the pulfe
in confequence fubfides along with the increafe of heat ; if more vio-
lent efforts of volition are exerted, the fyftem becomes ftill lefs af-
fe£ted by fenfation or irritation. Hence the fever and vertigo of intoxi-
cation are leffened by intenfe thinking, Sed. XXI. 8 ; and infane
people are known to bear the pain of cold and hunger better than
others, Seft. XXXIV. 2. 5 ; and laftly, if greater voluntary efforts
exift, as in violent anger or violent exercife, the whole fyftem is
thrown into more energetic a6tion, and a voluntary fever is induced,
as appears by the red Ikin, quickened pulfe, and increafe of heat ;
whence dropfies and fevers with debility are not unfrequently removed
by infanity.

Hence the exertion of the voluntary power in its natural degree
diminifhes the increafed fenfibihty, and irritability, and probably the
increafed affociability, which occurs during fleep ; and thus reduces
the frequency of the pulfe in the feverifh fleep after a full meal. In
its more powerful fl:ate of exertion, it diminiflies or deflrroys fenfa-
tions and irritations, which are llronger than natural, as in intoxica-
tion.

400 DISEASES OF VOLITION. Class III. 2. r.

tion, or which precede convulfions, or infanity. In its ftill more
powerful degree, the fuperabundance of this fenforial power aftuates
and invigorates the whole moving lyftem, giving ftrength and fre-
quency to the pulfe, and an univerfal glow both of colour and of heat,
as in violent anger, or outrageous infanities.

If, in the feverifh fleep above defcribed, the Ikin becomes cooled
by the evaporation of much perfpirable matter, or by the application
of cooler air, or thinner clothes, the aftions of the cutaneous capil-
laries are leflened by defedl of the ftimulus of heat, which counteradls
the increafe of fenfibility during fleep, and the pulfations of the heart
and arteries become flower from the leflened ftimylus of the particles
of blood thus cooled in the cutaneous and pulmonary veflels. Hence
the admiflion of cold air, or ablution with fubtepid or with cold
water, in fevers with hot flcin, whether they be attended with ar-
terial fl:rength, or arterial debility, renders the pulfe flower ; in the
former cafe by diminiftiing the flimulus of the blood, and in the latter
by lefiening the expenditure of fenforial power. See Suppl. I. 8.
and 15.

13. Incuhus. The night-mare is an imperfed fleep, where the de-
fire of locomotion is vehement, but the mufcles do not obey the will;
it is attended with great unealinefs, a fenfe of fufFocation, and fre-
quently with fear. It is caufed by violent fatigue, or drunkennefs,
or indigeftible food, or lying on the back, or perhaps from many
other kinds of uneafinefs in our fleep, which may originate either
from the body or mind.

Now as the action of refpiration is partly voluntary, this complaint
may be owing to the irritability of the fyfl:em being too fmall to carry
on the circulation of the blood through the lungs during fleep, when
the voluntary power is fufpended. Whence the blood may accumu-
late in them, and a painful oppreflion fupervene ; as in fome hemor-
rhages

ClassIH. 2. I. DISEASES OF VOLITION. 401

rhages of the lungs, which occur during fleep; and in patients much
debilitated by fevers. See Somnus interruptus, Clafs I. 2. i. 3. and

1. 2. I. 9.

Great fatigue with a full fupper and much wine, I have been well
informed by one patient, always produced this difeafe in himfelf to a
great degree. Now the general irritability of the lyftem is much de-
creafed by fatigue, as it exhaufls the fenforial power ; and fecondly,
too much wine and flimulating food will again diminifh the irritability
of fome parts of the fyftem, by employing a part of the fenforial
power, which is already too fmall, in digefting a grpat quantity of
aliment ; and in increafing the motions of the organs of fenfe in con-
fequence of fome degree of intoxication, whence difficulty of breath-
ing may occur from the inirritability of the lungs, as in Clafs I.

2. 1.3.

M. M. To fleep on a hard bed with the head raifed. Moderate
fupper. The bark. By fleeping on a harder bed the patient will
turn himfelf more frequently, and not be liable to fleep too profound-
ly, or lie too long in' one pofture. To be awakened frequently by an
alarm clock.

14. Lethargus. The lethargy is a {lighter apoplexy. It is fuppofed
to originate from univerfal preffure on the brain, and is faid to be pro-
duced by compreffing the fpinal marrow, where there is a deficiency
of the bone in the fpina bifida. See Se6t. XVIII. 20. Whereas in
the hydrocephalus there is only a partial preffure of the brain ; and
probably in nervous fevers with ftupor the preffure on the brain may
afFeft only the nerves of the fenfes, which lie within the fkull, and
jnot thofe nerves of the medulla oblongata, which principally contri-
bute to move the heart and arteries ; whence in the lethargic or apo-
ple£lic ftupor the pulle is flow as in fleep, whereas in nervous
fever the pulfe is very quick and feeble, and generally fo in hydroce-
phalus.

Vol. II. 3 F 'In

402 DISEASES OF VOLITION. Class III. 2.1.

In cafes of obftrudled kidneys, whether owing to the tubuli urini*
feri being totally obfl:ru6;ed bj calculous matter, or by their pa-
ralyfis, a kind of drowfinefs or lethargy comes on about the eighth
or ninth day, and the patient gradually links. See Clafs I.
1. 3. 9.

15. Syncope epileptica, is a temporary apoplexy, the pulfe continuing
in its natural flate, and the voluntary power fufpended. This termi-
nates the paroxyfms of epilepfy.

When the animal power is much exhaufted by the preceding con-
vulfions, fo that the motions from fenfation as well as thofe from vo-
lition are fufpended ; in a quarter or half an hour the fenforial power
becomes reftored, and if no pain, or irritation producing pain, recurs,
the fit of epilepfy ceafes ; if the pain recurs, or the irritation, which
ufed to produce it, a new fit of convulfion takes place, and is fuc-
ceeded again by a lyncope. See Epilepfy, Clafs III. 1.1.7.

16. Apopkx'ia. Apoplexy may be termed an univerfal palfy, or a
permanent fleep. In which, where the pulfe is weak, copious bleed-
ing mufl: be injurious ; as is well obferved by Dr. Heberden, Tranf.
of the CoUesfe.

Mr. , about 70 years of age, had an apopledtic feizure.

His pulfe was ftrong and full. One of the temporal arteries was
opened, and about ten ounces of blood fuddenly taken from it. He
feemed to receive no benefit from this operation ; but gradually funk,
and lived but a day or two.

If apoplexy arifes from the preffure of blood extravafated on the
brain, one moderate venefedlion may be of fervice to prevent th,e
further effufion of blood ; but copious venefe£lion muft be injurious
by weakening the .patient ; fnice the efFufed blood mufl have time, as
in common vlbices or bruil'es, to undergo a chemico-animal procefs,
fo to change its nature as to fit it for abforption ; which may take
8 two

Class III. 2. i. DISEASES OF VOLITION. 403

two or three weeks, which time a patient weakened by repeated ve-
nefecEtion or arteriotomy may not furvive.

Mrs. , about 40 years old, had an apopledic feizure after

great exertion from fear ; flie had lain about 24 hours without fpeech,
or having fwallowed any liquid. She was then forcibly raifed in bed,
and a fpoonful of folution of aloes in wine put into her mouth, and
the end of the fpoon withdrawn, that fhe might more eafily fwallow
the liquid. — This was done every hour, with broth, and wine and
water intervening, till evacuations were procured ; which with
other means had good effed:, and fhe recovered, except that a con-
fiderable degree of hemiplegia remained, and fome imperfedion of her
fpeech.

Many people, who have taken fo much vinous fpiiit as to acquire
the temporary apoplexy of intoxication, and are not improperly faid
to be dead-drunk, have died after copious venefe£tion, I fuppofe in
confequence of it. I once faw at a public meeting two gentlemen in
the d;unken apoplexy ; they were totally infenfible with low pulfe,
on this account they were direfted not to lofe blood, but to be laid on
abed with their hfeads high, and to be turned every half hour ; as
foon as they could fwallow, warm tea was given them, which eva-
cuated their ftomachs, and they gradually recovered, as people do
from lefs degrees of intoxication.

M. M. Cupping on the occiput. Venefetlion once ki moderate
quantity. Warm fomentations long continued and frequently re-
peated on the fhaved head. Solution of aloes. Clyfters with folution
of aloe and oil of amber. A blifter on the fpine. An emetic. Af-
terwards the bark, and fmall dofes of chalybeates. Small ele6lric
(hocks through the head. Ei rhines. If fmall dofes of opium, ?

17. Mors afrigore. Death from cold. The unfortunate travellers,
who almoft every winter perifh in the fnow, are much exhaufted by
their efforts to proceed on their journey, as well as benumbed by cold,

q F 2 And

404 DISEASES OF VOLITION. Class III. 2.1.

And as much sreater exercife can be borne without fatigue in cold
weather than in warm ; becaufe the exceffive motions of the cutane-
ous veflels are thus prevented, and the confequent wafte of fenforial
power; it may be inferred, that the fatigued traveller becomes para-
lytic from violent exertion as well as by the application of cold.

Great degrees of cold afFed the motions of thofe veflels moft, which
have been generally excited into adtion by irritation ; for when the
feet are much benumbed by cold, and painful, and at the fame time
almoft infenfible to the touch of external objedts, the voluntary muf-
cles retain their motions, and we continue to walk on ; the fame
happens to the fingers of children in throwing fnow-balls, the volun-
tary motions of the mufcles continue, though thofe of the cutaneous
veflels are benumbed into inadivity.

Mr. Thompfon, an elderly gentleman of Shrewfbary, was feized
with hemiplegia in the cold bath ; which I fuppofe might be owing
to fome great energy of exertion, as much as to the coldnefs of the
water. As in the inftance given of Mr. Nairn, who, by the exer-
tion to fave his relation, periflied himfelf. See Se£l. XXXIV. i. 7.

Whence I conclude, that though heat is a fluid necefTary to muf-
cular motion, both perhaps by its flimulus, and by its keeping the
minute component parts of the ultimate fibrils of the mufcles or or-
gans of fenfe at a proper diftance from each other ; yet that paralyfis,
properly fo called, is the confequence of exhauftion of fenforial power
by exertion. And that the accumulations of it during the torpor of
the cutaneous veflels by expofure to cold, or of fome internal vifcus in
the cold fits of agues, are frequently inftru mental in recovering the
ufe of paralytic limbs, or of the motions of other paralytic parts of the
fyftem. See Spec. 4. of this genus.

Animal bodies refift the power of cold probably by their exertions in
confequence of the pain of cold, fee Botan. Gard. V. i. additional
note xii. But if thefe increafed exertions be too violent, fo as to ex-
haufl the fenforial power in producing unneceflary motions, the ani-
mal

Class III. 2. i. DISEASES OF VOLITION. V5

mal will probably fooner perifh. Thus a moderate quantity of wine
or fpirit repeated at proper intervals of time might be of fervice to
thofe, who are long expofed to exceflive cold, both by increafing the
adlion of the capillary veffels, and thus producing heat, and perhaps
by increafing in fome degree the fecretion of fenforial power in the
brain. But the contrary muft happen when taken immoderately, and
not' at due intervals. A well attefted hiftory was once related to me
of two men, who fet out on foot to travel in the fnow, one of whom
drank two or three glalTes of brandy before they began their journey,
the other contented himfelf with his ufual diet and potation ; the
former of whom perifhed in fpite of any affiftance his companion could
afford him ; and the other performed his journey with fafety. In this
cafe the fenforial power was exhaufted by the unneceffary motions of
incipient intoxication by the ftimulus of the brandy, as well as by the
exertions of walking ; which fo weakened the dram-drinker, that the
cold fooner deftroyed him ; that is, he had not power to produce fuf-
ficient mufcular or arterial adlion, and in confequence fufficient heat,
to fupply the great expenditure of it. Hence the capillaries of the (kin
firfl ceafe to zS:, and become pale and empty ; next thofe which are
immediately aflbciated with them, as the extremities of the pulmonary
artery, as happens on going into the cold bath. By the continued in-
aftion of thefe parts of the vafcular fyftem the blood becomes accu-
mulated in the internal arteries, and the brain is fuppofed to be af-
fefted by its compreffion ; becaufe thefe patients are faid to fleep, or
to become apoplectic, before they die. I overtook a fifliman afleep on
his panniers on a very cold frofty night, but on waking him he did not
appear to be in any degree of ftupor. See Clafs I. 2. 2. i.

When travellers are benighted in deep fnow, they might frequent-
ly be faved by covering themfelves in it, except a fmall aperture for
air; in which fituation the lives of hares, (heep, and other animals,
are fo often preferved. The fnow, both in refpe£l to its component
parts, and to the air contained in its pores, is a badcondudor of heat,

and

4o6 DISEASES OF VOLITION. Class III. 2. x,

and will therefore v/ell keep out the external cold ; and as the water,
when part of it diflblves, is attracted into the pores of the remainder
of it, the fituation of an animal beneath it is perfectly dry ; and, if
he is in contaft with the earth, he is in a degree of heat between 48,
the medium heat of the earth, and 32, the freezing point; that is,
in 40 degrees of heat, in which a man thus covered will be as warm
as in bed. See Botan. Garden, V. II. notes on Anemone, Barometz,
and Mufchus. If thefe fails were more generally underftood, it
might annually fave the lives of many.

After any part of the vafcular fyftem of the body has been long ex-
pofed to cold, the fenforial power is fo much accumulated in it, that
on coming into a warm room the pain of hotach is produced, and in-
flammation, and confequent mortification, owing to the great exer-
tion of thofe veflels, when again expofed to a moderate degree of
warmth. See Se£l. XII. 5. Whence the propriety of applying but
very low degrees of heat to limbs benumbed with cold at firft, as of
fnow in its ftate of diffolving, which is at 32 degrees of heat, or of
very cold water. A French writer has cbferved, that if frozen ap-
ples be thawed gradually by covering them with thawing Inow, or
immerfing them in very cold water, that they do not lofe their tafle ;
if this fa(ft was well afcertained, it might teach us how to preferve
other ripe fruits in ice-houfes for winter eonfuraption.

ORDO

ClassIII.z. 2. DISEASES OF VOLITION. 407

OR DO II.

Dec re of ed Fo lit ion.

GENUS II.
JJ^ith decreafed Adions of the Organs of Ssnfc.

SPECIES.

\. ^ecolkdlionis jaElura. Lofs of recollection. This is the defe<ft
of memory in old people, who forget the adlions of yefterday, being
incapable of voluntary recolledlion, and yet remember thofe of their
youth, which by frequent repetition are introduced by affociation or
fuggeftion. This is properly the paralyfis of the mind; the organs of
fenfe do not obey the voluntary power ; that is, our ideas cannot be
recollefted, or a£led over again by the will.

After an apoplectic attack the patients, on beginning to recover,
find themfelves moft at a lofs in recollefting proper names of perfons
or places ; as thofe words have not been fo frequently affociated with
the ideas they ftand for, as the common words of a language. Mr.

, a man of ftrong mind, of a fhort necked family, many of

whom had fufFered by apoplexy, after an apopledic fit on his recover-
ing the ufe of fpeech, after repeated trials to remember the name of a
perfon or place, applauded himfelf, when he fucceeded, with fuch a
childifh fmile on the partial return of his fagacity, as very much af-
fefted me. — Not long, alas ! to return ; for another attack in a few
weeks deftroyed the whole.

I faw a child after the fmall-pox, which was left in this fituation ;
it was lively, adlive, and even vigorous ; but fhewed that kind of

furprife,

4o8 DISEASES OF VOLITION. Class III. z. 2.

furprlfe, which novelty excites, at every obje£t it viewed ; and that
as often as it viewed it. I never heard the termination of the cafe.

2. Stultitia voluntaria. Voluntary folly. The abfence of volun-
tary power and confequent incapacity to compare the ideas of prefent
and future good. Brute animals may be faid to be in this fituation,
as they are in general excited into aftion only by their prefent painful
or pleafurable fenfations. Hence though they are liable to furprife,
when their pafliiig trains of ideas are diffevered by violent ftimuli ;
yet are they not afFefted with wonder or aftonifhment at the novelty
of objeds ; as they poffefs but in a very inferior degree, that volun-
tary power of comparing the prefent ideas with thofe previoufly ac-
quired, which diftinguifhes mankind ; and is termed analogical rea-
foning, when deliberatively exerted ; and intuitive analogy, when
ufed without our attention to it, and which always preferves our
hourly trains of ideas confiftent with truth and nature. See Seft.
XVII. 3. 7.

3. CreduUtas. Credulity. Life is fiiort, opportunities of know-
ledge rare ; our fenfes are fallacious, our reafonings uncertain, man-
kind therefore flruggles with perpetual error from the cradle to the
coffin. He is neceffitated to corredt experiment by analogy, and ana-
logy by experiment ; and not always to reft fatlsfied in the belief of
facls even with this two-fold teftimony, till future opportunities, or
the obfervations of others, concur in their fupport.

Ignorance and credulity have ever been companions, and have mif-
led and enfiaved mankind ; philofophy has in all ages endeavoured to
oppofe their progrefs, and to loofen the fhackles they had impofed ;
philofophers have on this account been called unbelievers : unbelievers
of what ? of the fiifllons of fancy, of witchcraft, hobgobblins, appa-
ritions, vampires, fairies ; of the influence of ftars on human a<ftions,
miracles wrought by the bones of faints, the flights of ominous birds,
4 th«

Class III. 2. 2. DISEASES OF VOLITION. 409

the prediiStions from the bowels of dy'mg animals, expounders of
dreams, fortune-tellers, conjurors, modern prophets, necromancy,
cheiromancy, animal magnetifm, with endlefs variety of folly ?
Thefe they have difbelieved and defpifed, but have ever bowed their
hoary heads to Truth and Nature.

Mankind may be divided in refpedl to the facility of their belief or
convidtion into two clafles ; thofe, who are ready to afTent to fingle
fafts from the evidence of their fenfes, or from the ferious aflertions
of others ; and thofe, who require analogy to corroborate or authen-
ticate them.

Our firft knowledge is acquired by our fenfes ; but thefe are liable
to deceive us, and we learn to detedt thefe deceptions by comparing
the ideas prefented to us by one fenfe with thofe prefented by another.
Thus when we firft view a cylinder, it appears to the eye as a fiat
furfacc with different fhades on it, till we corredl this idea by the
fenfe of touch, and find its furface to be circular ; that is, having
fome parts gradually receding further from the eye than others. So
when a child, or a cat, or a bird, firft fees its ovi^n image in a looking-
glafs, it believes that another animal exifts before it, and dete£ts this
fallacy by going behind the glafs to eicamine, if another tangible animal
really exifts there.

Another exuberant fource of error confifts in the falfe notions,
■which we receive in our early years from the defign or ignorance of
our inftruftors, which afi^edt all our future reafoning by their perpe-
tual intrufions ; as thofe habits of mufcular adlions of the face or
limbs, which are called tricks, when contradled in infancy continue
to the end of our lives.

A third great fource of error is the vivacity of our ideas of imagina-
tion, which perpetually intrude themfelves by various aflbciations,
and compofe the farrago of our dreams; in which, by the fufpenfion
of volition, we are precluded from comparing the ideas of one fenfe
with thofe of another, or the incongruity of their fucceffions with

Vol. II. 3 G the

4IO DISEASES OF VOLITION. Class III. 2/2.

the ufual courfe of nature, and thus to dete£l their fallacy. Which
we do in our waking hours by a perpetual voluntary exertion, a pro-
cefs of the mind above mentioned, which we have termed intuitive
analogy. Sed. XVII. 3. 7.

This analogy prefuppofes an acquired knov.dedge of things, hence
children and ignorant people are the moft credulous, as not poflefling
much knowledge of the ufual courfe of nature ; and fecondly, thole
are mofl credulous, whofe faculty of comparing ideas, or the volun-
tary exertion of it, is flow or imperfedl. Thus if the power of the
magnetic needle of turning towards the north, or the (hock given by
touching both fides of an ele«5lrized coated jar, was related for the
firft time to a phllofopher, and to an ignorant perfon ; the former
would be lefs ready to believe them, than the latter ; as he would
find nothing fimilar in nature to compare them to, he would again
and again repeat the experiment, before he would give it his entire
credence ; till by thefe repetitions it would ceafe to be a fingle fadi,
and would therefore gain the evidence of analogy. But the latter, as
having lefs knowledge of nature, and lefs facility of voluntary exer-
tion, would more readily believe the alTertions of others, or a fingle
faft, as prefented to his own obfervation. Of this kind are the bulk
of mankind ; they continue throughout their lives in a flat e of child-
hood, and have thus been the dupes of priefts and politicians in all
countries and in all ages of the world.

In regard to religious matters, there is an intellectual cowardice in-
ftilled into the minds of the people from their infancy j which pre-
vents their inquiry : credulity is made an Indifpenfable virtue ; to in-
quire or exert their realon in religious matters is denounced as finful ;
and in the catholic church is punilhed with more fevere penances than
moral crimes. But in refpedl to our belief of the fuppofed medical
fafts, which are publifhed by variety of authors ; many of whom are
ignorant, and therefore credulous ; the golden rule of David Hume
may be applied with great advantage. " When two miraculous af-
8 fertions

Class III. 2.2. DISEASES OF VOLITION. 411

fertions oppofe each other, believe the lefs miraculous." Thus if a
perfon is faid to have received the fmall-pox a fecond time, and to have
gone through all the f!:ages of it, one may thus reafon : twenty thou-
fand people have been expofed to the variolous contagion a fecond time
without receiving the variolous fever, to every one vi'ho has been faid
to have thus received it ; it appears therefore lefs miraculous, that the
affertor of this fuppofed fa£l has been deceived, or wiflies to deceive,
than that it has fo happened contrary to the long experienced order of
nature.

M. M. The method of cure is to increafe our knowledge of the laws
of nature, and our habit of comparing whatever ideas are prefented to
us with thofe known laws, and thus to counteract the fallacies of our
fenfes, to emancipate ourfelves from the falfe impreflions which we
have imbibed in our infancy, and to fet the faculty of reafon above
that of imagination.

3 G 2 , ^^^

Class IV, DISEASES OF ASSOCIATION. 413

T/ie- Orders and Genera of the Fourth Clafs of Dfeafes.

CLASS IV.

DISEASES OF ASSOCIATION.

OR DO I.

Increafed Ajfoc'iatc Motions.^

GENERA.

1. Catenated with irritative motions.

2. Catenated with fenfitive^ motions.,

3. Catenated with voluntary motions.

4. Catenated with external influences.

OR DO II.

Decreafed Affociate Motions^

GENERA.
1^ Catenated with irritative motions.

2. Catenated with fenfitive motions.

3. Catenated with voluntary motions.

4. Catenated with external influences*

OR DO HI.

Retrograde AJfociate Motions^

GENERA.

1. Catenated with irritative motions.

2. Catenated with fenfitive motions.

3. Catenated with voluntary motions.

4. Catenated with external influences.

the

414 DISEASES OF ASSOCIATION. Class lY. i. i.

The Orders, Genera, and Species, of the Fourth Clajs

of Dijeafes*

CLASS IV.

DISEASES OF ASSOCIATION.

O R D O I.

Increafed Ajfoc'iate Motions.

GENUS I.

Catenated "with Irritative Motions.

SPECIES.

1. Kuhor vtiltus franforum. Fluihing of the face after dinner.

2. Sudor Jlragtilis imtnerforum. Sweat from covering the face in bed.

3. Cejfath cEgritudiyiis cute excitata. Cure of ficknefs by Simulating

the Ikin.

4. ,DigeJlio au&afrigore cutanea. Digeftion increafed by coldnefs of

the Ikin.

5. Catarrhus a f rigor e cutanea. Catarrh from cold (kin.

6. Abforptio celhilaris auda vo- Cellular abforption increafed by

mitu. vomiting.

7. Syngultus nephriticus. Nephritic hiccough.

8. Febris irritativa. Irritative fever.

GENUS

Class IV. 1.2. DISEASES OF ASSOCIATION.

415

GENUS II.

.Catenated with Senjit'ive. Motions*

SPECIES.

I. LacrymaruM JIuxus 'fympa~

theticus.
1. Sternutatio a lumine.

3. Dolor dentiiim a Stridore,

4. EJfus fardonicuSt'i -

5. Saliva: JIuxus cibo vifo.

6. Tenjio mamularum vifo pu~

erulo.

7. Tenjto penis in hydrophobia.

8. 'Tenefmus calculofus.

9. Polypus narium ex afcaride.

I o. Grampus furarum in diarrhoea.

1 1 . Zona ignea nephritica.

1 2. Erupt io variolarum.

1 3. Gutta rofeajlomatica.

14. hepatic a. '_ .

15. Podagra.

16. Rheumatifmus.

17. Eryjipelas.

18. Tejiium tumor in gonorrhsea.

19. in parotitide.

Sympathetic tears.

Sneezing from lioht.

Tooth-edge from grating founds.

Sardonic fnniie.

Flux of faliva at fight of food.

Tenfion of the nipples of ladtefcent
women at fight of the child.

Tenfion of the penis in hydro-
phobia.

Tenefmus from ftone.

Polypus of the nofe from afcarides.

Cramp from diarrhoea.

Nephritic fliingles.

Eruption of fmall-pox,

Stomatic rofy drop* .

Hepatic rofy drop. ^ .

Gout.

Rheumatifm.

Eryfipelas..

Swelled teftls in gonorrhoea.

n\ mumps.

GENUS

4.i6

DISEASES OF ASSOCIATION. Class IV. 1.3.4.

GENUS III.

Catenated with Voluntary Motions.

SPECIES.

1. Deglutiiio inviia.

2. NiSlitatio invita,

3. Rifus invitus.

4^ Lufus digitorum invitus.

5. Unguium 7norJiiincula invita.

6. Vigllla Invlta.

Involuntary deglutition.

niditation.

■ laughter.

adlions with the fingers.
biting the nails.

watchfulnefs.

GENUS IV.

Xlatenated with External Influences,

SPECIES.

;i . Vita ovl.

2. Vita hleml-dormlentlum.

3. Pullulatlo arbor um,

4. Orgafmatls venerel ferlodus,

5. Brachll concujjlo ekdrlca.

6 . Oxygenatlo fangulnls .

7. Hume&atlo corporis.

Life of an eg-g:.

OO'

Life of winter-fleepers.
Budding of trees.
Periods of venereal defire.
Eledtric fliock through the arm.
Oxygenation of the blood.
Humedtation of the body.

ORDO

Class IV. 2. i.. DISEASES OF ASSOCIATION.

41^

O R D o ir.

Decreafed AJfociate Motions.

GENUS I.

Catenated with Irritative Motions^

SPECIES.

r. Cutis frigida pranforum,
2. Pall :'■ urince pranforum.
3. a frigore cutanea.

4. Pallor ex cegritudine.

5. Dyfpncea a balneofrigido.

6.. Dyfpepjia a pedibus frigidis,

7. T'ti/Jis a pedibusfrigidis,.

8. hepatic a,

9. arthritic a,

LO. Vertigo rotatoria^

I; I. vifualis,

12. ehriofa^

1-3. febriculofa..

14. ccrehrofa.

15. Murmur auriutn vertiginofum.
1.6. laSiiis, g^iftus, olfaSlus verti-

ginoji.
1:7. Pulfus mollis a vomitione,

18. intermittens a ventri^

culo.
1,9. Febris inirritativa.

Vol. IL.

Chillnefs after dinner.
Pale urine after dinner.

from cold (kin.

Palenefs from ficknefs.

Shortnefs of breath from cold bath»-

ing.
Indigeftion from cold feet; *

Cough from cold feet»
Liver-eough.
Gout-cousfh.
Vertigo rotatory.

' vifual.

inebriate.

' feverifh,

from the bralnv

Noife in the ears.
Vertiginous touch,, tafle, fmelK

Soft pulfe in vomiting;.
Intermittent pulfe from the ilo-

mach.
Inirritative {^s^r,

3.Ei GENUS-

41 8 DISEASES OF ASSOCIATION. ClassIVo2,2.

GENUS II.
Catenated with Senjitive Motions,

SPECIES.

1 . Torpor gence a dolor e dentis. Coldaefs of the cheek from tooth-

ach.

2. Stranguria a dolor e vejicce. Strangury from pain of the bladder.

3. conviilji'ua. Convulfive ftrangury.

4. Dolor termini duBus choledochi. Pain of the end of the blle-duft.

5. De/or pharyngis abacido gaf- Pain of the throat from gaftric

trico, acid.

€. Pruritus narium a vcrmibus. Itching of the nofe from worms.

7. Cephalcea. Head-ach.

8. Hemicrania et otalgia. Partial head-ach, and ear-ach.

9. Dolor humeri in hepatidide. Pain of flioulder in hepatitis.

10. torpor pedum variola erum- Cold feet in eruption of fmall-

pente. pox,

1 1. Tejiium dolor nephriticus. Nephritic pain of teftis.

12. Dolor digiii minimi fympathe- Pain of little finger from fym-

ticus. P^thy.

13. Dolor brachii in hydrope pec- Pain of the arm in dropfy of the

toris. cheft.

14. Diarrhoea a dentitione. Diarrhoea from toothing. .

GENUS

Class IV. 2. 3. 4. DISEASES OF ASSOCIATION.

41^

GENUS III.

Catenated with Voluntary Motions^

SPECIES.

I.

'Titubat'io linguce.

Impediment of fpeech.

2.

Chorea Jan£ii vitu

St. Vitus' dance.

3'

FJfus.

Laughter.

4.

"Tremor ex ird^

Tremblino; from anger.

5-

Rubor ex ird.

Rednefs from anger.

6.

criminatl.

Blufh of guilt.

7-

Tard'itas paralytica..

Slownefs fiom palfy.

8.

Jenilis.,

of age.

GENUS IV..
Catenated with' External Influences,

SPECIES.

I. Somni per'wdus.

Periods

of fleep.

2. Studii inanis periodus.

3. Hemtcran'ta periodus.

4. Epllepftte dolorifica: periodus.

5. Convulfionis dolorijicce periodus.

6. Tujjis periodica periodus.

7. Catamenice periodus.

8. Hcemorrhoidis periodus,

9. Podagra periodus.

- of reverie.

- of painful epilepfy.

- of painful convulfion.

- of periodic cough.

- of the piles.

- nf thp croiit-

3H

2 10. Eryjjpelatis

420

DISEASES OF ASSOCIATION. Class IV. 3. i, 2,

I o . "Eryfipelatls periodus .
1 1 . Febrium periodus.

Periods of eryfipelas.
-= — of fevers.

ORDO III.

'Retrograde AJJociate Motions.

GENUS I.

Catenated with Irritative Motions.

SPECIES,

1, Tiiahcetes irritata.

2. Sudor frigidus in ajihmate.
2,. Diabcetes a timore.

4. Diarrhcea a timore.

5. Pallor et tremor a timore.

6. Palpitatio cordis a timore.

7. Abortio a timore.

8. H^eria a timore.

Diabetes from irritation.

Cold fweat in afthma.

Diabetes from fear.

Diarrhoea from fear.

Palenefs and trembling from fear.

Palpitation of the heart from fear.

Abortion from. fear.

Hyflerics from fear.

GENUS 11.

■Catenated with Senfitiroe Motions.

l„ Naufea idealis.

2. a conceptu.

Q. Vomit io vertiginofa.

A. a calculo in uretere.

r ab infultu paralytica

SPECIES.

Naufea from ideas.
Naufea from conception.
Vomiting from vertigo,

■ from ftone in the ureter.

= from ftroke of palfy.

6. Vomit io

■*♦

Class IV. 3. 3. 4. DISEASES OF ASSOCIATION.

421

6. Vomitio a titilattone fauc'mm. Vomiting from tickling the throat.

y. . cute fympatheticcu from fympathy with the

fkin.

GENUS III.

€!atenaied with Voluntary Motions^

1. Rum'matTO,

2. Vomitio voluniaria.

3. EruSlatio voluntaria.

SPECIES.

Rumination.
Voluntary vomiting.
erudationi,

GENUS. IV.
Catenated with External Influences.

1. Catarrhus periodicusx

2. TuJJis periodica.

3. Hijleria a f rigor e,

4. Naufea pluvialis.

SPECIES.

Periodical catarrh.
Periodic cough.
Hyfterics from cold.
Sicknefs asainft rain,.

CLASS

Class IV. I.I. DISEASES OF ASSOCIATION. 423

^ CLASS IV.

DISEASES OF ASSOCIATION.

O R D O I.

tncreafed AJfoc'tate Motions,

GENUS I.

Catenated with Irritative Motion.

The importance of the fubfequent clafs not only confifts in its elu-
cidating all the fympathetic difeafes, but in its opening a road to the
knowledge of fever. The difficulty and novelty of the fubjed muft
plead in excufe for the prefent imperfe6l ftate of it. The reader is
entreated previoufly to attend to the following circunaftances for the
greater facility of inveftigating their intricate connections ; which I
ftiall enumerate under the following heads.

A. Affociate motions diftinguifhed from catenations,
■ B. Affociate motions of three kinds.

C. Affociations affe£ted by external influences.

D. Affociations affected by other fenforial motions.

E. Affociations catenated with fenfation.

F. Diredl and reverfe fympathy.

G. Affociations affefted four ways.
H. Origin of affociations.

I. Of the aftion of vomiting.
K. Tertian aflbciations.

8 A. Jffociaie

424 DISEASES OF ASSOCIATION. Class lY. i . r.

A. AJJoc'iaie Motions dljiinguijloed from Catenations^,

AiTociate motions properly mean only thofe, which are caufcd by
the fenforial power of affociation.. Whence it appears, that thole
fibrous motions, which conftitute the introdu£lory link of an aflbciate
train of motions, are excluded from this definition, as not being
themfelves caufed by the fenforial power of affociation, but by irrita-
tion, or fenfation, or volition. I fhall -give for example the flufhing
of the face after dinner ;. the capillary vefTels of the face increafe their
adions in confequence of their catenation, not their afTociation, witb
thofe of the ftom.ach \ which latter are caufed. to a<fl with greater
energy by the irritation excited by the ftlmukis of food. Thefe ca-
pillaries of the face are affociated with each other reciprocally, as being
all of them excited by the fenforial power of afTociation ; but they are
only catenated with thofe of the flomach, which are not in this cafe
afTociate motions but irritative ones. The common ufe of the word
afTociation for almofl every kind of connexion has rendered this fub-
je£l difficult ; from which, inaccuracy I. fear fome parts of this work
are not exempt..

B. AJfociate Motiom of ihret KinJL.

Thofe trains or tribea of afTociate motions, whofe introduifiory
link eonfrfts of an irritative motion, are termed irritative afTociations ;
as when the mulcles of the eyelids clofe the eye in common niftita-
tion. Thofe, whofe introductory link confifls of a fenfitive motion,
are termed fenfitive afTociations j as when the pedtoral and intercoflal
mufcles a£l in fneezing. And laftly, thole, whofe introdudlory
link confifts of a voluntary motion, are termed voluntary afTociations ;.
6 as

Class IV. 1. 1. DISEASES OF ASSOCIATION. 425

as when the mufcles of the lower limbs zCt in concert with thofe of
thd arm in fencing.

C. AJfociatlons offered hy external Influences.

Circles of affociate motions, as well as trains and tribes of them,
are liable to be afFefled by external influences, which confift of ethe-
rial fluids, and which, by penetrating the fyflem, aft upon it perhaps
rather as a caufa fine qud non of its movements, than, direftly as a
ftimuius ; except when they are accumulated in unufual quantity.
We have a fenfe adapted to the perception of the excefs or defeft of
one of thefe fluids ; I mean that of elementary heat ; in which all
-things are immerfed. See Clafs IV. 1.4. i. But there are others of
them, which as we have no power to evade their influence, fo wc
have no fenfe to perceive it ; thefe are the folar, and lunar, and ter-
reftrial gravitation, in which alfo all things are imn:>erfed ; the elec-
tric aura, which pervades us, and is perpetually varying. See Clafs
IV. I. 4. 5 ; the magnetic fluid, Clafs IV. i. 4, 6 ; and laftly, the
great life-preferver oxygen gas, and the aqueous vapour of the atmo-
fphere, fee Clafs IV. 1.4. 6. and 7. and 2.

Of thefe external influences thofe of heat, and of gravity, have di-
urnal periods of increafe and decreafej befides their greater periods of
mont'hly or annual variation. The manner in which they aft by pe-
riodical increments on the fyftem, till fome eifeft is produced, is
Ipoken of in Seft. XXXII. 3. and 6.

D. JJfoc'tationi offered by other Senforial Motions.

Circles and trains of aflbciate motions are alfo liable to be affefted

fcy their catenations with other fenforial powers, as of irritation, or

Vol. II. 3 I fenfation,

426 DISEASES OF ASSOCIATION. Class IV. i. u

fenfation, or volition; vvliich other fenforial powers either thus
iimply form Tome of the links of the catenation, or add to the energy
of the alTociated motions. Thus when vomiting is caufed by the fti-
mulus of a flone in the ureter, the fenfation of pain feems to be a
link of the catenation rather than an efficient caufe of the vomiting.
But when the capillary veffels of the Ikin increafe their aftion from
the influence of external heat, tliey are excited both by the ftimulus.
of unufual heat, as well as by the ftimulus of the blood, and by thei|-
accuflomed aflbciation with the actions of the heart and arteries. And
laftly, in the blufh of anger the fenforial power of volition is added to
that of aflociation, and irritation, to excite the capillaries of the face
with increafed aftion. See Ciafs IV. 2. 3. 5.

E. jljfoc'iatlons catenated with Senfation,.

Pain frequently accompanies ailociate trains or circles of motion,
without its being a caufe, or a link, of them, but (imply an attendant
fymiptom ; though it frequently gives name to the difeafe, as head-
ach. Thus in the cramp of the calves of the legs in diarrhoea, the
increafed fenforial power of affociation is the proximate caufe ; the
preceding increafed action of the bowels is the remote caufe ; and the
proximate effedl is the violent contraclions of the mufculi gaftrocne-
mii ; but the pain of thefe mufcles is only an attendant fymptom, or
a remote efFe£l, See Sed, XVIII. 15. Other fenfitive aflbciations are
mentioned in Clafs IV. i. 2. and IV. 1.2, 15.

Thus, if the fiufhiug of the face above mentioned after dinner be
called a difeafe, the immediate or proximate caufe is the increafed
power of affociation, the remote caufe is the increafed irritative mo-
tions of the flomach in confequence of the ftimulus of food and wine.
The difeafe or proximate eftedl confifls in the increafed adions of the
cutaneous veffels of the facej and the fenfation of heat, the exiftence

of

Class IV. I. r. DISEASES OF ASSOCIATION. 427

cf heat, and the red colour, are attendants or fymptoms, or remote
effe&.3, of the increafed aftions of thefe cutaneous veffels.

F. Diredi and reverfe Sympathy,

The increafed aftions of the prinaary part of the trains of affociated'
motions are fometimes fucceeded by increafed adlions of the fecoiidary
part of the train ; and fometimes by decreafed a6lionsofit. So like-
wife the decreafed adlions of the primary part of a train of aflbciatc
motions are fometimes fucceeded by decreafed adtions of the fecoudary
part, and fometimes by increafed adlions of it. The former of thefe
lituations is called diredt fympathy, and the latter reverfe fympathy.
In general I believe, where the primary part of the train of affociated
motions is exerted more than natural, it produces diredl fympathy in;
ftrong people, and reverfe fympathy in weak ones, as a full meal
makes fome people hot, and others chill. And where the primary
part of the train is exerted lefs than natural, it produces diredl fym-
pathy in weak people, and reverfe fympathy in ftrong ones, as on
being expofed for a certain length of time on horfeback in a cold day
gives indigeftion and confequent heart-burn to weak people, and
flrengthens the digeftion, and induces confequent hunger in ftrong
ones. See Sedt. XXXV". i.

This may perhaps be more eafily underftood, by confidering
ftrength and weaknefs, when applied to animal bodies, as confiftino-
in the quantity of fenforial power refiding in the contradling fibres,
and the quantity of ftimulus applied, as {hewn in Sedl. XII. 2. i.
Now when defedlive ftimulus, within certain limits, is partially ap-
plied to parts fubjedl to perpetual motion, the expenditure of fenforial
power is for a while leffened, but not its general produdlion in the
brain, nor its derivation into the weakly-ftimulated part. Hence in
flrong people, or fuch whofe fibres abound with fenforial power, if

3 I 2 ' the

428 DISEASES OF ASSOCIATION. ClassIV. t. r,

the firfl tribe of an aflbciate train of motions be deprived irv part of its.
accuftomed ftiraulus, its aftion becomes diminifhed ; and the fenfo-
rial power becomes accumulated, and by its fuperabundance, or over-
flowing as it were, increafes the aftion of the fecond tribe of the af-
fociate acSlions by reverfe fympathy. As expofing the warm Ikin fot
a moderate time to cold air increafes the ailioii of the flomach,, and
thus ftrengthens the power of digeflion..

On the reverfe, when additional ^imulus within certain, limits is.
partially applied to parts, which are deficient in refpedl to the natural
quantity of fenforial power, the expenditure of fenforial power is in-
creafed, but in a lefs degree than the increafed produdtion of it in the
brain, or its increafed derivation into the flrongly-ftimulated organ.
Hence in weak people, or fuch whofe fibres are deficient of fenforial
power, if the firft tribe of an aflbciate train of motions be fubje£led
for a while to greater ftimulus than ufual, a greater produftion of fen-
forial power, or a greater derivation of it into the ftimulated parts oc-
curs ; which by its excefs, or overflowing as it were, increafes the
actions of the fecond tribe of the aflbciate motions by dire£l fympathy.
Thus when vomiting occurs with cold extremities, a bllfter on the
back in a few hours occafions univerfal warmth of the Ikin, and ftops
the vomiting. And when a diarrhoea occurs with pale fkin and cold
extremities, the pricking of the points of a flannel fhirt, worn next
the ikin, occafions univerfal warmth of it, and checks or cures the
diarrhcEa.

In fome aflbciate trains of aftion ueveithelefs reverfe fympathies
more frequently occur than dire6l ones, and in others direft ones
more frequently than reverfe ones. Thus in continued fever with
debility there appears to be a reverfe fympathy between the capillary
veffels of the flomach and thofe of the Ikin : becaufe there exifts a
total averfion to foUd food, and conftant heat on. the furface of the
body. Yet thefe two fyftems of veflels are. at other times aftuated by
dired fympathy, as when palenefs attends licknefs,. or cold feet in-
3 ■ duces

Class IV. 1. 1. DISEASES OF ASSOCIATION, 429

duces hidigeftloa. This fubjeift requires to be further inveftigated,
as it probably depends not only on the prefent or previous plus or
minus of the fenforial power of aflbciatiwi, but alfo on the introduc-
tion of other kinds of fenforial power, as in Clafs IV. i. i. D; or the
increafed produ£lion of it in the brain, or the greater mobility of one
part of a train of adtions than another^

Thus when much food or wine is taken Into the ftoraach, if there
be no fuperflu-ity of fenforial power ii> the fyftem, that is, none to be
fpared from the continual adtions of it, a palenefs and chillnefs fuc-
ceeds for a time j becaufe now the expenditure of it by the increafed
actions of the ftomach is greater than the prefent produdtion of it. In
a little time however the ftimulus of the food and wine iiicreafes the
produftion of fenforial power in the brain, and this produces afuper-^
fluity of it in the fyftem ; in confequence of which the Ikia now be-
comes warm and florid, which was at firft cold and pale ; and thus
the reverfe fympathy is fhortly converted into a direct one j which is
probably owing to the introdudion of a fecond fenforial power, that of
pleafurable fenfation.

On the contrary, when an emetic drug produces ficknefs, the ikin
is at firft pale for a time by direft fympathy with the capillaries of the
flomach ; but in a few minutes, by the accumulation of fenforial
power in the ftomach during its lefs adlive ftate in ficknefs, the ca-
pillaries of the Ikin, which are aifociated with thofe of the ftomach,
adt with greater energy by reverfe fympathy, and a florid colour re-
turns. Where the quantity of adion is diminiftied in the firft part of
a train of motions, whether by previous diminution of fenforial power,
or prefent diminution of ftimulus, the fecond part of the train be-
comes torpid by diredt fympathy. And when the quantity of atStion,
of the firft part becomes increafed by the accumulation of fenforial
power during its previous torpor, or by increafe of ftimulus, the
adions of the fecond part of it likewife become increafed by diredt
fympathy,

la

430 . DISEASES OF ASSOCIATION. Class IV. i. i.

In moderate hunger the fkin is pale, as before dinner, and in mo-
derate ficknefs, as no great accumulation of fenforial power has
commenced; but in violent hunger, and in greater torpor of the
ftomach, as from contagious matter, the accumulation of fenforial
power becomes fo great as to affe£t the arterial and capillary fyflem,
and fever is produced in both cafes.

In contagious fevers with arterial debilities commencing with tor-
por of the ftomach, why is the adtion of the heart weakened, and
that of the capillaries increafed ? Is it becaufe the mobility of the heart
is lefs than that of the ftomach, and the mobility of the capillaries
greater ? Or is it becaufe the allociation between the mufcular fibres
of the flomach and thofe of the heart have been uniformly aflbciated
by direft fympathy ; and the capillaries of the flomach and thof^
of the fkin have been more frequently aflbciated by reverfe fym-
pathy ?

Where the aftions of the ftomach have been previoufly exhaufled
by long ftimulus, as on the day after intoxication, little or no accu-
mulation of fenforial power occurs, during the torpor of the oro-an,.
beyond vi'hat is required to replace the deficiency of it, and hence
fever feldom follows intoxication. And a repetition of the ftimulus
fometimes becomes neceflary even to induce its natural adion, as in
dram-drinkers.

Where there has been no previous exhauftion of fenforial power,
and the primary link of aflbciate motions is violently aduated by the
fenforial power of fenfation, the fecondary link is alfo violently ac-
tuated by dire<fl fympathy, as in inflammatory fevers. Where how-
ever the fenforial power of the fyftem is lefs than natural, the fecon-
dary link of afTociated motions becomes torpid by reverfe fympathy, as
in the inoculated fmall-pox during the eruption on the face the feet are
frequently cold.

G. AJfoclatkni

Class IV. i. i. DISEASES OF ASSOCIATION. 431

G. AJfociations affe Lied four Ways.

Hence affociated trains or circles of motions may be afFefted four
'difFerent ways. i. By the greater or lefs energy of aftion of the firfl:
link with which they are catenated, and from which they take their
names; as irritative, fenfitive, or voluntary affociations. 2. By
being excited by two or more fenforial powers at the fame time, as
by irritation and alTociation, as in the i-nftance of the application of the
ftimulus of increafed external heat to the cutaneous capillaries. 3. By
catenation with other fenforial powers, as with pain or pleafure,
which are in this cafe not the proximate caufe of motion, but which,
by becoming a link of catenation, excites the fenforial power of af-
fociation into aftion ; as the pain at the neck of the gall-bladder oc-
cafioned by a gall-ftone is transferred to the other end of that canal,
and becomes a link of catenation between the adion of the two ex-
tremities of it. 4. The influence of ethereal fluids, as of heat and
gravitation. To which laft perhaps might be added moifture and
oxygen gas as confiituting neceffary parts of the fyftem, rather than
•Rimuli to excite it into a(5tion.

H. The Origin of uijfociatiom.

Some trains or circles of afTociate motions muft have been formed
before our nativity, as thofe of the heart, arteries, and capillaries;
others have been afTociated, as occafion required them, as the muf-
cles of the diaphragm and abdomen in vomiting; and others by per-
petual habit, as thofe of the ftomach with the heart and artenes di-
redly, as in weak pulfe during ficknefs ; with the capillaries diredly,
as in the flulhed Ikin after dinner ; and laflly, with the cellular ab-
4 forbents

432 DISEASES OF ASSOCIATION. Class IV. i. i.

forbents reverfely, as in the increafed abforption in anafarca during
ficknefs ; and with the irritative motions of the organs of fenfe re-
verfely, as in vertigo, or fea-ficknefs. Some of thefe affociations
fhall be here fhortly defcribed to facilitate the inveftlgatiou of
others.

Firft, other congeries of glands occupy but a particular part of
the fyftem, or conftltute a particular organ, as the liver, or kidneys;
but thofe glands, which fecrete the mucus, and perfpirable matter,
w-hich are called capillaries, are of very great extent ; they receive
the blood from the arteries, feparate from it the mucus, which lines
every cell, and covers every cavity of body ; and the perfpirable mat-
ter, which fofteas and lubricates the whole furface of the ikin, and
the more extenfive furface of the air-veflels, which compofe the
lungs. Thefe are fupplied with blood by the perpetual adion of the
heart and arteries, and have therefore their motions affociated with the
former, and with each other, by fympathy, which is fometimes di-
re£l, and fometimes reverfe.

One branch of this alTociation, the capillaries of the ikin, are very
irritable by the increafed quantities of cold and heat, another branch,
that of the lungs, has not the perception of cold and heat, but is liable by
diredt fympathy to adl in concert with the former, as in going into
the cold bath. And it is probable the capillaries of the internal mem-
branes are llkewife direcTly afFedted by their fympathy with thofe of
the Ikin, as appears from .the defe£l of fecretioain ulcers during the
cold fits of agues.

'T'he n:K)tions of this extenfive fyllem of capillaries, thus affociated
by diredl (ympathy, are alfo affociated with thofe of the heart and ar-
teries, fometimes by reverfe and fometimes by dire6t fympathy ; and
thus conflitute fimple fever. The cold paroxyfm of which confifts in
iheir torpor, and the hot one in their orgafm, or increafed activity.

I, Of

Class IV. i. i. DISEASES OF ASSOCIATION". 433

I. Of the ASl'ion of Vomiting,

The manner, in which the ftomach and the diaphragm and abdo-
minal mufcles acquire their affociate adlion in vomiting, requires
fome attention. It is not probable, that this aftion of vomiting oc-
curs before nativity; as the uniform application of the nutritive liquor
amnii to the mouth of the foetus, and the uniform expenditure of its
nourishment, vi^ould not feem to give occafion to too great temporary-
repletion of the ftomach ; and would preclude the deglutition of any
improper material. After nativity the ftomach of the child may be
occalionally too much diftended with milk ; as previous hunger may
induce it to overgorge itfelf ; and by repeated efforts the adl of vo-
miting is learned, as a means of getting free from a difagreeable fen-
■fation. Thus when any difguftful material, as a bitter drug, is taken
into the mouth ; certain retrograde motions of the tongue and lips
are produced, for the purpofe of putting the difagreeable material out
of the mouth again.

When the ftomach is difagreeably ftimulated by the diftention or
acrimony of the aliment, a fimilar effort to regurgitate it muft occur;
and by repeated trials the a£lion of the diaphragm and abdominal muf-
cles by fqueezing the ftomach aflifts its retrograde exertion to dif-
gorge its contents. In the fame manner when a piece of gravel is
pufhed into the urethra, or a piece of indurated bile into the neck of
the gall-bladder, after they have been in vain prefled forward by the
ufual motions of thofe dufts, they return into the bladders of gall and
urine by the retrograde motions of them.

That this is one mode, in which vomiting is induced, appears from
the inftantaneous rejedion from the ftomach occafioned by fome nau-
feous drug, or from fome naufeous idea ; and laftly,- from the volun-

VoL. II. 3 K tary

434 ' -DISEASES OF ASSOCIATION. Class IV. i. r.

tary power, which fome people have been faid to have acquired, of
emptyino- their ftomachs, much in the fame manner as ruminating
animals bring up the grafs from their firfl ftomach.

There are neverthelefs many modes by which thefe inverted mo-
tions of the fiomach and oefophagus are induced, and which it is of
confequence to diftinguifh from each other. The firfl: is the mode
above defcribed, where an effort is made to diClodge fomething, which
Simulates the ftomach into difagreeable fenfation ; and which is re-
turned by repeated exertions ; as when a naufeous drug is taken into
the mouth f or a bit of fand falls into the eye, or a drop of water into
the wind-pipe. In this the periftakic motions of the fiomach are flrft
flopped, and then reverted by painful fenfation ; and the abdominal
mufcles and diaphragm by repeated efforts become affociated with
them. Now as iefs fenforial power is expended on the retrograde ac-
tions of the ftomach, and of the lymphatics, which open their
mouths on its furface, than by their natural motions, an accumula-
tion of fenforial power in the fibres of the fiomach follows the exhibi-
tion of an emetic, and on that account an emetic will fometimes flop
a fpontaneous vomiting which was owing to fenforial deficiency. See
Sed. XXXV. 1.3. and Art. V. 2. i.

As bitters and metallic falts, exhibited in fmall dofes, flimukte the
fiomach into greater aftion, as appears by their increafing the power
of djo'eftion, and yet become emetic, when given in larger dofes ; one
mi^ht fufpeft, that they became emetic by inducing debility, and
coufequent retrograde aftions of the fiomach, by their previoufly ex-
haullino- the fenforial power by their great flimulus ; which might be
effefted in a moment without producing pain, and in confequence
without our perceiving it. But on the contrary, there does not in
creneral appear on the exhibition of emetics to be any previous ex-
bauflion of fenforial power ; becaufe there is evidently an accumula-
tion of it during the iicknefs, as appears from the digeflion being
8 fironger

Class ,IV. i, i. PISEASES OF ASSOCIATION. 435

ilronger afterwards; and from the increafed adion of the cellular
and cutaneous abforbents durhig its operation. 5ee Art,. V. 2. i.

Another mode^ by which vomiting is induced, is owing to debi-
lity or deficiency .of fenforial power, from the previous exhauftion
of it ; as on the day after intoxication, or which occurs i,a people
enfeebled vfith the gout, and in dropfy, and in fome fevers with
debility. In thefe, when the vomiting ceafes, there is ijo appear-
ance of accumulation of fenforial power, as the digCiftiGn ftiil remains
weak and imperfe£l.

Another mode by which ficknefs or vomiting is induced, is by
defedl of ftimulus, as in great hunger ; and in thofe, who have been
habituated to fpice and fpirit with their meals, who are liable to be
iick after taking food without thefe additional ftimuli. Other means
of inducing ficknefs by vertigo, or by naufeous ideas, will be men-
tioned below; '

We fhall only add, that the motions of the mufcular fibres of the
ftomach are affociated with thofe of the heart and arteries by dire£t
Sympathy, as appears by the weaknefs of the pulfe during the exhi-
bition of an emetic ; and that the abforbents of the ftomach are aflb-
ciated with the cellular and cutaneous abforbents by reverfe fympathy,
as is ftiewn by the great abforption of the mucus of the cells in ana*
farca dviring ficknefs j at the fame time that the abforbents of the
ftomach invert their adlions, and pour the mucus and water thus
abforbed into that vifcus.

In cold paroxyfms of fever the ftomach partakes of the general
torpor, and vomiting is induced by its debiUty, either by its aflb-
ciation with the torpid capillaries, or other torpid parts, or by its
own torpor commencing firft, and caufing the cold fit. The difor-
dered motions of the ftomach frequently feem to be the caufe or
primary feat of fever, as where contagious miafmata are fwallowed
with the fahva, and where fever is produced by fea- ficknefs, which
1 once faw. Ncverthelefs a diforder of the ftomach does not always

3 K 2 induce

436 DISEASES OF ASSOCIATION. Class IV. i.u

induce fever, as in that cafe it fliould conftantly attend indigeftion,.
and vertigo, and fea-licknefs ; but is itfelf frequently induced by
affociation with the difordered movements of other parts of the
fyflem, as when it arifes from gravel in the ureter, or from a per-
cuffion on the head.

The connexion of the motions of the ftomach with irritative ideas,,
or motions of the organs of fenfe, in vertigo, is Ihevvn in Sed. XX^
and thus it appears, that many circles of aiTociation are either diredly.
or reverfely affociated, or catenated, with this vifcus ; which will
much contribute to unfold fome of the fymptoms of fever.

K. 'Tertian j^Jociations,,.

The third link of affociate trains of motion is fometimes asfluated"
by reverfe fympathy, with the fecond link, and that by reverfe
fympathy with the firft link ; fo that the fi'rfl: and third link may adt
by dire£l fympathy, and the intermediate one by reverfe fympathy.
Of this inftances are given in. the fyngultus nephriticus, Clafs IV".
I. I. 7. and IV. 2. I, At other times the tertian or quartan links of
affociate motions are adluated by dire£t fympathy ; and that fome-
times forwards and fometimes backwards in refpeft to the ufual order
of thofe trains of affociate motions, as in Clafs IV. i,. 2. i..

■ SPECIES.

I. Rubor viiltus pranforimz. Flufliing of the face after dinner is
explained in Sett. XXX Y. i. In the beginning of intoxication the
whole Ikin becomes florid from the aflbciation of the actions of the
cutaneous arteries with thofe of the ftomach, becaufe vinous fpirit
excites the fibres of the ftomach into more violent a<5lion than the
ftimulus of common food ; and the cutaneous capillaries of the face,
from their more frequent expofure to the viciffitudes of cold and beat,

poffefs

Class IV. i. r. DISEASES OF ASSOCIATION. 437;

pofTefs more mobility or irritability than thofe of other parts of the
Ikin, as further explained in Sed:. XXXIII. 2. 10. Vinegar is liable
to produce this flufiiing of the face, which probably is owing to the
quantity of vinous fpirit it contains, as I believe the unfermented
. vegetable acids do not produce this efFeft. In every kind of blufl-i the
arterial blood is propelled into the capillaries fafter than the venous
abforption can carry it forwards into the veins, in this refpedt
refembhng the tenfio phalli-
Can the beginning vinous or acetous fermentation of the aliment
in weak ftomachs contribute to this efFedl ? or is it to be afcribed to
the greater power of affociation between the arteries of the face and
the fibres of the ftomach in fome people than in others ?

M. M. Eat and drink Icfs at a time, and more frequently. Put
20 drops of weak acid of vitriol into water to be drank at meals. Let
the drefs over the ftomach and bowels bs looie. Ufe no fermented
liquors, or vinegar, or fpice..

2. Sudor Jiragulis Immerforuim Sweat from being covered in bed,-
In the commencement of an epidemic fever, in which the perpetual
efforts to vomit was a diftreffing fymptom, Dr. Sydenham difco-
vered, that if the patient's head was for a fhort time covered over
with the bed clothes, warmth was produced, and a Aveat broke out
upon the Ikin, and the tendency to vomit ceafed. In this curious
fa<3: two trains of afTociated motions are excited into increafed a£lion.
Firft, the veflels of the lungs are known to have their motion affo-
ciated with thofe of the ikin by the difficulty of breathing on going
into the cold bath, as defcribed in Seft. XXXII. 3. 2. Hence, when
the vefiels of the lungs become excited into ftronger aftion, by the
bad air under the bed clothes, warmed and adulterated by frequent
. breathing, thofe of the external Ikin foon become excited by their
affociation into more energetic adlion, and generate more heat along
with a greater fecretion of perfpirable matter. Secondly, the fym-

pathy

438 DISEASES OF ASSOCIATION. Class IVo i. u

pathy between the ftomach and Ikin is evident in variety of clrcum-
ftances ; thus the cold air of frofty days applied to the fkin for a
fliort time increafes the a£lion of the ftomach by reverfe fympathy,
but decreafes it if continued too long by dired fympathy ; fo in the
circumflance above mentioned the a6lion of the ftomach is increafed
by dire£t fympathy with that of the Ikin ; and the tendency to vomit,
which was owing to its diminifhed adtion, ceafes.

3. Cejfailo cegrifud'mis cute excitata. The cure of ficknefs by Simu-
lating the (kin. This is explained in the preceding article; and fur-
..ther noticed in IV. 2. 2. 4. and in IV. 1. i. f.

Similar to thefe is the effeft of a blifter on the back in relieving
iicknefs, indigeftion, and heart-burn.; and, on the contrary, by
•thefe fymptoms being frequently induced by coldnefs of the extre-
mities. The blifter ftimulates the cutaneous veffels into greater
adion ; whence warmth and pain are produced at the fame time, and
the fibres of the ftomach are excited into greater aftion by their aflb-
ciation vi'ith thofe of the fkiu. It does not appear, that the con-
comitant pain of the bllfter caufes the increafed energy of the
ftomach, becaufe the motions of it are not greater than natural j
•though it is fometimes difficult to determine, whether the primary
part of fome alTociated trains be conne6led with irritative or fenfitive
.motions.

In the fame manner a flannel fhirt, to one who has not been in
the habit of wearing one, ftimulates the fkin by its points, and thus
ftops vomiting in fome cafes ; and is particularly efficacious in check-
ing fome chronical diarrhoeas, which are not attended with fever ;
for the abforbents of the Ikin are thus ftimulated into greater a£tion,
with which thofe of the inteftines confent by direct fympathy.

This efFe6l cannot be afcribed to the warmth alone of the flannel
iliirt, as being a covering of loofe texture, and confining air in its
pores, like a fppnge, which air is known to be a bad condudor of

heat J,

Glass IV. i. i. DISEASES OF ASSOCIATION. 439

heat, fince in that cafe its ufe fhould be equally efficacious, if it were
worn over a linen fhirt ; and an increafcd warmth of the room
of the patient would be equally ferviceable. -

4. Digejlio aiifJa frigore cutanea. Digeftion increafed by coldnefs
of the fkin. Every one has experienced the increafe of his appetite
after walking in the cool air in frofly days ; - for there is at this time
not only a faving of fenforial power by the lefs exertion of the cuta-
neous veffels ; but, as thefe confent with thofe of the ftomach and
bowels, this faving of fenforial power is transferred by reverfe fym-
pathy from the cutaneous capillaries and abforbents to thofe of . the
ftomach and niteftines.

Hence weak people (hould ufe the cold air of winter as a cold
bath; that is, they fhould ftay in it but a ihort time at once, but
Ihould immerfe themfelves in it many ti-mes a day. .

5. Catarrhtis a frigore 'citianeo. Catarrh from cold llcin. This has
■feieen already explained in Clafs I. 1.2. 7. and is further defcribed in
Sedl. XXXV. 1.3. In this difeafe the veffels of the membrane,
which lines the noftrils, are excited into greater action ; when thofe
of the Ikin, with which they are affociated, are excited into lefs
adlion by the deficiency of external heat, by reverfe fympathy ; and
though the pain of cold attends the torpor of the primary link of this
aflbciation, yet the increafed motions of the membrane of the noftrils
are affociated with thofe of the cutaneous veffels, and not with the
pain of them, becaufe no inflammation follows. '

6. Ahforpt'to cellularis auBa vom'iHu In the a£l of vomiting the
irritative motions of the ftomach are inverted, and of the abforbents,
which open their mouths into it ; while the cutaneous, cellular, and
pulmonary abforbents are induced, by reverfe fympath j with them,

to

440 - DISEASES OF ASSOCIATION. Class IV. i. i,

■to aiffc with greater energy. This is {een m cafes of anafarca, when
long ficknefs and vomiting are caufedby Iquills, or antimonial falts,
or moft of all by the deco£lioa of digitalis purpurea, foxglove; and
Mr. J. Hunter mentions a cafe, in which a large bubo, which was
juft ready to break, was abforbed in a few days by ficknefs at fea.
Treatife on the Blood, p. 501, which is thus accounted for; lefs
rfenforial power is expended during ficknefs by the decreafed a£lion of
.the -fibres of the ftomach, and of its abforbents; as ihcwn in Se£l.
XXXV. I. 3. whence an accumulation of it is produced, and there
is in confequence a greater quantity of fenforial power for the exer-
tion of thofe motions, which are affociated with the abforbents of the
flomach by reverfe fympathy.

The reverfe fympathy between the Ia£leal and lymphatic branches
of the abforbent fyflem have been produced by the one branch being
lefs excited to a£t, when the other fupplies fufEcient fluid or nutri-
ment to the fanguiferous veffels. Thus when the ftomach is full,
^nd the fupply of chyle and mucus and water is in fufficient quantity;
the pulmonary, cellular, and cutaneous lymphatics are not excited
into action ; whence the urine is pale, and the Ikin moift, from the
defedl of abforption on thofe furfaces.

7. Singultus nephriticus. When a flone irritates the ureter, and
that even without its being attended with pain or fever, fometimes a
.chronical hiccough occurs, and continues for days and weeks, inftead
.of ficknefs or vomiting ; which are the common fymptoms. In this
cafe the motions of the ftomach are decreafed by their fympathy with
thofe of the ureter, which are increafed by the ftimulus of the ftone
in it ; and the increafed motions of the diaphragm feem to exift in
confequence, of their affociation vk'ith the ftomach hy a fecond reverfe
fympathy This hiccough may neverthelefs admit of another ex-
planation, and be fuppofed to be a convuliive exertion oi the dia-

. Phragm

Class IV. i. i. DISEASES OF ASSOCIATION. 441

phragm to relieve the difagreeable fenfation of the ftomach in
confequence of its difordered irritative aflbciations ; and in that cafe
it would belong to Clafs III. i. i. See Clafs IV. 2. i. for another
example of tertiarj affbciation.

M. M. Venefe«£lion. Emetic. Calomel. Cathartic, opium, oil
of cinnamon from two to ten drops. Aerated alcaline water. Pe-
ruvian bark.

8. Febris trritattva. Irritative fever, defcribed in Clafs I. 1. r. r.
The difeafes above explained in this genus are chiefly concerning the
fympathies of the abforbent fyftem, or the alimentary canal, which
are not fo much aflbciated with the arterial fyftem, as to throw it
into diforder, when they are flightiy deranged ; but when any great
congeries of conglomerate glands, which may be confidered as the
extremities of the arterial fyftem, are afFedted with torpor, the whole
arterial fyftem and the heart fympathize with the torpid glands, and
a(Sl with lefs energy; which conftitutes the cold fit of fever ; which
is therefore at firft a decreafed adlion of the aflbciate organ ; but as
this decreafe of adion is only a temporary efFeft, and an increafe of
exertion both of the torpid glands, and of the whole arterial fyftem,
foon follows ; the hot fit of irritative fever, or fever with ftrong pulfe,
properly belongs to this clafs and genus of difeafes.

Vol. II. , 3 L O R D O

442 DISEASES OF ASSOCIATION. Class IV. 1.2,

ORDO L

Jncreafed Ajjociate Motions^

GENUS II.
Catenated "with Senjitive Motions. -

The primary links of the afTociated aflions of this genus are either
produced or attended bj^ painful or pleafurable fenfation. The fe-r
eondary links of the firft ten fpecies are attended with increafed mo-
tions without inflammation, thofe of the remainder are attended with
inflammation. All inflammations, which do not arife in the part
which was previoufly torpid, belong to this genus ; as the gout, rheii*
matiiiTi, eryfipelas. It is probable many other inflammations may,,
by future obfervation, require to be tranfplanted into this clafs.

The circles of fenfitive aflbciate motions conlift chiefly of the ex-
cfetory du6ls of the capillaries and of the mouths of the abforbeat
veifels, which conftitute the membranes j and which have been in-
duced into adion at the fame time ; or they coniift of the termina-
tions of canals ; or of parts which are endued with greater fenfibility
than thofe which form the firfl link of the aflbciation. An inftance
of the firft of thofe is the fympathy between the membranes of the
alveolar procelTes of the jaws, and the membranes above or beneath
the mufcles about the temples in hemicrania. An inftance of the
fecond is in the fympathy between the excretory du6l of the lacrymal
gland, and the nafal du£t of the lacrymal fack. And an inftance of
the third is the fympathy between the membranes of the liver, and
the Ikin of the face in the gutta rofea of inebriates.

SPECIES,

Class IV, 1.2. DISEASES OF ASSOOATION. 44c

SPECIES.

I. Liacrymarum fluxus fympathet'icus. A flow of tears from grief
or joy. When the termination of the du6l of the lacrjnial fac in
the noftrils becomes affeded either by painful or pleafurable fenfa-
tions, in confequence of external ftimulus, or by its affociation with
agreeable or difagreeable ideas, the motions of the lacrymal gland are
at the fame time exerted with greater energy, and a profufion of tears
fucceeds by fenfitive affociation, as explained in Sedl. XVI. 8. 2.

In this cafe there exifts a chain of affociated adions, the fecretion
of the lacrymal gland is increafed by whatever ftimulates the furface
of the eye, at the fame time the increafed abundance of tears ftimu-
lates the pundla lacrymalia into greater a<3:ion ; and the fluid thus
abforbed ftimulates the lacrymal fac, and its nafal du£t in the nofe
into greater adion. In a contrary diredlion of this chain of affo-
ciation the prefent increafe of adion is induced. Firft, the nafal dud
of the lacrymal fae is excited into increafed adion by fome plea-
furable or painful idea, as defcribed in Sed, XVI. 8. 2. 2<1. The
punda lacrymalia or other extremity of the lacrymal fac fympa-
thizes with it (as the two ends of all other canals fympathize with
each other). 3d. With thefe increafed motions of the punda lacry-
malia thofe of the excretory dud of the lacrymal gland are affociated
from their having fo perpetually aded together. And, laftly, with
the increafed adions of the excretory dud of this gland are affociated
thofe of the other end of it by their frequently ading together ; in
the fame manner as the extremities of other canals are aflbciated; and
thus a greater flow of tears is poured into the eye.

When a flow of tears is produced in grief, it is believed to relieve
the violence of it, which is worthy a further inquiry. Painful fen-
fations, when great, excite the faculty of volition ; and the perfon
continues voluntarily to call up or perform thofe ideas, which occafion

3 L 2 the

444 DISEASES OF ASSOCIATION. Class IV. 1.2.

the painful fenfation j that is, the affliiled perfon becomes fo far ih-
farie or melancholy ; but tears are produced by the fenforial faculty
of aflbclation, and (hew that the paiais fo far relieved as not to ex-
cite the exceffive power of volition, or infanity, and are therefore a.
fign of the abatement of the painful ftate of grief^ rather than a caufs.
of that abatement. See Clafs HI., u %. IQ.,

2'. Sternutatloa lumine: Some perfbns fheeze from looking up at:
the light Iky in a morning after coming out of a. dark bedroom. The
olfadory nerves are brought into, too great a£tion by their fympathy
with the optic nerves, 017 by their refpedlive iympathies with fome-
intervening parts, as probably with the two extremities of the lacry-
mal fac ; that is, with the punfta lacrymalia aiid the nafal.duil-.. Sea.
Clafs IL I.I. 3..

3. Dolor dentium Stridore. Tooth-edge from gj'ating founds, and
from the touch of certain fubftances, and even from imaginatioa
alone, is defcribed and explained in; Se<St., XVI,. 10.. The increafed:
aftions of the alveolar veffels or membranes are alTociated with tho;
ideas, or fen fual motions of the auditory nerves in the firfl cafe; and:
of thofe of the fenfe of touch j in the fecond cafe ; and by imagination^^
or ideas exerted of painful fenfation alone, in the lafl...

4. Rjfusfardonicus. A difagreeable fmile attends inflammations o£-
the diaphragm arifing from the affociations of the reiterated exertions
of that mufcle with thofe of the lips and cheeks in laughing. See;
Diaphragmitis, Clafs II. i. 2. 6...

5. SaiiviX fuxus cibovifo. The flow of faliva into the mouths of
hungry animals at the fight or fmell of food is feen in dogs flanding
round a dinner-table. The increafed adions of the falivary glands
have been ufually produced by the ftimulus of agreeable food on their

excretory

Class IV. 1.2. DISEASES OF ASSOCIATION. 445

excretory du£ls during the maftication of it ; and with this increafed
allien of their excretory du£ts the other terminations of thofe glands
in the capillary arteries have been excited into increafed a£lion by the
mutual affociation of the ends of canals ; and at the fame time the
pleafurable ideas, or fenfual motions,, of the fenfe of fmell and of fight
have accompanied this increafed fecretion of faliva. Hence this chain
of motions becomes aflbciated with thofe vifual or olfadlory ideas, or
with, the pleafure, which produces or attends them..

6'. 'Tenjio mamularum vifo pueruh. The nipples of ladtefcent
women are liable to become turgid at the fight of their young off^
fpring. The nipple has generally been rendered turgid by the titilla-
tion of the lips or gums of the child in giving fuck ; the vifible idea
of the child has thus frequently accompanied this' pleafurable fenfa*
tion of parting with the milk, and turgefcence of the tubes,, which
conftitute the nipple. Hence the vifual idea of the child, and the
pleafure which, attends it, become aflbciated with thofe increafed
arterial a<ftions,. which fwell the cells of the mamula, and extend its
tubes"; which is very fimilar to the tenfio phalli vifa muliere nuda
etiam in inlomnio^.

7. Tenfio penis in hydrophobia. An ereftlon of the, penis occurs ia
the hydrophobia, and is a troublefome fymptom, as obferved by
Coelius Aurelianus, Fothergill, and Vaughn, and, would feem to be
produced by an unexplained fympathy between, the fenfations about
the fauces and the penis. In men the hair grows about both thefe
parts, the voice changes, and the. neck thickens at puberty. In the
mumps, when the fwellings about the throat fubfides, the tefticles
are liable to fwell. Venereal infection received by the penis is ^tvy
liable to affeft the throat with ulcers. Violent coughs, with forenefs-
or rawnefs about the fauces are often attended with eredlion of the.
genis ;, which is alfo faid to happen to male animals, that are hanged;

which.

446 DISEASES OF ASSOCIATION. Class IV. 1.2.

which laft circumftatice has generally been afcribed to the ob{lru(fl:ioii
of the circulation of the blood, but is more probably occafioned by the
ftimulus of the cord in comprefling the throat ; fince if it was owing
to impeded circulation it ought equally to occur in drowning animals.

In men the throat becomes fo thickened at the time of puberty,
that a meafure of this is ufed to afcertain the payment of a poll-tax
on males in fome of the iflands of th.e Mediterranean, which com-
mences at puberty ; a firing is wrapped twice round the thinneft part
of the neck, the ends of it are then put into each corner of the mouth ;
and if, when thus held in the teeth, it pafles readily over the head,
the fubje6l is taxable.

It is difficult to point out by wliat circumftance the fenfitive mo-
tions of the penis and of the throat and nofe become afibciated ; I can
only obferve, that thefe parts are fubjeded to greater pleafurable fen^
fations than any other parts of the body ; one being defigned to pre-
ferve ourfelves by the pleafure attending the fmell and deglutition of
food, and the other to enfure the propagation of our fpecies ; and
may thus gain an afTociation of their fenfitive motion by their being
eminently fenfible to pleafure. See Clafs I. 3. i. 11. and III. i. 1. 15.
and Sed. XVI. 5,

In the female fex this afTociation between the face, throat, nofe,
and pubis does not exift ; whence no hair grows on their chins at the
time of puberty, nor does their voices change, or their necks thicken.
This happens probably from there being in them a more exquifite
fenfitive fympathy between the pubis and the breaftsi Hence their
breafts fwell at the time of puberty, and fecrete milk at the time of
parturition. And in the parotitis, or mumps, the breafts of women
fwell, when the tumor of the parotitis fubfides. See Clafs I, i. 2. 15.
Whence it would appear, that their breafts poflefs an intermediate
fympathy between the pubis and the throat ; as they are the feat of a
pafiion, which men do not poftefs, that of fuckling children.

8. Tinefinus

Class IV. 1.2. DISEASES OF ASSOCIATION. 447

8, Tenefmus calctdofus. The fphindler of the rediim becomes
painful or inflamed from the affociation of its fenfitive motions with
thofe of the fphinfter of the bladder, when the latter is Simulated into
violent pain or inflammation by a flone.

9. Polypus narium ex a/car idibusf The ftimulation of afcarides in
the redlum produces by fenfitive fympathy an itching of the nofe, as
explained in IV. 2. 2. 6 ; and in three children I have feen a polypus
iii the nofe, who were all affeded with afcarides; to the perpetual
Simulation of which, and the confequent fenfitive alTociation, I was
led to afcribe the inflammation and thickening of the membrane of
idle noftrils^ 5 . -

1X3. Cfampus furarum in cholera, A cramp of the mufcles of the
legs occurs in violent diarrhoea, or cholera, and from the ufe of too
much acid diet in gouty habits. This feems to fympatbize with uneaiy
fenfation in the bowels. See Clafs III. i^ i. 14. This aflbciation
is not eafily accounted for, but is analogous in fome degree to the
paralyfis of the mufcles of the arms i^ colica faturnina. It would
feem, that the mufcles of the legs in walking get a fympathy with
the lower parts of the inteftines, and thofe of the arms in variety of
employment obtain a fympathy with the higher parts of them. See
Cholera and Ileus*

II. Zona ignea nephritica. Nephritic fhingles. The external Ikin
about the loins and (ides of the belly I fuppofe to have greater mobi-
lity in refpe£t to fenfitive aflbciation, than the external membrane of
the kidney; and that their motions are by fome unknown means thus
aflbciated. When the torpor or beginning inflammation of this mem-
brane ceafes, the external flcin becomes inflamed in its Head, and a
kind of herpes, called the fhingles, covers the loins and fides of the
belly. See Clafs II, I. 5. 9.

J J 2. 'Erupt k>

44S DISEASES OF ASSOCIATION. Class IV. i. %.

1 2. Eruptio variolarum. After the dnflammation of the inoculated
arm has fpread for a quarter of a lunation, it affeds the flomach by
reverfe fympathy ; that is, the actions of the ftomach are affociated
with thofe of the fkin ; and as much fenforial power is now exerted
on the inflamed fkin, the other part of this fenfitive aflbciation is de-
prived of its -natural fhare, and becomes torpid, or inverts its mo-
tions. After tliis torpor of the flomach has continued a time, and
much fenforial :power is thus accumulated.; other parts of the Ikin,
which are alfo affociated with it, as that of the face firft, are thrown
into partial inflammation^ that is, the eruptions of the fmall-pox
sppear on the face.

For -that the variolous matter affefts the flomach previous to its
eruption on the fkin appears from the ficknefs at the commencement
ef the fever ; and becaufe, when the morbid motions affedl the fkin,
thofe of the flomach ceafe^ as in the gout and eryfipdas, mentioned
below^ The confent between the ftomach and the fkin appears in
variety of other difeafes ; and as they both confift of furfaces, which
abforb and fecrete a quantity of moiflure, their motions muft fre-
quently be produced together or in fucceflion ; which is the founda-
tion of all the fympathies of animal motions, whether of the irritative,
fenfitive, or voluntary kinds.

Now as the fkin, which covers the face, is expofed to greater va-
riations of heat and cold than any other part of the body; it probably
poffefTes more mobility to fenfitive afTociations, not only than the
ftomach, but than any other part of the fkin ; and is thence afFe(fl:ed
at the eruption of the fmall-pox with violent action and confequent
inflammation, by the affociation of its motions with thofe of the
ilomach, a day before the other parts of the fkin j and becomes fuller
of puflules, than any other part of the body. See Clafs II. i. 3. 9.

It might be fuppofed, that the fucceffive fwelling of the hands,
when the face fubfides, at the height of the fmall-pox, and of the
feet, when the hands fubfide, were governed by fome unknown

6 affociation s

Class IV. i. 2. DISEASES OF ASSOCIATION. 449

affociations of thofe parts of the fyftem ; but thefe fucceffions of tumor
and fubfidence more evidently depend on the times of the eruption of
the puftules on thofe parts, as they appear a day fooner on the face than
on the hands, and a day fooner on the hands than on the feet, owing
to the greater compai'ative mobihty of thofe parts of the Ikin.

13. Gutia rofeajlomatlca. Stomatic red face. On drinking cold
water, or cold milk, when heated with exercife, or on eating cold
vegetables, as raw turnips, many people in harvefl-time have been
affiidled with what has been called a furfeit. The flomach becomes
painful, with indigeflion and flatulency, and after a few days an
eruption of the face appears, and continues with fome relief, but not
with entire relief ; as both the pimpled face and indigefrion are liable
to continue even to old age.

M. M. Venefedlion. A cathartic with calomel. Then half a
grain of opium twice a day for many weeks. If faturated folution
of arfenic three or five drops twice or thrice a day for a week ?

14. Gutta rofea hepatlca. The rofy drop of the face of fome
drinking people is produced like the gout defcribed below, in confe-
quence of an inflamed hver. In thefe conftitutions the fkin of the
face being expofed to greater variation of heat and cold than the
membranes of the liver, poffefles more mobility than thofe hepatic
membranes ; and hence by whatever means thefe membranes are in-
duced to fympathize, when this fenfitive affociation occurs, the cu-
taneous vefiels of the face run into greater degrees of thofe motions,
which conftitute inflammation, than previoufly exifted in the mem-
branes of the liver ; and then thofe motions of the liver ccafe. See
Clafs.Il. I. 4. 6.

An inflammation of the liver fo frequently attends the great potation
of vinous fpirit, there is reafon to fufpeft, that this vifcus itfelf becomes
inflamed by fenfitive affociation with the flomach ; or that, when one

"Vol. IL 3 M termination

450 DISEASES OF ASSOCIATION. Class IV. r. 2-,

termination of the bile-du6t, which enters the duodenum is flimu-
lated violently, the other end may become inflamed by fenfitivc
aflbciation.

15. Podagra. The gout, except when it affefts the liver of
ftomach, feems always to be a fecondary difeafe, and, like the rheu-
matifm and eryfipelas mentioned below, begins with the torpor of
fome diftant part of the fyftem.

The mofl frequent primary feat of the gout I fuppofe to be the
liver, which is probably afFeded with torpor not only previous to the
annual paroxyfms of the gout, but to every change of its fituatiou
from one limb to another. The reafons, which induce me to fufped;
the liver to be firfl: affefted, are not only becaufe the jaundice foixie'*
times attends the commencement of gout, as defcribed in Bed. XXIV.
2. 8. but a pain alfo over the pit of the flomach, which 1 fuppofe
to be of the termination of the bile-du£t in- the duodenum,- and which"
is erroneoufly fuppofed to be the gout of the ftomach, with indi-
geftion and flatulency, generally attends the commencement of the
inflammation of each limb. See Arthritis ventriculi, Clafs I. 2. 4. 6.
In the two cafes, which I faw, of the gout in the limbs being pre-
ceded by jaundice, there was a cold fhivering fit attended the inflam-
mation of the foot, and a pain at the pit of the ftomach ; which,
ceafed along with the jaundice, as foon as the foot became inflamed.
This led me to fufpeft, that there was a torpor of the liver, and per-
haps of the foot alfo,. but neverthelefs the liver might alfo in this cafe
be previoufly inflamed,- as obferved in Sed. XXIV". 2. 8.

Now as the membranes of the joints of the feet fuffer greater va-
riations of heat and cold than the membranes of the liver, and are
more habituated to extenfion and contraction than other parts of the
/kin in their vicinity ; I fuppofe them to be more mobile, that is,
iTiore liable to run into extremes of exertion or quiefcencei and are
thence more fufceptible of inflammation, than fuch parts as are lefs
3 expofed

Class IV. i. 2. DISEASES OF ASSOCIATION. 451

expofed to great variations of heat and cold, or of extenfion and
contradion.

When a Hone preffes into the fphinder of the bladder, the glans
penis is afFefted with greater pain by fympathy, owing to its greater
fenfibility, than the fphinder of the bladder ; and when this paiu
commences, that of the fphinder ceafes, when the ftone is not too
large, or-pufhed too far into the urethra. Thus when the membrane,
which covers the ball of the great toe, fympathizes with fome mem-
>branous pJirt of a torpid or inflamed liver ; this membrane of the toe
falls into that kind of a£lion, whether of torpor or inflammation,
with greater energy, than thofe aftions excited in the difeafed liver;
and when this new torpor or inflammation commences, that with
which it fympathifes ceafes ; which I believe -to be a general law of
aflbciated inflammations.

The paroxyfms of the gout would feem to be catenated with folar
•influence, both in refpeft to their larger annual periods, and to their
diurnal -^periods — See 6e6l, XXXVI. 3. 6 — -as the former occur
about the fame feafon of -the year, and the latter commence about
an hour before fun-rife ; neverthelefs the annual periods may depend
^on the fucceffion of great viciflitudes of cold and heat, and the
diurnal ones on our increafed fenfibihty to internal fenfations durine
fleep, as in the fits of afthma, and of fome -epilepfies. See Se<5t.
XVIII. 15.

In refpedl to the pre-remote caufe or difpofition to the gout, there
can be no doubt of its individually ariling from the potation of fer-
mented or fpirituous liquors in this country ; whether opium pro-
tluces the fame effeOi in the countries, where it is in daily ufe, I have
never been well informed. See Sedl. XXI. 10, where this fubjed is
treated of; to which I have to add, that I have feen fome, and heard
of others, who have moderated their paroxyfms of gout, by diminifli-
-ing the quantity of fermented liquors, -which they had been accuf-
tomed to ; and others who, by a total abflinence from fermented

3 M 2 liquors,

452 DISEASES OF ASSOCIATION. Class IV. i. 2.

liquors, have entirely freed themfelves from this excruciating malady;
which otherwife grows with our years, and curtails or renders mi-
ferable the latter half, or third, of the lives of thofe, who are fubje£t
to it. The remote caufe is whatever Induces temporary torpor or
weaknefs of the fyflem ; and the proximate caufe is the inirritability,
or defeftive irritation, of fome part of the fyftem ; whence torpor
and confequent inflammation. The great Sydenham faw the bene-
ficial effefts of the abflinence from fermented liquors in preventing
the gout, and adds, " if an empiric could give fmall-beer only to
" o-outy patients as a noftrum, and perfuade them not to drink any
" other fpirituous fluids, that he might refcue thoufands from this
" difeafe, and acquire a fortune for his ingenuity." Yet it is to be
lamented, that this accurate obferver of difeafes had not refolution to
pra6tife his own prefcription, and thus to have fet an example to the
world of the truth of his doctrine ; but, on the contrary, recom-
mends Madeira, the flrongeft wine in common ufe, to be taken in
the fits of the gout, to the detriment of thoufands ; and is faid him-
felf to have periflied a martyr to the difeafe, which he knew how to
fubdue !

As example has more forcible efFedl than fimple afiertion, I fhall
^now concifely relate my own cafe, and that of one of my mofl: re-
fpefted friendso E. D. was about forty years of age, when he was
firft feized with a fit of the gout. The ball of his right great toe
was very painful, and much fwelled aiid inflamed, which continued
five or fix days in fpite of venefe£lion, a brifk cathartic with ten
grains of calomel, and the application of cold air and cold water to
his foot. He then ceafed to drink ale or wine alone; confining him-
felf to fmall beer, or wine diluted with about thrice its quantity of
water. In about a year he fuffered two other fits of the gout, in lefs
violent degree. He then totally abftained frgm all fermented liquors,
not even tafting fmall-beer, or a drop of any kind of wine; but eat
plentifully of flefli-meat, and all kinds of vegetables, and fruit, ufing

7 f°i'

Class IV. i. 2. DISEASES OF ASSOCIATION. 453

for his drink at meals chiefly water alone, or lemonade, or cream and
water ; with tea and coffee between them as ufual.

By this abftinence from fermented liquors he kept quite free from
the gout for fifteen or fixteen years ; and then began to take fmall-
beer mixed with water occafionally, or wine and water, 'or perry
and water, or cyder and water ; by which indulgence after a few
months he had again a paroxyfm of gout, which continued about
three days in the ball of his toe; which occafioned him to return to
. his habit of drinking water, and has now for above twenty years
kept in perpetual health, except accidental colds from the changes of
the feafons. Before he abflained from fermented or fpirituous li-
quors, he was frequently fubjefl to the piles, and to the gravel, nei-
ther of which he has fince experienced.

In the following cafe the gout was eflablifhed by longer habit and
greater violence, and therefore required more cautious treatment.
The Rev. R. W. was feized with the gout about the age of thirty-
two, which increafed fo rapidly that at the age of forty-one he was
confined to his room feven months in that year ; he had fome deoree
of lamenefs during the intervals, with chalky fwellings of his heels
and elbows. As the difeafe had continued fo long and fo violently,
and the powers of his digeftion were fomewhat weakened, he was
advifed not entirely to leave off all fermented liquors ; and as fmall-
beer is of fuch various flrength, he was advifed to drink exadtly two
wine glaffes, about four ounces, of wine mixed with three or four
times its quantity of water, with or without lemon and fugar, for his
daily potation at dinner, and no other fermented liquor of any kind ;
and was advifed to eat flefh-meat with any kind of boiled vegetables,
and fruit, with or without fpice. He has now fcrupuloufly con-
tinued this regimen for above five years, and has had an annual mo-
derate gouty paroxyfm of a few weeks, inftead of the confinement
of fo many months, with great health and good fpirits during the
intervals. «

The

454 DISEASES OF ASSOCIATION. Class IV, 1.2.

The following is a more particular account of the hiftory of this
cafe ; being part of a letter which Mr. Wilmot wrote oa that fub-
je£l at my entreaty. ^

" I entered into the army with an excellent conftitution at the
age of fifteen. The corps I ferved in was diftinguiflied by its regu- .
larity, that is, the regular allowance of the mefs was only one pint
■of wine per man each day; unlefs we had company to dine with us;
then, as was the general cuftom of the time, the bottle circulated
without limit. This mode of living, though by no means considered
as excefs for men, was certainly too great for a youth of my age.
This ftyle of living I continued, when v/ith the regiment, till the
•latter end of the year 1 769, when I had the misfortune to fleep in a
damp bed at Sheffield on a journey to York, but arrived there before
I felt the ill effeiSs of it, I was then feized with a violent inflam-
matory rheumatifm with great inflammation of my eyes, and was
-attended by Dr. Dealtry ; fo violent was the diforder, that I was
i»led for it eight times in lefs than a fortnight; and was three months,
before I could confider my health perfedly re-eftabli(hed. Dr. Dealtry
told me, that I (hould be fub]e£t to fimilar attacks for many years ;
.and that he had no doubt, from the tendency he found in my habit to
inflammation, that, when I was farther advanced in life, I {hould
-change that complaint -for -the gout. He predided truly ^ for the
three fucceeding winters Ih ad the fame complaint, but not -fo vio^-
lently ; th^ fourth winter I efcaped, and imputed my efcape to the
-continuance of cold bathing during the whole of that winter ; after
-that I never efcaped it, till Ihad a regular and fevere fit of the gout :
after the firft attack of rheumatic fever I -was more abfliemious in my
manner of living, though when in company I never fubjedted myfelf
to any great reftraint. In the year 1774 1 had quitted the army, and
being in a more retired fituatioii,' was feldom led into any excefs ; in
1776 and 1777 I was in the habit of drinking a good deal of wine
very frequently, though not conflantLy. After that period till th«

year

Class IV. 1.3. DISEASES OF ASSOCIATION. 455

year 1781, I drank a larger quantity of wine regularly, but very fel-
dom to any degree of intoxication. I lived much at that time in the
fociety of fome gentlemen, who ufually drank nearly a bottle of wine
daily after dinner. I muft here however obferve, that at no part of
my life was I accuftomed to drink wine in an evening, and very fel-
dom drank any thing more than a fingle half- pint glafs of fome fort
of fpirits diluted with much water. Till the year 178 1 I had always
been accuftomed to ufe very violent and continued exercife on horfe-
back ; in the winter months I purfued all field diverfions, and in the
fummer months I rode frequent and long journeys; and with this
exercife was liable to perfpire to great excefs; befides which I was
fubjeft to very profufe night-fweats, and had frequently boils break
out all over me, efpecially in the fpring and autumn; for which I
took no medicine, except a little flour of fulphur with cream o£
tartar in honey.

*' You will obferve I bring every thing down to the date of 1781,^
In the month of October in that year, when 1 was juft entered into
the thirty-fecond year of my age, I had the firft attack of gout ; thafe
fit was very fevere, and of many weeks continuance. I now deter-
mined upon a more abftemious method of living, in refpe£t to wine ;
and indeed the fociety, in which 1 had before been accuflomed to
live, being confiderably changed, I had lefs frequent temptations to
excefs. From this time I enjoyed the moft perfect good flate of
health till Auguft 17S4, when I had my lecond attack of gout. I
never perfectly recovered from this attack through the fucceedino-
winter, and in March 1785 was advifed to try the Bath waters, and
drank them under the diredion of one of the faculty of that place.
I was there foon feized with a fever, and a flight attack of gout in
one knee. I fliould obferve, that when I fet out from home, I was
in a weak and low ftate, and unequal to much fatigue ; as appeared
by my having a fainting fit one day on the road, after having tra^
veiled only about fifty miles ; in the courfe of the fummer I had two.

or

456 DISEASES OF ASSOCIATION. Class IV. i. 2.

or three more flight attacks of gout of lefs confequence, till the
month of Oiilober; when I was afflifted with it all over me in fuch
a manner, as to be without the poflibility of the lead: degree of re-
moval for fome days ; and was about two months without being able
to get into the air. This was the fevereft attack I had then expe-
rienced; though I have fince had feveral equally fevere. In the
courfe of this fummer I had a fall with my horfe ; and foon after it,
having difeovered an enlargement on one elbow, I concluded I had
hurt it at that time; but in the courfe of this lad attack having a
fimilar enlargement on the other elbow, I found my miftake, and
that they were colledllons of gouty matter ; thefe increafed to the
fize of pullet's eggs, and continue in that ftate. I had foon after
fimilar enlargements on my heels ; the right heel being feverely
bruifed, I was under the neceffity of having it lanced, and a large
quantity of chalky matter was difcharged from it ; and have fince
that time frequently had chalky matter taken from it, and fometimes
fmall bits of apparently perfeft chalk. My right hand foon was
affli<3:ed in the fame way, and I have fcarcely a joint on thofe fingers
now in a natural ftate. My left hand has efcaped tolerably well.
After this laft attack (viz. Oitober 1785), I had two or three flight
attacks before the month of June 1787, when I had a very fevere
intermittent fever ; from that time I continued very well till the
latter end of the year, when I began to feel the gout about me very
much, but was not confined by it. I was in this fta,te advifed to try
what is called the American Recipe (gum guaiacum and nitre dif-
folved in fpirits) ; it had apparently been of eflential fervice to a friend
of mine, who from the inability to walk a mile for lome years, was
believed to be reftored by the ufe ef this medicine to a good flate of
health, fo as to walk ten miles a day. In addition to this medicine I
drank, as my common beverage with my -meals, fpruce beer. I had
fo high an opinion of this medicine in the gout, and of fpruce beer
-as an antifcorbutic, that I contemplated with much latisfa£tion, and

vyitb,

Class IV. i. 2. DISEASES OF ASSOCIATION. 457

with very little doubt, the perfe£t reftoration of my health and
ftrength; but I was miferably deceived; for in September 1788 I
was feized with the gout in a degree that none but arthritics, and
indeed but few of thofe, can eafily conceive. From this time till
Auguft 1789 I fcarcely ever pafTed a comfortable dayj {even months
of this time I had been confined, my health feemed much impaired,
my ftrength was diminifhed, and my appetite almofl gone. In this
ftate my friends preffed me to confult you. I was unwilling for fome
time to do it, as I had loft all hope of relief; however, when I had
determined to apply to you, I likewife determined to give up evety
prejudice of my own refpefting my cafe, and to adhere mofl: ftri£lly
to your advice. On the 20th of Auguft 1789 I confulted you, on
the 25th I entered upon the regimen, which you prefcribed, and
which was as follows.

" Drink no malt liquor on any account. Let your beverao-e at
*' dinner confift of two glaffes of wine diluted with three half-pints
** of water. On no account drink any more wine or fpirituous
*' liquors in the courfe of the day; but, if you want more liquid,
" take cream and water, or milk and water, or lemonade, with tea,
*' coffee, chocolate. Ufe the warm bath twice a week for half an
*' hour before going to bed, at the degree of heat which is moft
*' grateful to your fenfations. Eat meat conftantly at dinner, and
*' with it any kind of tender vegetables you pleafe. Keep the body
*' open by two evacuations daily, if poffible without medicine, if not
** take the fize of a nutmeg of lenitive eleftuary occafionally, or five
*' grains of rhubarb every night. 'Ufe no violent exercife, which
*' may fubjeft yourfelf to fudden changes from heat to cold ; but as
*' much moderate exercife as may be, without being much fatio-ued
'* or ftarved with cold. Take fome fupper every night ; a fmall
** quantity of animal food is preferred ; but if your palate refufes
*• this, take vegetable food, as fruit pie, or milk ; fomethino- fliould
*' be eaten, as it might be injurious to you to faft too long." To
Vol. II, 3 N the

458 DISEASES OF ASSOCIATION. Class IV. i. 2.

the whol^ of this I adhered moft fcrupuloufly, a;>d (oqii found my
appetite improve, and with it my ftrength and fpirits, I had in
December a fevere attack, and two or three flight ones in the courfe
of twelve months; but the improvement in the general ftate of my
health induced me to perfevere. On the i8th of Augufl 1790 I had
another fevere attack, but it went off eafier than before, and I foou
recovered fufficiently to go to Buxton, which you advifed me to,
and from which I reaped great benefit ; neverthelefs on the 29th of
December I had a flight attack in comparifon of fome that I had be-
fore experienced, and from that time I was free from gout, and en-
joyed my health perfedly well till the fourth week in 06tober 1791 ;
from that till the third week in Oftober 1792 ; from that till the
third week in Odlober 1793; and from that till June 1794. From
what happened for the lafl: three years I dreaded the month of Octo-
ber ; but I efcaped then, and have enjoyed my health moft perfeclly
ever flnce till within the laft week, that I have had a flight attack in
one knee, which is nearly gone, without any fymptom to lead me
to fuppofe that it will go further.

*' I adhered to your advice mofl: fcrupuloufly for the firft year; and S
in regard to the not drinking malt liquor, and taking only the two
o-lafles of wine with water, I have never deviated but two days ; and
then the firfl: day I only drank one glafs of ale and one glafs of
Champaigne ; on the fecond only one glafs of Champaigne. With
regard to the warm bath, I only ufe it now when 1 have gouty
fymptoms upon me, and in fuch fltuations I find it of infinite fer-
vice; and in other refpeds I continue to live according to your
direftion.

" Many perfons have laughed at the idea of my perfeverance in a
fyfliem, which has not been able to cure the gout after five years
trial ; but fuch perfons are either ignorant of what I before fuffered,
or totally unacquainted- with the nature of the diforder. Under the
blefllng of Providence, by an adherence to your advice, I am reaping

7 all

Class IV. i. 2. DISEASES OF ASSOCIATION. 459

.all the benefit you flattered me I might expe6l from it, viz. my at-
tacks lefs frequent, my fufferings lefs acute, and an improvement in
the general (late of my health.

" I have been particular in this account of myfelf at your requeft,
and am, Sir, &c. • '

MoRLEY, near Derby,
. February loth, 179s. RoBERT WiLMOT."

There are fituations neverthelefs in which a paroxyfm of o-out
has been believed to be delirable, as relieving the patient from other
difagreeable dlfeafes, or debilities, or fenfations. Thus when the
liver is torpid, a perpetual uneafinefs and depreflion of fpirits occur ;
which a fit of gout is fuppofed to cure by a metaftafis of the difeafe.
Others have acquired epileptic fits, probably from the difagreeable
fenfation of a chronically inflamed liver ; which they fuppofe the
pain and inflammation of gout would relieve. When gouty patients
become much debilitated by the progrefs of the difeafe, they are
liable to dropfy of the cheft, which they fuppofe a fit of the o-out
would relieve. But in all thefe cafes the attempt to procure a pa-
roxyfiTi of gout by wine, or aromatics, or volatiles, or blifters, or
mineral waters, feldom fucceeds ; and the patients are obliged to ap-
ply to other methods of relief adapted to their particular cafes. In
the two former fituations fmall repeated dofes of calomel, or mer-
curial undion on the region of the liver may fucceed, by giving new
activity to the veflTels of the liver, either to fecrete or to abforb their
adapted fluids, and thus to remove the caufe of the gOut, rather than
to promote a fit of it. In the lafl cafe the tincture of digitalis, and
afterwards the clafs of forbentia, mufl be applied to.

M. M. In young ftrong patients the gout fhould be cured by
venefetSlion and cathartics and diluents, with poultices externally.
But it has a natural crifis by producing calcareous matter on the in-
flamed membrane, and therefore in old enfeebled people it is fafeft to

3 N 2 vvait

460 DISEASES OF ASSOCIATION. Class IV. i. 2.

wait for this crifis, attending to the natural evacuations and the de-
gree of fever; and in young ones, where it is not attended with
much fever, it is cuftomary and popular not to bleed, but only to
keep the body open with aloes, to ufe gentle fudoriiics, as neutral
falts, and to give the bark at the decline of the fit ; which is parti-
cularly ufeful where the patient is much debilitated. See Arthritis veu-
triculi, Clafs I. 2. 4. 6. and Se<5l. XXV. J 7.

When there is not much fever, and the patient is debilitated with
age, or the continuance of the difeafe, a moderate opiate, as twenty
drops of tinilure of opium, or one grain of folid opium, may be taken
every night with advantage. Externally a pafte made with double
the quantity of yeaft is a good poultice ; and booterkins made with
oiled filk, as they confine the perfpirable matter, keep the part moifl
and fupple, and thence relieve the pain like poultices.

The only lafe way of moderating the difeafe is by an uniform and
equal diminution, or a total abftinence from fermented liquors, with
the cautions direded in Sedl. XII. 7. 8. The continued ufe of ftrong
bitters, as of Portland's powder, or bark, has been frequently inju-
rious, as fpoken of in the Materia Medica, Art. IV. 2. 11.

One of my acquaintance, who was much affli£led with the gout,
abfcained for about half a year from beer and wine ; and not having
refolution to perfift, returned to his former habits of potation in lefs
quantity; and obferved that he was then for one winter flronger and
freer from the gout than ufual. This however did not long con-
tinue, as the difeafe afterwards returned with its ufual or increafed
violence. This I think is a circumftance not unlikely to occur, as
opium has a greater efFeft after its ufe has been a while intermitted;
and the debility or torpor, which is the caufe of gout, is thus for a
few months prevented by the greater irritability of the lyftem, ac-
quired during the leffened ufe of fermented liquor.

For the fame reafon an ounce of fpirituous tindtureof guaiacum, or

of bark, is faid to have for fome time prevented returns of the gout ;

6- which

Class IV. i. 2. DISEASES OF ASSOCIATION. 461

which has afterwards, like all other great ftimuli when long con-
tinued, been fucceeded by greater debility, and deftroyed the patient.
This feems to have been exemplified in the cafe of the ingenious
Dr. Bown, fee Preface to his Elementa Medicinic ; he found tem-
porary relief from the flimulus of wine, rcgardlefs of its future
effedts.

16. Rheumatifmus. Acute rheumatifm. There is reafon to
fufpeft, that rheumatic inflammations, like the gouty ones, are not
a primary difeafe ; but that they are t"he confequence of a tranflation
of morbid a£lion from one part of the fyflem to another. This idea
is countenanced by the frequent change of place of rheumatic-like
gouty inflammations, and from their attacking two limilar parts at
the lame time, as both ankles and' both wrifts, and thefe attacks
being in fucceffion to each other. Whereas it is not probable that
both feet or both hands fhould at the fame time be equally expofed
to any external caufe of the difeafe, as to cold or moillure; and lefs
fo that thefe fhould occur in fucceffion. LafHy, from the inflamma-
tory diathefis in this difeafe being more difficult to fubdue, and more
dangerous in event, than other common inflammations, efpecially to
pregnant women, and in weak conftitutions.

From this idea of the rheumatifm being not a primary difeafe, like
the gout, but a transferred morbid adion owing to the previous tor-
por of fome other part of the fyflem, we perceive why it attacks
weak people with greater pertinacity than flrong ones ; refiftino- or
recurring again and again after frequent evacuations, in a manner
very difl-erent from primary inflammations ; becaufe the caufe is
not removed, which is at a diflance from the feat of the inflam-
mation.

This alfo accounts for rheumatic inflammations fo very rarely ter-
minating in flippuration, becaufe like the gout the original caufe is
not in the inflamed part, and therefore does not continue to a£l after

the

462 DISEASES OF ASSOCL\TION. Class IV. i. 2.

the inflammation commences. Inftead of fuppuration in this difeafe,
as well as in the gout, a quantity of mucus or coagulable lymph is
formed on the inflamed membrane ; which in the gout changes
into chalkftones, and in the rheumatifm is either reabforbed, or lies
on the membrane, producing pains on motion long after the termina-
tion of the inflammation, which pains are called chronic rheumatifrao
The membranes, which have thus been once or repeatedly inflamed,
become lefs mobile, or lefs liable to be afFedled by fympathy, as ap-
pears by the gout affe£ling new parts, when the joints of the foot
have been frequently inflamed by it ; hence as the caufe of the inflam-
mation does not exift in the inflamed part, and as this part becomes
lefs liable to future attacks, it feldom fuppurates.

Secondly, when rheumatifm affedts the mufcles of the chefl, it
produces fymptoms fimilar to pleurify, but are diftinguifiied from
that by the patient having previoufly fufFered rheumatic afi'edions in
other parts, and by the pertinacity or continuance of the inflam-
matory flate of the patient, this Ihould be termed pleurodyne rheu-

matica.

Thirdly, when rheumatic infla'mmation afFe£ls the bowels, it pro-
duces a difeafe very different from enteritis, or common inflammation
i of the bowels, and fhould be termed enteralgia rheumatica. The
pain is lefs than in enteritis, and the difeafe of longer continuance,
with harder pulfe, and the blood equally fizy. It is attended with
frequent dejedtions, with much mucus, and previous griping pains,
but without vomiting ; and differs perhaps from dyfentery from its
not being attended with bloody ftools, and not being infedious.

Fourthly, there is another kind of rheumatifm attended with de-
bility, which fuppurates, and fliould be termed rhcumatifmus fup-
purans. It is generally believed to be the gout, till fuppuration takes
place on the fwelled joint; and, as the patient finks, there are
llou<yhs formed over the whole mouth ; and he feems to be deftroyed
by inflammation or gangrene of the mucous membranes. I have

twice

Class IV. i. 2. DISEASES OF ASSOCIATION. 463

twice feen this difeafe iii patients about fixty. Some other dlfeafes
are erroneouflj called rheumatic, as hemicrania, and odontalgia. See
Sea. XXVI. 3.

M. M. In the three former kinds venefe6lion repeatedly. Cathar-
tics. Antimonials. Diluents. Neutral falts. Oil. Warm bath.
Afterwards the bark. Opium with or without ipecacuanha ; but not
till the patient is confiderably weakened. Sweats forced early in the
difeafe do injury. Opium given early in the difeafe prolongs it. In
the laft kind, gentle flimulants, as wine and water, mucilage, for-
bentia.

The following is a cafe of fuppuratlve rheumatifm. Mr. F ,

about fixty, was fuppofed to have the gout in his hand, which how-
ever fuppurated, and it was then called the fuppurative rheumatifm.
He had lived rather intemperately in refpe6l to wine, and was now
afflicted with a tendency to inflammation of the mucous membranes.
As he lay on the bed half refupine, propped up with pillows, and alfo
flept in that poflure, his lower jaw dropped by its own weight, when
the voluntary power of the mufcles was fufpended. The mucus of
his mouth and throat became quite dry, and at length was fucceeded
with floughs ; this was a moft diftrefling circumftance to him, and
was in vain endeavoured to be relieved by fupporting his jaw by flender
fteel fprings fixed to his night-cap, and by fprings of elaftic gum.
The floughs fpread and feemed to accelerate his death. See Clafs I.
1.3.2.

17. Eryjtpelas. The eryfipelas differs from the zona ignea, and
other fpecies of herpes, in its being attended with fever, which is
fometimes of the fenfitive irritated or inflammatory kind, with ftrono-
and full pulfe ; and at other times with weak pulfe and great inirritabi-
lity, as when it precedes or attends mortifications. See Clafs II. ;. 3. 2.

Like the zona ignea above defcribed, it feems to be a fecondary dif-
eafe, having for its primary part the torpor or inflammation of fome

internal

464 DISEASES OF ASSOCIATION. Class IV. 1.2.

internal or diflant membrane, as appears from its fo frequently attend-
ing wounds ; fometimes fpreading from iffues over the whole limb,
or back, by fympathy with a tendon or membrane, which is Simulated
by the peafe in them. In its more violent degree I fuppofe that it
fympathizes with fome extendve internal membranes, as of the liver,
ftomach, or brain. Another reafon, which countenances this idea,
is, that the infiammation gradually changes its fituation, one part
healing as another inflames ; as happens in refpe£l to more diftant
parts in gout and rheumatifm ; and which feems to (hew, that the
caufe of the difeafe is not in the fame place with the inflammation.
And thirdly, becaule the eryfipelas of the face and head is liable to
affeft the membranes of the brain ; which were probably in thefe cafes
the original or primary feat of the difeafe ; and laflly, becaufe the fits
of eryfipelas, like thofe of the gout, are liable to return at certain an-
nual or monthly periods, as further treated of in Clafs II. i. 3. 2.

Many cafes of eryfipelas from wounds or brulfes are related in De-
fault's Surgical Journal, Vol. II. in which poultices are faid to do
great injury, as well as oily or fatty applications. Saturnine folutions
were fometimes ufed with advantage. A grain of emetic tartar given
to clear the ftomach and bowels, is faid to be of great fervice.

1 8. Tejliuni tumor in gonorrhcea, Mr. Hunter in his Treatifc on
the Venereal Difeafe obferves, that the tumor of the teftes in gonor-
rhoea arifes from their fympathy with the inflammation of the urethra;
and that they are not fimilar to the adions arifing from the applica-
tion of venereal matter, whether by abforption or otherwifej as they
feldom or never fuppurate ; and when fuppuration happens, the mat-
ter produced is not venereal. Treatife on Venereal Difeafe, p. 53.

19. Tefllum tumor in paroiidite. The fympathy between fome parts
about the throat and the genitals 'has been treated of in Clafs IV. i. 2. 7.
The fwelling of the teftes, when' that of the parotis fubfides, feems

to

ClassIV. r.2. DISEASES OF ASSOCIATION. 465

to arife from the aflbciation of fucceffive adtlon ; as the tenfion of the
penis in hydrophobia appears to arife from the previous fynchronous
affociations of the fenfitive motions of thefe parts ; but the manner of
the production of both thefe affociations is yet very obfcure. In wo-
men a fwelling of the breafts often fucceeds the decline of the mumps
by another wonderful fympathy. See Clafs IV. i. 2. 7. and I. i, 2. 15.
In many perfons a delirium fucceeds the fwelling of the parotis, or
the fubfequent ones of the teftes or breafts; which is fometimes fatal,
and feems to arife from a fympathy of fucceffive adion, and not of
fynchronous action, of the membranes of the brain with thofe of the
parotide glands. Sometimes a ftupor comes on inftead of this deli-
rium, which is relieved by fomenting the ftiaved head for an hour or
two. See Clafs II. 1 . 3. 4.

^VoL. 11. - O ORDO

466 DISEASES OF ASSOCIATION. Class IV. 1.5.

ORDO I.

Increajed AJJociate Motions.

GENUS III.
Catenated with Voluntary Motions

SPECIES.

1. Deglutitio invita. When any one is told not to fwallow his fa=
liva, and that efpecially if his throat be a little fore, he finds a necef-
fity of immediately fwallowing it j and this the more certainly, the
more he voluntarily endeavours not to do fo.

In this cafe the voluntary power exerted by our attention to the
pharinx renders it more fenfible to irritation, and therefore occafions
it to be more frequently induced to fwallow the faliva. Here the ir-
ritation induces a volition to fwallow it, which is more powerful
than the defire not to fwallow it. See XXiV. 1.7. So in reverie,
when the voluntary power was exerted on any of the fenfes, as of
fight or tafle, the obje£ls of thofe fenfes became perceived ; but not
otherwife. Sedt. XIX. 6. This is a troublefome fymptom in fome
fore throats.

M. M. Mucilage, as fugar and gum arable. Warm water held in
the mouth frequently, as a fomentation to the inflamed throat.

2. Ni&itatio invita. Involuntary winking with the eye-lids, and
twitchings of the face, are originally induced by an endeavour to re-
lieve fome difagreeable fenfations about inflamed eyes, as the dazzling
of light ; and afterwards thefe motions become catenated with other

4 motions

Class IV. i . 3. DISEASES OF ASSOCIATION. 467

motions or fenfations, fo as not to be governed by the will. Here the
irritation firft produces a volition to wink, which by habit becomes
ftronger than the anti-volition not to wink.

This fubjedl is rendered difficult from the common acceptation of
the word, volition, including previous deliberation, as well as the
voluntary exertion, which fucceeds it. In the vohtions here fpoken of
there is no time for deliberation or choice of objedls, but the voluntary
ad immediately fucceeds the fenfation which excites it.

M. M. Cover the afFe£led parts with a flicking plafter or a blifter.
Pafs a fine needle and thread through a part of the fkin over the muf-
cle, which moves, and attach the other end of the thread by a flick-
ing plafler to a diflant part. An ifTue behind the ear. To pra£tife
daily by a looking-glafs to flop the motions with the hand. See the
cure of a cafe of the leaping of a mufcleof the arm, Sedl. XVII. i. S.
See Convulfio debilis, Clafs III. i, 1.5.

3. Rifus invitus. Involuntary laughter. When the pleafure arif-
ing from new combinations of words and ideas, as in puns ; or of
other circumflances, which are fo trivial, as to induce no voluntary
exertion to compare or confider their prefent importance or their future
confequence ; the pleafure is liable to rife into pain ; that is, the ideas
or fenfual motions become exerted too violently for want of fome an-
tithefiflic ideas ; in the fame manner as thofe mufcles, which have
weak antagonifts, as thofe of the calf of the leg, are liable to fall into
cramp or painful contradion. In this fituation a fcream is begun to
relieve this pain of ideas too violently exerted, which is flopped ao-ain
foon, as explained m Seft. XXXIV. i. 4. and Clafs III. i. i. 4. and
IV. 2. 3. 3.

The pain, into which this pleafure rifes, which- would excite the
fcream of laughter, has been felt forcibly by every one ; when they
have been under fuch circumflances, as have induced them to reflrain
it by a counter- voHtion ; till at length the increaled afTociate motions

3 O 2 produce

468 DISEASES OF ASSOCIATION. Class IV. i. 3.

produce fo much pain as to overcome the counter-volition, and the
patient burfts out into indecent laughter, contrary to his will in the
common acceptation of that vi'ord.

4» hufus dighorum tnvltus. An awkvs'ard pinying with the fingers
in fpeaking in public. Thefe habits are began through bafhfulnefs,
and feem rather at firft defigned to engage the attention in part, and
thus prevent the difagreeable ideas of mauvaife hont ; as timorous
boys whiftie, when they are obliged to walk in the dark ; and as it is
fometimes neceflary to employ raw foldiers in perpetual manoeuvres,
as they advance to the firft charge.

5. Unguium morjiuncula Invlta. Biting the nails is a depraved habit
arifing from fimilar caufes as thofe of the laft article.

M, M. Dip the fingers in folution of aloes.

6. Vigilia invlta. Watch fulnefs, where the perfon wifhes, and
endeavours to fall afleep, properly belongs to this place, as the wifli
or volition to fleep prevents the defired efFe£l ; becaufe fleep confifts
in an abolition of volition. See Clafs III. i. 2. 3.

ORDO

Class IV. i. 4, DISEASES OF ASSOCIATION. 469

ORDO I.

Increafed AJfociate Motions,

GENUS IV.

Catenated with External Influences.

SPECIES.

1 . Vita avi. Life of an egg. The eggs of fowls were fliewn by-
Mr. J. Hunter to refift the freezing procefs in their living ftate more
powerfully, than when they were killed by having the yolk and-
white Ihook together. Philof. Tranf. It may be alked, does the heat
during the incubation of eggs a6t as a ftimulus exciting the livino-
principle into activity? Or does it a£l fimply as a caufa fine qua non,
as an influence, which penetrating the mafs, removes the particles of
it to a greater diftance from each other, fo as to allow their movement
over each other, in the fame manner as heat is conceived to produce
the fluidity of water ; not by flimulus, but by its penetrating-influ-
ence ? Or may elementary heat in its uncombined ftate be fuppofed to
Z&. only as an influence neceflTary to life in its natural quantity ;
wTience torpor and death follows the edudtion of it from the body j
but in its increafed flate above what is natural, or ufual, that it afts
as a ftimulus ; which we have a fenfe to perceive ; and which excites
many parts of the fyftem into unnatural a£lion ? See Clafs IV.
I. I. C.

2. Vita hiemi-dormientium. The torpor of infedls, and birds, and
quadrupeds, during the cold fcafon, has been called fleep ; but I fup-

6 pofe-

470 DISEASES OF ASSOCIATION. Class IV. i. 4.

pofe it muft differ very much from that ftate of animal life, (incc not
only all voluntary power is fufpeiided, but fenfation and vafcular mo-
tion has ceafed, and can only be reftored by the influence of heat.
There have been related inftances of fnails, which have recovered life
and motion on being put into vi'ater after having experienced many
years of torpidity, or apparent death, in the cabinets of the curious.
Here the water as well as the heat are required not only as a fti.mulus,
but as a caufa fine qua non of fluidity and motion, and confequent
life.

3. Pullulat'w arborum. The annual revivefcence of the buds of
trees feems not only to be owing to the influence of the returning
warmth of the fpring, but alfo to be catenated with folar gravitation j
becaufe feeds and roots and buds, which are analogous to the eggs of
animals, put forth their fhoots by a lefs quantity of heat in fpring,
than they had undergone in the latter part of autumn, which may
however be afcribed to their previous torpid flate, and confequent ac-
cumulation of fenforial power, or irritability ; as explained in Botanic
Garden, Part II. Cant. I. 1. 322. note. Other circumftances, which
countenance the idea, that vegetation is afteded by folar gravitation,
as well as by heat, may be obferved in the ripening of the feeds of
plants both in thofe countries where the fummers are (hort, and in
thofe where they are long. And by fome flowers clofing their bells
at noon, or foon after ; and hence feem to fleep rather at folar diurnal
periods, than from the influence of cold, or the deficiency of hght.

4. Orgafmatis venerei per'iodus. ,The venereal orgafm of birds and
quadrupeds commences or returns about the vernal or autumnal equi-
noxes, and thence feems in refpeft to their great periods to be. go-
verned by folar influence. But if this orgafm be difappointed of its
©bjeclj.it is faid to recur at about monthly periods, as obferved in

mares

Class IV. i. 4. DISEASES OF ASSOCIATION. 471

mares and bitches in this refpedl refembling the female catanaenia.
See Sea. XXXVI. 2. 3. and Sea. XVI. 13.

5. 'Brachli concujfio ele£lrlca. The movement of the arm, even of
a paralytic patient, when an ele£lric fhock is pafied through it, is
owing to the flimulus of the excefs of eledlricity. When a piece of
zinc and filver, each about the fize of a crown-piece, are placed one
under the upper lip, and the other on the tongue, fo as the outer
edges may be brought into contaft, there is an appearance of light in
the eyes, as often as the outer edges of thefe metals are brought into
contad): or feparated; which is another inftance of the ftimulus of the
paffage of eledlric fhocks through the fibres of the organs of fenfe, as
well as through the mufcular fibres. See Seft. XII. i. i. and firft
addit. note to Vol. I. of this work. But in its natural ftate eledlricity
feems only to a6: as an influence on animal and vegetable bodies ; of
the falutary ©r injurious effeds of which we have yet no precife
knowledge.

Yet if regular journals were kept of the variations of atmofpheric
eleilricity, it is probable fome difcoveries of its influence on our iy{-
tem might in time be difcovered. For this purpofe a machine on the
principle of Mr^ Bennet's eledlric doubler might be applied to the pen-
dulum of a clock, fo as to manifeft, and even to record the daily or
hourly variations of aerial eleftricity. Which has already been exe-
cuted, and applied to the pendulum of a Dutch wooden clock, by
Mr. Bennet, curate of Wirkfworth in Derbyfliire.

Beiides the variations of the degree or kind of atmofpheric eleftri-
gity, fome animals, and fome men^ feem to poflefs a greater power of
accumulating this fluid in themlelves than others. Of which a fa-
mous hillory of a Ruflian prince was lately publifhed ; who, durino-
the clear and fevere frofts of that country, could not move himfelf in
bed without luminous corrufcations. Such may have been the cafe of
thofe people, who have been related to have taken fire fpontaneoufly,

and

472 DISEASES OF ASSOCIATION. Class IV. i. 4,

and to have been reduced to afhes. The elecStric concuffion from the
gymnotus eleftrlcus, and torpedo, are other inftances of the power of
the animal fyftem to accumulate eleftricity, as in thefe it is ufed as a
weapon of defence, or for the purpofe of taking their prey.

Some have believed that the accumulation or paffage of the magne-
tic fluid might afFe(fl the animal fyftem, and have aflerted that the
application of a large magnet to an aching tooth has quickly effe£led a
cure. If this experiment is again tried in odontalgia, or hemicrania,
the painful membrane of the tooth or head fhould be included between
the fouth and north poles of a horfe-fhoe magnet, or between the
contrary poles of two different magnets, that the magnetifm may be
accumulated on the torpid part.

6. Oxygenatio fangu'inls. The variation of the quantity of oxygen
gas exifting in the atmofphere muft afted all breathing animals ; in
its excefs this too muft be efteemed a ftimulus ; but in its natural
quantity would feem to adl as an influence, or caufe, without which
animal life cannot exifl even a minute. It is hoped that Dr. Beddoes's
plan for a pneumatic infirmary, for the purpofe of putting this and
various other airs to the teil of experiment, will meet with public en-
couragement, and render confumption, afthma, cancer, and many
difeafes conquerable, which at prefent prey with unremitted devafla-
tion on all orders and ages of mankind.

•7. Humecfatio corporis. Water, and probably the vapour of water
vdiffolved or diffufed in the atmofphere, unites by mechanical attradtion
with the unorganized cuticle, and.foftens and enlarges it; as may be
£qq\.\ in the loofe and wrinkled flcin of the hands of waftierwomen ; the
fame probably occurs to the mucous membrane of the lungs in moift
weather ; and by thickenuig it increafes the difficulty of refpiration of
fome people, who are faid to be ailhmatical. So far water may be
faid to ad as an influx or influence,, but when it is taken up by the

mouths

Class IV. 1.4. DISEASES OF ASSOCIATION. -^473

mouths of the abforbent fyflem, it muft excite thofe mouths into ac-
tion, and then a£ls as a ftimulus.

There appears from hence to be four methods by which animal
bodies are penetrated by external things, i. By their ftimulus, which
induces the abforbent veflels to imbibe them. 2. By mechanical at-
tradlion, as when water foftens the cuticle. 3. By chemical attrac-
tion, as when oxygen paffes through the membranes of the air- veflels
of the lungs, and cojnbines with the blood. And laflly, by influx
without mechanical attra(5tion, chemical combination, or animal ab-
forption, as the univerfal fluids of heat, gravitation, eledricity, mag-
netifm, and perhaps of other ethereal fluids yet unknown.

Vor^n. I P OR DO

474 DISEASES OF ASSOCIATION. Class IV. 2. i.

ORDO IT.

Decreafed AJfociate Motions;

GENUS I.

-Catenated with Irritative Motions.

As irritative mnfcukr motions are attended with pain, when they
are exerted too weakly, as well as when they are exerted too ftrongly ;
fo irritative ideas become attended with fenfation, when they are ex-
erted too weakly, as well as when they are exerted too flrongly.
Which accounts for thefe ideas being attended with fenfation in the
various kinds of vertigo defcribed below.

There is great difficulty in tracing the immediate caufe of the de-
ficiences of aftion of feme links of the affociations of irritative mo-
tions ; firft, becaufe the trains and tribes of motions, which compofe
thefe links, are fo widely extended as to embrace almoft the whole
animal fyftem ; and fecondly, becaufe when the firft link of an alTo-
ciated train of adions is exerted with too great energy, the fecond
link by reverfe fympathy may be affeiled with torpor. And then
this fecond link may tranfmit, as it were, this torpor to a third link,
and at the fame time regain its own energy of adlion ; and it is poffible
this third hnk may in like manner tranfmit its torpor to a fourth, and
thus retrain its own natural quantity of motion.

I fhall endeavour to explain this by an example taken from fenfitive
aflbciated motions, as the origin of their difturbed adlions is more
eafily detefted. This morning I faw an elderly perfon, v\ho had
o-radually loft all the teeth in his upper jaw, and all of the under ex-
cept three of the molares ; the laft; of thefe was now loofe, and occa-
8 fionally

Class IV. 2. r. DISEASES OF ASSOCIATION. 475

fionally painful ; the fangs of which were almoft naked, the gunas
being much wafted both within and without the jaw. He is a maa
of attentive obfervation, and aflured me, that he had again and again
noticed, that, when a pain commenced in the membranes of the al-
veolar procefs of the upper jaw oppofite to the loofe tooth in the under
one (which had frequently occurred for feveral days paft), the pain of
the loofe tooth ceafed. And that, when the pain afterwards extend-
ed to the ear and temple on that fide, the pain in the membranes of
the upper jaw ceafed. In this cafe the membranes of the alveolar
procefs of the upper jaw became torpid, and confequcntly painful, by
their reverfe fympathy with the too violent aftions of the inflamed
membranes of the loofe tooth ; and then by a fecondary fympathy the
membranes about the ear and temple became torpid, and painful ; and
thofe of the alveolar procefs of the upper jaw regained their natural
quantity of adlion, and ceafed to be painful. A great many more
nice and attentive obfervations are wanted to elucidate thefe curious
circumftances of aflbciation, which will be found to be of the greateft
importance in the cure of many difeafes, and lead us to the knowledge
of ftver.

SPECIES.

I. Cutis frlgida pranforum. Chillnefs after dinner frequently at-
tends weak people, or thofe who have been exhaufted by exercife ;
it arifes from the great expenditure of the fenforial power on the or-
gans of digeftion, which are Simulated into violent adlion by the ali-
ment ; and the veffels of the fkin, which are aflbciated with them,
become in feme meafure torpid by reverfe fympathy ; and a confe-
quent chillnefs fucceeds with lefs abforption of atmofpheric moifture.
See the fubfequent article.

3 P 2 2. Pallor

476 DISEASES OF ASSOCIATION. Class IV. 2.1.

2. Pallor urince pranforum. The palenefs of urine after a full meal
is an inftance of reverfe affociation ; where the fecondary part of a
train of alTociate motions a£ls with lefs energy in confequence of the
greater exertions of the primary part. After dinner the abforbent
veffels of the ftomach and inteftines are Simulated into greater a£lion,
and drink up the newly taken aliment ; while thofe, which are fpread
in great number on the neck of the bladder, ablorb lefs of the aqueous
part of the urine than ufual, which is therefore difcharged in a more
dilute flate ; and has been termed crude by fome medical writers,
but it only indicates, that fo great a proportion of the fenforial power
is expended on digeftion and abforption of the aliment, that other
parts of the fyftem adl for a time with lefs energy. See Clafs IV..
I. 1.6.

3. Pallor ur'intx a frigore cutanea. There is a temporary difcharge-
of pale water, and a diarrhoea, induced by expofing the Ikin; to the
Gold air ; as is experienced by boj^s, who flrip themfelves before-
bathing. In this cafe the mouths of the cutaneous lymphatics be-
come torpid by the fubdudion of their accuftomed degree of heat, and
thofe of the bladder and inteftines become torpid by direft fympathyi;
whence lefs of the thinner part of the urinary fecretion, and of the
mucus of the inteftines, is reabforbed. See Sect, XXIX. 4,. 6. This-
efFe£l of fuddenly cooling the ikiti by the afperfion of cold water has
been ufed with fuccefs in coftivenefs, and has produced evacuations,
when other means have failed. When young infants are affli61:ed
with griping joined with coftivenefs, I have fometimes directed them
to be taken out of a warm bed, and carried about for a iz'w minutes
in a cool room, with almoft inftant relief.

4. Pallor ex cegritudine. When ficknefs of ftomach firft occurs, a
palenefs of the Ikin attends it ; which is owing to the affociation or
catenation between the capillaries of the ftomach and the cataneous

ones ;

Class IV. 2. i. DISEASES OF ASSOCIATION. 477

ones ; which at firft a£t by dlre£t fympathy. But in a fhort time
there commeiices an accumulation of the fenforial power of aflbcia-
tion in the cutaneous capillaries during their ftate of inailivity, and
then the Ikin begins to glow, and fweats break out, from the in-
creafed adlion of the cutaneous glands or capillaries, which is now in
reverfe fympathy with thofe of the flomach. So in continued fevers,
when the flomach is totally torpid, which is known by the total
averfion to folid food, the cutaneous capillaries are by reverfe fympa-
thy in a perpetual ftate of increafed adlivity, as appears from the heat
of the fkin.

5. Dyfpncea a balneo frigtdo. The difficulty of breathing on going;
up to the middle in cold water is owing to the irritative affociatioa or
catenation of the aftion of the extreme veffels of the lungs with thofe
of the Ikin. So that when the latter are rendered torpid or inadlive
by the application of fudden cold,, the former become inadtive at the
fame time, and retard the circulation of the blood through the lungs,.
for this difficulty of breathing cannot be owing to the preffure of the
water impeding the circulation downwards, as it happens equally by a
cold fhower-bath, and is loon conquered by habitual immerfions.
The capillaries of the Ikin are rendered torpid by the fubdudion of
the ftimulus of heat, and by the confequent diminution of the fenforial
power of irritation.. The capillaries of the lungs are rendered torpids
by the diminution of the fenforial power of affociation, which is now
excited in lefs quantity by the leilened adions of the capillaries of the
Ikin, with which they are catenated. So that at this time both the
cutaneous and pulmonary capillaries are principally adtuated, as far as-
they have any aftion, by the {1-imulus of the blood. But in a fhort:
time the fenforial powers of irritation, and of affociation, become ac-
cumulated, and very energetic adion of both thefe membranes fuc-
ceed. Which dius refemble the cold and hot fit of an intermittent
fever*

478 DISEASES OF ASSOCIATION. Class IV. 2. i.

6. 'Dyfpepfto, a pedibus frigidis. When the feet are long cold, as in
riding in cold and wet weather, fome people are very liable to indi-
geftion and confeqnent heart-burn. The irritative motions of the
ftomach become torpid, and do their office of digeftion im perfectly,
in confequence of their affociation with the torpid motions of the vef-
fels of the extremities. Fear, as it produces palenefs and torpidity of
the fkin^ frequently occafions temporary indigeftion in confequence
of this affociation of the veffels of the Ikin with thofe of the ftomach ;
as riding in very bad roads will give flatulency and indigeftion to ti-
morous people.

A fhort expofure to cold aLi" increafes digeftion, which is then
owing to the reverfe fympathy between the capillary veffels of the
Ikin, and of the ftomach. Hence when the body is expofed to cold
air, within certain limits of time and quantity of cold, a reverfe
fympathy of the ftomach and the fkin firft occurs, and afterwards a
diredl fympathy. \v\ the former cafe the expenditure of fenforial
power by the (kin being leffened, but not its production in the brain ;
the fecond link of the affociation, viz. the ftomach, acquires a greater
fhare of it. In the latter cafe, by the continuation of the deficient
flimulus of heat, the torpor becomes extended to the brain itfelf, or
to the trunks of the nerves ; and univerfal inactivity follows.

7. 'Tujfn a pedibus frigidis. On ftanding with the feet in thawino-
fnow, many people are liable to inceffant coughing. From the tor-
pidity of the abforbent veffels of the lungs, in confequence of their
irritative affociations with thofe of the ikin, they ceafe to abforb the
faiine part of the fecreted mucus ; and a cough is thus induced by the
irritation of this laline fecretion ; which is fimilar to that from the
noftrils in frofry weather, but differs in refped to its immediate caufe ;
the former being from affociation with a diftant part, and the latter
from dtfed of the ftimulus of heat on the noftrils themfelves. See
Catarrhus fngidus, Clafsl. 2. 3.3.-

8. TiiJ/is

ClassIV. 2. 1. DISEASES OF ASSOCIATION. 479

8. Tulfis hepatica. The cough of inebriates, which attends the en-
largement of the liver, or a chronical inflammation of its upper mem-
brane, is fuppofed to be produced by the inconvenience the diaphragm
fuffers from the compreffion or heat of the liver. It differs however
effentially from that attending hepatitis^ from its not being accompa-
nied with fever. And is perhaps rather owing to irritative affociation,
or rev^rfe fympathy, between the lungs and the liver. As occurs in
ftieep, which are liable to a perpetual dry cough, when the fleuk-
worm is preying on the fubftance of their livers. See Clafs II.
I. I. 5.

M. M. From half a grain to a grain of opium twice a day. A
drachm of mercurial ointment rubbed on the region of the liver every
•night for eight or ten times.

9. 'Tujjis arthrltica. Gout-cough. I have {&t\\ a cough, which
twice recurred at a it^N years diftance in the fame perfon, during his
fits of the gout, with fuch pertinacity and violence as to refifi: vene-
feftion, opiates, bark, blilters, mucilages, and all the ufual methods
employed in coughs. It was for a time fuppoled to be the hooping-
cough, from the violence of the action of coughing ; it continued
two or three weeks, the patient never being able to fleep more than
a ifw minutes at once during the whole time, and being propped up
in bed with pillows night and day.

As no fever attended this violent cough, and but little expectora-
tion, and that of a thin and frothy kind, I fufpe6led the membrane
of the lungs to be rather torpid than inflamed, and that the laline
part of the mucus not being abforbed Simulated them into perpetual
. exertion. And laflly, that though the lungs are not fenfible to cold
.and, heat, and probably therefore lels mobile ; yet, as they are jiever-
thelels liable to confent with the torpor of cold feet, as dei'cribed in
Species b of this Genus, I fufpefted this torpor of the lungs to luc-
ceed the gout in the feet, or to ad a vicarious part for them,

10. Vertigo

4?o DISEx\SES OF ASSOCIATION. Class IV. 2, i.

10. Vertigo rotatoria. In the vertigo from circumgyration the ir-
ritative motions of vifion are iiicreafed ; which is evinced from the
pleafure that children receive on being rocked in a cradle, or by
Swinging on a rope. For whenever fenfation arifes from the produc-
tion of irritative motion with lefs energy than natural, it is of the
difagreeable kind, as from cold or hunger; but when it arifes from
their produflion with greater energy than natural, if it be confined
within certain limits, it is of the pleafurable kind, as by warmth or
wine. With thefe increafed irritative motions of vifion, I fuppofe
thofe of the flomach are performed with greater energy by dire6l fyni-
pathy ; but when the rotatory motions, which produce this agreeable
vertigo, are continued too long, or are too violent, ficknefs of the
ftomach follows ; which is owing to the decreafed adion of that or-
gan from its reverfe fympathy with the increafed a£lions of the organ
of vifion. For the expenditure of fenforial power by the organ of
•vifion is always very great, as appears by the fize of the optic nerves;
and is now fo much increafed as to deprive the next link of alTociation
of its due ftiare. As mentioned in Article 6 of this Genus.

In the fame manner the undulations of water, or the motions of a
flilp, at firfc give pleafure by increafing the irritative motions belong-
ing to the fenfe of vifion ; but produce -ficknefs at length by expend-
ing on one part of the affociated train of irritative actions too much of
that fenforial power, which ufually ferved the whole of it ; whence
fome other parts of the train acquire too little of it, and perform their
aftions in confequence too feebly^ and thence become attended with
difagreeable fenfation.

It muft alfo be obferved, that when the irritative motions are fti-
aiiulated into unufual action, as in inebriation, they become fucceeded
by fenfation, either of the pleafurable or painful kind ; and thus a
new link is introduced between the irritative motions thus excited,
and thofe which ufed to fucceed them ; whence the aff>clatlon is
either diflevered or much weakened, and thus the vomiting in fea-

fickuefs

Class IV. 2. i. DISEASES OF ASSOCIATION. 481

iicknefs occurs from the defeO. of the power of affoclation, rather than
from the general deficiency of fenforial power.

When a blind man turns round, or when one, who is not blind,
revolves in the dark, a vertigo is produced belonging to the fenfe of
touch. A blind man balances himfelf by the fenfe of touch, which
being a lefs perfed" means of determining fmall quantities of deviation
from the perpendicular, occafions him to walk more carefully upright
than thofe, who balance themfelves by vifion. When he revolves,
the irritative affociations of the mufcular motions, which were ufed
to preferve his perpendicularity, become difordered by their new
modes of fucceflive exertion j and he begins to fall. For his feet now
touch the floor in manners or directions different from thofe they
have been accuftomed to; and in confequence he judges lefs perfedlly
of the fituation of the parts of the floor in refpedt to that of his own
body, and thus lofes his perpendicular attitude. This may be illuf-
trated by the curious experiment of crofling one finger over the next
to it, and feeling of a nut or bullet with the ends of them. When,
if the eyes be clofed, the nut or bullet appears to be two, from the
deception of the fenfe of touch.

In this vertigo from gyration, both of the fenfe of fight, and of the
fenfe of touch, the primary link of the afl})ciated irritative motions is
increafed in energy, and the fecondary ones are increafed at firfi: by
dire6t fympathy ; but after a time they become decreafed by reverfe
fympathy with the primary link, owing to the exhauftion of fenforial
power in general, or to the power of affociation in particular ; becaufe
in the lafl cafe, either pleafurable or painful fenfation has been intro-
duced between the links of a train of irritative motions, and has dif-
fevered, or much enfeebled them.

Dr. Smyth, in his Effay on Swinging in Pulmonary Confumption,
has obferved, that fwinging makes the pulfe flower. Dr. Evvart of
Bath confirmed this obfervation both on himfelf and on Col. Cathcart,
who was then he£lic, and that even on fhipboard, where fome de-

VoL. 11. 3 Q^ gree

4S2 DISEASES OF ASSOCIATION. Class IV. 2. i.

gree of vertigo might be fuppofed previoufly to exifl. Dr. Currie of
Liverpool not only confirmed this obfervation frequently on himfelf, '
when he was alfo phthifical, but found that equitation had a fimilar
efFe6t on him, uniformly retarding his pulfe. This curious circum-
fcance cannot arife from the general effect of exercife, or fatigue, as
in thofe cafes the pulfe becomes weaker and quicker ; it muft there-
fore be afcribed to a degree of vertigo, which attends all thofe modes
of motion, which we are not perpetually accuflomed to.

Dr. Currie has further obferved, that " in cafes of great debility
the voluntary mufcular exertion requifite in a fwing produces weari-
nefs, that is, increafes debility ; and that in fuch inftances he had
frequently noticed, that the diminution of the frequency of the pulfe
did not take place, but the contrary." Thefe circumflances may
thus be accounted for.

The links of aflbciation, which are effefted in the vertigo occa-
fioned by unufual motion, are the irritative motions of the fenfe of
vifion, thofe of the ftomach, and thofe of the heart and arteries.
When the irritative ideas of vifion are exerted with greater energy at
the beginning of vertigo, a degree of fenfation is excited, which is of
the pleafurable kind, as above mentioned ; whence the affociated
trains of irritative motions of the flomach, and heart, and arteries,
aft at firft with greater energy, both by dired fympathy, and by the
additional fenforial power of fenfation. Whence the pulfe of a con-
fumptive patient becomes ftronger and confequently flower.

But if this vertigo becomes much greater in degree or duration,
the firft link of this train of aiTociated irritative motions expends too
much of the fenforial power, which was ufually employed on ths
whole train ; and the motions of the ftomach become in confequence
exerted with lefs energy. This appears, becaufe in this degree of
vertigo licknefs fupervenes, as in fea-ficknefs, which has been fhewii
to be owing to lefs energetic attion of the ftomach. And the mo-
tions of the heart and arteries then become weaker, and in confe-
quence

Class IV. 2. i. DISEASES OF ASSOCIATION. 483

quence more frequent, by their direft fympathy with the leiTened ac-
tions of the ftomach. See Supplement, I. 12. and Clafs II. i, 6. 7.
The general weaknefs from fatigue is owing to a fimilar caufe, that is,
to the too great expenditure of fenforial power in the increafed aftions
of one part of the fyflem, and the conlequent deficiency of it in other
parts, or in the whole.

The abatement of the heat of the fkin in hectic fever by fwino^ino-.
is not only owing to the increafed ventilation of cool air, but to the
reverfe fympathy of the motions of the cutaneous capillaries with
thofe of the heart and arteries ; which occurs in all fevers with arterial
debility,, and a hot or dry Ikin. Hence during moderate fvvinging
the adlion of the heart and arteries becomes ftronger and flower, and
the a6lion of the capillaries, which was before too great, as appeared
by the heat of the fkin, now is leflened by their reverfe fympathy
with that of the heart and arteries. See Supplement, I. 8.

II. Vertigo vifuaUs. Vifual vertigo. The vertigo rotatoria defcribed
above, was induced by the rotation or undulation of external objefts,
and was attended with increafed adion of the primary link of the af-
fociated motions belonging to vifion, and with confequent pleafure.
The vertigo vifualis is owing to lefs perfect vifion, and is not accom-
panied with pleafurgible fenfation. This frequently occurs in'flrokes
ofthepalfy, and is then fucceeded by vorniting ; it fometimes pre-
cedes epileptic fits, and often attends thofe, whofe fight begins to 'be
impaired by age.

In this vertigo the irritative ideas of the apparent motions of objeds
are lefs diftinct, and on that account are not fucceeded by their ufual
irritative affociatlons of motion ; but excite our attention. Whence
the objects appear to librate or circulate according to the motions of
our heads, wjiich is called dizzinefs ; and we lofe the means of ba-
lancing ourfelves, or preferving our perpendicularity, by vifion. So
that in this vertigo the motions of the afibciated organs are decreafed

3 0^2 . by

484 DISEASES OF ASSOCIATION. Class IV. 2. u

by dire6l fympathy with their primary link of irritation ; as in the
preceding cafe of fea-ficknefs they are decreafed by reverfe fym-
pathy.

When vertigo afFefts people about fifty years of age, their fight has
generally been fuddenly impaired ; and from their lefs accurate vifioii
they do not fooa enough perceive the apparent motions of objects ;
like a perfon in a room, the walls of which are fiained with the uni-
form figures of lozenges, explained in Se6l, XX. i. This is gene-
rally afcribed to indigeftion ; but it ceafes fpontaneoufly, as the pa-
tient acquires the habit of balancing himfelf by lefs difi:in£l obje<£ls.

A gentleman about 50 was feized with an uncommon degree of
vertigo, fo as to fall on the ground, and not to be able to turn his
head, as he fat up either in his chair or in bis bed, and this continued
eight or-ten weeks. As he had many decayed teeth in his mouth,
and the vertigo was preceded and fometimes accompanied by pains on
one fide of his head, the difeafe of a tooth was fufpe£led to be the
caufe. And as his timidity was too great to admit the extradlion of
thofe which were decayed ; after the trial of cupping repeatedly, fo-
mentations on his head, repeated blifters, with valerian, Peruvian
bark, mufk, opium, and variety of other medicines ; mercurials were
ufed, both externally and internally, with defigu to inflame the mem-
branes of the teeth, and by that means to prevent the torpor of the
a£l:ion of the membranes about the temple, and parietal bone ; which
are catenated with the membranes of the teeth by irritative affocia-
tioii, but not by fenfitive aflbciation. The event v>'as, that as foon
as the gums became fore with a flight ptyalifm, the pains about the
head and vertigo gradually diminifhed, and during the forenefs of
his gums entirely ceafed ; but I believe recurred afterw.ards, though
in lefs degree.

The idea of inflaming the membranes of the teeth to produce in-
creafed fenfation in them, and thus to prevent their irritative connec-
tion with thofe of the cranium, was taken from the treatment of trif-

mus^

Class IV. 2. i. DISEASES OF ASSOCIATION. 485

mus, or locked jaw, by endeavouring to inflame the injured tendon ;
which is faid to prevent or to remove the fpalm of the mufcles of the
jaw. See Clafs III. 1. i. 13. and 15.

M, M. Emetics. BUfters, Iflues about the head. Extradion of
decayed teeth. Slight falivation. Sorbentia. Incitantia.

12. Fertigo ebr'iofa. Vertigo from intoxication is owing to the af-
fociation of the irritative ideas of vifion with the irritative motions of
the ftomach. Whence when thefe latter become much increafed by
the immoderate ftimulus of wine, the irritative motions of the retina
are produced with lefs energy by reverfe fympathy, and become at
the fame time fucceeded by fenfation in confequence of their decreafed
adlion. See Sedt. XXI. 3. and XXXV. 1.2. So converfely when
the irritative motions of vifion are increafed by turning round, or by
our unaccuftomed agitation at fea, thofe of the flomach become in-
verted by reverfe fympathy, and are attended in confequence with
difagreeable fenfation. Which decreafed aftion of the ftomach is in
confequence of the increafed expenditure of the fenforial pov/er on the
irritative ideas of vifion, as explained in Vertigo rotatoria.

Whence though a certain quantity of vinous fpirit Simulates the
whole fyftem into increafed aftion, and perhaps even increafes the
fecretion of fenforial power in the brain ; yet as foon as any deo-ree of
vertigo is produced, it is a proof, that by the too great expenditure of
fenforial power by the flomach, and its neareft affociated motions,
the more' diftant ones, as thofe of vifion, become imperfedlly exerted.
From hence may be deduced the necefiity of exhibiting wine in fevers
with weak pulfe in only appropriated quantity ; becaufe if the lead
intoxication be induced, fome part of the fyftem muft a£l more feebly
from the unneceflary expenditure of fenforial power.

13. Vertigo febriculofa. Vertigo in fevers either proceeds from the
general deficiency of fenforial power belonging to the irritative alToci-

7 ations,

486 DISEASES OF ASSOCIATION. Class IV. 2. u

ations, or to a greater expenditure of it on fome links of the trains
and tribes of aflbciated irritative motions. There is however a (lighter
vertigo attending all people, who have been long confined in bed, on
their firft rifing ; owing to their having been lb long unufed to the
apparent motions of objects in 'their ere£t pofture, or as they pafs by
them, that they have lofl in part the habit of balancing themfelves
by them.

14. Vertigo cerebrofa. Vertigo from injuries of the brain, either from
external violence, or which attend paralytic attacks, are owing to
the general deficiency of fenforial power. In thefe diftrefsful fitua-
tions the vital motions, or thofe immediately neceflary to life, claim
their fliare of fenforial power in the firft place, otherwife the patient
muft die ; and thofe motions, which are lefs neceflary, feel a defici-
ency of it, as thefe of the organs of fenfe and mufcles ; which con-
flitute vertigo ; and laftly the voluntary motions, which are flili
lefs immediately neceflary to life, are frequently partially deflroyed,
as in palfy ; or totally, as in apoplexy.

15. Murmur aiir'ium vert igtnofum. The vertiginous murmur in the
ears, or noife in the head, is compared to the undulations of the
found of bells, or to the humming of bees. It frequently attends
people about 60 years of age ; and like the vifual vertigo defcribed
above is owing to our hearing lefs perfectly from the gradual inirrita-
bility of the organ on the approach of age ; and the difagreeable fenfa-
tion of noife attending it is owing to the lefs energetic adion of thefe
irritative motions j which not being fufficiently diftindl to excite their
ufual affociatlons become Tucceeded by our attention, like the indiftind:
view of the apparent motions of objects mentioned in vertigo vifualis.
This may be better underflood from confidering the u'e, which
blind men make of thefe irritative founds, which they have taught
themielves to attend to, but which efcape the notice of others. The

late

ClassIV. 2. 1. DISEASES OF ASSOCIATION. 487

late blind Juftice Fielding walked for the firfl: tinae into my roooi,
when he once vilited me, and after fpeaking a few words faid, " this
room is about 22 feet long, 18 wide, and 12 high;" all which he
gueffed by the ear with great accuracy. Now if thefe irritative
founds from the partial lofs of hearing do not correfpond with the
fize or ufual echoes of the places, where we are ; their catenatioa
with other irritative ideas, as thofe of vifion, becomes diffevered or
difturbed ; and we attend to them in confequence, which I think
■unravels this intricate circumftance of noifes being always heard in
the head, when the fenfe of hearing begins to be impaired, from
whatever caufe it occurs.

This ringing in the ears alfo attends the vertigo from intoxication;
for the irritative ideas of found are then more weakly excited in con-
fequence of the deficiency of the fenforial power of aflbciation. As
is known by this alfo being attended with difagreeable fenfation, and
by its accompanying other difeafes of debility, as flrokes on the head,
fainting fits, and paralytic feizures. For in this vertigo from intoxi-
cation fo much fenforial power in general is expended on the increafed
a£lions of the flomach, and its neareft connexions, as the capillaries
of the Ikin ; that there is a dejiciency for the purpofes of the other
irritative affociations of motions ufually connefted with it. This au-
ditory vertigo attends both the rotatory and the vifual vertigo above
mentioned ; in the former it is introduced by reverfe fympathy, that
is, by the diminution of fenforial power; too great a quantity of it
being expended on the increafed irritative motions of vifion ; in the
latter it is produced either by the fame caufes which produce the vi-
fual vertigo, or by diredl fympathy with it. See Se6l. XX, 7.

M. M. Stimulate the internal ear by ether, or with effential oil di-
luted with expreffed oil, or with a folutioa of opium in wine, or in
water. Or with fait and water.

8 16. Taclus,

488 ; DISEASES OF ASSOCIATION. Class IV. 2. i.

16. T'aSius, gujlus, olfaBus vert'iginoji. Vertiginous touch, tafte, and
fmeil. In the vertigo of intoxication, when the patient lies down in
bed, it fometimes happens even in the dark, that the bed feems to
librate under him, and he is afraid of falling out of it. The fame oc-
curs to people, who are fea-fick, even when they lie down in the
dark. In thefe the irritative motions of the nerves of touch, or irri-
tative tangible ideas, are performed with lefs energy, in one cafe by
reverfe fympathy with the ftomach, in the other by reverfe fympathy
with the nerves of vifion, and in confequence become attended with
fenfation, and produce the fear of falling by other affociations.

A vertigo of the lenfe of touch may be produced, if any one turns
round for a time with his eyes (hut, and fuddenly flops without
opening them ; for he will for a time feem to be flill going forwards;
which is difficult to explain. See the notes at the end of the firft and
fecond volume belonging to Se£t, XX. 6.

In the beginning of feme fevers, along with inceffant vomiting, the
patients complain of difagreeable taftes in their mouth, aiid difagree-
able odours; which are to be afcribed to the general debility of the
great trains and tribes of aflbciated irritative motions, and to be ex-
plained from their dired fympathy with the decreafed adion of a fick
ftomach j or from the lefs fecretion of fenforial power in the brain.
Thefe organs of fenfe are conftantly ftimulated into adlion by the
faliva or by the air ; hence, like the fenfe of hunger, when they are
torpid from want of ftimulus, or from want of fenforial power, pain
, or difagreeable fenfation enfues, as of hunger, or faintnefs, or fick-
nefs in one cafe ; and the ideas of bad taftes or odours in the other.
This accords with the laws of caufation, Sed. IV. 5.

17. Pulfus mollis in vomitione. The foftnefs of the pvilfe in the ad
of vomiting is caufed by dlredl aflbciation between the heart and the
ftomach; as explained in Se6l. XXV. 17. A great flovvnefs of the

pulfation

Class IV. 2. i. DISEASES OF ASSOCIATION. 4S9

puliation of the heart fometimes attends ficknefs, and even with iu-
termiffions of it; as in the exhibition of too great a dofe of digitalis.

18. Pulfus intermittens a ventriculo. When the pulfe flrfl: begins
to intermit, it is common for the patient to bring up a little air from
his flomach ; which if he accomplifhes before the intermiffion occurs,
always prevents it ; whence that this debility of the heart is owing to
the dire£t affociation of its motions with thofe of the flomach is well
evinced. See Se<£l. XXV. 17.

I this morning faw Mr. , who has long had at times an un-
equal pulfe, with indigeftion and flatulency, and occafional afthma ;
he was feized two days ago with diarrhoea, and this morning with
ficknefs, and his pulfe was every way unequal. After an emetic his
pulfe ftill continued very intermittent and unequal. He then took
fome breakfaft of toafi: and butter, and tea, and to my great furprife
his pulfe became immediately perfectly regular, about 100 in a mi-
nutcj and not weak, by this ftimulus on his ftomach.

A perfon, who for many years had had a frequent intermiffioti of
Jiis pulfe, and occafional palpitation of his heart, was relieved from
them both for a time by taking about four drops of a faturated folutiori
of arfenic three or four times a day for three or four days. As this
intermiflion of the pulfe is occafioned by the dire£l aflbciation of the
motions of the heart with thofe of the ftomach, the indication of
.cure muft be to flrengthen the aftion of the ftomach by the bark.
Spice. Moderate quantities of wine. A blifter. Half a grain of
^pium twice a day. Solution of arfenic ?

19. Febris inirritativa. Inirritative fever defcribed in Clafsl. 2. 1. 1.
belongs to this place, as it confifts of difordered trains and tribes of
aflbciated irritative motions, with leffened a(5lions of the alTociated
organs. In this fever the pulfations of the heart and arteries are
weakened or leffened, not only in the cold paroxyfm, as in the irrita-

VoL. II. 3 R tive

490 DISEASES OF ASSOCIATION. Class IV. 2. i.

live fever, but alfo in the hot paroxyfm. The capillary arteries or
glands have their aftions neverthelefs increafed after the firft cold fit,
as appears by the greater produ£lion of heat, and the glow of arterial
blood, in the cutaneous veffels ; and laftly, the adlion of the ftpmach
is much impaired or deftroyed, as appears by the total want of appe-
tite to folid food. Whence it would feem, that the torpid motions
of the flomach, whatever may occafion them, are a very frequent
caufe of continued fever with weak pulfe ; and that thefe torpid mo-
tions of the ftomach do not fufficiently excite the fenforial power of
aflbciation, which contributes in health to aduate the heart and arte-
ries along with the irritation produced by the flimulus of the blood;
a-nd hence the adlions of thefe organs are weaker. And laftly, that
the accumulation of the fenforial power of aflbciation, which ought
to be expended on the motions of the heart and arteries, becomes now
exerted on the cutaneous and pulmonary capillaries. See Supplement
I. 8. and Sea. XXXV. i. i. and XXXIII. 2. 10.

I have dwelt longer on the vertiginous difeafes in this genus, both
becaufe of their great intricacy, and becaufe they feem to open a road
to the knowledge of fever, which coniifts of affociated trains and tribes
of irritative or fenfitive motions, which are fometimes mixed with the
vertiginous ones, and fometimes feparate from them..

ORDO

Cf.ASs IV, 2. 3. DISEASES OF ASSOCIATION. 49 1

ORiDO II.

Decreajed Affociate Motions,

GENUS II.
Catenated with Senjitive Motions,

In this genus the fenforial power of aflbciatlon is exerted with lefs
energy, and thence the aftions produced by it are lefs than natural ;
and pain is produced in confequence, according to the fifth law of
animal caufation, Se£t. IV. This pain is generally attended with
coldnefs of the afFe<5led part, and is feldom fucceeded by inflammation
of it. This decreafed adlion of the fecondary link of the alTociated
motions, belonging to this genus, is owing to the previous exhauftion
of fenforial power either in the increafed adions of the primary link
of the afTociated motions, or by the pain which attends them ; both
which are frequently the confequence of the ftimulus of fomethino-
external to the affefted fibres.

As pain is produced either by excefs or defe£l: of the natural exer-
tions of the fibres, it is not, confidered feparately, a criterion of the
prefence of either. In the aflbciations belonging to this genus the
fenfation of pain or pleafure produces or attends the primary link of
the aflbciated motions, and very often gives name to the difeafe.

V^'hen great pain exifts without caufi^^ig any fibrous motions, I
conjefture that it contributes to exhaaft or expend the general quan-
tity of fenforial power; becaufe peopk are fatigued by enduring pain,
till at length they fleep. Which is contrary to what I had perhaps
errqneoufly fuppofed in Se£l. XXXV. 2. 3. If it caufes fibrous mo-
tions, it then takes the name of fenfation, according to the definition

3 R 2 of

492 DISEASES OF ASSOCIATION. Class IV. 2. 2.

of fenfation in Se£l. II. 2. 9. ; and increafed fibrous aftion or inflam-
mation is the confequence. This circumftance of the general ex-
hauftion of fenforial power by the exiftence of pain will aflift in ex-
plaining many of the difeafes of this genus.

Many of the canals of the body, as the urethra, the bile-dudl, the
throat, have the motions of their two extremities alTociated by having
been accuftomed to feel pleafurable or painful fenfations at the fame
time or in fucceffion. This is termed fenfitive aflbciation, though
thofe painful or pleafurable fenfations do not caufe the motions, but
only attend them ; and are thus perhaps, ftridly fpeaking, only ca-
tenated with them.

SPECIES.

I. 'Torpoi' genee a dolore denth. In tooth-ach there is generally a
coldnefs of the cheek, vvhich is fenfible to the hand, and is attended
in fome degree with the pain of cold. The cheek and tooth have fre-
quently been engaged in pleafurable aiftion at the fame time during
the mafticating of our food ; whence they have acquired fenfitive af-
fociations. The torpor of the cheek may have for its caufe the too
great expenditure of fenforial power by the painful fenfation of the
membranes of the dileafed tooth ; whence the membranes of the
cheek aflbciated with thofe of the alveolar procefs are deprived of
their natural fliare of it, and become torpid ; thus they produce lefs
fecretions, and lefs heat, and the pain of cold is the confequence.
This torpor of the veflels of the cheek cannot be produced by the ac-
tivity of the fenforial power of fenfation j for then they would a(3:
more violently than natural, or become inflamed. And though the
pain by exhaufting fo much fenforial power may be a remote caufe,
it is the defeft of the power of aflbciation, which is the immediate
caufe of the torpor of the cheek.

After fome hours this pain occafioned by the torpor of the veflels of

the

Class IV. 2. 2. DISEASES OF ASSOCIATION. 495

the cheek either gradually ceafes along with the pain of the difeafed
tooth ; or, by the acGumulation of fenforial power during their ftate
of torpor, the capillaries of the cheek a6t with greater violence, and
produce more fecretions, and heat, and confequent tumour, and in-
flammation. In this ftate the pain of the difeafed tooth ceafes; as
the fenforial power of fenfation is now expended on the inflamed vef-
fels of the cheek. It is probable that mofl: other internal membranous
inflammations begin in a fimilar manner ; whence there may feem to
be a double kind of fenfitive aflbciation ; firft, with decreafed adion
of the aflTociated organ, and then with increafed aftion of it ; but the
latter is in this cafe fimply the confequence of the former ; that
is, the tumor or inflammation of the cheek is in confequence of its
previous quiefcence or torpor.

2. Stranguria a dolore vejtca. The ftrangury, which has its orio-in
from pain at the neck of the bladder, confifts of a pain in the external
extremity of the urethra or of the glans penis of men, and probably
in the external termination of the urethra or of the clitoris of women ;
and is owing to the fympathy of thefe with fome diftant parts, gene-
rally with the other end of the urethra;, an endeavour and difficulty
of making water attends this pain.

Its remote caufe is from the internal or external ufe of cantharides,
which ftimulate the neck of the bladder; or from a ftone, which
whenever it is pufhed into the neck of the bladder, gives this pain of
ftrangury, but not at other times ; and hence it is felt moft feverely
in this cafe after having made water.

The lenfations or fenfitive motions of the glans penis, and of the
fphindter of the bladder, have been accuftomed to exift together
during the difcharge of the urine ; and hence the two ends of the
urethra fympathize by aflociation. When there is a ftone at the neck
of the bladder, which is not fo large or rough as to inflame the part,
the fphinder of the bladder becomes ftimulated into pain ; but as the .

glans

494 DISEASES OF ASSOCIATION. Class IV. 2. ^.

glans penis is for the piirpofes of copulation more fenfitive than the
fphinder of the bladder, as foon as it becomes affefted with pain by
the aflbciation above mentioned, the fenfation at the neck of the blad-
der ceafes ; and then the pain of the glans penis would feem to be af-
fociated with the irritative motions only of the fphin£ler of the
•bladder, and not with the fenfitive ones of it. But a circumftance
fimilar to this occurs in epileptic fits, which at firft are induced by
difagreeable fenfation, and afterwards feem to occur without previous
pain, from the fuddennefs in which they follow and relieve the pain,
which occafioned them. From this analogy I imagine the pain of the
glans penis is aflbciated with the pain of the fphinder of the bladder;
but that as foon as the greater pain in a more feitfible fart is produced \
the Jejfer one, which occafioned it, ceafes ; and that this is one of the
laws of fenfitive aflbciation. See Se£t. XXXV. 2. i.

A young man had by an accident fwallowed a large fpoonful or
more of tindure of cantharides ; as foon as he began to feel the pain
of flrangury, he was advifed to drink large quantities of warmifh
water; to which, as foon as it could be got, fome gum arable was
added. In an hour or two he drank by intervals of a few minutes
about two gallons of water, and difcharged his urine every four or
five minutes. A little blood was voided towards the end, but he fuf-
fered no ill confequence.

M. M. Warm water internally. Clyfters of warm water. Fo-
mentation. Opium. Solution of fixed alkali fuperfaturated with car-
bonic acid. A bougie may be ufed to pufli back a ftone into the blad-
der. See Clafs I. 1.3. 10.

3. Stranguria convulfiva. The convulfive flrangury, like that be-
fore defcribed, is probably occafioned by the torpor or defe6live aftion
of the painful part in confequence of the too great expenditure of fen-
forial power on the primary link of the aflbciated motions, as no
heat or inflammation attends this violent pain. This kind of flrangury

•J recurs

Class IV. 2. 2. DISEASES OF ASSOCIATION. 4^^

recurs by ftated periods, and fometimes arifes to fo great a degree,'
that conviilfion or temporary madnefs terminates each period of it.-
It aiFe6ls women oftener than men, is attended with cold extremities
without fever, and is diftinguifhed from the ftone of the bladder by
the regularity of its periods, and by the pain being not increafed after
making water.

On introducing the catheter fometimes part of the urine will come
away and not the whole, which is difficult to explain ; but may arife
from the weaknefs of the mufcular fibres of the bladder ; which are
not liable fuddenly to contrad themfelves fo far as to exclude the
whole of the urine. In fome old people, who have experienced a
long retention of urine, the bladder never regains the power of com-
pletely emptying itfelf ; and many who are beginning to be weak
from age can make water a fecond time, a few minutes after they
fuppofed they had emptied the bladder.

I have believed this pain to originate from fympathy with fome
diftant part, as from afcarides in the redum, or from piles in women ;
or from caruncles in the urethra about the caput gallinaginis in men ;
and that the pain has been in the glans or clitoris by reverfe fympathy
of thefe more fenfible parts with thofe above mentioned.

M. M. Venefedlion. Opium in large quantities. Warm bath..
Balfams. Bark. Tin£lure of cantharides. Bougie, and the treat-
ment for haemorrhoids. Leeches applied to the fphindler ani. Ae-
rated akaline water. Soap and fal foda. Opium in clyfters given an
hour before the expeded return. Smoke of tobacco ia clyflers,
Arfenic ?

4. Do/or termini inlejiinalis dutius choledochi. Pain at the inteffinal end
of the gall-du6l. When a gall-ftone is protruded from the gall-bladder
a little way into the end of the gall-du6l, the pain is felt at the other
end of the gall-dudl, which terminates in the duodenum. P'or the
adions of the two- terminations of this canal are afTociated together

fji»m

496 DISEASES OF ASSOCIATION. Class IV. 2. 2.

from the fame ftreams of bile pa.ffing through them in fucceflion, ex-
adly as the two terminations of the urethra have their actions afTo-
ciated, as defcribed in Species 2 and 3 of this genus. But as the in-
teftinal termination of the bile-dud is made more fenfible for the
purpofe of bringing down more bile, when it is ftimulated by nevv
fupplies of food from the ftomach, it falls into violent pain from aflb-
ciation ; and then the pain on the region of the gall-bladder ceafes,
exaAly as above explained in the account of the pain of the glans
penis from a flone in the fphinfter of the bladder.

The common bile-du£l opens into the inteftine exadlly at what is
called the pit of the ftomach ; and hence it has fometimes happened,
that this pain from aflbciation with the fenfation of a gall-llone at
the other end of the bile-dud has been miftaken for a pain of the
ilomach.

For the method of cure feeClafs I. 1.3.8. to which fliould be
added the ufe of ftrong eledric fliocks palTed through the bile-dud
from the pit of the ftomach to the back, and from one fide to the
other. A cafe of the good effed of eledricity in the jaundice is re-
lated in Sed. XXX. 2. And another cafe, where it promoted the
paffage of a painful gall-flone, is defcribed by Dr. Hall, experienced
on himfelf. Tranf. of the College at Philadelphia, Vol.1, p. 192.

Half a pint of warm water two or three times a day is much re-
commended to dilute the infpiffated bile.

{;. Do/or pharyngts ah ac'ido gajlrico. The two ends of the throat
fympathize by fenfitive affociation in the fame manner as the other
canals above mentioned, namely, the urethra and the bile-dud ;
hence when too great acidity of undigefled aliment, or the carbonic
acid air, which efcapes in fermentation, ftimulates the cardia ventri-
cuh, or lower end of the gula, into pain ; the pharinx, or upper
end of it, is affeded with greater pain, or a difagreeable fenfation of

heat.

8 6. Prwitus

Class IV. 2. 2. DISEASES OF ASSOCIATION. /^()^-

6. Pruritus narium a^vcrmibus. The itching of the nofe from
worms in the rnteftines is anothef curious inftance of the fenfitive af-
fociatlons of the motions of membranes ; efpecially of thofe which
conftitute the canals of the body. Previous to the deglutition of
agreeable food, as milk in our earlieft infancy, an agreeable odour
affedts the membrane, which lines the rioftrils ; and hence an aflbci-
ation feems to take place between the agreeable fenfations produced
by food ill the ftomach and bowels, and the agreeable fenfations of
the noftrils. The exiflence of afcarides in the rectum I believe pro-
duces this itching of the noftrils more than the worms in other parts
of the inteftines ; as we have already feen, that the terminations of
canals fympathize more than their other parts, as iu the urethra and
gall-dufts. See Clafs I, 1.5. 9. IV. i. 2. 9.

7. Cephalcea. Head-ach. In cold fits of the ague, the head-ach
arifes from confent with fome torpid vifcus, like the pain of the loins.
After drunkennefs the head-ach is very common, owing to dire6l
fympathy of the membranes of the head with thofe of the ftomach j
which is become torpid after the too violent ftimulus of the preeedino-
intoxication ; and is hence removeable by fpirit of wine, or opium,
exhibited in fmaller quantities. In fome conftitutions thefe head-
achs are induced, when the feet- are expofed to m.uch external cold ;
in. this cafe the feet (hould be covered with oiled 'k, which. prevents
the evaporation of the perfpirable matter, and thence diminiflies one
c-aufe of external cold.

M. M: Valerian in powder two drams three or four times a day is
recommended. The bark. Chalybeates. A grain of opium twice
a day for a long time. From five to ten drops of the faturated folu-
tion of arfenlc two or three times a day. See Clafs I. 2.4. 11. A
lady once affured me, that when her head-ach was coming on, file
drank three pints (pounds) of hot water, as haftily as (lie could ;
which prevented the progrefs of the difeafe. A folution of arfenic is

Vol. II. 3 S recommended

498 DISEASES OF ASSOCIATION. ClassIV. 2. 2.

recommended by Dr. Fowler of York. Very ftrong errhines are faid
Ibmetimes to cure head-achs taken at the times the pain recurs, till a-
few drops of blood iflue from the noflrils. As one grain of turpeth
mineral (vitriolic calx of mercury) mixed with ten grains of fine
fugar. Euphorbium or cayan pepper mixed with fugar, and ufed
with caution as an errhine. See the M. M. of the next Species.

8. Hem'icranla, Pain on one fide of the head. This difeafe is at-
tended with cold Ikin, and hence whatever may be the remote caufe,
the immediate one feems to be want of ftimulus, either of heat or
diftention, or of fome other unknown ftimulus in the painful part ;
or \v\ thofe, with which it is aflbciated. The membranes in their
natural ftate are only Irritable by diftention ; in their difeafed ftate,
they are fenfible like mufcular fibres. Hence a difeafed tooth may
render the neighbouring membranes fenfible, and is frequently the
caufe of this difeafe.

Sometimes the ftomach is torpid along with the pained membrane
of the head; and then ficknefs and inappetency attends either as a
caufe or confequence. The natural cure of hemicrania is the accu-
mulation of fenfbrial power during the reft or ficknefs of the patient,

Mrs. is frequently liable to hemicrania with ficknefs, which is

probably owing to a difeafed tooth ; the paroxyfm occurs irregularly,
but always after fome previous fatigue, or other caufe of debility.
She lies in bed, fick, and without taking any folid food, and very
little of fluids, and thofe of the aqueous kind, and, after about 48 or
50 hours, rifes free from complaint. Similar to this is the recovery
from cold paroxyfms of fever, from the torpor occafioned hy fear, and
from fyncope J which are all owing to the accumulation of fenforial
power during the ina^livity of the fyftem. Hence it appears, that,
though when the fenforial power of volition Is much exhaufted by fa-
tigue, it can be reftored by eight or ten hours of fleep; yet, when
the fenforial power of irritation is exhaufted by fatigue, that it

requires

clasjiv. 2.2. Diseases of association. 499

requires two whole folar or lunar days of refl, before it can be
reftored.

The late Dr. Monro afierted in his leflures, that he cured the he-
micrania,. or megrim, by a ftrong vomit, and a briflc purge immedi-
ately after it. This method fucceeds bell if opium and the bark are
given in due quantity after the operation of the cathartic ; and with
ftill more certainty, if bleeding in fmall quantity, is premifed,, whers.
the pulfe will admit of it. See Sed. XXXV.. 2. iw

The pain generally afFefts one eye, and fpreads a little way on
that fide of the nofe,. and may fometimes be relieved by prefling or
cuttiag the nerve, where it pafles into the bone of the orbit above
the eye. When it. afFe£ts-a fmalldefined part on the parietal bone on
one fide, it is generally termed Clavus hyftericus, and is always I
believe owing to a difeafed dens molaris. The tendons of the muf-
cles, which ferwe t-he office of maftication, have been extended into
pain at the fame time, that the membranous coverings of the roots of
the teetli have been comprefled into pain, during the biting or mafli-
Gation of hard bodies.. Hencei when the membranes, which cover
the roots of the teeth, become affe6led with pain by abeginning de-
cay, or perhaps by the torpor or coldnefs of the dying part of the
tooth, the tendons and membranous fafcia of the mnfcles about the
fame fide of the head become afFeded' with violent pain by. their fen-
fitiv-e aflbciations : and as foon as this affociated pain takes place,, the
pain of the tooth entirely ceafes, as explained in. the fecond fpecies of
this genus.

A remarkable circumftance attends this kind of hemieranla, viz.-
that it recurs- by periods like thofe of intermittent fevers, as explained
in the Sedlion on Catenation of Motions ; thefe periods fometimes
correfpond Math alternate lunar or folar days like tertian agues, and
that even when a decaying tooth is evidently the caufe; which has
been.eviiiced by the cure of the difeafe by extra^ing the tooth. At

3 S 2 other:

500 DISEASES OF ASSOCIATION. Class IV. z. z.

other times they obferve the monthly lunations, and feem to be in-
duced by the debility, which attends menftruation.

The dens fapientixe, or laft tooth of the upper jaw, frequently de-
cays firft, and gives hernicrania over the eye on the fame fide. The
firfl or fecond grinder in the under-jaw is liable to give violent pain
about the middle of the parietal bone, or fide of the head, on the fame
fide, which is generally called the Clavus hyflericus, of which an in-
ftru6live cafe is related in Sed. XXXV. 2. i.

M. M. Dete£l and extra6l the difeafed tooth. Cut the afFe£led
nerve, or flimulate the difeafed membrane by acu-pun£ture. Vene-
fedion to fix ounces by the lancet or by leeches. A ftrong emetic
and a fubfequent cathartic ; and then an opiate and the bark. Pafs
fmall eleftric fliocks through the pained membrane, and through the
teeth on the fame fide. Apply vitriolic ether externally, and a graia
of opium with camphor internally, to the cheek on the afFeded fide,
where a difeafed tooth may be fufpeiled. Foment the head with
warm vinegar. Drink two large fpoonfuls of vinegar. Stimulate the
gums of the fufpe61:ed teeth by oil of cloves, by opium. See Clafs I.
1.4.4. Snuff volatile fpirit of vinegar up the noftrils. Laflly, in
permanent head-achs, as in permanent vertigo, I have feen good efFe£l
by the ufe of mercurial ointment rubbed on the fhaved head or about
the throat, till a mild falivation commences, which by inflaming the
membranes of the teeth may prevent their irritative fympathy with
thofe of the cranium. Thus by inflaming the tendon, which is the
caufe of locked jaw, and probably by inflaming the wound, which is
the caufe of hydrophobia, thofe difeafes may be cured, by difuniting
the irritative fympathy between thofe parts, which may not poffefs
any fenfitive fympathy. This idea is well worth our attention.

Otalgia. Ear-ach is another difeafe occafioned by the fympathy of
the membranes of the ear with thofe which iuvefl or furround a de-
caying

Class IV. 2. 2. DISEASES OF ASSOCIATION. 501

caying tooth, as I have had frequent reafon to believe ; and is fre-
quently relieved by filling the ear with tindure of opium. See Ciafs
I. 2. 4.

9. Dolor humeri in hepatidide. In the efforts of excluding the fisces
and urine the mufcles of the fhoulders are exerted to comprefs the air
in the lungs, that the diaphragm may be prefTed down. Hence the
diftention of the tendons or fibres of thefe mufcles is afTociated with
the diftention of the tendons or fibres of the diaphragm ; and when
the latter are pained by the enlargement or heat of the inflamed liver>
the former fympathize with them. Sometimes but one flioulder is
affe£ted, fometlmes both ; it is probable that many other pains,
which are termed rheumatic, have a limilar origin, viz. from fenlitivc
afTociations.

As no inflammation is produced in confequence of this pain of the
flioulder, it feems to be owing to inadion of the membranous part
from defed of the fenforial power of afTociatlon, of which the pri-
mary link is the inflamed membrane of the liver ; which now expends
fo much of the fenforial power in general by its increafed aflion, that
the membranes about the fhoulder, which are links of afTociation
with it, become deprived of their ufual fhare, and confequently fall
into torpor.

I o. T^orpor pedum in eruptione variolarum. At the commencement
of the eruption of the fmall-'pox, when the face and breafl of chil-
dren are very hot, their extremities are frequently cold. This I
afcribe to fenlitive afrociation between the different parts of the fkin ;
whence when a part afts too violently, the other part is liable to aft
too weakly; and the Ikin of the face being affected firfl in the erup-
tion of the fmall-pox, the fkin of the feet becomes cold in confe-
quence by reverfe fympathy.

7 M. M. Cover

502 DISEASES OF ASSOCIATION. Class TV. 2. s.

M. M, Cover the feet with- flannel, and expofe the face and bofora
to cool air, which in a very fhort time both warms the feet and cools
the face; and hence what is erroneouHy called' a rafli, but which is
probably a too hafly eruption of the fmall-pox, difappears ; and after-
wards fewer and. more diftirKH:' eruptions of the fmall-pox fuper-
vene.

\\,'\EeJihim dolor nephrh'tcus. The pain- and retraiSiioii of the tef--
ticle on the fame fide, when there is a ftone in the ureter, is to be
afcribed to fenfitive aflbciation ; whether the connedling caufe be a
branch of the fame nerve, or from membranes, which have been fre-
quently affeded at the fame time,

12. Dolor digit! minimi fyMpatheticus. When any one accidentally
flrikes his elbow againft any hard body, a tingling pain runs down,
to the little finger end. This is owing to fenfitive aflbciation of mo-
tions by means of the fame branch of a nerve, as in hemicrania frorn
a decaying tooth the pain is owing to the fenfitive afloGiation of tear
dons or membranes.

13. Dolor brachii in iSydrope pe&oris. The pain in the left arm
which attends fome dropfies of the chefl:, is explained in Sedl. XXIXl
5. 2. 10. which refembles the pain of the little finger from a per-
cuflion of the nerve at the elbow in the preceding article. A numb-
nefs of this kind is produced over the whole leg, when the crural
nerve is much compreflTed by fitting for a time with one leg croflTed
over the other.

Mr. , about fixty, had for two years been afFeded with dif-
ficulty of refpiration on any exertion, with pain about the fternum,
aud of his left arm ; which lafl: was more confiderable than is ufual

6 in

Class IV. 2. 2. DISEASES OF ASSOCIATION. 503

ia dropfy of the cheft ; fbme months ago the pain of his arm, after
walking a mile or two, became exceffive, with coldnefs and numb-
nefs ; and on the next day the back of the hand, and a part of the
arm fwelled, and became inflamed, which relieved the pain; and
was taken for the gout, and continued feveral days. He after fomc
months became dropfical both in refpe<£l to his cheft and limbs,
and was fix or {even times perfedlly relieved by olie dram of fa-
turated tincture of digitalis, taken two or three times a day for a
few days in a glafs of peppermint water. He afterwards breathed
oxygen gas undiluted, in the quantity of fix or eight gallons a
day for three or four weeks without any efFed:, and funk at length
from general debility.

In this inftrudive cafe I imagine the preffure or ftimulus of, one
part of the nerve within the cheft caufed the other part, which
ferves the arm, to become torpid, and confequently coid by fym-
pathy ; and that the inflammation was the confequence of the pre-
vious torpor and coldnefs of the arm, in the fame manner as the
fwelling and inflammation of the cheek in tooth-ach, in the firft
fpecies of this genus ; and that many rheumatic inflammations arc
thus produced by fympathy with fome diftant part.

14. Diarrhaa a dentitione. The diarrhoea, which frequently at-
tends dentition, is the confequence of indigeftion ; the aliment
acquires chemical changes, and by its acidity ads as a cathartic ;
and changes the yellow bile into green, which is evacuated
along with indigefted parts of the coagulum of milk. The in-
digeftion is owing to the torpor of the ftomach and inteftines
cau(ed by their aflfociation with the membranes of the gums,
whicji , ar,e now ftimulated into great exertion with pain ; both
which qofitfibute to expend the general quantity of fenforial power,
vyhith belongs to this membranous affociation ; and thus the

ftomach

504 DISEASES OF ASSOCIATION. Class IV, 2. 2.

flomach and inteftines aft with lefs than their natural energy.
This is generally efteemed a favourable fymptom in difficult denti-
tion, as the pain of the alveolar membranes exhaufts the fenforial
power without producing convulfions for its relief. See Clafs I. 1.4. 5.
And the diarrhoea ceafes, as the tooth advances.

O R D O

Class IV. 2. 3, DISEASES OF ASSOCIATION. 505

ORDG II.

Decreafed Ajfociate Motions.

GENUS III.

Catenated with Voluntary Motions.

SPECIES.

I. 'TAtuhatio Unguce. Impediment of fpeech is owing to the aflbci-
ations of the motions of the organs of fpeech being interrupted or dif-
fevered by ill-employed fenfation or fenfitive motions, as by awe,
baflifulnefs, ambition of fhining, or fear of not fucceeding, and the
pcrfon ufes voluntary efforts in vain to regain the broken afTociations,
as explained in Se<£t. XVII. i. 10. and XVII. 2. 10.

The broken afTociation is generally between the firfl confonant and
the fucceeding vowel ; as in endeavouring to pronounce the word
parable, the p is voluntarily repeated again and again, but the re-
mainder of the word does not follow, becaufe the affociation between
it and the next vowel is diffevered.

M. M. The art of curing this defed is to caufe the ftammerer to
repeat the word, which he finds difficult to fpeak, eight or ten times
without the initial letter, in a flrong voice, or with an afpirate before
it, as arable, or harable ; and at length to fpeak it very foftly with
the initial letter p, parable. This fhould be pradifed for weeks or
months upon every word, which the flammerer hefitates in pro-
nouncing. To this fhould be added much commerce with mankind,
in order to acquire a careleflhefs about the opinions of others.

Vol. II. ■? T 2. Chorea

5o6 DISEASES OF ASSOCIATION. Class IV. 2. 3.

2. Chorea St Viti. In the St. Vitus's dance the patient can at any
time lie ftill in bed, which fhews the motions not to be convulfive ;
and he can at different times voluntarily exert every mufcle of "his
body ; which evinces, that they are not paralytic. In this difeafe
the principal mufcle in any defigned morion obeys the will ; but thofe
mufcles, whofe motions were affociated with the principal one, do
not aft ; as their aflbciation is diffevered, and thus the arm or leg is
drawn outward, or inward, or backward, inftead of upward or for-
ward, with various gefticulations exa(3:ly refembling the impediment
of fpeech.

TliTs difeafe is frequently left after the itch has been too haftily
cured. See Convulfio dolorifica, Clafs III. i. i. 6. A girl about
eighteen, after wearing a mercurial girdle to cure the itch, acquired
the Chorea St, Viti in fo univerfal a manner, that her fpeech became
affected as well as her limbs ; and there was evidently a difunion of
the common trains of ideas ; as the itch was ftill among the younger
children of the family, fhe was advifed to take her fifler as a bed-
fellov/, and thus received the itch again ; and the dance of St. Vitus
gradually ceafed. See Clafs II. i. 5. 6.

M. M. Give the patient the itch again. Calomel a grain every
night, or fublimate a quarter of a grain twice a day for a fortnight.
Steel. Bark. Warm-bath. Cold-bath. Opium. Venefediion
once at the beginning of the difeafe. Eledlricity. Perpetual flow
and repeated efforts to move each limb in the defigned direftion, as ia
the titubatio linguae above defcribed.

3. Rjfus. Laughter is a perpetual interruption of voluntary exer-
tion by the interpofltion of pleafurable fenfation ; which not being
checked by any important confequences rifes into pain, and requires
to be relieved or moderated by the frequent repetition of voluntary
exertion. See Sedl. XXXIV. 1.4. and Clafs III. i. 1.4. and IV. i.

4. Tremo^t

Class IV. 2. 3. DISEASES OF ASSOCIATION. 507

4. Tremor ex t'rd. The trembling of the limbs from anger. The
interruption of the voluntary aflbciations of motions by anger, origi-
nates from too great a part of the fenforial power being exerted ou
the organs of fenfe ; whence the mufcles, which ought to fupport
the body upright, are deprived of their due quantity, and tremble
from debility. See Clafs III. 2. i. i.

5. Rubor ex ird. Rednefs from anger. Anger is an excefs of aver-
fion, that is of voluntarity not yet employed. It is excited by the
pain of offended pride ; when it is employed it becomes outrage,
cruelty, infanity. The cutaneous capillaries, efpecially thofe of the
face, are more mobile, that is, more eafily excited into increafed ac-
tion, or more eafily become torpid, from lefs variation of fenforial.
power, than any other parts of the fyflem, which is owing to their
being perpetually fubjedl to the viciffitudes of heat and cold, and of
extenfion and corrugation. Hence, when an excefs of voluntarity
exifts without being immediately expended in the aflions of the large
mufcles, the capillary arteries and glands acquire more energetic ac-
tion, and aflufhed Ikin is produced, with increafed fecretion of per-
fpirable matter, and confequent heat, owing to the paufe or inter-
ruption of voluntary aftion ; and thus the alliens of thefe cutaneous
vefTels become affociated between the irafcent ideas and irafcent muf- ■
cular actions, which are thus for a time interrupted.

6. Rubor crimtnatl. The bluihing of accufed people, whether
guilty or not, appears to be owing to circumftances fimilar to that of
anger J for in thefe fituations there is always a fuddea voluntarity, or
wifh, of clearing their chara6lers arifes in the mind of the accufed
perfon ; which, before an opportunity is given for it to be expended
on the large mufcles, influences the capillary arteries and glands, as
in the preceding article. Whence the increafed aftions of the capil-
laries, and the confequent rednefs and heat, become exerted between

3 T 2 the

5o8 DISEASES OF ASSOCIATION. ClassIV. 2. 3.

the voluntary ideas of felf-defence, and the mufcular a£lions neceffary
for that purpofe; which laft are thus for a tinie interrupted or delayed.

Even in the blufli of modefty or baflifulnefs there is a felf-condem-
nation for feme fuppofed defe6t or indecorum, and a fudden volunta-
rity, or wifh, of felf-defence ; which not being expended in a£lions
of the laro-er mufcles excites the capillaries into adion ; which ia
thefe fubjeds are more mobile than in others.

The blufti of young girls on coming into an aflembly room, where
they expeft their drefs, and fteps, and manner to be examined, as in
dancing a minuet, may have another origin ; and may be confidered
as a hot fit of returning confidence, after a previous cold fit of fear.

7. Tard'itas paralytica. By a ftroke of the palfy or apoplexy it
frequently happens, that thofe ideas, which were aflbciated in trains,
whofe firft link was a voluntary idea, have their connexion diflevered ;
and the patient is under the neceffity by repeated efforts flowly to re-
new their affociations. In this fituation thofe words, which have the
feweft other words aflbciated with them, as the proper names of per-
fons or places, are the moft difficult to recoiled. And in thofe efforts
of recolledion the word oppofite to the word required is often pro-
duced, as hot for cold, winter for fummer, which is owing to our
aifociating our ideas of things by their oppofites as well as by their
fimiUtudes, and in fome in fiances perhaps more frequently, or more
forcibly. Other paralytic patients are liable to give wrong names to
external objeds, as ufing the word pigs for flicep, or cows for horfes;
in this cafe the affociation between the idea of the animal and the
name of it is diffevered ; but the idea of the clafs or genus of the thing
remains ; and he takes a name from the firfl: of the fpecies, which
prefents itfelf, and fometimes can corred himfelf, till he finds the
true one.

8. 'farditasfenUis. Slownefs of age. The difficulty of affociating

ideas

Class IV. 2. 3. DISEASES OF ASSOCIATION. 509

ideas increafes with our age ; as may be obferved from old people for-
getting the bufinefs of the laft hour, unlefs they imprefs it flrongly,
or by frequent repetition, though they can well recollefl the tran-
fadtions of their youth. I faw an elderly man, who could reafon
with great clearnefs and precifioii and in accurate language on fub-
je£lsj which he had been accuftomed to think upon ; and yet did not
know, that he had rang the bell by his fire-fide in one minute after-
wards ; nor could then recoUefl the objedl he had wanted, when his
fervant came.

Similar to this is the difficulty which old people experience in
learning new bodily movements, that is, in aflbciating new mufcular
adions, as in learning a new trade or manufadlury. The trains of
movements, which obey volition, are the laft which we acquire;
and the firft, which are difaflbciated.

ORDO

510 DISEASES OF ASSOCIATION, Class IV. 2. 4.

ORDO II.

Decreafed AJfociate Motions. ,

GENUS IV.
Catenated with External Influences,

As the difeafes, which obey folar or lunar periods, commence with
torpor or inaftivity, fuch as the cold paroxyfms of fevers, the torpor
and confequent pain of hemicrania, and the pains which precede the
fits of epilepfy and convulfion, it would feem, that thefe difeafes are
more generally owing to the diminution than to the excefs of folar or
lunar gravitation; as the difeafes, which originate from the influ-
ence of the matter of heat, are much more generally in this country
produced by the defe6l than by the excefs of that fluid.

The periodic returns of io many difeafes coincide with the diurnal,
monthly, and annual rounds of time ; that any one, who would deny
the influence of the fun and moon on the periods of quotidian, ter-
tian, and quartan fevers, muft deny their effedl on the tides, and on
the feafons. It has generally been believed, that folar and lunar ef-
fect was exerted on the blood ; which was thus rendered more or
lefs ftimulant to the fyflem, as defcribed in Se6l. XXXII. 6. But as
the fluid matter of gravitation permeates and covers all things, like
the fluid matter of heat ; I am induced to believe, that gravitation
adts in its medium ftate rather as a caufa fine qua non of animal mo-
tion, like heat ; which may diforder the fyflem chemically or me-
chanically, when it is diminifhed ; but may neverthelefs Simulate it,
when increafed, into animal exertion.

4. Without

Class IV. 2. 4. DISEASES OF ASSOCIATION. 3 r i

Without heat and motion, which fome philofophers frill believe to
be the fame thing, as they fo perpetually appear together, the particles
of matter would attract and move towards each other, and the whole
univerfe freeze or coalefce into one folid mafs. Thefe therefore coun-
teracSl the gravitation of bodies to one center; and not only prevent
the planets from falling into the fun, but become either the efficient
caufes of vegetable and animal life, or the caufes without which hfe
cannot exift j as by their means the component particles of matter are
enabled to Aide over each other with all the various degrees of fluidity
and repulfion.

As the attradion of the moon countervails or diminiHies the ter-
rene gravitation of bodies on the furface of the earth ; a tide rifes on
that fide of the earth, which is turned towards the moon ; and fol-
lows it, as the earth revolves. Another tide is raifed at the fame
time on the oppofite fide of the revolving earth ; which is owing to
the greater centrifugal motion of that fide of the earth, which coun-
teracts the gravitation of bodies near its furface. For the earth and
moon may be confidered as two cannon balls of different fizes held
together by a chain, and revolving once a month round a common
center of gravity between them, near the earth's furface ; at the fame
time that they perform their annual orbits round the fun. Whence
the centrifugal force of that fide of the earth, which is fartheft from
this center of motion, round which the earth and moon monthly re-
volve, is confiderably greater, than the centrifugal force of that fide
of the earth, which is. neareft it; to which (hould be added, that
this centrifugal force not only contributes to diminifh the terrene gra-
vitation of bodies on the earth's iurface on that fide furtheft from this
center of motion, but alfo to increafe it on that fide, which is
neareft it.

Another circuraftance, which tends to raife the tide on the part of
the earth's furface, which is moft diftant from the moon, is, that the
attradioji of the moon is lefs on that part of the ocean, than it is on

the

512 DISEASES OF ASSOCIATION. Class IV. 2. 4.

the other parts of the earth. Thus the moon may be fuppofed to at-
tradl the water on the fide of the earth neareft it with a power equal
to three; and to attradl the central parts of the earth with a power
equal to two; and the water on the part of the earth moft diftant
fr6m the moon with a power only equal to one Hence on the
fide of the earth moft diftant from the moon, the moon's attrac-
tion is lefs, and the centrifugal force round their common center of
motion is greater ; both which contribute to raife the tides on that
fide of the earth. On the fide of the earth neareft the moon, the
moon's attraction is fo much greater as to raife the tides ; though the
centrifugal force of the furface of the earth round their common cen-
ter of motion in fome degree oppofes this efFe£l.

On thefe accounts, when the moon is in the zenith or nadir, the
o-ravitation of bodies on the earth's furface will be greateft at the two
oppofite quadratures ; that is, the greateft gravitation of bodies on the
earth's furface towards her center during the lunar day is about fix
hours and an half after the fouthing, or after the northing of the
moon.

Circumftances fimllar to thefe, but in a lefs degree, muft occur in
refpeil to the folar influence on terreftrial bodies ; that is, there muft
be a diminution of the gravity of bodies near the earth's furface at
noon, when the fun is over them ; and alfo at midnight from the
o-reater centrifugal force of that fide of the earth, which is moft dif-
tant from the center, round which the earth moves in her annual
orbit, than on the fide neareft that center. Whence it Ukewife fol-
lows, that the gravitation of bodies towards the earth is greateft about
fix hours after noon, and after midnight.

Now when the fun and moon have their united gravitation on the
fame fide of the earth, as at the new moon; or when the folar attrac-
tion coincides with the greater centrifugal motion of that fide of the
earth, which is furtheft diftant from the moon, as at the full moon ;
and when this happens about noon or midnight, the gravitation of
7 terrene

Class IV. 2. 4. DISEASES OF ASSOCIATION. 513

terrene bodies towards the earth will be greater about fix hours after
noon, and after midnight, than at any other part of the lunar period;
"becaufe the attra6lion of both thefe luminaries is then exerted on thofe
fides of the earth over which they hang, which at other times of the
month are more or lefs exerted on other parts of it.

Laftly, as heat and motion counteract the gravitation of the par-
ticles of bodies to each other, and hence become either the efficient
caufes of vegetable and animal life, or the caufes without which life
cannot exift, it feems to follow, that when our gravitation towards
the earth's center is greateil:, the powers of life fhould be the leaft ;
and hence that thofe difeafes, which begin with torpor, fliould occur
about fix hours after the folar or lunar noon, or about fix hours after
the folar or lunar midnight ; and this moft frequently about fix hours
after or before the new or full moon ; and efpecially when thefe
happen at noon or at midnight ; or laftly, according to the combina-
tion of thefe powers in diminifliing or increafing the earth's attradlioa
to bodies on its fur face.

The returns or exacerbations of many fevers, both irritative and
inflammatory, about fix in the evening, and of the periodic cough
defcribed in Sed. XXXVI. 3. 9. countenance this theory. Tables
might be made out to fhew the combined powers of the fun and
moon in diminiftiing the gravitation of bodies on the earth's furface,
at every part of their diurnal, monthly, and annual periods ; and
which might facilitate the elucidation of this fubjedl. But I am well
aware of the- difficulty of its application to difeafes, and hope thefe
conjedlures may induce others to publifli more numerous obfervations,
and more conclufive reafouings.

VoL.IL ' 31; SPECIES.

p4. DISEASES OF ASSOCIATION. Class IV. z, 4,

SPECIES.

I. Somrn periodus. The periods of fleeplng and of waking are
fhortened or prolonged by fo many other circumftances in animal life,
befides the minute difference between diurnal and noilurnal folar gra-
vitation, that it can fcarcely be afcribed to this influence. At the
fame time it is curious to obferve, that vegetables in refpefh to their
times of fleeping more regularly obferve the hour of the day, than
the prefence or abfence of light, or of heat, as may be feen by con-
fulting the calendar of Flora. Botanic Garden, Part II. Canto 2,
3. 165. note.

Some difeafes, which at firft fight might be fuppofed to be infl^u.-
enced by folar periods, feem to be induced by the increafing fenfibi-
lity of the fyftem to pain during our fleeping hours ; as explained in
Sedl. XVIII. 15. Of thefe are the fits of afthma, of fome epilepfies,,
and of fonae hajmoptoes y all which diifturb the patient after fome
hours fleep, and are therefore to be afcribed to the increafe of our
dormant fenfibility. There may likewife be fome doubt, whether
the commencement of the pain of gout in the foot, as it generally
makes its attack after fleep, fliould be afcribed to the increafed fen-
fibility in fleep, or to folar influence ? - ^'"

M. M. When afthmatic or epileptic fits or hasmoptoe occur after a
certain number of hours of fleep, the patient fliould be forcibly awak-
ened before the expected time by an alarm clock, and drink a cup of
chocolate or lemonade. — Or a grain of opium fliould be given at going
to bed. — In one cafe to prevent the too great increafe of feniibility by
fliortening the time of fleep ; and in the other by increafing the irri-
tative motions, and expending by that means a part of the fenforial
power.

2.' Stud'n

CLAS5 IV. 2. 4. DISEASES OF ASSOCIATION. 515

2. Studii inanh per'wdus. Clafs III. 1.2.2. The cataleptic fpafm
which preceded the reverie and fomnambulation in the patient, whofe
cafe is related in SecSl. XIX. 2. occurred at exa6lly the fame hour,
which was about eleven in the morning for many weeks ; till thofc
periods were difturbed by large dofes of opium ; and raufl: therefoift
be referred to fome efFe6t of folar srravitation. In the cafe of Mafter A,
Se6l. XXXIV. 3. as the reverie began early in the morning during
flcep, there may be a doubt, whether this commenced with torpor ot
fome organ catenated with folar gravitation ; or was caufed by the ex-
igence of a previous torpid part, which only became fo painful as to
excite the exertions of reverie by the perpetual increafe of fenfibility
during the continuance of fleep, as in fome fits of epilepfy, afthnia,
and h^emoptoe mentioned in the preceding article.

3. Hemicraniae periodus. Periods of hemicrania. Clafs IV. 2. 2. S.
The torpor and confequent pain of fome membranes on one fide of
the head, as over one eye, is frequently occafioned by a decaying
tooth, and is liable to return every day, or on alternate days at folar
or lunar periods. In this cafe large quantities of the bark will fre-
quently cure the difeafe, and efpecially if preceded by venefecStion and
a briik cathartic ; but if the offending tooth can be detected, the mofl
certain cure is its extra(5lion. Thefe partial head-achs are alfo liable
to return at the greater lunar periods, as about once a month. Five
drops from a two-ounce phial of a faturated folution of arfenic twice
a day for a week or two have been faid to prevent the returns of this
difeafe. See a Treatife on Arfenic by Dr. Fowler, of York. Strong
errhines have alfo been recommended.

4. Epilepjie^ dolor ificce perlodus. Clafs III. i. i. 8. The pain
which induces after about an hour the violent convulfions or infanity,
which conftitute the painful epilepfy, generally obferve folar diurnal
periods for four or five weeks, and are probably governed by folar and

3 U 2 lunar

5x6 DISEASES OF ASSOCIATION. Class IV. 2.4.

lunar times in refped to their greater periods ; for I have obferved-
that the daily paroxyfms, unlefs difturbed by large dofes of opium,,
recur at very nearly the fame hour, and after a few weeks the pati-
ents have recovered to relapfe again at the iiiterval of a few i-nouths.
But more obfervations are wanted upon this fubjedt, which- might be
of great advantage in preventing the attacks of this difeafe j, as much;
lefs opium given an hour before its expedled daily return will pre-
vent the paroxyfm^ than is neceilary to cure it, after it has com-
menced..

5. Convulfionis dolorificce periodus. Clafs III. 1..1. 6. The pains>
which produce thefe convulfions, are generally left after rheumatifm,
and come on when the patients are become warm in bed, or have
been for a fhort time afleep, and are therefore perhaps rather to be
afcribed to the increafing fenfibility of the lyftem daring fleep, thaii'
to folar diurnal periods, as in Species firft and. fecond of this Genus.

6. Tuffis periodlcce periodus. Periodic cough, Clafs IV. 2. i. 9. re-
turns at exa£l folar periods ; that defcribed in Sed. XXXVI. 3. ^,.
recurred about feven in the afternoon for feveral weeks, rill its periods
were difturbed by opium, and then it recurred at eleven at night for
about a week, and was then totally deftroyed by opium given in.
very large quantities, after having been previoufly for a icw days.
omitted..

7. Catamen'tce periodus. Periods of menftruation. The corre-
fpondence of the periods of the catamenia with thofe of the moon was
treated of in Se£l. XXXIL 6. and can admit of no more doubt, than:
that the returns of the tides are governed by lunar influence. But
the manner in which this is produced, is lefs evident ; it has com-
monly been afcribed to fome effed of the lunar gravitation on the cir-
culating blood, as mentioned in Sed. XXXII. 6. But it is mors

analogous.

Class IV. 2.4. DISEASES OF ASSOCIATION. 51;

analogous to other animal phenomena to fuppofe that the lunar gravi-
tation immediately affe£ls the folids by its influx or ftlmulus. Which
we believe of the fluid element of heat, in which we are equally im-
merfed ; and of the eleiSlrie fluid, which alfo furrounds and pervades
us. SeeSed.XXXVI. 2. 3.

If the torpor of the uterine veins, which induces the monthly peri-
ods of the catamenia, be governed by the increafe of terrene gravita-
tion ; that is, by the deficiency of the counter-influence of folar and
lunar gravitation ; why does not it occur moft frequently when the
terrene gravitation is the greateft, as about fix hours after the new
moon, and next to that at about fix hours after the full moon ? This
queftion has its diflSculty; firft, if the terrene gravitation be greateft
about fix hours after the new moon, it muft become lefs and lefs
about the lame time every lunar day, till the end of the firft quarter,
whea it will be the leafl: ; it muft then increafe daily till the full.
After the full the terrene gravitation muft again decreafe till the end
of the third quarter, when it will again be the leaft, and muft in-
creafe again till the new moon ; that is, the folar and lunar counter-
gravitation is greateft, when thofe luminaries are vertical, at the new
moon, and full moon, and leaft about fix hours afterwards. If it was
known, whether more menftruations occur about fix hours after the
moon is in the zenith or nadir ; and in the fecond and fourth quarters
of the moon, than in the firft and third ; fome light would be throv/n
on this fubjedt ; which muft in that refped wait for future obferva-
tions--

Secondly, if the lunar influence produces a very fmall deo-ree of
quiefcence, fuppofe of the uterine veins, at firft ; and if that recurs
at certain periods, as of lunar days, or about 25 hours, even with lefs
power to produce quiefcence than at firft ; yet the quiefcence will
daily increafe by the acquired habit adling at the fame time, as ex-
plained in Se£t. XII. 3. j. till at length fo great a degree of quiefcence
will be induced as to caufe the inadion of the veins of the uterus, and

confeq^uent

5i8 DISEASES OF ASSOCIATION. Class IV. 2.4.

confequent venous haemorrhage. See Se6l. XXXII. 6. Clafs I. 2. i.
1 1. IV. I. 4. 4. See the introdudlion to this Genus.

,8. Hccjno7'rhoidis periodus. The periods of the piles depend on the
torpor of the veins of the redlum, and are believed to recur nearly at
monthly intervals. See Se£l. XXVII. 2. and Clafs I. 2. 1.6.

9. Podagra periodm. The periods of gout in fome patients recur
at annual intervals, as, in the cafe related above in Clafs IV. 1.2. 15.
in which the gouty paroxyfm returned for three fucceflive years on
nearly the fame day of the month. The commencement of the pain
of each paroxyfm is generally a few hours after midnight, and may
thence either be induced by diurnal folar periods, or by the increafing
fenfibility during fleep, as mentioned in the f rft fpecies of this genus.

10. Ery/ipelatis periodus. Some kinds of eryfipelas which probably
originate from the alTociation of the cutaneous veflels with a difeafcd
liver, occur at monthly periods, like the hsemorrhois or piles j and
others at annual periods like the gout ; as a torpor of fome part I fup-
pofe always precedes the eryfipelatous inflammation, the periods
Ihould accord with the increafing influence of terrene gravitation, as
defcribed in the introdu6tion to this Genus, and in Species the feventh
of it. Other periods of difeafes referable to folar and lunar influence
are mentioned in Seft. XXXVI. and many others will probably be
difcovered by future obfervation.

11. Febrium periodus. Periods of fevers. The commencement of
the cold fits of intermittent fevers, and the daily exacerbations of
other fevers, fo regularly recur at diurnal folar or lunar periods, that
it is impofilble to deny their conneftion with gravitation ; as explained
in Se(fl. XXXVI. 3. Not only thefe exacerbations of fever, and their
remiffions, obey the diurnal folar and lunar periods ; but the prepara-

4 tory

Class IV. 2.4. DISEASES OF ASSOCIATION. 519

tory circumft nces, which introduce fevers, or which determine their
crififes, appcir to be governed by the parts of monthly lunar periods,
and of folat- annual ones. Thus the variolous fever in the natural
fmall-pox commences on the 14th day, and in the inoculated fmall-
pox- on the feventh day. The fever and eruption in the diftindt kind
take up another quarter of a lunation, and the maturation another
quarter. ^

The fever, wh^ch is termed canine madnefs, or hydrophobia, is
believed to commence near the new or full moon ; and, if the caufe
is not then great enough to bring on the difeafe, itfeems to acquire
fome ftrength, or to lie dormant, till another, or perhaps more
powerful lunation calls it into a£tion. In the fpring, about three or
four years ago, a mad dog very much worried one fwine confined in
a fty, and bit another in the fame fly in a lefs degree ; the former
became mad, refufed his meat, was much convulfed, and died ia
[ about four days ; this difeafe commenced about a month after the bite»
The other fwine began to be ill about a month after the iirfl, and
died in the fame manner.

ORDO

530 DISEASES OF ASSOCIATION, Class IV. 3. u

OR DO m.

Retrograde ^Jfociate Motions.

GENUS I.
Catenated 'with Irritative Motions^

Those retrograde aflbciate motions, the firfl links of which arc
catenated with irritative motions, belong to this genus. All the re-
trograde motions are confequent to debility, or inadlivity, of the or-
gan ; and therefore properly belong to the genera of decreafed adtions
both in this and the former clafles.

SPECIES,

I. Diahcetes irrltata. When the abforbents of the inteflines are
ftimulated too flrongly by fpirit of wine, as in the beginning of
drunkennefs, the urinary abforbents invert their motions. The fame
happens from worms in the inteftines. In other kinds of diabetes
may not the remote caufe be the too ftrong adlion of the cutaneous
abforbents, or of the pulmonary ones ? May not in fuch cafes oil ex-
ternally or internally be of fervice ? or warm bathing for an hour at a
time ? In hyfteric inverfions of motion is fome other part too much
ftimulated ? or pained from the want of flimulus ?

2. Sudi)r frigtdtis in qjihmate. The caufe of the paroxyfms of hu-
snoral afthma is not well underflood ; I fuppofe it to be owing to a
torpidity or inaction of the abforbents belonging to the pulmonary

' veflels.

Class IV. 3. r. DISEASES OF ASSOCIATION. 521

veffels, as happens probably to other vifcera at the commencement of
intermittent fevers, and to a confequent accumulation of fluids in
them ; which at length producing great irritation or uneafy fenfatlon
caufes the violent efforts to produce -the abforption of it. The
motions of the cutaneous abforbent veffels by their aflbciation
with thofe of the pulmonary ones become retrograde, and effufe
upon the fkin a fluid, which is faid to be vifcid, and which adheres
in drops.

A few days ago I faw a young man of delicate conftitutlon in what
was called a fit of the aflhma j he had about two months before had a
peripneumony, and had been ever fince fubjecSt to difficult refpiration
on exertion, with occafional palpitation of his heart. He was now
feized about eight at night after fome exertion of mind in his bufinefs
with cold extremities, and difficulty of breathing. He gradually be-
came worfe, and in about half an hour, the palpitation of his heart
and difficult refpiration were very alarming ; his whole fkin was cold
and pale, yet he did not fhudder as in cold paroxyfm of fever; his
tongue from the point to the middle became as cold as his other ex-
tremities, with cold breath. He feemed to be in the a£t of dying,
except that his pulfe continued equal in time, though very quick*
He loft three ounces of blood, and took ten drops of laudanum with
mufk and fait of hartffiorn, andrecovered in an hour or two without
any cold fweat.

There being no cold fweat feems to indicate, that there was no
accumulation of fcrous fluid in the lungs; and that their inadlivity,
and the coldnefs of the breath, was owing to the fympathy of the
air-cells with fome diftant part. There was no Ihuddering produced,
feecaufethe lungs are not fenfible to heat and cold; as any one may
obferve -by going from a warm room into a frofty air, and the con-
trary. So the fleam of hot tea, which fcalds the mouth, does not
nffedt the iungs with the fcnfation of heat. I was induced to believe,

Vql. II. 3 X that

522 DISEASES OF ASSOCIATION. Class IV. j.i.

that the whole cold fit might be owing to fuppuratlon in fome part
of the cheft ; as the general difficulty of breathing feemed to be in-
creafed after a few days with pulfe of 120, and other figns of empy-
ema. Does the cold fweat, and the occurrence of the fits of afthma
after fleep, diftinguifh the humoral afthma from the cold paroxyfm of
intermittents, or which attends fuppuration, or which precedes in-
flammation ? — I heard a few weeks afterwards, that he fpit up much
matter at the time he died.

3. Dlabcetes a timore. The motions of the abforbent vefTels of the
neck of the bladder become inverted by their confent with thofe of
the Ikin ; which are become torpid by their reverfe fympathy with
the painful ideas of fear, as in Se£t. XVI. 8. i. whence there is a great
difcharge of pale urine, as in hyfteric difcafes.

The fame happens from anxiety, where the painful fufpenfe is
continued, even when the degree of fear is fmall ; as in young men
about to be examined for a degree at the univerfities the frequency of
making water is very obfervable. When this anxiety is attended with
a fleeplefs night, the quantity of pale urine is amazingly great in fome
people, and the mifturition very frequent.

M. M. Opium. Joy, Confol'ations of friendfhip.

4. 'Diarrhcea a, timore. The abforbent vefTels of the inteftlnes iii^
vert their motions by dired confent with the Ikin; hence many
liquid flools as well as much pale urine are liable to accompany con-
tinued fear, along with coldnefs of the fkin. The immediate caufe of
this is the decreafed fenforial power of alTociation, which intervenes
between the a£tions of the abforbents of the cold fkin, and thofe of
the inteftinal abforbents ; the motions of the latter become on that
account weakened and at length retrograde. The remote caufe is the

torpor

Cr.Ass IV. J. I. DISEx-^SES OF ASSOCIAl'ION. 523

torpor of the veffels of the ikin catenated with the pain of fear, as ex-
plained in Sea. XVI. 8. i.

The capillaries of the fkin confent more generally by dire^; fym-
pathy with thofe of the lower intelHnes, and of the bladder ; but by
reverfe fympathy more generally with thofe of the flomach and upper
inteftines. As appears in fevers, where the hot Ikin accompanies in-
digeftion of the Itomach ; and in diarrhoeas attended with cold extre-
mities.

The remote caufe is the torpor of the Ikin owing to its reverfe
fympathy with the painful fenfual motions, or ideas, of fear ; which
are now aduated with great energy, fo as to deprive the fecond link
of alTociated motions of their due fhare of fenforial power. It is alfo
probable, that the pain of fear itfelf may contribute to exhauft the
fenforial power, even when it produces no mufcular action. See Clafs
IV. 2. 2.

5. Tallow- et tremor a tltnore. A retrograde aflron of the capil-
laries of the Ikin producing palenefs, and a torpor of the mufcular
fibres of the limbs occafioning trembling, are caufed by their re-
verfe aflbciations with the ideas or imaginations of fear ; which are
now actuated with violent energy, and accompanied with great
pain. The caufe of thefe aflbciations are explained in Se<Sl. XVI.
8. 1.

Thefe torpid adions of the capillaries and mufcles of the limbs are
not caufed immediately by the painful fenfation of fear ; as in that
cafe they would have been increafed and not decreafed aftions, as oc-
curs in anger ; where the painful volition increafes the adtions of the
capillaries, exciting a blufh and heat of the fkin. Whence we may
gain fome knowledge of what is meant by deprefling and excitino-
paffions ; the former confiding of ideas attended with pain, which
pain occafions no mufcular adlions, like the pain of cold head-ach ;

3X2 the

524 DISEASES OF ASSOCIATION. Class IV. 3. u

the latter being attended with volitions, and confequent mufcular ex-
ertions.

That is,^ the pain of fear, and the pain of anger, are produced by
the exertion of certain ideas, or motions of certain nerves of fenfe j
in the former cafe, the painful fenfation of fear produces no mufcular
aftions, yet it cxhaufts or employs fo much fenforial power, that the
whole fyflem a£ls more feebly, or becomes retrograde ; but fome
parts of it mare fo than others, according t'o their early aflbciations
defcribed in Sedl. XVL 8. i. hence the tremor of the limbs, palpitation
of heart, and even fyncope. In anger the painful volition produces vio-
lent mufcular a£lions ; but if previous to thefe any deliberation oc-
curs, a flufhed countenance fometimes, and a red (kin, are produced
by this fuperabundance of volition exerted on the arterial fyftem ;
but at other times the ikin becomes pale, and the legs tremble, from
the exhauftion or expenditure of the fenforial power by the painfu
volitions of anger on the organs of fenfe, as by the painful fenfations
of fear above mentioned, '

Where the paffion of fear exifts in a great degree, it exhaufls or
expends fo much fenforial power, either {imply by the pain which
attends it, or by the violent and perpetual excitement of the terrific
imaginations or ideas, that not only a cold and pale Ikin, but a retro-
grade motion of the cutaneous abforbents occurs, and a cold fweat
appears upon the whole furface of the body, which probably fome-
times increafes pulmonary abforption ; as in Clafs II. i. 6. 4. and as
in the cold fweats, which attend the paroxyfms of humoral afthma.
Hence anxiety, which is a continued pain of fear, fo univerfally de-
bilitates the conftitution as to occafion a lingering death ; which hap-
pens much more frequently than is ufually fuppofed ; and thefe vic-
tims of continued anxiety are faid to die of a broken hearts Other
kinds of palenefs are defcribed in Clafs I. 2. 2. 2.

M. M, Opium. Wine. Food. Joy,

6. Palpltatio

Class IV. 3. i, DISEASES OF ASSOCIATION. 525

6. Palpltatio cordis a thnore. The palpitation of the heart from
fear is owing to the weak a6lion of it, and perhaps fometimes to
the retrograde exertion of the ventricules and auricles ; becaufe it
feems to be afFeded by its affociation with the capillaries, the adions-
of which, with tbofe of the arteries> and veins, conftitute one great
circle of aflbciate motions. Now when the capillaries of the fkin
become torpid, coldnefs and palenefs fucceed j and with thefe are
affociated the capillaries of the lungSy whence difficult refpiration ;
and with thefe the weak and retrograde adlions of the heart. At
the fame time the abforbents of the fkin, and of the bladder, and of
the inteftines, fometimes become retrograde, and regurgitate their
contents ; as appears by the pale urine in large quantities,- which
attends hyfteric complaints along with this palpitation of the
heart ; and from the cold fweats,. and diarrhoea ; all which, as^
well as the hyfteric complaints, are liable to be induced or attended
by fear.

When fear has flill more violently affeded the fyftem, there have
been inftances where fyncope, and fudden death, or a total Hoppage
of the circulation, have fucceeded : in thefe laft cafes, the pain of
fear has employed or exhaufted the whole of the fenforial power,.
fo that not only thofe mufcular fibres generally exerted by volition
ceafe to a6t, whence the patient falls down ; and thofe, whicb
conftitute the organs of fenfe, whence fyncope ;> but laftly thofe^
which perform the vital motions, become deprived- of fenforial power,
and death enfues. See Clafs I. 2. 1.4. and I. 2. i, 10. Similar ta
this in fome epileptic fits the patient firft fuddenly falls down, with-
out even endeavouring to fave himfelf by his hands before the con-
vulfive motions come on. r In this cafe the great exertion of fome
fmall part in eonfequence of great irritation or fenfatiou exhaufts the
whole fenforial power, which was lodged in the extremities of the
locomotive nerves, for a Ihort time, as in fyncope ; and as foon as
7 thelc

526 DISEASES OF ASSOCIATION. Class IV. 3. i.

thefe mufcles are again fupplled, convulfions fuperveue to relieve th e
painful fenfation. See Clafs III. i. i. 7.

7. Ahorth a thn&re. Women mifcarry much more frequently
from a fright, than from bodily injury. A torpor or retrograde
motion of the capillary arteries of the internal uterus is probably
the immediate caufe of thefe mifcarriages, owing to the affociation
of the aftions of thofe veflels with the capillaries of the ikin,
which are rendered torpid or retrograde by fear. By this contrac-
tion of the uterine arteries, the fine vefTels of the placenta, which
are inferted into them, are detruded, or otherwife fo afFeded,
that the placenta feparates at this time from the uterus, and the
fetus dies from want of oxygenation. A flrong young woman,
in the fifth or fixth month of her pregnancy, who has fince borne
many children, went into her cellar to draw beer ; one of the
fervant boys was hid behind a barrel, and flarted out to furprife her,
believing her to be the maid-fervant ; (he began to flood immediately,
and mifcarried in a few hours. See Se(5l. XXXIX. 6« 5. and Clafs L
z. I. 14.

8. Hyjleria a thnore. Some delicate ladies are liable to fall
into hyfteric fits from fudden fright. The periftaltic motions of
the bowels and flomach, and thofe of the oefophagus, make a part
of the great circle of irritative motions with thofe of the Ikin, and
many other membranes. Hence when the cutaneous veflels be-
come torpid from their reverfe fympathy with the painful ideas of
fear ; thefe of the bowels,, and fliomach, and oefophagus, become
firft torpid by direct fympathy with thofe of the Ikin, and then
-feebly and ineffedually invert the order of their motions, which
■conftitutes a paroxyfm of the hyfl:eric difeafe. See Clafs I. 3. i. 10.
Thefe hyfteric paroxyfms -are fometimes followed by convulfions,,

which

Class IV. 3. i. DISEASES OF ASSOCIATION. 327

which belong to Clafs III. as they are exertions to relieve pain ;
and fometimes by death. See Species 9 of this Genus, and Clafs I.
2. I. 4.

Indiseftion from fear is to be afcribed in the fame manner to the
torpor of the ftomach, owing to its aflbciation with the fkin. As ia
Clafs IV. 1.2.5. IV. 2. I.

A hJUxi

! ■. L ,.i;

■J'^ffi hZ'l.VA-'':

ORDO

528 DISEASES OF ASSOCIATION. ClassXV. 3.2.

ORDO III.

'Rjstrograde AJfociate Motions.

GENUS 11.
Catenated with Senjit'ive Motions,,

SPECIES.

1. Natifca idcalis. Naufea from difguftful ideas, as from nau-
feous ftories, or difguftful fights, or fmells, or taftes, as well as vo=
miting from the fame caufes, confifts in the retrograde actions of the
lymphatics of the throat, and of the oefophagus, and ftomach ; which
are afTociated with the difguftful ideas, or fenfual motions of fight,
or hearing, or fmell, or tafle ; for as thefe are decreafed motions of
the lymphatics, or of the oefophagus, or flomach, they cannot im-
mediately be excited by the fenforial power of painful fenfation, as in
that cafe they ought to be increafed motions. So much fenforial
power is employed for a time on the difguftful idea, or expended in
the produdion of inaftive pain, which attends it, that the other
parts of the aflbciated chain of adion, of which this difguftful idea is
now become a link, is deprived of their accuftomed fhare ; and there-
fore firft flop, and then invert their motions. Owing to deficiency of
fenforial power, as explained more at large in Se6l. XXXV. 1. 3.

2. Naufea a conceptu. The naufea, which pregnant women are
fo fubjeiS to during the firft part of geftation, is owing to the reverfe
fympathy between the uterus and ftomach, fo that the increafed ac-
tion of the former, excited by the ftimulus of the growing embryon,

which

Class IV. 3. 2. DISEASES OF ASSOCIATION. 529

which I believe is fometimes attended with fenfation, produces de-
creafed a6lions of the latter with the difagreeable fenfation of ficknefs
with indigeftion and confequent acidity. When the fetus acquires
fo much mufcular power as to move its limbs, or to turn itfelf,
which is called quickening, this ficknefs of pregnancy generally
ceafes. " ■

M. M. Calcined magnefia. Rhubarb. Haifa grain of opium twice
a day. Recumbent pofture on a fofa.

3. Fomitio vertiginofa. Sea-ficknefs, the irritative motions of vi-
. fion, by which we balance ourfelves, and preferve our perpendicula-
rity, are difturbed by the indiftinftnefs of their objeils ; which is
either owing to the fimilarity of them, or to their diftance, or to
their apparent or unufual motions. Hence thefc irritative motions of
vifion are exerted, with greater energy, and are in confequence at-
tended with fenfation ; which at firft is agreeable, as when childi'en
fwing on a rope ; afterwards the irritative motions of the flomach,
and of the abforbent veffels, which open their mouths into it, be-
come inverted by their affociations with them by reverfe fym-
pathy.

For the adlion of vomiting, as well as the difagreeable fenfation of
iicknefsj are (hewn to be occafioned by defedt of the fenforial power ;
which in this cafe is owing to the greater expenditure of it by the
fenfe of vifion. On the fame account the vomiting, which attends
the paffage of a flone through the ureter, or from an inflammation of
the bowels, or in the commencement of fome fevers, is caufed by
the increafed expenditure of the fenforial power by the too great ac-
tion of fome links of the affociations of irritative motions ; and there
being in confequence a deficiency of the quantity required for other
links of this great catenation.

, It muft be obferved, that the expenditure of fenforial power by
Vol. IL 3 Y the

530 DISEASES OF ASSOCIATION. Class IV. 3. 2.

the retinas of the eyes is very great ; which may be eftimated by the
perpetual ufe of thofe organs during our waking hours, and during
moft of our fleeping ones ; and by the large diameters of the two op-
tic nerves, which are nearly the fize of a quill, or equal to fome of
the principal nerves, which ferve the limbs.

4. Fomitio a calculo in Jiretere. The a£lion of vomiting in confe-
quence of the increafed or decreafed actions of the ureter, when a
ftone lodges in it. The natural adions of the ftomach, which confifl
of motions fubje6t to intermitted irritations from the fluids, which
pafs through it, are affociated v/ith thofe of the ureter ; and become
torpid, and confequently retrograde, by intervals, when the adlions
of the ureter becomes torpid owing to previous great ftimulus from
the ftone it contains ; as appears from the vomiting exifting when
the pain is leaft. When the motions of the ureter are thus leffened,
the fenforial power of affociation, which ought to aduate the fto-
mach along with the fenforial power of irritation, ceafes to be excited
into a£tion ; and in confequence the actions of the flomach become
lefs energetic, and in confequence retrograde.

For as vomiting is a decreafed aftion of the ftomach, as explained
in Sedl. XXXV. i. 3. it cannot be fuppofed to be produced by the
pain of gravel in the ureter alone, as it fhould then be an increafed ac-
tion, not a' decreafed one.

The perpetual vomiting in ileus Is caufed in like manner by the
defective excitement of the fenforial power of aflbciation by the bowel,
which is torpid during the intervals of pain ; and the flomach fym-
pathizes with it. See Enteritis, Clafs II. i. 2. 11. Does this fymp-
tom of vomiting indicate, whether the difeafe be above or below the
valve of the colon ? Does not the fofter pulfe in fome kinds of ente-
ritis depend on the fympathy of the heart and arteries with the ficknefs
of the flomach ? See Ileus and Cholera,

6 Hence

Class IV. 3. 2. DISEASES OF ASSOCIATION. 531

Hence this ficknefs, as well as the ficknefs iii fome fevers, can-
not be efteemed an effort of nature to diflodge any offenfive material ;
but like the fea-ficknefs defcriBed above^ and in Sedc. XX. 4. is the
confequence of the affociations of irritative or fenfitive motions. See
Clafs I. 1.3. 9.

5. Fomitw ab infultu paralytica. Paralytic afFe<£lions generally com-
mence with vomiting, the fame frequently happens from a violent
blow with a flick on the head ; this curious connection of the brain
and ftomach has not been explained ; as it refembles the ficknefs in
confequence of vertigo at fea, it would feem to arife from a fimilar
caufe, viz. from difturbed irritative or fenfitive affociations,

6. Vhmtth a titlllatlone faucium. If the throat be (lightly tickled
with a feather, a naufea is produced, that is, an inverted adliou
of the mouths of the lymphatics of the fauces, and by dire6l fym-
pathy an inverted a£tion of the flomach enfues. As thefe parts
have frequently been flimulated at the fame time into pleafurable
adion by the deglutition of our daily aliment, their aftions become
ftrongly afTociated, And as all the food, we fwallow, is either moift
originally, or mixed with our moifl faUva in the mouth ; a feather,
which is originally dry, and which in fome meafure repels the
moift faliva, is difagreeable to the touch of the fauces; at the
fame time this naufea and vomiting cannot be caufed by the dif^
agreeable fenfation limply, as then they ought to have been in-
creafed exertions, and not decreafed ones, as fhevvn in Se£lion
XXXV, I. 3, But the mouths of the lymphatics of the fauces
are ftimulated by the dry feather into too great adion for a time,
and become retrograde afterwards by the debility confequent to too
great previous flimulus.

J Y 2 7. Vomhh

532 DISEASES OF ASSOCIATION. Class IV. 3. 2.

7. Fomifio cute fympathetica^ Vomiting is fuccefsfuUy flopped by
the application of a blifter on the back in fome fevers, where the ex-
tremities are cold, and the Ikin pale. It was flopped by Sydenham
by producing a fwcat on the Ikin by covering the head with the bed-
clothes. See Clafs IV. i. i. 3. and Suppl. I. 11. 6.

ORDO

Class IV. 3. 3. DISEASES OF ASSOCIATION, 533

ORDO III.

. Retrograde AJfociate Motions,

GENUS III.

Catenated with Voluntary Motions o

SPECIES.

r. Ruminatio. In the rumination of horned cattle the food is
brought up from the firft ftomach by the retrograde motions of the
flomach and oefophagus, which are catenated with the voluntary
motions of the abdominal mufcles.

2. Vom'itio voluntaria. Voluntary vomiting. Some human fubjeifls-
have been faid to have obtained this power of voluntary adlion over
the retrograde motions of the ftomach and cefophagus, and thus to
have been able to empty their ftomach at pleafure. See Sedt. XXV. 6.
This voluntary aft of emptying the ftomach is pofTeffed by fome birds,,
as the pigeon ; who has an organ for fecreting milk in its ftomach,,
as Mr. Hunter obferved ; and foftens the food for its young by previ-
oufly fvvallowing it ;. and afterwards putting its bill into theirs returns ^
it into their mouths. See Seft. XXXIX. 4. 8. The peHcans ufe a'
ftomach, or throat bag, for the purpofe of bringing, the fifh, which
they catch in the fea to fhore, and then ejeft them, and eat them at
their leifure. See Sedl. XVI. 11. And I am well informed of a
bitch, v.'ho having puppies in a ftable at a diftance from the houfe,
fwallowed the flefh meat, which was given her, in large pieces, and
carrying it immediately to her v/helps, brought it up out of her fto-
mach, and laid it down before. them,.

3. Eru^atio'

534 DISEASES OF ASSOClAtlOk; Class IV. 3. 3.

3. Eru8atto voluntaria. Voluntary eru£lation. Some, who have
weak digeftions, and thence have frequently been induced to eruft the
quantity of air difcharged from the fermenting aliment in their fto-
machs, have gradually obtained a power of voluntary eruftation, and
have been able thus to bring up hoglheads of air from their flomachs,
whenever they pleafed. This great quantity of air is to be afcribed
to the increafe of the fermentation of the aliment by drawing off the
gas as foon as it is produced. See Se6l. XXIII. 4,

ORDO

Class IV, 3. 4. DISEASES OF ASSOCIATION. S2S

ORDO III.

Retrograde AJfociate Motions.

GENUS. IV.

Catenated with External Influences,

SPECIES.

1. Catarrhus periodicus. Periodical catarrh is not a very uncom-
mon difeafe ; there is a great difcharge of a thin faline mucous mate-
rial from the membranes of the noftrils, and probably from the max-
illary and frontal finufes, which recur once a day at exa£l folar periods ;
unlefs it be difturbed by the exhibition of opium ; and refembles the
periodic cough mentioned below. See Clafs T. 3. 2. i. It is probably
owing to the retrograde aftion of the lymphatics of the membranes
affedled, and produced immediately by folar influence.

2. 1'uJJts periodica. Periodic cough, called nervous cough, and
tuffis ferina.. It feems to arife from a periodic retrograde adlion of
the lymphatics of the membrane, which lines the air-cells of the
lungs. And the action of coughing, which is violently for an hour
or longer, is probably excited by the flimulus of the thin fluid thus
produced, as well as by the difagreeable fenfation attending mem-
branous inactivity ; and refembles periodic catarrh not only in its fitu-
ation on a mucous membrane, but in the difcharge of a thin fluid.
As it is partly refl:rainable, it does not come under the name of : con-
vulfion ; and as it is not attended with difficult refpiration, it cannot
be called afthma; it is cured by very large dofes of opium, fee a cafe

and .

536 DISEASES OF ASSOCIATION. Class IV. 3. 4;

and cure in Se£t. XXXVI. 3. 9, fee Clafs IV. 2. 4. 6. and feems im-
mediately to be induced by folar influence,

3. H'ljfer'ia afrigore, Hyfteric paroxyftris are occafioned by what"
ever fuddenly debilitates the iyftem, as fear, or cold, and perhaps
fometimes by external moifture of the air, as all delicate people have
their days of greater or lefs debility, fee Clafs IV. 3. i. 8.

4. Naiifea pluvialis. Sicknefs at the commencement of a rainy fea~
fon is very common among dogs, who affift themfelves by eating the
agroftris canina, or dog's grafs, and thus empty their ftomachs. The
fame occurs with lefs frequency to cats, who make ufe of the fame
expedient. See Sed. XVI. 1 1. I have known one perfon, who from
his early years has always been fick at the beginning of wet weather,
-and ftill continues fo. Is this owing to a fympathy of the mucous
membrane of the ftomach with the mechanical relaxation of the ex-
ternal cuticle by a moifter atmofphere, as is feen in the corrugated
cuticle of the hands of wafhing-women ? or does it fympathize with
the mucous jnembrane of the lungs, which muft be affeded along
with the mucus on its furface by the refpiration of a moifter atmo-
fphere I ■

SUPPLEMENT.

SUPPLEMENT

TO

CLASS IV.

Sympathetic Theory of Fever.

As fever confifts in the increafe or diminution of direct or reverfe
aflbciated motions, whatever may have been the remote caufe of
them, it properly belongs to the fourth clafs of difeafes ; and is in-
troduced at the end of the clafs, that its great difficulties might re-
ceive elucidation from the preceding parts of it. Thefe I fhall en-
deavour to enumerate under the following heads, trufling that the
candid reader will difcover in thefe rudiments of the theory of fever a
nafcent embryon, an infant Hercules, which Time may rear to ma-
turity, and render ferviceable to mankind.

I. Simple fever of two kinds.
II. Compound fever.

III. Termination of the cold fit.

IV. Return of the cold fit.
V. Senfation excited in fever.

VI. Circles of afTociated motions.
VII. Alternations of cold and hot fits.
Vlll. Orgafm of the capillaries.
Vol. II. 3 Z . IX. Torpor

538 THEORY OF FEVER. Sup. I. i,

IX. Torpor of the lungs.
X. Torpor of the brain.
XI. Torpor of the heart and arteries.
XII. Torpor of the ftomach and iateftines,

XIII. Cafe of continued fever explained.

XIV. Termination of continued fever.
XV. Inflammation excited in fever.

XVI. Recapitulation.

I. Simple Fever,

1. When a fmall part of the cutaneous capillaries with their mu-
cous or perfpirative glands are for a fhort time expofed to a colder me-
dium, as when the hands are immerfed in iced water for a minute,
thefe capillary veffels aad their glands become torpid or quiefcent,
owing to the eduflion of the flimulus of heat. The fkin then be-
comes pale, becaufe no blood pafles through the external capillaries ;
and appears fhrunk, becaufe their fides are coUapfed from inaftivity,
not contracted by fpafm ; the roots of the hair are left prominent
from the feceding or fubfiding of the ikui around them j and the pain
of coldnefs is produced.

In this fituation, if the ufual degree of warmth be applied, thefe
veffels regain their aftivity ; and having now become more irritable
from an accumulation of the fenforial power of irritation during their
quiefcence, a greater exertion of them follows, with an increafed glow
of the fkin, and another kind of pain, which is called the hot-ach ;
but no fever, properly fo called, is yet produced ; as this efFedl is not
tiniverfal, nor permanent, nor recurrent.

2. If a greater part of the cutaneous capillaries with their mucous
and perfpirative glands be expofed for a longer time to cold, the tor-
por

Sup. I. I. THEORY OF FEVER. 535

por or quiefcence becomes extended by dire<!il fympathy to the heart
and arteries ; which is known by the weaknefs, and confequent fre-
quency of the pulfe in cold fits of fever.

This requires to be further explained. The movements of the
heart and arteries, and the vi^hole of the circulatory veflels, are in ge-
neral excited into adlion by the tvi'o fenforial powers of irritation, and
of affociation. The former is excited by flimulus, the latter by the
previous aftions of a part of the vital circle of motions. In the above
fituation the capillaries adt weakly from defed of irritation, which is
caufed by deficient flimulus of heat ; but the heart and arteries a£t
weakly from defeat of affociation, which is owing t-o the weak aftion
of the capillaries ; which does not now excite the fenforial power of
aflbciation into adion with fufficient energy.

After a time, either by the apphcation of warmth, or by the in-
creafe of their irritability "owing to the accumulation of the fenforial
power of irritation during their previous quiefcence, the capillary
veffels and glands ad with greater energy than natural ; whence the
red colour and heat of the fkin. The heart and arteries acquire a
greater flrength of pulfation, and continue the frequency of it, owing
to the accumulation of the fenforial power of affociation during their
previous torpor, and their confequent greater affociability ; which is
now alfo more flrongly excited by the increafed adions of the capil-
laries. And thus a fit of fimple fever is produced, which is termed
Febris ii ritativa ; and confifts of a torpor of the cutaneous capillaries
with their mucous and perfpirative glands, accompanied with a torpor
of the heart and arteries ; and afterwards of an increafed adion of all
thefe veffels, by what is termed dired fympathy.

This fever, with ftrong pulfe without inflammation, or febris ir-
ritativa, defcribed in Clafs I. i. i. i. is frequently feen in vernal in-
termittents, as the orgafm of the heart and arteries is then occafioned
by their previous ftate of torpor ; but more rarely I believe exifts in
the type of continued fever, except there be an evident remiffion, or

3 Z 2 approximation

540 THEORY OF FEVER. Sup. I. i.

approximation to a cold fit ; at which time a new accumulation of the
fenlorial power of afl'ociation is produced; which afterwards adluates
the heart and arteries with unnatural vigour ; or unlefs there be fome
flim'ulus perpetually afting on the fyftem, fo as to induce an increafed
fecretion of fenforial power in the brain, as occurs in flight degrees
of intoxication. Since without one or other of thefe circumftances in
continued fevers without inflammation, that is, without the addi-
tional fenforial power of fenfation being introduced, it feems difficult.
to account for the produdlion of fo great a quantity of fenforial power,.
as muil: be necefTary to give perpetual increafe of a6lion to the whok
fanguiferous iyflem.

3. On the contrary, while the cutaneous capillaries with their mu-
cous and perfpirative glands acquire an increafed irritability, as above,
by the accumulation of that fenforial power during their previous
quiefcence, and thus conftitute the hot fit of fever ; if the h-eart and
arteries do not acquire any increafe of aflbciability, but continue in
their {late of torpor, another kind of fimple fever is produced ; which
is generally of the continued kind, and is termed Febris inirritativa ;
which confifts of a previous torpor of the capillaries of the Ikin, and
of the heart and arteries by diredt fympathy with them; and after-
wards of an orgafm or increafed a£lion of the capillaries of the Ikin,
with a decreafed a6lion, or continued torpor, of the heart and arteries
by reverfe fympathy with them. This orgafm of the cutaneous ca-
pillaries, which appears by the blufli and heat of the fkin, is at firffc
owino- to the accumulation of the fenforial power of irritation during
their previous torpid ftate, as in the febris irritata above defcribed ;
bnt which is afterwards fupported or continued by the reverfe fym-
pathy of thefe capillaries with the torpid ftate of the heart and
arteries, as will be further explained in article 8 of this Supple-
ment.

4. The

Sup. I. I. THEORY CF FEVER. 541

4. The renovated a&ivky of the capillaries commences as foon or
fooner than that of the heart and arteries after the cold fit of irritative
fever ; and is not owing to their being forced open by the blood being
impelled into them mechanically, by the renovated a£lion of the heart
and arteries ; for thefe capillaries of the (kin have greater mobility
than the heart and arteries, as appears in the fudden blufh of fliame ;
which may be owing to their being more liable to perpetual varieties
of adlivity from their expofure to the viciffitudes of atmofpheric heat.
And becaufe in inirritative fevers, or thofe with arterial debility, the
capillaries acquire increafed ftrength, as is evinced by the heat of the
Ikin, while the pulfations of the heart and arteries remain feeble.

5. It was faid above, that the cutaneous capillaries, when they
were rendered torpid by expofure to cold, either recovered their ac-
tivity by the reapplication of external warmth ; or by their increafed
irritability, which, is caufed by the accumulation of that fenforial
power during their quiefcence. An example of the former of thefe
may be feen on emerging from a very cold bath ; which produces a
fit of fimple fever ; the cold fit, and confequent hot fit, of which
may be prolonged by continuing in the bath ; which has indeed
proved fatal to fome weak and delicate people, and toothers after
having been much exhaufled by heat and exercife. See Se£l. XXXII.
3. 2. An example of the latter may be taken from going into a bath
of about eighty degrees of heat, as into the bath at Buxton, where
the bather firft feels a. chill, and after ai minute becomes warm,
though he remains in the fame medium, owing to the increafe of ir-
ritability from the accumulation of that fenforial power during the.
fhort time, which the chilnefs continued.

6. Hence fimple fevers are of two kinds ; firfl, the febris irritativa,
or fever with ftrong pulfe ; which confifts of a previous torpor of the
heart, arteries, and capillaries, and a fucceeding orgafm of thofe vef-

fels.

542 THEORY OF FEVER. Sup. I. 2

fels. Secondly, the febris inlrritativa, or fever with weak pulfe,
which confiftsof a previous torpor of the heart, arteries, and capilla-
ries ; and of a fucceeding orgafm of the capillaries, the torpor of the
heart and arteries continuing. But as the frequency of the pulfe oc-
curs both in the fiate of torpor, and in that of orgafnn, of the heart
and arteries ; this conftitutes a criterion to diftingiiifli fever from other
difeafes, which are owing to the torpor of fome parts of the fyftem,
as parefis, and hemicrania.

7. The reader will pleafe to obferve, that where the cutaneous or
pulmonary capillaries are mentioned, their mucous and perfpirative
glands are to be underflood as included ; but that the abforbents be-
longing to thofe fyflems of veflels, and the commencement of the veins,
are not always included ; as thefe are liable to torpor feparately, as in
anafarca, and petechias ; or to orgafm, or increafed adion, as in the
exhibition of ftrong emetics, or in the application of vinegar to the
lips ; yet he will alfo pleafe to obferve, that an increafed or decreafed
adion of thefe abforbents and veins generally occurs along with that
of the capillaries, as appears by the dry Ikin in hot fits of fever ; and
from there being generally at the fame time no accumulation of
venous blood in the cutaneous velTels, which would appear by its
purple colour.

II. CompDwtd Fever.

1. When other parts of the fyftem fympathize with this torpor
_and orgafm of the cutaneous capillaries, and -of the heart and arteries ;
the fever-fit becomes more complicated and dang^erous ; and this in
proportion to the number and confequence of fuch affeded parts.
Thus if the lungs become afFeded, as in going into very cold water,
a fhortnefs of breath occurs .; which is owing to the coUapfe or inac-
8 tivity

Sup. I. 2. THEORY OF FEVER. 543

tivity (not to the adllve coutraiflion, or fpafcn,), of the pulmonary ca-
pillaries ; which, as the lungs are not fenfible to cold, are not fubje<$t
to painful fenfation, and confequent fhuddering, like the Ikin. In
this cafe after a time the pulmonary capillaries, like the cutaneous
ones, zd: with increafed energy ; the breathing, which was before
quick, and the. air thrown out at each refpiration in lefs quantity, and
cool to the back of the hand, oppofed to it, now becomes larger in
quantity, and warmer than natural i which however is not accom-
panied with the fenfation. of heat in the menxbrane, which lines the
air-velTels of the lungs, as in the fkin,

2. One confequence of this increafed heat of- the breath is the in-
creafed evaporation of the mucu& on the tongue and npftrils^ A vifcid
naaterial is fecretfd by thefe, oj-enihranes to prefqrve t.hern moifl and
fupple, far the purpoffs of the fenfe§ of tafte and of fmell, which are
extended beneath thei;r furfaces; this vifcid mucus, when the aqueous
part of it h evapx>.rated by th^ increafed heat of the refpired air, or i$
abfqrbed by the too gr?at aftion of the mucous abforbents, adheres
clofely on thqfe m°-mbranes, asd is not without difficulty to be fepa-
rated from them. This d'rynefs <?f the tongue and noftrils is a cir-
cumftance therefore worthy toi be attended to ; as it fhews the hi"
creafed afti'on of t^iie pulmonary capillaries, and the confequent in-
creafed he^X Qjfithe expiired air j, &nd may t.hu-s indicate, when colder
air {hQuld be admitted to the patient. 5ee Clafs I. 1.3.1. The
middle part pf the tongue becomes dry fooner, and recovers its moif-
ture later, than the edges of it ; beeaufe the currents of refpired air
pals moft over the middle part of it. This however is not the cafe,
when th.edrynefs of the tongue is owing only to the increafed mucous
abforption. When however a, frequent cough attends pulmonary in-
flammation, the edges of the tongue are liable to be as much furred
as the middle of it ; as during the adlion of coughing the middle of
tb-e tongue is depreffed, fo as to form half a cylinder, to give a greater
, aperture

544 THEORY OF FEVER. Sup: I. 2.'

aperture for the emiflioa of air from the larynx j and the edges of it
become thus as much expofed to the currents of air, as the middle
parts of it.

3. When the internal capillaries or glands fympathize with the
cutaneous capillaries; or when any of them are previoufly affeded
with torpor, and the external or cutaneous capillaries are affedled fe-
condarily ; other fymptoms are produced, which render the paroxyfms
of fever ftill more complicate. Thus if the fpleen or pancreas are
primarily or fecondarily afFeded, fo as to be rendered torpid or quief-
cent, they are liable to become enlarged, and to remain fo even after
the extin£lion of the fever-fit. Thefe in fome intermittent fevers are
perceptible to the hand, and are called ague-cakes ; their tumour
feems to be owing to the permanent torpor of the abforbent fyftem^
the fecerning veflels continuing to adl fome time afterwards. If the
fecretory veflels of the liver are afFedled firft with torpor, and after-
wards with orgafm, a greater fecretion -ef bile is produced, which
fometimes caufes a diarrhoea. If a torpor of the kidneys, and of the
abforbents of the bladder occurs, either primarily, or by fympathy
with the cutaneous capillaries, the urine is in fmall quantity and pale,
as explained in Clafs I. 2. 2. 5. ; and if thefe fecretory velTels of the
kidneys, and the abforbents of the bladder ad more ftrongly than na-
tural afterwards by their increafed irritability or affoc lability, the urine
becomes in larger quantity, and deeper coloured, or depofits its earthy
parts, as in Clafs I. 1.2. 4. which has been efteemed a favourable
circumftance. But if the ui-ine be in'fmall quantity, and no fediment
appears in it^ after the hot fit is over ; it (hews, that the fecerning
veflels of the 'kidneys and the abforbent veflels of the bladder have not
regained the whole of their' adivity, and thence indicates a greater
tendency to a return of the cold fit.

4. When the flomach is affeded with torpor either primarily j or

fecondarily

Sup. I. 2. THEORY OF" FEVER.

545

fecoadarily by its fympathy with the cutaneous capillaries ; or with
fome internal vifcus ; ficknefs occurs, with a total want of appetite
to any thing folid ; vomiting then fupervenes, which may often be
relieved by a blifter on the fkin, if the fkin be cool and pale ; but not
if it be hot and flufhed. The inteftines ceafe to perform their office
of abforption from a fimilar torpor ; and a diarrhoea fupervenes owing
to the acrimony of their putrid, or of their acid contents. The loofe
undigefted or fetid ftools indicate the inability of the inteftines to per-
form their proper office ; as the mucus and gaftric acid, which are
vomited up, does that of the ftomach ; this torpor of the ftomach is
liable to continue after the cold paroxyfm ceafes, and to convert in-
termittent fevers into continued ones by its diredl fympathy with the
heart and arteries. See article lo of this Supplement.

5. If the meninges of the brain fympathize with other torpid parts,
or are primarily afFeiSled, delirium, flupor, and perhaps hydrocephalus
internus occur, fee Clafs II. 1.7. i. and I. 2. 5. 10 ; and fometimes
the pulfe becomes flow, pro'ducing parefis inftead of fever. But if
t'he membranes, which cover the mufcles about the head, or of the
pericranium, become torpid by their fympathy with other torpid parts,
or are primarily affefted, a head-ach fupervenes ; which however
generally ceafes with the cold paroxyfm of fever. For as when the
•fenforial power of volition is exhaufled by labour, a few hours, or
half a folar day, paffed in fleep recruits the fyftem by accumulation
of this fenforial power ; fo when the fenforial power of irritation is
exhaufled, one or two folar or lunar days of reft or quiefcence of the
affe£led part will generally reftore its adion by accumulation of irrita-
bility, and confequent increafe of affociation, as in hemicrania, Clafs
IV. 2. 2. 8. But when the heart and arteries become torpid, either
primarily, or by their fympathy with the ftomach, this accumula-
tion of the fenforial power of irritation can take place but flowly ; as
to reft IS death! This explains the caufe of the duration of fevers with

Vol. XL 4 A weak

546 THEORY OF FEVER. Sup. T. 2

weak pulfe, which continue a quarter, or half, or three quarters, or
a whole lunation, or ftill longer, before fufficient accun^ulatioa
of irritability can be produced to. reftore their natural flrength of
adlion.

6. If the abforbent veffels, which are fpread around the neck of
the bladder, become torpid by their direct fympathy with the ab-
forbents of the Ikin in cold fits of fever ; the urine, which is poured
into the bladder in but fmall quantity from the torpid kidneys, has
iieverthelefs none of its aqueous faline part reabforbed ; and this faline
part flimulates the bladder to empty itfelf frequently, though the
urine is in fmall quantity. Which is not therefore owing to any
fuppofed fpafm of the bladder, for the action of it in excluding
the urine is weak, and as much controlable by the will as in ordi-
nary midlurition.

7. If the beginnings or abforbent mouths of the venous fyftem re-
main torpid, petechiie or vibices are produced in fevers, fimilar to
thofe which are feen in fcurvy without fever. If the fkin was fre-
quently moiftened for an hour, and at the fame time expofed to the
common air, or to oxygen gas, it might contribute to turn the black
colour of thefe points of extravafated blood into fearlet, and thus by
increafing its ftimulus facilitate its reabforption ? For oxygen gas pe-
netrates moift animal membranes though not dry ones, as in the
lungs during refpiration.

8. When the fenforial power of fenfation is introduced Into the ar-
terial fyftem, other kinds of compound fevers are produced, which
will be fpoken of in their place.

III. I'erm'ination

Sup. I. 3. THEORY OF FEVER. 547

III. 'Termination of the cold Fit.

I. If all the parts, which were afFefted with torpor, regain their
irritability, and afTociability, the cold paroxyfm of fever ceafes ; but
as fome of the parts afFedled were previoufly accuftomed to inceffant
aftion, as the heart and arteries, and others only to intermitted ac-
tion, as the ftomach and inteftines ; and as thofe, which are fub-
jefted during health to perpetual aftion, accumulate fenforial power
fafter, when their motions are impeded, than thofe which are fub-
jefted to intermitted adlion ; it happens, that fome of the parts,
•which were afFeiled with torpor during the cold fit, recover their ir-
ritability or afTociability fooner than others, and more perfectly, or
acquire a greater quantity of them than natural ; as appears by the
partial heat and flufhings previous to the general hot fit.

Hence if all the parts, which were previoufly torpid, regain their
due degree of irritability, or of afTociabihty, the difeafe is removed,
and health reflored. If fome or all of them acquire more than their
natural degree of thefe fenforial powers ; increafed actions, and con-
fequent increafed fecretions, and greater heat occur, and conftitute
the hot fit of fever. If after this hot fit of fever all the parts, which
had acquired too great irritability, or afTociability, regain their natural
degree of it ; the difeafe is removed, and health reflored. But if
fome of thefe parts do not regain their natural degree of thefe fenfo-
rial powers, the adlions of thofe parts remain imperfeft, and are
more or lefs injurious to the fyftem, according to the importance of
their functions,

2. Thus if a torpor of the heart and arteries remains; the quick
pulfe without ftrength, which began in the cold fit, perfifls ; and a
continued fever is produced. If the torpor of the flomach and intef-

4 A 2 tines

548 THEORY OF FEVER. Sup. I. 3.

tines remains, which are known by ficknefs and undigefted ftools,
the fever is liable to be of confiderable length and danger ; the lame
if the kidnies and abforbent fyftem retain fome degree of torpor, as is
fhewn by the pale urine in not unufual quantity. If part of the ab-
fqirbent lyftem remains torpid, as the abforbent vefTels of the fpleen, a
tumour of that vifcus occurs, which may be felt by the hand; the
fame fometimes happens to the liver; and thefe from their tendency
to more complete torpor are afterwards liable to give occafion to a re-
turn of the cold fit. If the cellular abf6rbents do not completely re-
cover their activity, a pale and bloated countenance with fwelled legs
mark their want of adlion.

3. As the termination of the cold fit is owing to the accumulation
of the fenforial power of irritation and of aflbciation during the previ-
ous quiefcence of the fyftem ; and as thofe parts, which are in per-
petual a£lion during health, are more fubjedl to this accumulation
during their torpor, or quiefcence ; one fhould have imagined, that
the heart and arteries would acquire this accumulation of fenforial
power fooner or in greater degree than other parts. This indeed fo
happens, where the pulfe is previoufly ftrong, as In febris irritativa ;
or where another fenforial power, as that of fenfatlon, is exerted 011
the arterial fyftem, as In inflammations. The heart and arteries in
thefe cafes foon recover from their torpor, and are exerted with great
violence.

Many other parts of the fyftem fubje£t to perpetual motion in health
may reft for a time without much inconvenience- to the whole ; as
when the fingers of fome people become cold and pale ; and during
this complete reft great accumulation of irritability may be produced.
But where the heart and arteries are previoufly feeble, they cannot
much dimlnifti their adions, and certainly cannot reft entirely, for
that would be death ; and therefore in this cafe their accumulation of
the fenforial power of irritatioa or of aflbciation is flovvly produced,
I, and

Sup. I. 4. THEORY OF FEVER. 549

and a long fever fupervenes in confequence; or fudden death, as fre-
quently happens, terminates the cold fit.

Whence it appears, that in fevers with weak pulfe, if the a£lion of
the heart, arteries, and capillaries could beditniniftied, or flopped for a
Ihort time without occafioning the death of the patient, as happens in
cold bathing, or to perfons apparently drowned, that a great accu-
mulation of the fenforial powers of irritation or of aflbciation might
foon be produced, and the pulfe become ftronger, and confequently
flower, and the fever ceafe. Hence cold ablution may be of fervice
in fevers with weak pulfe, by preventing the expenditure and pro-
ducing accumulation of the fenforial power of irritation or affociation.
Stupor may be ufeful on the fame account. Could a centrifugal
fwing be ferviceable for this purpofe, either by placing the head or
the feet in the outward part of the circle, as defcribed in Art. 15. 7».
of this Supplement I

IV. Re f urn of the cold Fit.

r. If the increafed adtion of the cutaneous and pulmonary capil-
laries, and of the heart and arteries, in febris irritativa continues long
and with violence, a proportional expenditure or exhauflion of fenfo-
rial power occurs J which by its tendency to induce torpor of fome
part, or of the whole, brings on a return of the cold fit.

2. Another caufe which contributes to induce torpor of the whole
fyftem by the fympathy of its parts with each other, is the remaining
torpor of fome vifcus ; which after the laft cold paroxyfm had not re-
covered itfelf, as of the fpleen, liver, kidnies, or of the ftomach and
inteflines, or abforbent veflels, as above mentioned.

3. Other

550 THEORY OF FEVER. Sup. T. 4.

3. Other caufes are the deficiency of the natural ftimuli, as hunger,
thirft, and want of frefh air. Other caufes are great fatigue, want
of reft, fear, grief, or anxiety of mind. And laftly, the influence of
external ethereal fluids, as the defeat of external heat, and of Iblar or
lunar gravitation. Of the latter the return of the paroxyfms of con-
tinued fevers about fix o'clock in the evening, when the folar
gravitation is the leaft, affords an example of the influence of it ;
and the ufual periods of intermittents, whether quotidian, tertian,
or quartan, which fo regularly obey folar or lunar days, afford
inftances of the influence of thofe luminaries on thefe kinds of
fevers.

4. If the tendency to torpor of fome vifcus is confiderable, this
will be increafed at the time, when the terrene gravitation is greateft,
as explained in the introdudlion to Clafs IV. 2. 4. and may either
produce a cold paroxyfm of quotidian fever ; or it may not yet be
fufEcient in quantity for that purpofe, but may neverthelefs become
greater, and continue fo till the next period of the greateft terrene
gravitation, and may then either produce a paroxylm of tertian
fever ; or may ftiU become greater, and continue fo till the next
period of greateft terrene gravitation, and then produce a paroxyfm
of quartan ague. And lafl:ly, the periodical times of thefe paroxyfms
may exceed, or fall fhort of, the time of greateft diurnal terrene gra-
vitation according to the time of day, or period of the moon, in which,
the firft fit began ; that is, whether the diurnal terrene gravitation
was then in an increafing or decreafing ftate.

V. Senfation

Sup. I. 5. THEORY OF FEVER. 551

V. Setifation excited In Fever.

I. A curious obfervatlon is related by Dr. Fordyce in his Trafl on
Simple fever, page 168. He afferts, that thofe people, who have
been confined fome time in a very warm atmofphere, as of 120 or 130
degrees of heat, do not feel cold, nor are fubjeft to palenefs of their
fkins, on coming into a temperature of 30 or 40 degrees ; which
would produce great palenefs and painful fenfation of coldnefs in thofe,
who had been fome time confined in an atmofphere of only 86 or 90
degrees. Analogous to this, an obferving friend of mine allured me,
that once having fat up to a very late hour with three or four very in-
genious and humorous companions, and drank a confiderable quantity
of wine ; both contrary to his ufual habits of life; and beino- oblio-ed
to rife early, and to ride a long journey on the next day;: he expefted
to have found himfelf weak and foon fatigued ; but on the contrary
he performed his journey with unufualeafe and alacrity; and fre-
quently laughed, as he rode, at the wit of the preceding evening. Jn
both thefe cafes a degree of pain or pleafure a6luated the fyftem ; and
thus a fenforial power, that of fenfation, was fuperadded to that of ir-
ritation, or volition. See Sed. XXXIV. 2. 6.

2. Similar to this, when the energetic exertions of fome parts of
the fyftem in the hot fit of fever arife to a certain excefs, a degree of
fenfation is produced ; as of heat, which particularly increafes the:
adlions of the cutaneous veifels, which are more liable to be excited
by this ftimulus. When this additional fenforial power of fenfatioa
exifts to a greater degree, the pulfe, which was before full, now be-
comes hard, owing to the inflammation of the vafa vaforum, or coats.
of the arteries. In thefe cafes, whether there is any topical inflam-
mation or not, the fever ceafes to intermit ; but neverthelefs there.

7 ara

55 a THEORY OF FEVER. Sup. I. 6.

are daily remiffions and exacerbations of it ; which recur for the moft
part about fix in the evening, when the folar gravitation is the leaft,
as mentioned in Seft. XXXVI. 3. 7.

3. Thus the introduftion of another fenforial power, that of fen-
iation, converts an intermittent fever into a continued one. If it be
attended with flrong pulfe, it is termed febris fenfitiva irritata, or py-
rexia, or inflammation ; if with a weak pulfe, it is termed febris fen-
fitiva inirritata, or typhus gravior, or malignant fever. The feat of
the inflammation is in the glandular or capillary fyftem, as it confifts
in the fecretion of new fluids, or new fibres, which form new veffels,
as they harden, like the filk of the filk-worm. See Art. 15. of this
Supplement.

VI. Circles of irrliatlve AJfociate Motions.

1. There are fome affociate motions, which are perpetually pro-
ceeding in our waking hours, and are catenated by their firfi; link, or
in fome fubfequent parts of the chain, with the ftimuli or the influ-
ence of external things ; which we ihall here enumerate, as they
contribute to the knowledge of fever. Of thefe are the irritative
ideas, or fenfual motions of the organs of fenfe, and the mufcular
motions aflTociated with them ; which, when the chain is difturbed or
interrupted, excite the lenforial power of fenfation, and proceed in
confufion. Thus if the irritative ideas of fight are difturbed, the pa-
ralaftic motions of obje6ls, which in general are uuperceived, ^ecome
fenfible to us ; and the locomotive mufcles alTociated with them,
which ought to preferve the body ere£t, ftagger from this decreale
or interruption of the fenforial power of afllbciation ; and vertigo is
produced. , .

When

Sup. I. 6. THEORY OF FEVER.

'ss:

When the irritative fenfual motions, or ideas, belonoins: to one
fenfe are increafed or diminiflied, the irritative fenfual motions, or
ideas, of the other fenfes are liable to become diflurbed by their ge-
neral catenations ; whence occur noifes in the ears, bad taftes in the
mouth, bad odours, and numbnefs or tingling of the limbs, as a
greater or lefs number of fenfes are affedled. Thefe conftitute con-
comitant circles of difturbed irritative ideas ; or make apart of the
great circle of irritative ideas, or motions of the organs of fenfe; and
when thus dlfturbed occafion many kinds of hallucination of our other
fenfes, or attend on the vertigjo of vifiou.

Ci^

. 2. Another great circle of ir,ritative affociated motions confifls of
thofe of the alimentary canal ; which are catenated with ftimuli or
with influences external to the fyftem, but continue to be exerted
in our fleeping as well as in our waking hours. When thefe alTb-
ciations of motion are diflurbed by the too great or too fmall ftimulus
of the food taken into the flomach, or by the too great excefs or de-
privation of heat, or by indigellible fubftances, or by torpor or orgafm
occafioned by their aflbciation with other parts, various difeafes are
induced under the names of apepfia, hypochondriacs, hyfteria, diarr-
hoea, cholera, ileus, nephritis, fever.

3. A third circle of irritative affociate motions confifts of thofe of
the abforbent fyflem ; which may be divided into two, the ladleals,
and the lymphatics. ' When the flomach and inteftines are recently
filled with food and fluid, the ladeal fyflera is Simulated into great
adtion ; at the fame time the cellular, cutaneous, and pulmonary
lymphatics 3(3; with lefs energy ; becaufe lefs fluid is "then Wanted
from thofe branches, and becauie more fenforial power is expended
by the lacteal branch. On this account thefe two fyflems of ab-
forbents are liable to atfl by reverfe fympathy ; hence pale urine is
made after a full dinner, as lefs of the aqueous part of it is imbibed by

Vo-L. U, - 4 B the

5:^4 THEORY OF FEVER. Sup. I. 6.

the urinary lymphatics ;. and hence the water in anafarca of the langs
and hmbs is fpeedily abforbcd, when the adions of the ladeals of the
flomach OF inteftines are weakened or inverted by the exhibition of
thofe drugs,, which produce naufea, or by violent vomiting, or vio-
lent cathartics.

Hence in. diabetes the lacteal fyfteai afts ilrongly, at the fame
time that the urinary lymphatics invert their motions, and tranfmit
the chyle into the bladder ; and' in diarrhoea from crapula, or to©
great a. quantity of food and fluid taken at a time, the la6leals adl
ftrongly, and abforb chyle or fluids from, the ftomach and upper ia-
teftines J while the lymphatics of the lower inteftines revert their
motions, and tranfmit this over-repletion into the lower inteftines,
and thus produce diarrhoea; which accounts for the fpeedy operation
of fame cathartic drugs,, when much fluid, is taken along, with
t;hem»-

4i Other circles of irritative alFociate motions of" great importance
are thofe. of the fecerning fyftem ; of thefe are the motions of the
larger congeries of glands, which form, the liver,., fpleen,. pancreas,
gaftric glands,, kidneys, falivary glands, and many, others j fome of
which a£l by diredland others by reverie fympathy with each other.
Thus when the gaftric glands a<fl moft powerfully, as when the
ftomach is filled with food, the- kidneys adt.with lefs energy ; as is
fhevvn. by the fmall fecretion of urine for the firft.hour or two after
dinner;, which reverfs fympathy is occafioned by the greater expen-
diture of fenforial. power on the gaftric glands,, and to the newly ab-
forbed' fluids not yet being fufficiently animalized, or otherwife
prepared, to ftimulate the fecretory veffels of the kidneys.

But thofe very extenfive glands, which, fecrete the perfpirable
matter of the flcin and lungs, with the mucus,, which lubricates all
the internal cells and cavities of the body, claim our particular atten-
tion., Thefe glands, as well as all the others, proceed from the ca-

Sup. I. 6. THEORY OF FEVER. :s,2.§

pillary velTels, which unite the arteries with the veins, and are not
properly a part of them ; the mucous and perfpirative glands, which
arife from the cutaneous and pulmonary capillaries, are affociated by
direct fympathy ; as appears from immerfion in the cold bath., which
is therefore attended with a temporary difficult refpiration ; while
thofe from the capillaries of the ftomach and heart and arteries are
more generally affociated by reverfe fympathy with thofe of the cu-
taneous capillaries ; as appears in fevers with weak pulfe and indi- '
geftion, and at the fame time with a hot and dry Ikin.

The difturbed a£lions of this circle of the affociate motions of the
fecerning fyftem, when the fenforial power of fenfation is added to
that of irritation, frequently produces inflammation, which conlifts
in the fecretion of new fluids or new veflTels. Neverthelefs, if thefe
dlflurbed adtions be of the torpid kind, the pain, which attends them
is feldom produdive of inflammation, as in hemicrania; but is liable
to excite voluntary aflions, and thus to expend much fenforial power,
as in the fliuddering in cold fits of fever, or in convulfions ; or laftlv
the pain itfelf, which attends torpid actions, is liable to expend or
exhauft much fenforial power without producing any increafed
aftions ; whence the low pulfe, and cold extremities, which ufuallv
attend hemicrania ; and hence when inert, or inaftive fenfation at-
tends one link of aflbciated adlion, the fucceeding link is o-enerally
rendered torpid, as a coldnefs of the cheek attends tooth-ach.

5. A fifth important circle of irritative motions is that of the
fangulferous fyflem,,in which the capillary veflels are to be included
which unite the arterial and venous iyflems, both pulmonary and
aortal. The diflurbed adion of this fyflem of the heart and arteries
and capillaries, conflitute fimple fever ; to which may be added, that
the fecerning and abforbent veflTels appending to the capillaries, and
the bibulous mouths of the veins, are in fome meafure at the fame
time generally affedled.

4^2 6. New,

556 THEORY OF FEVER. Sup. I. 7.

6. Now, thongh the links of each of thefe circles of irritative
motions are more ftriclly affociated together, yet are they in greater
or lefs degree affociated or catenated with each other by dire£l or
reverfe fympathy. Thus the ficknefs, or inverted irritative motions
of the flomach, are affociated or catenated with the difturbed irrita-
tive ideas, or feufual motions, in vertigo ; as in fea-ficknefs. This
ficknefs of the fLomach is alfo affociated or catenated with the torpor
of the heart and arteries by direft fympathy, and with the capillaries
and abforbents by reverfe fympathy j and are thus, all of them liable
occafionally to be difturbed, when one of them is difeafed ; and con-
ftitute the great variety of the kinds or fymptoms of fevers.

VII. Alternation of the cold and hot Tits.

I. When any caufe occurs, which diminifhes to a certain degree
the fupply of fenforial power in refpeft to the whole fyffem ; as fup-
pofe a temporary inexertion of the brain j what happens ? Firff,
thofe motions are exerted with lefs energy, which are not imme-
diately neceffary to life, as the locomotive mufcles ; and thofe ideas,
which are generally excited by volition -, at the fame tilne this defi-
ciency of voluntary motion is different from that which occurs in
deep ; as in that the movements of the arterial fyftem are increafed
in energy though not in frequency. Next, the motions of the ali-
mentary canal become performed with lefs energy, or ceafe alto-
gether ; and a total want of appetite to folid food occurs, or ficknefs,
or a diarrhoea occaiioned by the indigefted aliment. Then the ab-
forbent veffels ceafe to a6t with their due energy; whence thirff,
and pale urine, though in fmall quantities. Fourthly, the fecerning
veffels become affedled by the general diminution of fenforial power ;
whence all the fecreted fluids are produced in lefs quantity. And
laflly, the fanguiferous canals feel the general torpor ; the pulfations

of

Sup. I 7. THEORY OF FEVER. 557

of the heart and arteries become feeble, and confequently quick ; and
the capillaries of the fkin become inadlive, acquire lefs blood from the
arteries, and are eonfequently paler and flirunk.

In this laft circumftance of the torpor of the fangulferous fyflem
confifls inirritative fever; as all the others are rather accidental or
concomitant fymptoms, and not effential ones ; as fewer or more of
them may be prefent, or may exift with a greater or lefs degree of
inadtivity.

2. Now as the capillaries of the Ikin are expofed to greater va-
rieties of heat and cold, than the heart and arteries, they are fup- '
pofed to be more mobile, that is, more fufceptible of torpor or
exertion, or to inflammation, by external ftimuli or influences, than
the other parts of the fangulferous fyftem ; and as the flcin is more
fenfible to the prefence of heat, than the internal parts of the body,
the commencement of the cold paroxyfms of fever generally either
firft exifts in, or is firfl perceived by, the coldnefs and palenefs of
the Ikin ; and the commencement of the hot fits by the heat and
rednefs of it.

3. The accumulation of fenforial power occurs in thefe organs
fooneft, and in greateft quantity, during their qulefcence, which
were moft perpetually in adion during health ; hence thofe parts of
the fyftem fooneft recover from torpor in intermittent fever, and
fooneft fall into the contrary extreme of increafed adtivity ; as the
fangulferous fyftem of the heart and arteries and capillaries. But of
thefe the capillaries feem firft to acquire a renovation of their a6lion,
as the heat of the flcin becomes firft renewed, as well as increafed
beyond its natural quantity, and this in fome parts fooner than in
others; which quantity of heat is however not to be eftimated fimply
by the rife of the mercury in the thermometer, but alfo by the quan-
tity carried away into the atmofphere, or diffufed amongft other

bodies

55« THEORY OF FEVER. Sup. 1. 7.

bodies in a given time ; as more heat paffes through water, which
boils vehemently, than when it boils gently, though the rife of the
thermometer in both cafes continues the fame. This fadt may be
known by boiling an egg in water, the white of which coagulates
in much lefs time, if the water boils vehemently, than if it boils
moderately, though the fenfible heat of the water is the fame in both
cafes.

Another caufe, which induces the cutaneous capillaries to renew
their adlions fooner than the heart and arteries after immerfion in the
cold bath, is, that their torpor was occafioned by defeft of irritation ;
whereas that of the heart and arteries was occafioned by defeft of
aflbciation ; which defeft of aflbciation was owing to the decreafed
ailions of the capillaries, and is now again excited by their renewed
a£lion ; which excitement muft therefore be fubfequent to that in-
creafed aftlon of the capillaries; and in confequence the Increafed
aiStlon of the heart and arteries at the commencement of the hot fit
of fome fevers is fubfequent to the increafed a£t:ion of the cutaneous
capillaries. There is, however, in this cafe an accumulation of the
fenforial power of aflbciation in the heart and arteries, which muft
contribute to Increafe their orgafm in the hot fit, as well as the in-
creafed excitement of it by the increafed adllon of the capiljaries.

4. Now this increafed a6llon of the fyflem, during the hot fit, by
exhauftlng the fenforial powers of irritation and aflbciation, contri-
butes to Induce a renewal of the cold paroxyfm ; as the accumulation
of thofe fenforial powers in the cold fit produces the increafed a6tlons
of the hot fit; which two ftates of the fyflem reciprocally induce
each other by a kind of llbration, or a plus and minus, of the fenforial
powers of irritation and aflbciation.

If the exhauftion of fenforial power during the hot fit of fever

only reduces the quantity of irritability and aflbciability to its natural

ilandard, the fever is cured, not being liable to return. If the

I quantity

Sup. I. 8. THEORY OF FEVER. ^s<)

quantity of thefe fenforial powers be reduced only fo much, as not
to produce a fecond cold fit during the prefent quantity of external
flimuli or influences ; yet it naay be fo far reduced, that a very
fmall fubtra£lion of ftimulus, or of influence, may again induce a
cold fit ; fuch as the cotdnefs of the night-air, or the diminution of
folar or lunar gravitation, as in intermittent fevers,

5". Another eaufe of the renovation of the cold fits of fever is from
fome parts of the fyflem not having completely recovered from the
former cold paroxyfm J as happens to the fpleen, liver, or other in-
ternal vifcus ; which fometimes remains tumid, and either occafions
a return of the cold fit by direcSt, fympathy with other parts of the
body, or by its own want- of adion caufes a diminution of the general
quantity of heat, and thus facilitates the renovation of the torpor of
the whole fyflem, and gives caufe to intermittent fevers catenated,
with lunar or folar influence.

Vlir. Orgafm of the Capillaries,

As the remaining torpor of fome lefs efTential part of the fyflem,^
as of the fpleen, when the hot fit ceafes, produces after one, two, of
three days a return of cold fit by diredl fympathy. with the cutaneous
capillaries, when joined with fome other caufe of torpor, as the de-
fed of folar or lunar influences, or the expofure to cold or hunger,
and thus gives origin to intermittent fever; fo.the remaining torpor
of fome more efTential parts of the fyflem,. as of the flomach and
inteflines, is probably the caufe of the immediate recurrence of the
cold paroxyfm, at the time the hot onexeafes, by their dired fym-
pathy with the cutaneous capillaries, without the afiiflance of any
other caufe of torpor; and thus produces remittent fever.. And
laflly the remaining torpor of fome flill more efTential parts of the

fvflem,.

560 THEORY OF FEVER. Suf. I. 8.

fyflem, as the heart and arteries, after the hot fit ought to ceafe, is ■
liable by reverfe fympathy with the cutaneous capillaries to continue
their orgafm, and thus to render a fever continual, which would
otherwife remit or intermit.

Many difficulties here occur, which we fliall endeavour to throw

fome light upon, and leave to future inveftigation ; obferving only

hat difficulties were to be expeded, otherwife fevers would long

fince have been underftood, as they have employed the unremitted

attention of the phyficians of all ages of the world.

I. Why do the fame parts of fucceffive trains of aftion fometimes
affe£t each other by dire£l, and fometimes by reverfe fympathy ? — •
I ft. When any irritative motion ceafes, or becomes torpid, which
was before in perpetual aftion ; it is either deprived of its ufual
flimulus, and thence the fenforial power of irritation is not excited;
or it has been previoufly too much ftimulated, and the fenforial power
has been thus exhaufted.

In the former cafe an accumulation of fenforial power foon occurs,
which is excitable by a renewal of the ftimulus; as when the fingers,
which have been immerfed fome time in fnow, are again expofed to
the ufual warmth of a I'oom. Or, fecondly, the fenforial power of
irritation becomes fo much accumulated, that the motions, which
were torpid, are now performed by lefs ftimulus than natural ; as
appears by the warmth, which foon occurs after the firfi: chill in
going into frofty air, or into the bath at Buxton, which is about
eighty degrees of heat. Or, laftly, this accumulation of the fenforial
power of irritation fo far abounds, that it increafes the aftion of the
next link of the affociated train or tribe of motions ; thus on expofing
the Ikin to cold air, as in walking out in a frofty morning, the adlions
of the ftomach are increafed, and digefrion ftreng-thened.

But where the torpor of fome irritative motion is owing to the

previous exhauftion of the fenforial power of irritation by too great

7 ftimulus,

Sup. I. 8. THEORY OF FEVER. 561

ilimulus, the reftoration of it occurs either not at all, or much more
flowly than iii the former inftances; thus after intoxication the
ftomach is very flow in recovering its due quantity of the fenforiai
power of irritation, and never fhews any accumulation of it.

2. When an aflociate motion, as defcribed in the introdudion to
Clafs IV. I. I. afts with lefs energy, the fenforiai power of affoci-
ation is either not fufficiently excited by the preceding fibrous mo-
tions ; or it has been expended or exhaufted by the too violent a6tions
of the preceding fibrous motions. In the former cafe there occurs
an accumulation of the fenforiai power of airociation ; exa6lly as,
where the ufual flimulus is v/ithdrawn, there occurs an accumulation
of the fenforiai power of irritation. Thus when the aftions of the
capillaries of the Ikin are diminiihed by immerfion in cold water, the
capillaries of the lungs are rendered torpid by the want of the excite-
ment of the fenforiai power of afTociation, owing to the lefl'ened
a6lions of the previous fibrous motions, namely, of thofe of the Ikin.
Neverthelefs as foon as the capillaries of the fkin regain their in-
creafed adivity by the accumulation ©f the fenforiai power of irrita-
tion, thefe capillaries of the lung-S a6t with greater energy alfo owing
to their accumulated fenforiai power of afibciation. Thefe are in-
flances of direft fympathy, and conflitute the cold and hot paroxyfms
of intermittent fever; or the firft paroxyfm of a continued one.

3. When the firfl link of a train of affociated motions, which is
fubjed: to perpetual adion, becomes a confiderable time torpid for
want of being excited by the previous exertions of the irritative mo-
tions, with which it is catenated ; the fenforiai power of afTociation
becomes accumulated in fo great a degree as to affe6t the fecond link
of the train of affociated motions, and to excite it into ftronger
adion. Thus when the flomach is rendered torpid by contagious
matter fwallowed into it mixed with the faliva, the heart and arteries

Vol. II. ;i C ad

5^3 THEORY OF FEVER. Sup. I. g,

ad more feebly ; becaufe the fenforial power of affociation, which
ufed to be excited by the fibrous motions of the ftomach, is not nov/
excited ; and in confequence the motions of the heart and arteries
adl only by the fenforial power of irritation, which is excited by the
fiiimulus of the blood.

But during this torpor of the ftomach, and lefs adion of the heart
and arteries, fo great an accumulation of the fenforial powers of
irritation and of affociation occurs, that it adds to the acflion of the
next link of this vital circle of a<5lions, that is, to that of the cuta-
neous capillaries. Whence in this fituation the torpor of the fto-
mach occalions a diminifhed aftion of the heart and arteries by diredl
lympathy, and may be faid to occafion an increafed one of the cuta-
neous capillaries by reverfe j^mpathy; which conftitute continued
fever with weak pulfe.

Nor is this increafed aftion of the capillaries in confequence of the
decreafed adion of the heart -and arteries, as in fevers with weak
pulfe, a fingle fa£l in the animal economy ; though it exifts in this
cafe in the greateft degree or duration, becaufe the heart and arteries
are perpetually in greater adion than any other part of the fyt^em.
But a fimilar circumftance occurs, when the ftomach is rendered in-
adive by defedive excitement of the fenforial power of aflbciation,
as in fea-ficknefs, or in nephritis. In thefe cafes the fenforial power
of affociation becomes much accumulated in the flomach, and feems
by its fuperabundance to excite the abforbent fyftem, which is fo
nearly connedled with it, into great increale of aftion ; as is known
by the great quantity frequently in thefe fituations rejeded by vomit,
which could not otherways be fupplied. It is probable the increafe
of digeflion by walking in frofty air, with many other animal fads,
may by future obfervations be found to be dependent ou this principle,
as well as the increafed adion of the capillaries in continued fevers
with weak pulfe.

Whereas in continued fever with flrong pulfe, which may perhaps

occur

Sup. I. 8. THEORY OF FEVER. 563

occur fometimes on the firft day even of the plague, the {lomach with
the heart and arteries and the capillaries aft by diredt fympathy ; that
is, the flomach is excited into flronger a<flion by increafed irritation
owing to the fliimulus of" contagious matter ; thefe flronger irritative
motions of the flomach excite a greater quantity of the feiv-
forial power of afTociation, which therj adluates the heart and arte-
ries with greater energy, as thefe are catenated with the flomach ;
and in the fame manner the increafed adions of the heart and arte-
ries excite a greater quantity of the fenforial power of afllbciation,
which a£luates the cutaneous capillaries with increafe of energy.
See Clafs IV. i. i.

4. I fhall dwell a little longer on this intricate fubjeft. The com^
mencement of fever^fits is known by the inadlivity of the cutaneous
capillaries, which inaftivity is obfervable by the palenefs and coldnefs
of the fkin, and alfo by the pain .0/ coldnefs, which attends it. There is
neverthelefs in mofl cafes, except thofe which are owing to expofure
to external cold, a torpor of the capillaries of fome internal vifcus
preceding this inaflivity of the cutaneous capillaries ; which is known
by the tumour or hardnefs of the vifcus, or by an aching pain of it.
The capillaries of the lungs are at the fame time rendered ina6bive
or torpid, as appears by the difficulty of breathing, and coldnefs of
the breath in cold fits of fever, and in going into the cold bath ; but
the lungs are not afFeded with the pain either of coldnefs or of
torpor.

One caufe of this fj'^nchronous or fucceflive inadivity of the cu-
taneous capillaries, in confequence of the previous torpor of fome in-
ternal vifcus, may be owing to the deficiency of heat ; which mufl
occur, when any part becomes ina£live; becaufe the fecretions of
that part ceafe or are leffened, and the quantity of heat of it in con-
fequence. But the principal caufe of it I fuppofe to be owing to
the defedl of the fenforial power of afTociation ; which power of

4 C 2 afTociation

564 THEORY OF FEVER. Sup. I. 8.

aflbciatlon is excited by fome previous or concomitant motions of the
parts of every great circle of aftions. This appears on going into
the cold bath, becaufe the fhortnefs of breath inflantly occurs^
fooner than one can conceive the diminution of the heat of the fkia
could afFed the lungs by the want of its ftimulus ; but not fooner
than the defe£t of the fenforlal power of aflbciatlon could afFed
them ; becaufe this muft ceafe to be excited into adion on the in-
ftant that the cutaneous capillaries ceafe to ad ; whence in^ the firft
moment of contad of the cold water the cutaneous capillaries ceafe
to ad from defed of irritation ; which is caufed by defed of the
flimulus of heat ; and in the fecond moment the, capillaries of the
lungs ceafe to ad from the defed of aflbciatTon ; which is caufed by
the defed of the motions of the cutaneous capillaries. Thus tha
univerfal torpor in the cold paroxyfm of fever is an example of dired
fympathy, though occafioned in part by defed of irritation, and in
part by defed of affociation.

5. Thus in walking out in a frofly morning the Ikin is cooled by
the contad of the cold air, v/hence the adions of its capillaries are
diminiflied for want of their ufual ftimulus of heat to excite a fuffi-
cient quantity of the fenforlal power of irritation. Hence there is
at firft a. faving of fenforlal power of irritation for the purpofe of
aduating the other parts of the fyftem with greater energy. Secondly
the fenforlal power of aflbciatlon, which ufed to be excited by the:
motions of the cutaneous capillaries, is now not fo powerfully ex-
cited ; and in confequence the parts,, which conflitute the next links
of the circles of afibciated motions, are for a time a6luated with lefs.
energy, and a temporary general chillnefs iucceeds; which is fo far
fimilar to the cold fit of intermittent fever.

In this fituation there is a curious circumflance occurs, which me-
rits peculiar attention : after a fhort time, though the external fkln..
continues cool by its expofure to the cold air, and the adions of its

capillaries

Sup. I. 8. THEORY OF FEVER. 563

capillaries are confequently dimitiifhed, yet the capillaries of the
ftomach aft with greater energy ; as is known by increafed digeftion
and confequent hunger. This is to be afcribed to the accumulation
of the fenforial power of irritation, which now excites by its fuper-
abundance, or overflowing, as it were, the ftomach into increafed
aftion; though it is at the fame time excited lefs powerfully thant
■ufual by the fenforial power of aflbciation. Thus the accumulation
of the fenforial power of irritation in the veffels of the Ikin increafes-
in this cafe the a6lion of the ftomach, in the fame manner as an ac-
cumulation of the fenforial power of aflbciation in the heart and
arteries in fevers with weak pulfe increafes the adlion of the
capillaries.

-^ If neverthelefs the coldnefs of the Ikin be too long continued, or
exifts in too great a degree, fo as in fome meafure to impair the life
of the part, no further accumulation of the fenforial power of irri-
tation occurs ; and in confequence the a£tions of the ftomach become
lefs than natural by the defe£l of the fenforial power of aflbciation »
which has ceafed to be excited by the want of aftion of the cutaneous
capillaries. Whence continued coldnefs of the feet is accompanied
with indigeftion and heartburn. See Clafs IV. 2» 1.6.

6. Similar to this when the adions of the ftomach are rendered
torpid by the previous ftimulus of a violent emetic, and its motions
become retrograde in confequence, a great quantity of fenforial
power IS exerted on the lymphatics of the lungs, and other parts of
the body; which excites them into greater dire<ft aftion, as is evinced
by the exhibition of digitalis in anafarca. In this fituation I fuppofe
the emetic drug ftimulates the mufcular fibres of the ftomach into too
great aftion ; and that in confequence a great torpor foon fucceeds;.
and that this inaction of the mufcular parts of the ftomach is not fol-
lowed by much accumulation of the fenforial power of irritation ^
becaufe that fenforial power is in great meafure exhaufted by the

previous-

566 THEORY OF FEVER. Sup. I. 3,

previous exceflive ftimulus. But the lymphatics of the ftomach
have their a£lions leflened by defedl of the lenforial power of affo-
ciation, which is not now excited into a£lion, owing to the leffened
motions of the mufcular parts of it, with which the lymphatics are
affociated. The feiiforial power of afibciation becomes therefore ac-
cumulated in thefe lymphatics of the ftomach, becaufe it is not
excited into a£l:ion ; exadly as the power of irritation becomes accu-
mulated in the hand, when immerfed in fnow; and this accumulated
fenforial power of afibciation excites the lymphatic of the lungs and
of other parts, vi'hich are moft nearly aflbciated with thofe of the*
ftomach, into more energetic a£lions. Thus the mufcular fibres of
the ftomach ad with the lymphatics of that organ in dire£l lympathyf
and the lymphatics of the ftomach aft in reverfe fympathy with
thofe of the lungs and of other parts of the body ; the former of
which is caufed by defe£l of the excitement of the fenforial power of
afibciation, and the latter by the accumulation of it.

Befides the efficient caufe, as above explained, the final caufe, or
convenience, of thefe organic a£lions are worthy our attention. In
this cafe of an acrid drug fwallowed into the ftomach the reverted
actions of the mufcular fibres of the ftomach tend to eje6t its enemy;
the reverted a6lioi]s of its lymphatics pour a great quantity of fluids
into the ftomach for the purpofe of diluting or waftiing off the
noxious drug? and the increafed adlions of the other lymphatics fup-
ply thefe retrograde ones of the ftomach with an inconceivable fupply
of fluids, as is feen in Ileus and Cholera.

7. The inquifitive reader will excufe my continuing this fubje£l,
though perhaps with fome repetitions, as it envelopes the very efience
of fever. When the firft link of a train of aftions is excited by ex-
ceflive ftimulus, or exceflive irritability, and thus a6ls with unufual
energy by the increafed quantity of irritation, thele increafed mo-
tions excite a greater quantity of the fenforial power of afibciation,
8 which

^vp. I. 8, THEORY OF FEVER. -i^^y

which caufes increafed motions in thefecond liu'k, which Is catenated
•with the firfl ; and then the exceffive a£lion of this fecond link ex-
cites alfo a greater quantity of the fenforial power of affociation,
which increafes the motions of the third link of this chain of affo-
.ciation, and thus the increafe of the ftimulus on the irritative mo-
tions, to which the chain of affociation is catenated, increafes the
adtion of the whole chain or circle of affociated motions.

After a time the irritative motions become torpid by expenditure
of the fenforial power of irritation, and then the power of affociation
alfo becomes lefs exerted,, both becaufe it has been in part exhaufted
hy too great adion, and is now lefs excited by the leffened adion of-
■the irritative motions, which ufed to excite it. Thefe are both in-
ftances of dire£t lympathy, and. frequently conftitute the cold and hot:
£t of intermittents.

But though- the accumulation of the fenforial power of irritation
during the quiefcence of fome motion owing to want of ftimulus
generally induces torpor in^ the firfl link of the train -of affociated
motions catenated with it ;. as the capillaries of the lungs become-
torpid immediately on immerfion of the Ikin into cold water; yet in.
fome fituatlons an orgafm or excefs of adion is produced in the firft.
link of the aflbciated motions thus catenated with irritative ones ; as in
the increafed- adion of the ftomach, when the Ikin is for a time eX'--
pofed to cold air; which may in part be afcribed to the general:
increafe of ad ion of the whole, fyftem,. owing to the diminifhed-
expenditur« of fenforial power, but particularly of the parts, which-
have habitually aded together; as when one arm is paralytic the
other is liable to more frequent or almoft continual motion; and
v/hen one eye becomes blind the other frequently becomes ftronger;.
which is well known to farriers, who are faid fometimes to. deffroy
the fight of one eye to ftrengthen that of the other in difeafed.
horfes. sr

Hence there is fometimes. a diredt fympathy, and fometimes a

reverfe

^68 THEORY OF FEVER. Sup. I. g.

reverfe one fucceeds the torpor occafioned by defed of ftimulus, the
latter of which is perhaps owing to a certain time being required for
the produftion of an accumulation of the fenforial power of irritation
by the nervous branches of the torpid organ ; which accumulation is
now in part or entirely derived to the next link of the affociation.
Thus in going into a cbldifti bath, as into a river in the fummer
months, we at firft experience a difficulty of breathing from the
torpid a£tion of the pulmonary capillaries, owing to the deficient
excitement of the fenforial power of aflbciation in confequence of the
torpor of the cutaneous capillaries. But in a very fhort time, as in
one minute, the fenforial power of irritation becomes accumulated
by the ina6livity of the cutaneous capillaries ; and as its fuper-
abundance becomes now expended on the pulmonary capillaries, the
difficult refpiration ceafes ; though the cutaneous capillaries continue
torpid by their contact with the cold water, and confequently the
fenforial power of affociation, which ufed to contribute to aduate the
pulmonary capillaries, is lefs excited.

8. In like manner when there exifts an accumulation of the fen-
forial power of affociation, owing to defe£l of its excitement by feme
previous irritative or affociate motions, it is generally accompanied for
a certain time by a torpor not only of the link firft affefted, but of
the fubfequent parts, or of the whole train of affociated motions, as in
the cold fits of intermittent fevers. Yet after a time an increafed
aftion of the next links of affociated motions fucceeds the torpor of
the firfl, as the abforbent veffels of the lungs aft more violently in
confequence of the deficient adion of thofe of the ftomach ; and, the
Ikin at the commencement of ficknefs is pale and cold, but in a little
time becomes fiuffied and v/arm.

Thus we fee in affociate motions, which are rendered torpid by

defed of excitement, that fometimes a dired, and fometimes a re-:

verfe fympathy fucceeds in the fubfequent links of the chain, But

4 . . I believe

Sup. I. 8. THEORY OF FEVER. 569

.1 believe where a torpor of irritative or of the alTociate motions is
caufed by a previous too great expenditure or exhauftion of the fenfo-
rial powers of irritation or aflbciation, no increafe of adlion in the fub-
fequent link ever occurs, or not till after a very long time.

Thus when the flomach becomes torpid by previous violent exerr
tion, and confequent exhauftion of the fenforial power of irritation^ as
after intoxication with wine or opium, or after the exhibition of fome
violent emetic drug, the torpor is communicated to the heart and ar^
- teries, as in continued fevers with weak puife. But where the tor-
por of the ftomach is produced from defedlive aflbciation, as in fea-
ficknefs; or in the ficknefs which occurs, when a flone ftimulates the
tireter ; no torpor is then communicated to the heart and arteries.
For in the former cafe there is no accumulation of fenforial power in
the ftomach, which was previoufly exhanfted by too great flimulus ;
but in the latter cafe the accumulation of fenforial power in the fto-
mach during its torpor is evinced by this circumftance ; that in fea-
ficknefs the patients eat and drink voracioufly at intervals ; and the
pulfe is generally not afFe£ted by the ficknefs occafioned by a ftone in
the ureter. For the adion of the ftomach is then leflened, and in
confequence becomes retrograde, not owing to the exhauftion of the
fenforial power of irritation, but to the want of excitement of the
fenforial power of aflbciation ; which is caufed by the defedive adioa
of the ureter, which becomes occafionally torpid by the great ftimulus
of the ftone it contains ; or which is caufed by the great exhauftion of
fenforial power by the pain ; which affeds the ureter without excitino-
inflammation, or increafcd adion of it. -

9. Thus though the ftomach after the great ftimulus of intoxica-
tion from excefsof wine or opium will continue many hours without
accumulation of fenforial power, as appears from the patient's experi-
encing no appetite at the intervals of ficknefs ; yet after long abftinencc
from food, at length not only the exhaufted quantity of fenforial

Vol. II. 4 I) power

570 THEORY OF FEVER. Sup. 1. 8.

power is renewed, but an accumulation of it at length occurs, and
kunger returns. In this fituation the ftomach is generally about a
whole day before it regains its ufual powers of dtgeftion ; but if it has
been ftill more violently Simulated, and its anions further impaired,
a ftill more permanent torpor along with a continued fever with weak
pulfe is liable to occur ; and a fourth part, or a half, or three fourths,,
or a whole lunar period paffes, before it recovers its due irritability-
and confeq;Uent a£lion.

In (imilar manner, after a perfon has been confined in a very warm
room for fbme hours, the cutaneous capillaries, with their fecretory
and abforbent veflels, become exhaufted of their fenforial power of ir-
ritatioa by the too great violent exertions occafioned by the unufuaL
ftimulus of heat ; and in coming into a colder atmofphere an inaftivity
of the cutaneous veflels exifts at firfl for fbme time without accumu-
lation of fenforial power ; as is (hewn by the continuance of the paiiii
of cold and the palenefs ; but after a time both the pain of cold and'
palenefs vanifti, which now indicates an accumulation of the fenforial;
power of irritation,, as lefs degrees of heat Simulate the fyftem into,
due a£lion.

In the fame manner, after any one has been fome time in the fum-
mer funfhine,. on coming into a dark cell he continues much longer
before he can clearly diftlnguifli objects, than if his-eyes had only been?
previoufly expofed to the light of a cloudy day in winter ; becaufe the
fenforial power of irritation, and:confequent fenfation, had in the Br€t~
cafe been previoufly much. expended or exhaufted ; and therefore re-
quired a much, longer time before it could< be produced in the brain,.,
or derived to the optic nerves, in fuch quantity as to reftore the defi-
ciency, and to caufean accumulation of it i whereas in the latter cafe,-
no deficiency had occurred*,

i,Q.. Thus the accumulation or deficiency of fenforial power in a
torpid organ, which had previoufly been ac.cuilomed to perpetual ac-
tion.

Sup. I. 8. THEORY OF FEVER. 571.

tion, depends on the manner in which it becomes torpid ; that is,
whether by great previous ftimulus, or great previous excitement of
the power of aflbciation ; or by defedl of its accuftomed ftimulus, or
of its accuftomed excitement of the power of aflbciation. In the
former cafe the fenforial power is in an exhaufted ftate, and therefore
is not Hkely to become fo foon accumulated, as after drunkennefs, or
expofure to great heat, or to great hght ; in the latter a great accu-
mulation of fenforial power occurs, as after expofure to cold, or hun-
ger, or darknefs.

Hence when the ftomach continues torpid by previous violent fli-
mulus, as in the exhibition of digitalis, no accumulation of fenforial
power of irritation fupervenes ; and in confequence the motions of the
heart and arteries, which are aflbciated with thofe of the ftomach,
become weak, and flow, and intermittent, from the defedl of the
excitement of the fenforial power of aflbciation. But what follows ?
as the a6tions of the heart and arteries are leflened by the deficient ac-
tion of the fenforial power of aflbciation, and not by previous increafed
excitement of it ; a great accumulation of the fenforial power of aflb-
ciation occurs, which is exerted on the pulmonary and cutaneous ab-
forbents by reverfe fympathy, and produces a great abforption of the
fluid efFufed into the cellular membrane in anafarca, with dry flcin ;
conftituting one kind of atrophy.

But if at the fame time the feceruing vefl^els of the fl:omach are fl:i-
mulated into fo violent activity as to induce great confequent torpor,
as probably happens when contagious matter is fwallowed into the
fl:omach with our faliva, thofe of the heart and arteries a£l feebly
from the deficient excitement of the power of aflbciation ; and then
the cutaneous and pulmonary fecerning veflbls adt with greater force
than natural, owing to the accumulation of the fenforial power of af-
fociation ; and unnatural heat of the flcin, and of the breath fucceed ;
but without frequency of pulfe, confliituting the parefis irritativa of
Clafs I, 2. I. 2. And laflly, if a paucity of blood attends this parefis,

4 D 2 or

572 THEORY OF FEVER. Sup. I. 8.

or fome other caufe inducing a frequency of pulfe, the febris inirrita-
tiva, or fever with weak pulfe, is produced,

But on the contrary when the ftomach has prevloufly been render-
ed torpid by defe<Sl of ftimulus, as by hunger, if food be too haftily
fupplied, not only great exertion of the ftomach itfelf fucceeds, but
fjever with ftrong pulfe is induced in confequence ; that is, the heart
and arteries are excited into more energetic adlion by the excefs of the
power of affociation, which catenates their motions with thofe of the
ftomach. For the redundancy of fenforial power of irritation, which
was accumulated during the inaftivity of the ftomach, and is now
called into adion by ftimulus, adluates that organ with increafed
energy, and excites by thefe increafed motions the fenforial power of
affociation ; which has alfo been accumulated during the inadivity of
the heart and arteries ; and thus thefe organs alfo are now excited into
greater adion.

So after the Ikin has been expofed fome hours to greater heat than
natural in the warm room, other parts, as the membranes of the
noftrils, or of the lungs, or of the ftomach, are liable to become tor-
pid from dired fympathy with it, when we come into air of a mode-
rate temperature ; whence catarrhs, coughs, and fevers. But if this
torpor be occafioned by defed of ftimulus, as after being expofed to
frofty air, the accumulation of fenforial power is exerted, and a glow
of the ikin follows, with increafed digeftion, full refpiration, and
more vigorous circulation.

1 1. It may be afked, Why is there a great and conftant accumula-
tion of the fenforial power of affociation, owing to the torpor of the
ftomach and heart and arteries, in continued fever with weak pulfe ;
which is exerted on the cutaneous and pulmonary capillaries, fo as to
excite them into increafed adion for many weeks, and yet no fuch
exuberance of fenforial power produces fever in winter-fleeping ani-
mals, or in chlorofis, or apepfia, or hyfferia ?

In

Sup. I. S. THEORY OF FEVER. 573

In winter-fleeping animals I fuppofe the whole nervous fyftem is
torpid, or paralyfed, as ia the fleep of frozen people ; and that the
ftomach is torpid in confequence of the ina6tivity or quiefcence of the
brain ; and that all other parts of the body, and the cutaneous capil-
laries with the reft, labour under a fimilar torpor.

In chlorofis, limagine, the anions of the heart and arteries, as
well as thofe of the cutaneous and pulmonary capillaries, fuffer along,
with thofe. of the flomach from the deficient ftimulus of the pale
blood ; and that though the liver is probably the feat of the original
torpor in this difeafe, with which all other parts fympathize from
defeft of the excitation of the fenforial power of afibciation ; yet as
this torpor occurs in fo fmall a degree as not to excite a.fliuddering or
cold fit, no obfervable confequences are in general occafioned by the
confequent accumulation of fenforial power. Sometimes indeed ia
chlorofis there does occur a frequent pulfe and hot (kin ; in which cir-
cumftances I fuppofe the heart and arteries are become, in fome de-
gree torpid by direct fympathy with the torpid liver ; and that hence
not only the pulfe becomes frequent, but the capillaries of the ikin.
z£t more violently by reverfe fympathy with the heart and arteries,
owing to the accumulation of the fenforial power of afTociation in them
during their torpid ftate, as occurs in irritative fever. See Article
1 1 of this Supplement.

In ape,pfia chronica theailion? of the flomach are not fo far impaired'
or deftroyed as totally to prevent the excitation of the fenforial power
of afTociation, which therefore-contributes fomething towards the ac-
tions of the heart and arteries^ though lefs than natural,, as a weak.
p.ulfe always I believe attends this difeafe.

There is a torpor of the flomach,. and of the upper part of the ali-
mentary canal in hyfleria, zs is evident from the retrograde adions of
the duodenum, flomach, and (xfophagus, which conflitute the globus^
byftericus, or fenfation of a. globe nfing into the throat. But as thefe;
retrograde aclions are lela than thofe,. which induce ficknefs or vomit-

574 THEORY OF FEVER. Sup. I. 8,

ing, and are not occafioned by previous exhauftion of the fenforial
power of irritation, ^they do not fo totally prevent the excitement of
the ienforial power of aflbciation, as to leffen the motion of the heart
and arteries fo much as to induce fever ; yet in this cafe, as in apep-
lia, and in chlorofis, the pulfations of the heart and arteries are weaker
than natural, and are fometimes attended with occafionally increafed
adtion of the capillaries ; as appears from the flufliings of the face, and
hot flcin, which generally form an evening febricula in difeafes attend-
ed with weak digeftion.

12. The increafed a(£tion., or orgafm, of the cutaneous, pulmo-
nary, and cellular capillaries, with their fecerning and abforbent vef-
fels, in thofe fevers which are attended with deficiency of vital action,
exhaufts the patient both by the additional expenditure of fenforial
power on thofe organs df fecretion, and by the too great abforption of
the mucus and fat of the body; whence great debility and great ema-
ciation. Hence one great indication of cure of continued fever with
arterial debility is to diminifla the, too great adlion of the capillaries ;
which is to be done by frequent ablutions, or bathing the whole Ikin
in tepid or in cold water, as recommended by Dr. Currieof Liver-
pool (Philof. Tranf. for 1792), for half an hour, twice a day, or at
thofe times when the Ikin feels dryeft and hotteft. Much cool air
Ihould alfo be admitted, when the breath of the patient feels hot to
one's hand ; or when the tongue, efpecially its middle part, is dry,
and covered with a cruft of indurated mucus ; as thefe indicate the
increafed aftion of the pulmonary capillaries ; in the fame manner as
the dry and hot fkin indicates the orgafm of the cutaneous capillaries ;.
and the emaciation of the body that of the cellular ones.

For this purpofe of abating the action of the capillaries by frequent
ablution or fomentation, water of any degree of heat beneath that of
the body will be of fervice, and ought in accurate language to be
called a cold bath ; but the degree of coldnefs, where the patient is

fenfible.

Sup. I. f^. THEORY OF FEVER. sjs

fenfible, fliould In fome rneafure be governed by his fenfiitions ; as it
is probable, that the degree of coldnefs, which is moft grateful to
him, will alfo be of the greatefh benefit to him. See Clafs IIL 2. i.
12. and Article 15 of this Supplement.

Another great ufe of frequent ablutions, or fomentations, or baths,
in fevers, where the ftomach is in fome degree torpid, is to fupply
the fyftem with aqueous fluid by means of the cutaneous abforbents ;
which is diffipated fafter by the increafed aftion of the fecerning ca-
pillaries, than the ftomach can fumifli, and occafions great thirft at
the intervals of the licknefs..

IX. Torpor of the Lungs.

v.. The lungs in many cafes of contagion may firft be afFeflied witE
torpor, and the Ikin become cold by fympathy; in the fame manner
as a cold Ikin on going into the cold bath induces difficulty of breath-
ing. Or the ftomach may become affeded with torpor by its fympa-
thy with the lungs,, as in the experiments of Mr. Watt with hydro-
carbonate gas ; a few refpirations of which induced ficknefs, and even
fyncope. When the ilomach or Ikin is thus affeded fecondarily by
alTociation, an accumulation of fenforial power occurs much fooner,
than when thefe parts become torpid in confequence of previous ex-
cefs of ftimulus J and hence they fooner recover their accuftomed ac-
tion, and the fever ceafes. The particles of contagious matter thus
received by relpiration fomewhat refemble in their efFeds the acid
gafes from burning fulphur, or from charcoal ; which, if they do not
infiantly deitroy, induce a fever, and the patient flowly recovers.

2. I was fome years ago {looping down to look, which way the

water oozed from a morafs,, as a labourer opened it with a fpade, to

i . - - deteft

57^ THEORY OF FEVER. Sup. I. 9.

detecSl the fource of the fpruig, and inhaled a vapour, which occafion-
ed an inftant fenfe of fuffocation. lmn:>ediately recoiling 1 believe I
inhaled it but once; ,yeti a few hours afterwards in the cool of the
evening, when I returned home rather fatigued and hungry, a fhiver-
ing and cold fit occurred, which was followed by a hot one ; and the
whole difeafe began and terminated in about twelve hours without re-
turn. In this cafe the power of fear, or of imagination, was not con-
cerned ; as I neither thought of the bad air of a morafs before I per-
ceived it ; nor expelled a fever- fit, till it occurred.

In this cafe the torpor commenced in the lungs, and after a few
hours, by the addition of fatigue, and cold, andhunger, was propa-
gated by direct fympathy to the reft of the fyftem. An orgafm or in-
creafed a£lion of the whole fyftem was then induced by the accumu-
lation of fenforial power of irritation in the lungs, and of aflbciation
in the other organs ; and when thefe fubfided, the difeafe ceafed. It
may be afked, could a torpor of the capillaries of the air-veflels of the
lungs be fo fuddenly produc-ed by great ftimulation ? — It appears pro-
bable, that -it might, becaufe great exertion of irritative motions may-
be inftantly produced without our perceiving them j that is, without
their being attended by fenfation, both in the lungs and ftomach ; and
the organs may become torpid by the great expenditure of the fenforial
power of irritation in an inftant of time ; as paralyfis frequently in-
ftantly follows too great an exertion of voluntary power.

3. When the capillaries of the lungs ad too violently, as in fome
continued fevers ; which is known by the heat of the breath, and by
the drynefs of the tongue, efpecially of the middle part of it; not
only cooler air might be admitted rhore freely into' a fick room ta
counterafi: this orgafm of the pulmonary capillaries ; but perhaps the
patient might breathe with advantage a mixture of carbonic acid gas,
or of hydrogene gas, or of azote with atmofpheric air. And on the
contrary, when there exifts an evident torpor of the pulmonary capil-

6 laries.

Sup. I. 10. THEORY OF FEVER. ^^-j

laries, which may be known by the correfpondent chihieft of the
Ikin ; and by a tickling cough, which fometimes attends cold paroxJ-
yfms of fever, and is then owing to the deficient abforption of the
pulmonary mucus, the faline parts of which ftimulate the broachiae,
or air-veffels ; a mixture of one part of oxygen gas with ioor2o
parts of atmofpheric air might -probably be breathed with great ad-

vantage.

X. Torpor of the Brain.

As the inaflivity or torpor of the abforbent veffels of the brain is
the caufe of hydrocephalus internus ; and as the deficiency of venous
abforption in the brain, or torpor of the extremities of its veins, is
believed frequently to be the caufe of apoplexies ; fo there is-reafon to
conclude, that the torpor of the fecerning vefTels of the brain, which
are fuppofed to produce the fenforial power, may conftitute the im-
mediate caufe of fome fevers with arterial debility. And alfo that the
increafed adion of thefe fecerning veffels may fometimes conflitute
the immediate caufe of fevers with arterial flrength.

It is neverthelefs probable, that the torpor or orgafm of the fangui-
ferous, abforbent, or fecerning veffels of the brain may frequently
exiil: as a fecondary effedt, owing to their affociation with other or-
gans, as the flomach or lungs ; and may thus be produced like the
torpor of the heart and arteries in inirritative fevers, or like the orgafm
of thofe organs in irritative fevers, or inflammatory ones.

Where there exifts a torpor of the brain, might not, very flight
ele6lric fliocks paffed frequently through it in all dire6lions be ufed
with advantage ? Might not fomentations of 94 or 96 degrees of heat
on the head for an hour at a time, and frequently repeated, ftimulate
the brain, into adion ; as in the revival of winter-fleeping animals by

Vol. II. 4 E warmth ?

578 THEORY OF FEVER. Sup. I. ir.

warmth ? Ether externally might be frequently applied, and a blifter
on the (haved head.

Where the fecernins; veffels of the brain a£t with too sjreat energ-v,
as in iome inflammatory fevers, might it not be diminifhed by laying
the patient horizontally on a mill-ftone, and whirling him, till fleep
fhould be produced, as the brain becomes comprefled by the centri-
fugal force? See Article 15 of this Supplement.

XI. Torpor of the Heart and Arteries^

1. It was fhewn in Clafs IV. i. i. 6. in IV. 2. i. 2. and in SuppL
I. 6. 3. that a reverfe fympathy generally exifts between the ladleal
and lymphatic branches of the abforbent fyftem. Hence, when the
motions of the abforbents of the ftomach are rendered torpid or retro-
grade in fevers with arterial debility, thofe of the Ikin, lungs, and
cellular membrane, a£l with increafed energy. But the aftions of
the mufcular fibres of the heart and arteries arc at the fame time af-
fociated with thofe of the mufcular fibres of the ftomach by direft
fympathy. Both thefe actions occur during the operation of power-
ful emetics, as fquill, or digitalis ; while the motions of the ftomach
continue torpid or retrograde, the cellular and cutaneous abforbents
ad: with greater energy, and the pulfations of the heart and arteries
become weaker, and fometimes flower.

2. The increafed aftion of the ftomach after a meal, and of the
heart and arteries at the fame time from the flimulus of the new fup-
ply of chyle, feems originally to have produced, and to have eftablifh-
ed, this dire£l fympathy between them. As the increafed adion of
the abforbents of the ftomach after a meal has been ufually attended
with diminiflied adion of the other branches of the abforbent fyftem,

as.

Sup. I.I r. THEORY OF FEVER, 579

as mentioned In Clafs IV. i. i. 6. and has thus eftablifhed a reverie
fympathy between them.

2. Befides the reverfe fympathy of the abforbent velTels and the
Hiufcles of the ftomach, and of the heart and arteries, with thofe of
the ikin, lungs, and cellular membrane; there exifts a fimilar reverfe
fympathy between the fecerning veffels or glands of the former of
thefe organs with thofe of the latter ; that is the mucous glands of
the heart and arteries ad generally by dire£l fympathy with thofe of
the flomachj and the mucous glands of the cellular membrane of the
lungs, and of the Ikin, ad by reverfe fympathy with them both.

Hence when the ftomach is torpid, as in licknefs, this torpor fome-
times only affefts the abforbent veffels of it ; and then the abforbents
of the cellular membrane and the fkin only a£l with increafed energy
by reverfe fympathy. If the torpor affedts the mufcular fibres of the
ftomach, thofe of the heart and arteries a£l by diredt fympathy with
it, and a weak pulfe is produced, as in the exhibition of digitalis, but
without increafe of heat. But if the torpor alfo affefts the glands of
the ftomach, the cutaneous and pulmonary glands ad with o-reater
energy by their reverfe fympathy with thofe of the ftomach, and of
the heart and arteries ; and great heat is produced along with increafed
perfpiration both from the Ikin and lungs.

J"

There is fome difficulty in explaining, why the adions of the
extenfive fyftem of capillary glands, which exift on every other
membrane and cell in the body for the purpofe of fecreting mucug
and perfpirable matter, fliould fo generally acl by reverfe fympathy
with thofe of the ftomach and upper part of the inteftines. It was
fhewn in Clafs IV. i. i. 6. that when the ftomach was filled with
folid and fluid aliment, the abforbents of the cellular membrane, and
of the bladder, and of the fkin aded with lefs energy ; as the fluids,
they were uled to abforb and tranfmit into the circulation, were now

4 E 2 lefa

580 THEORY OF FEVER. Sup. 1. n.

lefs wanted ; and that hence^by habit a reverfe fympathy obtained
between thefe branches of the abforbents of the aUmentary canal, and
thofe of the other parts of the body.

Now, as at this time lefs fluid was abforbed by the cutaneous and
cellular lymphatics, it would happen, that lefs would be fecreted by
their correfpondent fecerning vefTels, or capillary glands ; and that
hence by habit, thefe fecerning veffels would acquire a reverfe fym-
pathy of a6lion with the fecerning veffels of the alimentary canal.

Thus when the abforption of the tears by the pundla lacrymalia is
much increafed by the ftimulus of fnufF; or of an afFeding idea, on
the nafal dufts, as explained in Se£t. XVL 8. 2. a great increafe of
the fecretion of tears from the lacrymal glands is produced by the
diredl fympathy of the a6lion of thefe glands with thofe of their cor-
refpondent abforbents ; and that though in this cafe they are placed
at fo great a diflance from each other.

4. A difBcult qneflion here occurs ; why does it happen, that m
fevers with weak pulfe the contradions of the heart and arteries be-
come at the fame time more frequent ; which alfo fometimes occurs
in chlorofis, and in fome hyfferic and hypochondriac difeafes, and in
fome infanities ; yet at other times the weak pulfe becomes at the
fame time flow, as in the exhibition of digitalis, and in parefis irrita-
tiva, defcribed in Clafs I. 2. 1, 2. which may be termed a fever with
flow pulfe ? this frequency of pulfe can not depend on heat, becaufe
it fometimes exifts without heat, as towards the end of fome fevers
with debility.

Now as apoplexies, which are fometimes afcribed to fulnefs of
blood, are attended with flow pulfe; and as in animals dying in the
flaughter-houfe from deficiency of blood the pulfe becomes frequent
in extreme; may not the frequency of pulfe in fevers with arterial
debiUty be in general owing to paucity of blood ? as explained in
Sed. XXXII. 2. 3. and its flownefs in parefis irritativa be caufed by

the

Sup. I. II. THEORY OF FEVER. 5Sr

the debility being accompanied with due quantity of blood ? or may
not the former circumftance fometimeS depend on a concomitant af-
fe£tion of the brain approaching to fleep ? or to the unufual facility
of the paffagc of the blood through the pulmonary and aortal capil-
laries ? in which circumftance the heart may completely enipty itfelf
at each pulfation, though its contradtions may be weak. While the
latter depends on the difficulty of the paflage of the blood through
the pulmonary or aortal capillaries, as in the cold fits of intermittents,
and in fome palpitations of. the heart, and in fome kinds of hi^mop-
toe ? in thefe cafes the increafed refiftance prevents the heart from
emptying Itfelf, and in confequence a new diaftole fooner occurs, and
thus the number of pulfations becomes greater in a given time..

c. In refpe^t to the fympathies of aflion,. which. produce or con-
flitute fever with debility, the fyftem may be divided intocertain
provinces, which are aflentient or oppofite to each other Firft, the
lafteals or abforbent vefl'els of the Ilomach, and upper part of the in-
teftines ; fecondly, the lymphatics or all the other branches of the
abforbent veffels, which arife from the fkin, mucous membranes, cel-
lular membranes, and the various glands. Thefe two divifions adt
by reverfe fympathy with each other in the hot fits of fever with
debility, though by direct fympathy in the cold ones. The third
divifion confifts of the fecerning veflels of the flomach and upper in-
teftines ; and the fourth of the fecerning veffels of all the other parts
of the body,, as the capillary glands of the fkin, lungs, and cellular
membrane, and the various other glands belonging to the fangui-
ferous fyflem. Many of thefe frequently, but the capillaries always,
aft by reverfe fympathy with thole of the third divifion above men-
tioned in the hot fits of fever with debility, though by dire6l fympa-^
thy with them in the cold fits. Fifthly, the mulcuiar fibres of the -
ftomach, and upper inteftines; and fixthly, the mufcular fibres of the
heart and arteries. The adions of thefe two lafl divilions of moving

fibres

582 THEORY OF FEVER. Sup. I. n.

fibres adl by dire£l fympathy with each other, both in the cold and
hot fits of fevers with debihty.

The efficient caufe of thofe apparent fympathies in fevers with
weak pulfe may be thus underftood. In the cold paroxyfm of fever
with weak pulfe the part firft afFedled I believe to be the flomach,
and that it has become torpid by previous violent exertion, as by
fwallowing contagious matter mixed with faliva, and not by defe(5t
of flimulus, as from cold or hunger. The adfions of this important
organ, which fympathizes with almoft every part of the body, being
thus much diminifhed or nearly deftroyed, the fenforial power of
afTociation is not excited ; which in health contributes to move the
heart and arteries, and all the reft of the fyflem ; whence an univer-
fal torpor occurs.

When the hot fit approaches, the flomach in fevers with flrong
pulfe regains its a6livity by the accumulation of the fenforial power
of either irritation, if it was the part firft afFe£led, or of afTociation if
it was affedted in fympathy with fome other torpid part, as the fpleen
or liver ; which accumulation is produced during its torpor. At the
fame time all the other parts of the fyftem acquire greater energy of
aftion by the accumulation of the fenforial power of afTociation, which
was produced, during their inadtivity in the cold fit.

But in fevers with weak pulfe the ftomach, whofe fenforial power
of irritation had been previoufly exhaufled by violent aftion, acquires
no fuch quick accumulation of fenforial power, but remains in a flate
of torpor after the hot fit commences. The heart and arteries re-
main alfo in a ftate of torpor, -becaufe there continues to be no
excitement of their power of aflbciation owing to the torpid motions
of the floraach ; but hence it happens, that there exifts at this time
a great accumulation of the power of afTociation in the lefs a£live
fibres of the heart and arteries; which, as it is not excited and ex-
pended by them, increafes the affociability of the- next link of the
alTociated chain of motions, which confifts of the capillaries or other

glands ;

Sup. I. II. THEORY OF FEVER. 583

glands; and that in fo great a degree as to aduate them with unna-
tural energy, and thus to produce a perpetual hot fit of fever. Be-
caufe the aflbclability of the capillaries is fo much increafed by the
accumulation of this power, owing to the lelFened a6tivity of the
heart and arteries, as to over-balance the lefTened excitement of it by
the weaker movements of the heart and arteries.

6. When the accumulation of the fenforial power of irritation
caufed by defedl of ftimulus is greater in the firft link of a train of
a£lions, to which affociated motions are catenated, than the deficiency
of the excitement of the fenforial power of afTociation in the next
link, what happens ? — the fuperabundance of the unemployed fen-
forial power of the firfl link is derived to the fecond ; the aflbclability
of which thus becomes to greatly increafed, that it adls more vio-
lently than natural, though the excitement of its power of afTociatioa
by the leflened adion of the firfl link is lefs than natural.. So that
in this fituation the withdrawing of an accuftomed ftimulus in fome
parts of the fyftem will decreale the irritative motions of that, part,
and at the fame time occafion an. increafe of the affociate motion of
another part, which is catenated with: it.

This circumftance nevei theleis can only occur in thofe parts of
the fyfl:em^ whofe natural adions are perpetual, and the accumula-
tion of fenforial power on that account very great, when their ac-
tivity is much leflened by the dedudtion of their ufual ftimulus; and
are therefore only to be found in the fanguiferous fyftem, or in the
alimentary canal, or in the glands- and capillaries.. Of the firft of
which the following is an inftance.

The refpiration of a reduced atmofphere,- that is of air mixed with
hydrngene or azote,, quickens the pulfe, as obferved in the cafe of
Mrs. Eaton by Dr. Reynolds and Dr. Thornton ; to which Dr,
Beddoes adds in a note, that *' he never faw an inflance in which a
lowered atmofphere did not at the moment quicken the pulfe, while

it

584 THEORY OF FEVER. Sup. I. n.

it weakened the action of the heart and arteries." Confiderations on
Fa6litious Airs, by Thomas Beddoes and James Watt, Part fll. p. 67.
Johnfon, London. By the affiftance of this new fadl the curious
circumftance of the quick produ6lion of warmth of the (kin on co-
vering the head under the bed-clothes, which every one muft at fome
time have experienced, receives a more fatisfaftory explanation, thaa
that which is given in Clafs IV. i. i. 2. which was pruited before
this part of Dr. Beddoes's Confiderations was publiflied.

For if the blood be deprived of its accuflomed quantity of oxygen,
as in covering the head in bed, and thus breathing an air rendered im-
pure by repeated refpiration, or by breathing a faditious air with lefs
proportion of oxygen, which in common refpiration paiTes through
the moift membranes of the lungs, and mixes with the blood, the
pulfations of the heart and arteries become weaker, and confe-
quently quicker, by the defeft of the ftimulus of oxygen. And as
thefe vefTels are fubjed to perpetual motion, the accumulation of the
fenforial power of irritation becomes fo great by their leflened ac-
tivity, that it excites the veffels next conne£led, the cutaneous capil-
laries for inflance, into more energetic actions, fo as to produce in-
creafed heat of the fkin, and greater perfpiration.

How exadlly this refembles a continued fever with weak and quick
pulfe ! — in the latter the adlion of the heart and arteries are leflencd
by defe6t of the excitement of the fenforial power of aflbciation,
owing to the torpor or leffened actions of the flomach ; hence the
accumulation of the fenforial power of aflbciation in this cafe, as the
accumulation of that of irritation in the former, becomes fo abundant
as to excite into increafed aftion the parts rnoft nearly conne£led, as
the cutaneous capillaries.

In refpeft to the circumftance mentioned by Sydenham, that co-
vering the head in bed in a fhort time relieved the pertinacious fick-
nefs of the patient, it mull be obferved, that when the adtion of the
heart and arteries become weakened by the want of the due ftimulus

8 of

Sup. I. II. THEORY OF FEVER.' 585

of the proper quantity of oxygen In the blood, that an accumulation
of the fenforial potver of irritation occurs in the fibres of the heart
and arteries, which then is expended on thofe of the capillary glands,
increafing their aftions and confequent fecretions and heat. And
then the ftomach is thrown into ftronger a£lion, both by the greater
excitement of its natural quantity of the fenforial power of affociation
by the increafed aftions of the capillaries, and alfo by fome increafc
of aflbciability, as it had been previoully a long time in a ftate of tor-
por, or lefs aftivity than natural, as evinced by its perpetual fick-
nefs.

la a manner fomewhat fimilar to this, is the rednefs of the fkia
produced in angry people by the fuperabundance of the unemployed
fenforial power of volition, as explained in Clafs IV. 2. 3. 5. Rubor
ex ira. From hence we learn how, when people in fevers with weak
pulfe, or in dropfies, become infane, the abundance of the unemployed
fenforial power of volition increafes the attions of the whole movina:
fyftem, and cures thofe difeafes.

7. As the orgafm of the capillaries In fevers with vi'eak pulfe is
immediately caufed by the torpid adtions of the heart and arteries, as
above explained, this fupplles us with another indication of cure ia
fuch fevers, and that is to Simulate thefe organs. This may pro-
bably be done by fome kind of medicines, which are known to pafs
into the blood unchanged in fome of their properties. It is poflible
that nitre, or Its acid, may pafs into the blood and Increafe the co-
lour of it, and thus increafe its fllmulus, and the fame may be
fuppofed of other ialts, neutral or metallic ? As rubia tindloria,
madder, colours the bones of young animals, it muft pafs into the
blood with Its colouring matter at leaft unchanged, and perhaps many
other medicines may likewife affect the blood, and thus aft by
fhmulating the heart and arteries, as well as by ftlmulating the fto-
mach ; which clrcumflance deferves further attention.

Vol. IL 4F Another

586 THEORY OF FEVER. Sw. I. 12.

Another way of immediately ftimulating the heart and arteries
would be by transfufing new blood into them. Is it pofllble that any
other fluid befides blood, as chyle, or milk, or water, could, if ma-
naged with great art, be introduced fafely or advantageoufly into the
vein of a living animal ?

A third method of exciting the heart and arteries immediately is
by increafing the natural ftimulus of the blood, and is well worthy
experiment in all fevers with weak pulfe ; and that confifts in fup-
plying the blood with a greater proportion of oxygen ; which may
be done by refpiration, if the patient was to breathe either oxygen
o-as pure, or diluted with atmofpheric air, which might be given to
many gallons frequently in a day, and by palling through the moift
membranes of the lungs, according to the experiments of Dr. Prieft-
ley, and uniting with the blood, might render it more ftimulant, and
thus excite the heart and arteries into greater a6lion ! May not fome
eafier method of exhibiting oxygen gas by refpiration be difcovered,
as by ufing very fmall quantities of hyper-oxygenated marine acid
gas very much diluted with atmofpheric air ?

XII. T'orpor of the Stomach and upper Iniejiines.

I. The principal circumftance, which fupports the increafed acf
tion of the capillaries in continued fever with weak pulfe, is their
reverfe lympathy with thofe of the flomach and upper inteftines, or
with thofe of the heart and arteries. The torpor of the flomach and
upper inteftines is apparent in continued fevers from the total want of
appetite for folid food, befides the ficknefs with which fevers gene-
rally commence, and the frequent diarrhoea with indigefted ftools, at
the fame time the thirft of the patient is fometimes urgent at the
intervals of the ficknefs. Why the ftomach can at this time take
fluids by intervals, and not folids, is difficult to explain ; except it be
fuppofed, as fome have affirmed, that the lafteal abforbents are a dif-
6 ferent

Sup. I. 12. THEORY OF FEVER. 587

fereiit branch from the lymphatic abforbents, and that in this cafe
the former only are in a ftate of permanent torpor.

2. The torpor of the heart and arteries is known by the weak-
nefs of the pulfe. When the adions of the abforbents of the flo-
mach are diminifhed by the exhibition of fmall dofes of digitalis, or
become retrograde by larger ones, the heart and arteries a.d: more
feebly by direct fympathy ; but the cellular, cutaneous, and pulmonary
abforbents are excited into greater aftion. Whence in anafarca the
■fluids in the cellular membrane throughout the whole body are ab-
forbed during the ficknefs, and frequently a great quantity of atmof-
pheric moifture at the fame timcj as appears by the very great dif-
charge of urine, which fometimes happens in thefe cafes ; and in
ileus the prodigious evacuations by vomiting, which are often a hun-
dred fold greater than the quantity fwallowed, evince the great
a-<5lion of all the other abforbents during the ficknefs of the ftomach.

3. But when the flomach is rendered permanently fick by an
emetic drug, as by digitalis, it is not probable, that much accumu-
lation of fenforial power is foon produced in this organ ; becaufe its
ufual quantity of fenforial power is previoufly exhaufted by the great
flimulus of the foxglove ; and hence it feems probable, that the great
accumulation of fenforial power, which now caufes the increafed
adtion of the abforbents, is produced in confequence of the inadlivity
of the heart and arteries ; which inadlivity is induced by deficient
excitement of the fenforial power of aflbciation betv/een thofe organs
and the ftomach, and not by any previous exhauftion of their natural
quantity of fenforial power ; whereas in ileus, where the toi-por of
the ftomach, and con fequent ficknefs, is induced by reverfe fympathy
with an inflamed inteftine, that is, by diffevered or defe£tive aflbcia-
tion ; the accumulation of fenforial power, which in that difeafe fo
violently aduates the cellular, pulmonary, and cutaneous abforbents, is

4 F 2 apparently

588 THEORY OF FEVER. Sup. I. 13.

apparently produced by the torpor of the ftomach and lafteals, and
the confequent accumulation of the fenforlal power of aflbciation in
them owing to their kffened adion in fickQefs.

4. This accounts for the dry Ikin in fevers with weak pulie,
Vi'here the ftomach and the heart and arteries are in a torpid ftate,
and for the fudden emaciation of the body ; becaufe the actions of the
cellular and cutaneous abforbents are increafed by reverfc fympathy
with thofe of the ftomach, or with thofe of the heart and arteries ;
that is by the expenditure of that fenforial power of affociation, which
is accumulated in confequence of the torpor of the ftomach and heart
and arteries, or of either of them ; this alfo explains the ftidden ab-
forption of the milk in puerperal fevers ; and contributes along with
the heat of the refpired air to the drynefs of the mucous membrane
of the tona;ue and noftrils.

5.. Belides the feverfe fympathy, with which the abforbent vef-
fels of the ftomach and upper inteftines adt in rcfpedl to all the other
abforbent veflels, as in the exhibition of digitalis, and in ileus ;
there is another reverfe fympathy exifts between the capillaries, or
iecretory veffels of the ftomach^ and thofe of the Ikin. Which may
neverthelefs be occafioned by the accumulation of fenforial power by
the torpor of the heart and arteries, which is induced by dire6l fym-
pathy with the ftomach ; thus when the torpor of the ftomach re-
mains in a fever-fit, which might otherwife have intermitted, the tor-
por of the heart and arteries remains alfo by diredl fympathy^ and the
increafed cutaneous capillary aftion, and confequent heat, are pro-
duced by reverfe fympathy ; and the fever is thus rendered continual^
owing primarily to the torpor of the ftomach.

6. The reverfe fympathy, which exifts between the capillaries of
the ftomach and the cutaneous capillaries, appears by the chillnefs of

fome

Sup. I. 12. THEORY OF FEVER. 589

fome people after dinner ; and contrary-wife by the digeftion beino-
flrengthened, when the fkin is expofed to cold air for a (hort time ;.
as mentioned in Clafs IV. 1. 1.4. and IV. 2. i. i. and from the
heat and glow on the Ikin, which attends the a6lion of vomiting ; for
though when ficknefs hrft commences, the jfkin is pale and cold ;
as it then partakes of the general torpor, which induces the ficknefs ;
yet after the vomiting has continued fome minutes, fo that an accu-
mulation of fenforial power exifts in the capillaries of the ftomach,
and of the Ikin, ov\'ing to their diminifhed adion ; a glow of the
Ikin fucceeds, with fweat, as well as with increafed abforption.

7. Neverthelefs in fome circumftances the ftomach and the heart
and arteries feem to a6t by direct fympathy with the cutaneous caoil-
laries, as in the flufhing of the face and glow of the fkin of fome
people after dinner ; and as in fevers with ftrong pulfe. In thefe
cafes there appears to be an increafed produdion of fenforial power,
either of fenfation, as in the blufh of fhame ; or of volition, as in the
blufh of anger; or of irritation, as in the flufhed face after dinner
above mentioned.-

This increafed adion of the capillaries of the (kin along with the
increafed adions of the ftomach and heart is perhaps to be efleemed a
fynchronous increafe of adion, rathex than a fympathy between thofe
organs. Thus the flufhing of the face after dinner may be owing to
the fecretion of fenforial power in the brain being increafed by the
aflbciation .of, that organ with the ftomach, in a greater proportion
than the increafed expenditure of it, or may be owing alfo to the fti-
mulus of new chyle received into the blood.

, , 8. When the ftomach and the heart and arteries are rendered
torpid in fevers, not only the cutaneous, cellular, and pulmonary ab-
forbents are excited to ad with greater energy ; but alfo their corref-
pond.eat capillaries and fecerning velTels or glands, efpecially perhaps

thofe

e.

59© THEORY OF FEVER. Sup. I. 12.

thofe of the Ikin, are induced into naore energetic action. Whence
greater heat, a greater fecretion of perfpirable matter, and of mucus ;
and a greater abforption of them both, and of aerial moifture. Thefe
reverfe fympathies coincide with other animal fa6ls, as in eruption of
fmall pox on the flice and neck the feet become cold, while the face
and neck are much flufhed ; and in the hemiplagia, when one arm
and leg become difobedient to volition, the patient is perpetually
moving the other. Which are well accounted for by the accumula-
tion of fenforial power in one part of an aflbciated feries of adlions,
when lefs of it is expended by another part of it ; and by a deficiency
of fenforial power in the fecond link of aflbciation, when too much
of it is expended by the firft.

9. This dodrine of reverfe fympathy enables us to account for that
difficult problem, why in continued fevers the increafed aftion o"
the cutaneous, cellular, and pulmonary capillaries proceeds without in-
terruption or return of cold fit;, though perhaps with fome exacerba-
tions and remiffions ; and that during a quarter, or half, or three
quarters, or a whole lunation ; while at the fame time the pulfations
of the heart and arteries are weaker than natural.

To this fhould be added the dire£l fympathy, which exifts be-
tween the periftaltic motions of the fibres of the ftomach, and the
pulfations of the heart. And that the ftomach has become torpid by
the too great ftimulus of fome poifonous or contagious matter; and
this very intricate idea of continued fever with feeble pulfe is reduced
to curious fimplicity.

The dired fympathy of the ftomach and heart and arteries not
only appears from the ftronger and flower pulfe of perfons exhaufted
by fatigue, after they have drank a glafs of wine, and eaten a few
mouthfuls; but appears alfo from the exhibition of large dofes of
digitalis ; when the patient labours under great and inceffant efforts
16 vomit, at the fame time that the adlions of the abforbent fyflem

are

Sup. I. 12. THEORY OF FEVER. 591

are known to be much increafed by the hafty abforption of the ferous
fluid in anafarca, the pulfations of the heart become flow and inter-
mittent to an alarming degree. See Clafs IV. 2. i. 17. and 18.

10. It would afllfl: us much in the knowledge" and cure of fevers,
if we could always determine, which part of the fyftem was pri-
marily affected ; and whether the torpor of it was from previous ex-
cefs or defe(ft of ftimulus ; which the induflry of future obfervers
mufl: difcover. Thus if the ftomach be affected primarily, and that
by previous excefs of ftimulus, as when certain quantities of opium,
or wine, or blue vitriol, or arfenic, are fwallowed, it is fome time in
recovering the quantity of fenforial power previoufly exhaufted by
excefs of fl:imulus, before any accumulation of it can occur. But if
it be affedled with torpor fecondarily, by fympathy with fome difl:ant
part ; as with the torpid capillaries of the fkin, that is by defeftive
excitement of the fenforial power of afl!bciation ; or if it be afFefted '
by defeft of flimulus of food or of heat ; it Iboner acquires fo much:
accumulation of fenforial power, as to be enabled to accomn^odate it^
felf to its leflened ftimulus by increafe of its irritability.

Thuj in the hemicrania the torpor generally commences in a dif-
eafed tooth, and the membranes about the temple, and alio thofe of
the ftomach become torpid by direct fynchronous fympathy; and
pain ot the head, and ficknefs fupervene ; but no fever or quicknefs
of pulfe. In this cafe the torpor of the ftomach is owing to defe£t
of the fenforial power of afibciation, which is caufed by the too
feeble aftious of the membranes furrounding the difeafed tooth, and
thus the train of fympathy ceafes here without affedling the motions
of the heart and arteries ; but where contagious matter is fwallowed into
the ftomach, the ftomach after a time becomes torpid from exhauftion
of the fenforial power of irritation, and the heart and arteries adl feebly
from defe£l of the excitement of the power of afibciation. In the former
cafe the torpor of the ftomach is conquered by accumulation of the

ppwerr

59-2- THEORY OF FEVER. Sup. I. 12.

power of aflociatiou in one or two whole days ; in the latter it recovers
by accumulation of the power of irritation in three or four weeks. ..

In intermittent fevers the ftomach is generally I believe afFedled fe-
condarily by fympathy with the torpid cutaneous capillaries, or with
fome internal torpid vifcus, and on this account an accumulation of fen-
forial power arifes in a few hours fufficient to refi:ore the natural irrita-
bility of this organ ; and hence the hot fit fucceeds, and the fever Inter-
-miis.. Or if this accumulation of lenforial power becomes exceffive
and permanent, the continued fever with flrong pulfe is produced, or
febris irritativa. '

In continued fevers the flomach is frequently I fuppofe afFeded
with torpor by previous excefs of ftimulus, and confequent exhauflioa
of feuforial power, as when contagious matter is fwallowed with the
laliva, and it is then much flower in producing an accurnulation of
ienforial power fufficient to reflore its healthy irritability ; which is
a frequent caufe of continued fever with weak pulfe or febris inirrita-
tiva. Which confifls, after the cold fit is over, in a more frequent
and more feeble adion of the heart and arteries, owing to their di-
re(fl fympathy with the mufcular fibres of the torpid flomach ; toge-
ther with an increafed a<£lion of the capillaries, glands, and abforbents
of the ikln, and cellular membrane, owing to their reverfe fympathy
with the torpid capillaries, glands, and abforbents of the ftomach, or
with thofe of the heart and arteries.

Or in more accurate language., i. The febris inirritativa, or fever
with weak pulfe, commences with torpor of the ftomach, occafioned
by previous exhauftion of fenforial power of irritation by the ftimulus
of contasious matter Iwallowed with the faliva. 2. The whole
fvftem becomes torpid from defeft of the excitement of the fenforial
power of affociation owing to the too feeble aftions of the ftomach,
this is the cold fit. 3. The whole fyftem, except the ftomach with
the upper inteftines, and the heart and arteries, falls into increafed
adion, or orgafm, owing to accumulation of fenforial power of affo-
I ciatioa

Sup. I. 12. THEORY OF FEVER. 593

elation during their previous torpor, this is the hot fit. 4. The fto-
jnach and upper inteflines have not acquired their natural quantity of
fenforial power of irritation, which was previoufiy exhaufted by vio-
lent action in confequence of the ftimulus of contagious matter, and
the heart and arteries remain torpid from deficient excitement of the
fenforial power of aflbciation owing to the too feeble adlions of the
ftomach, 5. The accumulation of fenforial power of aflbciation in
confequence of the torpor of the heart and arteries occafions a perpe-
tual orgafm, or increafed action of the capillaries.

II. From hence it may be dedu£ted firft, that when the torpor of
the ftomach firft occurs, either as a primary effeft, or as a fecondary
link of fome aflbciate train or circle of motions, a general torpor of
the fyflem fometimes accompanies it, which conftitutes the cold fit
of fever; at other times no fuch general torpor occurs, as durino- the
operation of a weak emetic, or during fea-ficknefs.

Secondly. After a time it generally happens, that a torpor of the
ftomach ceafes, and its a£tions are renewed with increafe of vio-our by
accumulation of fenforial power during its quiefcence ; as after the
operation of a weak emetic, or at the intervals of fea-ficknefs, or after
the paroxyfm of an intermittent fever.

Thirdly. The ftomach is fometimes much flower in recovering
from a previous torpor, and is then the remote caufe of continued
fever with weak pulfe ; which is owing to a torpor of the heart and
arteries, produced in confequence of the deficient excitement of the
power of aflbciation by the too weak adlions of the ftomach ; and to
an orgafm of the capillaries of the other parts of the fyftem, in con-
fequence of the accumulation of fenforial power occafioned by the
inactivity of the heart and arteries.

Fourthly. The torpor of the ftomach is fometimes fo complete,

that probably the origin of its nerves is likewife affeded, and then no

accumulation of fenforial power occurs. In this cafe the patient dies

Vo;.. II. .4 G for

594 THEORY OF FEVER. Sup. I. 12.

for want of nourifhment j either in three or four weeks, of the inirri-
tative fever ; or without quick pulfe, by what we have called parefis
irritativa. Or ke continues many years in a ftate of total debility.
When this torpor fuddenly commences, the patient generally futters
epileptic fits or temporary infanity from the difagreeable fenfation of
fo great a, torpor of the flomach ; which alfo happens fometimes at
the eruption of the diftind fmall pox ; whence we have termed this
difeafe anorexia epileptica. See Clafs II. 2. 2. i. and III, i. i. 7. aiid
Suppl. I. 14. 3>

Fifthly. When this torpor of the flomach is lefs in degree or ex-
tent, and yet without recovering its natural irritability by accumula-
tion of feafoi-ial power, as it does after the cold fit of intermittent
fever, or after the operation of mild emetics, or during fyncope ; a
permanent defe6l of its adivity, and of that of the upper inteftines,
remains, which conftltutes apepfia, cardialgia, hypochondriafis, and
hyfleria.. See Clafs I. 3. i. 3. and I. 2. 4. 5.

Sixthly. If the torpor of the flomach be induced by dire£l fym-
pathy,. as in confequence of a previous torpor of the liver, or fpleenj^,
or fkin,. an accumulation of fenforial power will fooner be produced.
in the flomach ; becaufe there has been no previous expenditure of
it, the prefent torpor of the flomach arlfing from, defedl of afToGiatloni
Hence fome fevers perfedly intermit, the flomach recovering its.
complete a£lion after the torpor and confequent orgafm, which con-
flitute the paroxyfm of fever, are terminated.

Seventhly. If the torpor of the flomach be owing to defefl of ir-
ritation,, as to the want of food, aa accumulation- of fenforial power
foon occurs with an increafe of digeflion, if food be timely applied ;;
or with violent inflammation, if food be given in too great quantity
after very long abftinence.

Eighthly. If the torpor of the flomach be induced by defeft of

pleafurable fenfation, as when ficknefs is caufed by the fuggeflion of

Jiaufeous ideas;, an accumulation of fenforial power foon occurs, and

I, the.

Sup. I. 12. THEORY OF FEVER. 5.95

the ficktiefs ceafes with the return of hunger; for in" this; cafe .thie
inadivity of the ftoraach is occafioned by the fubdu6lion of agreeable
fenfation, which ads as a fubdudion of ftiraulus, and riot by exhauft-
ing the natural quantity of fenforial power in the fibres or neme^ &[
the ftomach. v • ■; - : ji

Ninthly. If the torpor of the ftomach be induced by a twor
fold caufe, as in fea-ficknefs. See Vertigo rotatoria. Clafs IV. 2. i. lo.
in which the firft link of affociation ads too ftrongly, and in confer
quence expends more than ufual of the fenforial power of iritation 5
and fecoiidly in which fenfation is produced between the links ,of
affociation, and diffevers or enfeebles them ; the accumulation of
fenforial power foon occurs in the ftomach ; as no previous expendi-
ture of it in that organ has occurred. Whence in fea-ficknefs the
perfons take food with e.agernefs at times, when the vertigo cafes for
a few minutes.

Tenthly. If the gaftric torpor be induced by previous violent
exertion, as after intoxication, or after contagious matter has beea
fwallowed, or fome poifons, as digitalis, or arfenic ; an accumulation
of fenforial power very flowly fucceeds ; whence long ficknefs, or
continued fever, becaufe the quantity of fenforial power already
wafted muft firft be renewed, before an accumulation of it can be
produced.

12. This leads us to a fecohd indication of cure in continued
fevers, which confifts in ftrengthening the adions of the ftomach j as
the firft indication confifted in decreafing the adions of the cutane-
ous capillaries and abforbents. The adions of the ftomach may
fometimes be increafed by exhibiting a mild emetic ; as an accumula-
tion of fenforial power in the fibres of the ftomach is produced durino-
their retrograde adions. Befides the evacuation of any noxious ma-
terial from the ftomach and duodenum, and from the abforbents,

4 G 2 which

596 THEORY OF FEVER. Sup. I. 12.

which open their mouths on their internal furfaces, by their retrograde
motion.

It is probable, that when mild emetics are given, as ipecacuanha,
or antimonium tartarizatum, or iufufion of chamomile, they are re-
je6ted by an inverted motion of the ftomach and oefophagus in con-
fequence of difagreeable fenfation, as duft is excluded from the eye;
and thefe actions having by previous habit been found effedual, and
that hence there is no exhauftion of the fenforial power of irritation.
But where flrong emetics are adminiftered, as digitalis, or contagious
matter, the previous exhauftloii of the fenforial power of irritation
feems to be a caufe of the continued retrograde a£llons and ficknefs
cf the ftomach. An emetic of the former kind may therefore
ft:rengthen the power of the ftomach immediately after its operation
by the accumulation of fenforial' power of irritation durin-g its aftlon.
See Clafs IV. i. i.

Another method of decreafing the a£lion of the ftomach for a time,
and' thence of increafing- it afterwards, is by the accumulation of the
fenforial power of irritation during its torpor j is by giving ice, iced
water,- iced creams, or iced wine. This accounts for th« plfeafur©,
which many people in fevers with weak pulfa exprefs on- drinking'
cold beverage of any kind.

A fecond method of exciting the ftomach into action, and' of de-
creafing that of the capillaries in confequence, is by the ftlmulus of
wine, opium, bark, metallic falts of antimony, fteel-, copper, arfenlc,
given in fmall repeated quantities ; which fo long as they render the
pulfe flower are certainly of fervlce, and may be given warm or coIg,
as moft agreeable to the patient. For it is poflible, that the eapil'-
laries of the ftomach may act too violently, and; produce heat, at
the fame time that the large mufcles of it may be in a torpid ftate ;
which curious circumftance future obfervations muft determine.

Thirdly. Hot fomentation on the region of the ftomach migh^
^e of moft ellentlal fervlce by its ftlmulus, as heat penetrates the

fyftena

Sup. I. 12. THEORY OF FEVER. 59;

iyftem not by the abforbent vefTels, but by external influence;
whence the ufe of hot fomentation to the head in torpor of the
brain ; and the ufe of hot bath in cafes of general debility, which
has been much too frequently negledted from a popular error occa-
fioncd by the unmeaning application of the word relaxation to animaU
power. If the fluid of heat could be direded to pafs through partir
cular parts of the body with as little difflifion of its influence, as that
of eledricity in the fliocks from the coated, jar, it might be employed
with ftili greater advantage.

Fourthly. The ufe of repeated fmalt eledric fliocks through the
region of the ftomach might be of fervice in fevers with weak pulfe,.
and well deferves a trial; twenty or thirty fmall fliocks twice a day
for a week or two would be a promifvug experiments

Fifthly. A blifter on the back, or fides, or on the pit of the flo-
mach, repeated iii fuccefllony by Simulating the flcin frequently
£trengthens the adlion of the ftomach by exciting the fenforial power
of aflbciation ; this efpecially in. thofe fevers where the flcin of the ex-
tremities, as of the hands or nofe or ears, fooner becomes cold, when^
cxpofed to the air, than ufuaL

Sixthly. The adion of the fl;omach may be increafed by prevent-
ing too great expenditure of fenforial power in the link of previous
motion with which it is catenated, efpecially if the a«!;tion of that
link be greater than natural. Thus as the capillaries- of the flcin, aA
too violently in fevers with weak pulfe^ if thefe are expofed to cold
air or cold water, the fenforial power, which prevloufly occafioned
their orgafm,. becomes accumulated, and tends to increafe the adion
of the floraach ;. thus in thofe fevers with weak pulfe and hot flcin," if -
the flomach be ftimulated by repeated fmall dofes of bark. and wine
or opium, and be further excited, at the fame time by accumulation
ef fenforial power occafioned by rendering the capillaries torpid by
cold air or water, this twofold application is frequently attended with:
vifible good efFeif^,

■ ■' By

598 THEORY OF FEVER. Sup.. J;: 13,,

By thus ftlmukting the torpid ftorttach into greater l£lion, the
motions of the heart and arteries will likewife be increared by the
greater eJicitement of the power of aflbciation. And the" capillaries of
the ikin will ceafe .to ad foi violently, .from their not poiTefiing fd
•great a fuperfluity of fenforial power as during the grieater! quiefcence
of the ftonnach' and of the .heart andiarteries. Which is iaXome cir-
cumftances fimilaf to the curious phenomenon mentioned in Clafs.IV.
2. 2. 10; where, by covering the chill feet with- flannel at the
eruption of the fmall-pox, the points of the flannel Simulate the ftiiii
of the feet into greater adlion, and the q^uantity of heat, which they
pofTefs, is alfo confined,: or rnfulated, and further increafes by its fti->
mulus, the adlivity of the cutanfeous veffels of the feet ; and by that
circumftance abates the.too great action of the capillariesvof the- face,
and the confequeiit heat of it. , ■,.

XIU. Cafe of continued fever.

The follovv'ing cafe of continued fever which I frequently faw during
its progrefs, as it is lefs complicate than iifual, may illuftrate this
dodrine. Mafter S. D. an aftive boy about eight years of age, had
been much in the fnow for many days, and fat in the claflical fchool
with wet feet ; he had alfo about a fortnight attended a writing
fchool, where many children of the lower order were inftrufted.
He was feized on February the 8th, 1795, with great languor, and
pain in his forehead, with vomiting and perpetual ficknefs ; his pulfe
weak, but not very frequent. He took an emetic, and on the next
day, had a blifler, which checked the ficknefs only for a i&w hours; '
his flcin became perpetually hot, and dry ; and his tongue white and'
furred; his pulfe when afleep about 104 in a minute, and when avvake
about 1 12.

Fourth day of the difeafe. He has had another blifter, the pain

of

Sot. r. 13, THEORY OF FEVER.. s^,):

of his head is gone, but the ficknefs continues by intervals ; he re-
fufes to take any folid food, and willdfink nothing but milk, or milk
and water, cold.. He has two or three very liquid ftools every day,
which are fomtimes green, but generally of a darkifli yellow, vvith-
great flatulency both upwards and downwards at thofe timds. An
antimonial powder was once given, but inftantly rejedted ; a fpoonfui
of decodlion of bark was alfo exhibited wijth, the fame event. His
legs are bathed, and his hands and face are raoiftened twice a day for
half an hour in warmifh. water,, which is neverthelefs much colder
than his fkin»

Eighth day. His {kin continues hot and dry without any obferv-
able remiffions, with liquid ftools and much flatulency and ficknefs ;.
iiis water when obferved was of a flraw colpur. He has alked for
eyder, and dvinks nearly a bottle a day mixed witlv cold water, and
takes three drops of laudanum twice a day.

Twelfth day. He continues much the fame, takes no milk^
drinks only cyder and water, fldn hot and. dry,, tongue hot and
furred, with liquid.flools,. and ficknefs always at the fame time ;. fleeps
much.

Sixteenth day. Was apparently more torpid,, and once rather de-
lious ; pulfe 1 12. Takes only capillaire and water ; fleeps much-
. Twentieth day. .Pulfe 100, fkin dry but lefs hot, liquid ftools-
not fo frequent, he is emaciated to a. great degree, he has eaten half a
tea-cup full of cuftard to day, drinks only capillaire and water, has
thrice taken two large fpoonfuls of decodion of bark with three drops.
of laudanum, refufes to have his legs bathed ^ and will now take no-
thing but three drops of laudanum twice a day..

Twenty-fourth day. He has gradually taken more cuftard every-
day, and began to attend to fome new play things, and takes wine
•iyllabub.
. Twenty-eighth day. He daily grows flronger, eats eggs, and:

bread

6oo THEORY OF FEVER. Sup. L 15.

and butter, and fleeps immediately after his food, can creep on his
bands and knees, but cannot ftaud ere£l.

Thirty-fecond day. He cannot yet ftand alone fafely, but feems
hourly to improve in ftrength of body, and adivity of mind.

In this cafe the remote caufe of his fever could not be well afcer-
tained, as it might be from having his feet cold for many fucceffive
days, or from contagion ; but the latter feems more probable, becaufe
his younger brother became ill of a fimilar fever about three weeks
afterwards, and probably received the infection from him. The dif-
eafe commenced with great torpor of the ftomach, which was fhewn
by his total averfion to folid food, and perpetual ficknefs ; the watery
flools, which were fometimes green, orofadarkirti yellow, were
owing to the acrimony, or acidity, of the contents of the bowels ;
which as well as the flatulency were occafioned by indigeftion.
This torpor of the ftomach continued throughout the whole fever,
and vvhen it ceafed, the fever ceafed along with it.

The contagious material of this fever I fuppofe to have been mixed
with the faliva, and fwallowed into the ftomach ; that it excited the
velTels, which conftitute the ftomach, into the greateft irritative mo-
tion like arfenic ; which might not be perceived, and yet might render
that organ faralytic or inirritable in a moment of time \ as animals
fometimes die by one (ingle exertion, and confequent paralyfis, with-
out a fecond ftruggle ; as by lightning, or being fiiot through the
back part of the brain 1 of both which I have feen inftances, I had
once an opportunity of infpefting two oxen, a few minutes after they
were killed by lightning under a crab-tree on moift ground in long
grafs ; and obferved, that they could not have ftruggled, as the grafs
was not prefled or bent near them ; I have alfo feen two horfes fhot
through the cerebellum, who never once drew in their legs after
they firft ftretched them out, but died inftantaneoufly ; in a fimilar
manner the lungs feem to be rendered inftantly inanimate by the
fumes of burning fulphur.

The

Sup. I 13. THEORY OF FEVER. 6oi

'Th& lungs may be fometimes primarily affefled with contagious,
matter floating in the atmofphere as well as the flomacb, as men?-
tioned in article 9. of this Supplement. But probably this may oc-
cur much lefs frequently, becanfe the oxygene of the atmofphere
does not appear to be taken into the blood by animal abforption, as
the fahva in the ftomach, but paffes through the moift membriines
into the blood, like the ethereal fluids of eledricity or heat, or by
chemical attraction, and in confequence the; contagious matter may
be left behind; except it may fometimes be abfoj^bed along with
the mucus; of which however in this -eafe there appeared no
fymptoms.

The tonfils are other organs liable to receive contagious matter, as
in the fmall-pox, fcarlet-fever, and in other fenfitive inirritated^
fevers ; but no fymptom of this appeared ^herej as the tonfils were at
no time of the fever inflamed, though they were in this child previ-
oufly uncommonly large. "^

The pain of the forehead does not feem to have been of the inter--
nal parts of the head, becaufe the nerves, which ferve the flomacb,
are not derived from the .anterior pait of the braiti ;.' bwt it-feeOTS to
have been, owing to. a torpor of the external membranes about the
forehead from their diredl fympathy with thofe of the ftomach ;
that is, from the deficient .excitement of the fenforial power of
aiTociatiori ; and feemed^i^XoRi,? ,ffi'-??f^^J'e to be relieved by the emeti.qs
and blifters. .f!oiiV'i;::.'b "l^ ., ' - vl

Thepulfations of the heart were weaker and in confequence quicker
than natural^ owjng, tojheir direft fympathy vv'ith the torpid perif-
• taltic motiQii? of thft flomach ; that is to the deficient excitement of
the fenfor,ial,pQw^;^.of a^Qciation. *

- The -aition of'' the eutaneous capillaries . and abforbents were
ilronger than natural,' as' appeared by the perpetual heat and drynels
of the fkin ; which was lOwing to their reverfe fympathy with tlje
heart and arteries. This weaker and quicker adion of the heart

Vol. IL : 4H and

6oz THEORY OF FEVER. Sup. 'I. 13,

and arteries, and the ftronger adtion of the cutaneous capillaries and
abforbcnts, continued throughout the difeafe, and may be faid to have
conftituted the fever, of which the torpor of the ftomach was the
remote caufe.

His tongue was not very much furred or very dry, nor his breath
very hot ; which flievved, that there was no great increafe of the
action of the mucous abforbents, nor of the pulmonary capillaries,
and yet fufficient to produce great emaciation. His urine was nearly
natural both in quantity and colour ; which fhewed, that there was
no increafe of adion either of the kidnies, or of the urinary ab-
forbents.

The bathino; his \eg-s and hands and face for half an hour twice a
day feemed to refrefh him, and fometimes made his pulfe flower,
and thence I fuppofe flronger. This feems to have been caufed by
the water, though fubtepid, being much below the heat of his fkin,
and confequcntly contributing to cool the capillaries, and by fatiating
the abforbents to relieve the uneafy fenfation from the drynefs of the
Ikin.

He continued the ufe of three drops of tindure of opium from
about the eighth day to the twenty-fourth, and for the three preced-
ing days took along with it two large fpoonfuls of an infufion or
bark in equal parts of wine and water. The former of thefe by its
flimulus feemed to decreafe his languor for a time, and the latter to
flrengthen his returning power of digeftion.

The daily exacerbations or remiffions were obfcure, and not well-
attended to ; but he appeared to be worfe on the fourteenth or
fifteenth days, as his pulfe was then qaickeft, and' his inattention
greateft ; and he began to get better on the twentieth or twenty- firft
days of his difeafe ; for the pulfe then became lefs frequent, and his
ikin cooler, and he took rather more food : thefe eircumflances
feemed to obferve the quarter periods of lunation.

XIV* Termination

Sup. I. 14. THEORY OF FEVER. 603

XIV. Term'mation of continued fever,

1. When the ftomach is primarily affeded with torpor not by de-
feat of flimulus, but in confeqiience of the previous exhauftion of its
fenforial power ; and not fecondarily by its affociation with other
torpid parts ; it feems to be the general caufe of the weak pulfations
of the heart and arteries, and the confequent increafed adlion of the
capillaries, which conftitute continued fever with weak pulfe. In
this fituation if the patient recovers, it is owing to the renovation of
life in the torpid llomach, as happens to the whole fyflem in winter-
fleeping animals. If he perifhes, it is owing to the exhauftion of
the body for want of nouriftiment occafioned by indigeftion ; which
is haftened by the increafed anions of the capillaries and ab-
forbents.

2. When the flomach is primarily affe£led by defeft of ftimuius,
as by cold or hunger ; or fecondarily by defed of the power of alTo-
ciation, as in intermittent fevers ; or laftly in confequence of the in-
trodudtion of the fenforial power of fenfation, as in inflammatory dif-
eafes ; the aftions of the heart and arteries are not diminifhed, as
when the flomach is primarily afFecfted with torpor by its previous
cxhauftion of fenforial power, but become greatly increafed, pro-
ducing irritative or inflammatory fever. Where this fever is conti-
nued, though with. Ibme remiffions and exacerbations, the exceffive
aftion is at length fo much leffened by expenditure of fenforial
power, as to gradually terminate in health; or it becomes totally ex-
haufted, and death fucceeds the deftrudion of the irritability and af-
ibciability of the fyftem.

3. There is aifo another termination of the difeafes in confequencc
of o-reat torpor of the flomach, which are not always termed fevers ;

' ' 4 H 2 one

6o4 THEORY OF FEVER. Sup. i. 14.

one of thefe is attended with fo great and univeiTal torpor, that the
patient dies in the firft cold fit ; that is, within twelve hours or lefs -
of the firft feizure'j this is commonly termed fudden death. But the
quiclvjiefs of the pulfe, and the coldnefs with fhudderjng, and with
ficTc -ftomach, diftinguiflied. a cafe, which I lately fa\yj' from the.
fudden deaths oceafioned ' by apoplexy, of. "ruptured blood- veffels.

In h.emicrania I.lDeIieve" the ftornacti is always afFe£led fecoildarily,,
as no quicknefs of pulfe generally attehds~it,>hd'as the ftomach re-
covers its a6tivity in about two whole dayL But in the following,
cafe, which I faw laft week, I fuppofe the ftomach fuddenly be-
came paralytic, and caufed, in about a week the death of the patient.

Mifs , a fine young lady about nineteen, had bathed a few

times, about a month before,, In a cold fpring,, and was always mucTi
indifpofed after it ; (he was.feized with iicknefs, and cold' fiiuddering,
with very quick pulfe, which was fucceeded by a violent hot fit |.
during the next cold paroxyfm fhe had a convulfion fit ; and after
that fymptoms of infanity, fo as to flrike and bite the attendants, and
to fpeak furious language ;, the fame circumflances occurred during a
third fit, in which I b^Uevg a ftrait .W^iftcoat was put on, and
fome blood taken from Il-e-r ; dtiring all this tiftie her ftomach would
•receive no nutriment, except once or ^wice;;a little wine and water.
On the feventh day of"j the difeafe,' when. I; faw her, the extre-
mities were cold, the pulfe not to be Gounted^. ^.nd ihe was unable to
fwallow, or to fpeak ; a clyfler was ufed with turpentine and mufk.
and opium, with warm fomeutations, but fhe did not recover from
'that cold fit. :;;,;;.

In thiscafe the convulfion fit and the infanity fgem to have been

-violent efiDrts to relievje the difagreeable fenfation of the paralytic

ftomach ; and the quick pulfe, and returning fits of torpor and of

orgafm, evinced the difeafe to be attended with fever, though it

might have been called anorexia maniacalis, or epileptica.

4. Might

Sup. 1.14. THEORY OF FEVER. 605

4. Might not many be faved in thefe fevers with weak pulfe. for a
few weeks by the introdudlion of blood into a vein, once in two or
three days ; which might thus give further time for the recovery of
the ^torpid flomach ? Which feems to require fome weeks to ac-
quire its former habits of adlion, like the mufcles of paralytic patients,
who have all their habits of voluntary aflbciations to form afrefh, as
in infancy.

If this experiment be again tried on the human fubjeft, it fhould
be fo contrived, that the blood in paffing from the well perfon to the
fick one fhould not be expofed to the air; it fhould not be cooled or
heated; and it fhould be meafured ; all which may be done in the
following manner. Procure two filver pipes, each about an inch,
long, in the form of funnels, .wide, at top, with a tail beneath, the
'former fomething wider than a fwan-quill, and the latter lefs than a:
Imall crow-quill. Fix one of thefe filver funnels by its wide end to
one end of the gut of a chicken frefli killed about four or fix inches
long, and the other to the other end of the gut ; then introduce the
fmall end of one funnel into the vein of the arm of a well perfon
downwards towards the hand ; and laying the gut with the other
end on a v/ater-plate heated to 98 degrees in a very warm room, let
the blood run through it. Then prefling the finger on the gut near
the arm of the well perfon, Aide it along fo as to prefs out one gut--
ful into a cup, in order to afcertain the quantity by weight. Then
mtroduce the other end of the other funnel into a fimilar vein in the
arm' of the fick perfon upwards towards the fhoulder ; and by Aiding
one finger, and then another reciprocally, along the chicken's gut, fo
as to com prefs it, from the arm of the well perfon to the arrri of the
fick one, the blood may be meafured, and thus the exaO. quantity
known which is given and received. See Clafs I. 2. 3. 25.

XV. hifi animation

6o6 THEORY OF FEVER. Sup. I. 15.

XV. Inflammation excited in fever.

I. Whea the adlions of any part of the fyftem of capillaries are
excited to a certain degree, fenlation is produced, along with a greater
quantity of heat, as mentioned in the fifth article of this fCipplement.
When this increafed capillary a6lion becomes ftill more energetic, by
the combined fenforial powers of fenfation with irritation, new fibres
are fecreted, or new fluids, (which harden into fibres like the mucus
■fecreted by the filk-worm, or fpider, or pinna,) from which new
vefTels are conftrufted ; it is then termed inflammation : if this exifts
in the capillary veflTels of the cellular membrane or (kin only, with
feeble pulfations of the heart and arteries, the febris fenfitiva inirritata,
or malignant fever, occurs ; if the coats of the arteries are alfo in-
flamed, the febris fenfitiva irritata, or inflammatory fever, exifls.

In all thefe fevers th.e part inflamed is called a phlegmon, and by
its violent adlions excites fo much pain, that is, fo much of the fen-
forial power of fenfation, as to produce more violent aftions, and in-
flammation, throughout the whole fyfl:em. Whence great heat
from the excited capillaries of the fkin, large and quick pulfations of
the heart, full and hard arteries, with great univerfal fecretions and
abforptions. Thefe perpetually continue, though with exacerba-
tions and remiflions ; which feem to be governed by folar or lunar
influence.

2. In this fituation there generally, I fuppofe, exifts an increafed
activity of the fecerning veffels of the brain, and confequently an in-
creafed produdtion of fenforial power ; in lefs violent quantity of this
difeafe however the increafe of the action of the heart and arteries
may be owing Amply to the accumulation of fenforial power of aflib-
ciation in the flomach, when that organ is afl-e£ted by fympathy with
fome inflamed part. In the fame manner as the capillaries are vio-
lently

Svp.I. ij. THEORY OF FEVER. 607

lently and permanently adiuated by the accumulation of the fenforial
power of aflbciation in the heart and arteries, when the (lomach is
affedled primarily by contagious matter, and the heart and arteries fe-
condarily. Thus I fufpedl, that in the diftindl fmall-pox the ftomach
is affefted fecondarily by fympathy with the infeded tonfils or ino-
culated arm ; but that in the confluent fmall-pox the flomach is
affefted primarily, as well as the tonfils, by contagious matter mixed
with the faliva, and fwallowed.

3. In inflammatory fevers with great arterial a£lion, as the ftomach
is not always afFedled with torpor, and as there is a dired fympathy
between the ftomach and heart, fome people have believed, that nau-
feating dofes of fome emetic drug, as of antimonium tartarizatum,
have been adminiftered with advantage, abating by diredl fympathy
the anions of the heart. This theory is not ill founded, and the
life of digitalis, given in fmall dofes, as from half a dram to a dram of
the faturated tindlure, two or three times a day, as well as other lefs
violent emetic drugs, would be worth the attention of hofpitaL
phyficians.

Sicknefs might alfo be produced probably with advantage by whirl-
ing the patient in a chair fufpended from the cieling by two parallel
cords ; which after being revolved fifty or one hundred times in one
direction, would return with great circular velocity, and produce
vertigo, fimilar I fuppofe to fea-ficknefs. And laflly the ficknefs
produced by refpiring an atmofphere mixed with one tenth of carbo-
nated hydrogen, difcovered by Mr. Watt, and publifhed by Dr».
Beddoes, would be well worthy exa£t and repeated experiment..

4. Cool air, cool fomentations, or ablutions, are alfo ufeful in this
inflammatory fever ; as by cooling the particles of blood in the cutaneous
and pulmonary vefiels, they mufl return to the heart with lefs ftimulus,
tlian. when they are heated above the natural degree of ninety-eight.

For

6o8 THEORY OF FEVER. Sup. I. 15.,

For thisj)urpofe fnow and ice have been fcattered on the patients in
Italy; and cold bathing has been ufed at the eruption of the fmall pox
in China, and both, it is faid, with advantage. See Clafs III. 2, i, 12,
and Suppl. I. 8.

5. The lancet ho.wever with repeated mild cathartics is the great
a''''ent in deflrojing this enormous excitement of the fyftem, fo long
as the ftt'cngth of the patient will admit of evacuations. Blifters over
the painful part, where the phlegmon or topical inflammation is
fituated, after great evacuation, is of evident fervice, as in pleurify.
Warm bathing for half an hour twice a day, when the patient
becomes enfeebled, is of great benefit, as in peripneumony and

rheumatifm.

6. When other means fail of fuccefs in abating the violent ex-
citement of the fyftem in inflammatory difeafes, might not the fliaved
head be covered with large bladders of cold water, in which ice or
ialt had been recently diffolved ; and changed as often as necefrary,
till the brain is rendered in fome degree torpid by cold ? — Might
not a greater degree of cold, as iced water, or fnow, be applied to
the cutaneous capillaries ?

■7. Another experiment I have frequently wlflied to try, which
cannot be done in private pradtice, and which I therefore recommend
to fome hofpital phyfician ; and that is, to endeavour to ftill the violent
adions of the heart and arteries, after due evacuations by venefeftionand
cathartics, by gently compreffing the brain. This might be done by
fufpending a bed, fo as to whirl the patient round with his head
moft diftant from the center of motion, as if he lay acrofs a rnill-
ftone, as defcribed in Seft. XVIII. 20. For this purpofe a perpen-
dicular ihaft armed with iron gudgeons might have one end pafs

6 int<}

Sup. I. i6. THEORY OF FEVER. 609

into the floor, and the other into a beam in the cieling, with an hori-,
zontal arm, to which afmall bed might be readily fufpended.

By thus whirling the patient with increafing velocity fleep might
be produced, and probably the violence of the adtions of the heart and
arteries might be diminilhed in inflammatory fevers ; and, as it is
believed, that no accumulation of fenforial power would fucceed a
torpor of the origin of the nerves, either thus procured by mechanical
compreffion, or by the bladder-cap of cold water above defcribed, the
lives of thoufands might probably be faved by thus extinguishing
the exacerbations of febrile paroxyfms, or preventing the returns of
them.

In fevers with weak pulfe fleep, or a degree of ftupor, thus pro-
duced, might prevent the too great expenditure of fenforial power,
and thus contribute to preferve the patient. See Clafs I. 2. 5. 10. on
ftupor. What might be the confequence of whirling a perfon with
his head next the center of motion, fo as to force the blood from the
brain into the other parts of the body, might be difcovered by cau-
tious experiment without danger, and might probably add to our
ability of curing fever.

XVr. Recapitulation.

I. The fenforial power caufes the contradion of the fibres, and is
excited into adion by four different circumftances, by the ftimulus of
external bodies, by pain or pleafure, by defire or averfion, or by the
previous motions of other contrafling fibres. In the firft Situation it
is called the fenforial power of irritation, in the fecond the fenforial
power of fenfation, in the third the fenforial power of volition, and in
the fourth the fenforial power of aflbciation.

Many parts of the body are excited into perpetual adlion, as the
fanguiferous velTels confifting of the heart, arteries, and veins; others

Vol.. II. 4 1 into

6io THEORY OF FEVER. Sup. I. i6.

into nearly perpetual a£lion, as the conglomerate and capillary glands;
and others into a£tions ftill fomewhat lefs frequent, as the alin:ientary
canal, and the ladleal and lymphatic abforbents with their conglobate
glands: all thefe are principally aduated by the fenforial powers of ir-
ritation, and of aflbciation ; but in fome degree or at fome times hy
thofe of fenfation, and eveu of volition. There are three kinds of
ftimulus, which may eafily be occaiionally diminilhed, that of heat on
the fkin, of food in the ilomach, and of the oxygenous part of the
atmofphere, which mixes with the blood in refpiration, and ftimulates
the heart and arteries.

2. When any parts, which are naturally excited into perpetual ac-
tion by ftimulus, become torpid or lefs atS^ive from decreafe of that
ftimulusj there firfl occurs a decreafe of the adlivity of the parts
next catenated with them ; thus going into cold water produces
a torpor of the capillary veiTels of the lungs, as is known by the
difficult refpiration, which immediately occurs ; for the fenforial
power of aflbciation, which naturally contributes to actuate the
lungs, is now lefs excited by the decreafed adions of the cutaneous
veflels, with which they are catenated. This conftitutes the cold fit
of fever.

There next occurs an accumulation of the fenforial power
of irritation in the parts, which were torpid from defed of
ftimulus, as the cutaneous veflels for inftance when expofed to
cold air; and a fimilar accumulation of the fenforial power of
aflbciation occurs in the parts which were catenated with the for-
mer, as the veflels of the lungs in the example above men-
tioned. Whence, if the fubdudion of ftimulus has not been too
great, fo as to impair the health of the part, the adivity of the irri-
tative motions returns, even though the ftimulus continues lefs than
ufual ; and thofe of the aflbciate motions become confiderably in-
creafed, becaufe thefe latter are now excited by the previous fibrous
y . motions.

Sup. I. 1 6. THEORY OF FEVER. 6ti

motions, which now a£t as ftrong or flronger than tbrrnerly, and
have alfo acquired an accumulation of the fenforial power of aflbcia-
tion. This accounts for the curious event of our becoming warm in
a minute or two after remaining; in water of about 80 degrees of
heat, as in the bath at Buxton ; or in the cold air of a frofty morning
of about 30 degrees of heat.

But if the parts thus pofleffed of the accumulated fenforial powers
of irritation and of affociation be expofed again to their natural quan-
tity of flimulus, a great excefs of activity fupervenes ; becaufe the
£bres, which poffefs accumulated irritation, are now excited by their
ufual quantity of ftimulus ; and thofe which poffefs accumulated af-
fociation, are now excited by double or treble the quantity of the
preceding irritative fibrous motions, with which they are catenated ;
this conftitutes the hot fit of fever.

Another important circumflance occurs, when the parts, which
are torpid from decreafed flimulus, do not accumulate a quantity of
fenforial power fuflicient for the purpofe of renewing their own na-
tural quantity of adlion ; but are neverthelefs not fo torpid, as to have
the life of the part impaired. In this fituation the fuperabundance of
the accumulated power of irritation contributes to adluate the afTo-
ciate motions next catenated with them. Thus, when a perfbn
breathes air with lefs oxygene than natural, as by covering his head
in bed, and thus refpiring the fame atmofphere repeatedly, the heart
and arteries become lefs acftive by defe(St of the flimulus of oxygene ;
and then the accumulation of fenforial power of irritation becomes
inftantly very great, as thefe organs are fubje£t to perpetual and
energetic a£tion. This accumulation neverthelefs is not fo great as
to renew their own adivity under this defed of flimulus, but yet is
in fuflicient abundance to increafe the aflbciability of the next link of
catenation, that is, to actuate the capillaries of the fkin with great and
perpetual increafe of energy. This refembles continued fever with
weak pulfe ; in which the accumulation of the fenforial power

4 I 3 caufed

6i2 THEORY OF FEVER. Sup. I. i6.

caufed by the leflened motions of the heart and arteries, a6luates the
capillaries with increafe of energy.

3. When the accumulation of the fenforlal power of aflbciation,
which is caufed as above explained by deficient excitement owing to the
leflened quantity of adion of the irritative fibrous motions, with
which the aflbciate train is catenated, is not in quantity fufficient to
renew the natural a£tions of the firft link of an aflbciate train of mo-
tions ; it is neverthelefs frequently fo abundant as to a£luate the next
link of the affociated train with unnatural energy by increafing its af-
fociability ; and that in a ftill greater degree if that fecond link of the
aflbciated train was previoufly in a torpid ftate, that is, had previ-
oufly acquired fome accumulation of the feiiforial power of aflbcia-
tion. This important circumftance of the animal economy is worthy
our moft accurate attention. Thus if the heart and arteries are de-
prived of their due quantity of the flimulus of oxygerte in the blood^,
a weak and quick pulfe enfues, with an accumulation of the fenforial
power of irritation ; next follows an increafe of the aftion of the
capillaries by the fuperabundance of this accumulated power of irrita-
tion ; but there alfo exifts an accumulation of the power of aflbcia-
tion in thefe adling capillaries, which is not now excited by the de^
ficient adions of the heart and arteries ; but which by its abundance
contributes to afluate the next link of aflTociation, which is the fick
flomach in the cafe related from Sydenham in Clafs IV. i . i . 2: and
explained in this Supplement I. 4. And as this fick fbmach was in
a previous ftate of torpor, it might at the fame time poflefs an accu-
mulation of fome fenforial power, which, if it was of aflbciation, would
be thus more powerfully excited by the increafed aftions of the ca-
pillaries; which exifted in confequence of the weak adion of the
heart and arteries. This alfo refembles in fome refpedls the continued
fevers with weak pulfe, and with inereafed activity of the capillaries..

4. When

Sup, I. 1 6. THEORY OF FEVER. 613

4. When a torpor of fome irritative motions occurs from a previ-
ous exhauftion of the fenforial power of irritation by the adion of
fome very great ftimulus, it is long before any accumulation of the
fenforial power of irritation is produced ; as is experienced in the
ficknefs and languor, which continues a whole day after a fit of
drunkennefs. But neverthelefs there occurs an accumulation of the
fenforial power of alTociation in the fir ft link of the aflbciate train of
motions, which is catenated with thefe torpid irritative ones ; which
accumulation is owing to deficient excitement of that fenforial power
in the firft link of the affociate train. This firft link therefore exifts
alfo in a lefs adive or torpid ftate, but the accumulation of the fen*'-
forial power of alTociation by its fuperabundance contributesr to ac-
tuate the fecond link of the affociate train with unnatural quantity of
motion ; and that though its own natural quantity of the. power of
alTociation is not excited by the deficient aftion of preceding fibrous
motions.

When this happens to the ftomach, as after its irritative motions
have been much exerted from the unnatural ftimulus of wine, or
opium, or of contagious matter mixed with the faliva,. a torpor or
inadtivity of it fucceeds for a. greater or lefs length of time ;. as no
accumulation of the fenforial power of irritation can occur, till the
natural quantity, which hasbeenprevioufly expended, is firft reftored.
Then the heart and arteries, which are next in catenation, become
kfs ad;ive from the want of fufHcient excitement of the; fenforial
power of alTociation, which previoufly contributed to ailuate them^
This fenforial power of affociation therefore becomes accumulated-,
and by its fuperabundance contributes to a£luate the link, next in af''
fociation, which has thus acquired fo great a degree of aflbciability,
as to overbalance the lefs quantity of the excitement of it by the
torpid adion of the previous or firft aflbciate link. This happens to •
tlie capillaries, when the heart and arteries are affefted as above by
the torpor of the ftomach, when it is occafioned by previous gre.it
6..' expenditure

6 14 THEORY OF FEVER. Sup. I. 16.

expenditure of its fenforial power, and thus conftltutes fever
with weak pulfe, which is here termed inirritative fever, typhus
mitior.

5. When a deficiency of ftimulus is too great or too long con-
tinued, fo as to impair the life of the part, no further accumulation of
fenforial power occurs ; as when the Ikin is long expofed to cold and
damp air. In that cafe the link in catenation, that is, the firft of
the affociate train, is rendered torpid by defed of excitement of its
ufual quantity of the fenforial power of aflbciation, and from there
being no accumulation of the fenforial power of irritation to increafe
its alTociability, and thus to contribute to adluate it by overbalanc-
ing the defedl of the excitement of its aflbciation.

Thus on riding long and flowly on a cold and damp day, the ex-
halation of the vapour, which is impinged on the fkin, as the tra-
veller proceeds, carries away his warmth faflrer, than it is generated
within the fyftem ; and thus the capillaries of the Ikin have their
aftions fo much impaired after a time, that no accumulation of the
fenforial power of irritation occurs ; and then the flomach, whofe
motions are catenated with thofe of the capillaries, ceafes to a£t from
the deficient excitement of the power of aflbciation ; and indigefl:ion
and flatulency fucceed, infl:ead of the increafed digeftion and hunger,
which occur, when the cutaneous capillaries arc expofed to a lefs de-
gree of cold, and for a fhorter time. In which latter fituation the
accumulation of the fenforial power of irritation increafes by its
fuperabundance the aflbciability of the fibres of the flomach, fo as to
overbalance the defe£t of the excitement of their aflbciation.

6. The fl:omach is affe£led fecondarily in fevers with ftrong pulfe,
as in thofe with weak pulfe it is afFeded primarily. To illuftrate

this doflrine I Ihall relate the following cafe of Mr. Y — -. He

was a young man rather intemperate in the ufe of wine or beer, and

was

UP. I. i6. THEORY OF FEVER. 6ts

was feized with a cold fit, and with a confequent hot one with
ftrong pulfe ; on exanaining his hypochondrium an oblong tumour
was dift:in£tly felt on the left fide of the ftomach, which extended fix
or eight inches downward, and was believed to be a tumour of the
Ipleen, which thus occafioned by its torpor the cold fit and confe-
quent hot fit of fever with flrong pulfe. This fever continued,
though with remifi^ions, for two or three weeks ; and the patient re-
peatedly lofl blood, ufed cathartics with calomel and fena, and had fre-
quent antimonlal and faline medicines. And after he was much
weakened by evacuations, the peruvian bark and fmall dofes of fteel
removed the fever, but the tumour remained many years during the
remainder of his life.

In this cafe the tumour of the fpleen was occafioned by the torpor
of the abforbent veflels ; while the fecerning veflels continued fome-
what longer to pour their fluids into the cells of it. Then the inaftivity
of this vifcus affedled the whole fyftem with torpor by the deficient ex-
citement of the fenforial power ofaflbciation, which contributes along
with the irritation caufed by their fpecific ftimuli to aftuate the
whole fanguiferous, fecerning, and abforbent vefi'els ; and along with
thefe the ftomach, which pofTefles perhaps greater mobility, or
promptitude to torpor or to orgafm, than any other part. And after
a time all thefe parts recover their a£lions by the accumulation of
their fenforial power of affociation. But the fpleen not recovering
its adtion from the accumulation of its power of irritation, as ap-
peared from the continuance of the tumor, ftill afFefts the ftomach
by its defective irritative motions ceafing to excite the aflbciation,
which ought to contribute to adluate it.

Hence the ftomach continues torpid in refpedt to its motions, but
accumulates its power of affociation ; which is not excited into ac-
tion by the defedlive motions of the fpleen ; this accumulation of the
fenforial power of affociation now by its fuperabundance aduates the
next link of affociate motions, which confifts of the heart and arteries,,

into

6i6 ; THEORY OF FEVER. Sup. I. ,i6.

into o-reater 'energy of adion than natural, and thus caufes fever
with ilrong puife; which, as it was fuppofed to be mod fre-
quently excited by increafe of irritation, is called irritative fever or
fynocha.

- Similar to this in the fmall pox, which is given by inoculation,
the ftomach is affedled fecondarily, when the fever commences ; and
hence in this fmall- pox the pulfations of the heart and arteries arc
frequently ilronger than natural, but never weaker, for the reafons
above o-iven. Whereas in that fmall-pox, which is caufed by the
ftomacli being primarily afFedled, by the contagious matter being
fwallowed with the faliva, whether the tonfils are at the fame time
aftefted or not, the pulfations of the heart and arteries become weak,
and the inirritative fever is produced, as explained above, along with
the confluent fmall-pox. This unfolds the caufe of the mildnefs of
the inoculated fmall-pox ; becaufe in this difeafe the flomach is af-
fe£led fecondarily, whereas in the natural fmall-pox it is frequently af-
feded primarily by fwallowing the contagious matter mixed with faliva.
In the meafles I fuppofe the contagious matter to be diflblved in
the air, and therefore not liable to be mixed with the faliva ; where-
as the variolous matter is probably only diffufed in the air, and thence
more readily mixed with the faliva in the mouth during refpiration.
This difference appears more probable, as the fmall-pox I believe is
always taken at a lefs diftance from the difeafed perfon than is ue«
ceffary to acquire the meades. The contagion of the meafles affedls
the membranes of the noftrils, and the fecretion of tears in confe-
quence, but never I fufpedl the fliomach primarily, but always fe-
condarily ; whence the pulfation of the heart and arteries is always
flronger- than natural, fo as to bear the lancet at any period of th-e
difeale.

The great mildnefs fometimes, and fatality at other times, of the
fcarlet fever may depend on the fame circumftance ; that is, ou the
ilomach being primarily or fecondarily afFedted by the contagious

mattefj

Sup. I. 1.6 THEORY OF FEVER. 617

matter, obferving that the tonfils may be affe£l:ed at the fame time
with the ftomach. Should this prove to be the cafe, which future
obfervations muft determine, what certain advantage muft arife from
the inoculation of this difeafe ! When it is received by the Ikin pri-
. marily I fuppofe no fore throat attends it, nor fever with weak
pulfe; when it is received by the ftomach primarily, the tonfils are
affedled at the fame time, and the torpor of the ftomach produces- in-
irritative fever, and the mortification of the tonfils fucceeds.

We may hence conclude, that when the torpor of the ftomach is
either owing to defeat of ftimulus, which is not fo great as to impair
the life of the part, as in moderate hunger, or in fwallowing iced
water, or when its torpor is induced by its catenation or aftbciatioa
with other torpid parts, as in the commencement of intermittent
fevers, and inoculated fmall-pox, that the fubfequent adion of the
heart and arteries is generally increafed, producing irritative fever.
Which is owing to the accumulation of the fenforial power of irrita-
tion in one cafe, and of aflbciation in the other, contributing to
a£tuate the next link of the catenated or aflbciated motions. But
when the torpor of the ftomach is induced by previous exhauftion of its
fenforial powers of irritation or of aflbciation by continued violent
a£lion, as by the ftimulus of digitalis, or of contagious matter, or
after intoxication from wine or opium, a weaker a6lion of the heart
and arteries fucceeds, becaufe there is no ac<:umulation of fenforial
power, and a deficient excitement of aflbciation. And finally, as this
weak aftion of the heart and arteries is not induced by exhaaftion of
fenforial power, but by defe<5l of the excitement of aflbciation, the
accumulation of this power of aflbciation increafes the action of the
capillaries, and thus induces inirritative fever.

7. When any part of the fyftem ads very violently in fevers, the
fenforial power of fenfation is excited, which increafes the adions of
the moving fyftem ; whereas the pain, which arifes from decreafed

Voj-. II. A K irritative

6i8 THEORY OF FEVER. Sup. I. 1 6.

irritative motions, as ia hemicrania, feems to exhaufi: a quantity
of fenforial power, without producing or increafing any fibrous
actions.

When the flomach is primarily affe£led, as in inirritative fevers
from contao^ion, and in fuch a manner as to occafion pain, the aflion
of the capillaries feems to be increafed by this additional fenforial
power of fenfation, whence extenfive inflammation or mortification;
but when the ftomach and confequently the heart and arteries conti-
nue iheir torpidity of aftion ; as in confluent fmall-pox, and fatal
fcarlatina ; this conftitutes fenfitive inirritative fever, or typhus

gravior.

o

But when the ftomach is fecondarily affeeled, if the fenforial,
power of fenfation is excited, as in pleurify or peripneumony, the ac-
tions of the heart and arteries are violently increafed, and of all the
movino- fyftem along with them. Thus the peripneumony is gene-
rally induced by the patient refpiring very cold air, and this efpe-
cially after being long confined to warm air, or after being much fa-
tio-ued and heated by exceflive labour or exercife. For we can cover
the Ikin with more clothes, when we feel ourfelves cold ; but the
luno-s not having the perception of cold, we do not think of covering
them nor have the power to cover them, if we defired it ; and the
torpor, thus produced is greater, or of longer duration, in pro*
portion to the previous expenditure of fenforial power by heat or exr

ercife.

This torpor of the lungs affeds the Ikin with fliuddering, and the
flomach is alfo fecondarily afi^ecled ; next follows the violent aflion,
of the luno-s from the accumulation of the power of irritation, and an
inflammation of them follows this violent a£tion. While the flo-
mach recovers its aftivity by the increafe of the excitement of the
fenforial power of affociation, and along with it the heart and arteries,
and the whole moving fyflem. Hence this inflammation occurs
durino- the -hot fit of fever, and no cold fit fucceeds, becaufe the

excefs

Sup. I. 1 6. THEORY OF FEVER. 619

excefs of the feaforial power of fenfation prevents a fucceeding
torpor.

Thefe new motions of certain parts of the fyftem produce increafed
fecretions of nutritious or organic mucus, which forms new veflels ;
thefe new veflels by their unufual motions produce new kinds of
fluids ; which are termed contagious, becaufe they have the power,
when introduced into a healthy body, of producing fimilar aftions
and effedls, with or without fever, as in the fmall-pox and meafles,
or in the itch and venereal difeafe.

If any of thefe contagious matters afFe£t the ftomach with torpor
either by their ftimulus immediately applied, or by its fympathy
with the parts firft difeafed, a fever is produced with ficknefs and
want of appetite ; as in fmall-pox, and fcarlatina. If the ftomach is not
afFefted by contagious matter, no fever fucceeds, as in itch, tinea,
lyphilis.

All thefe contagious matters are conceived to be harmlefs, till
they have been expofed to the air, either openly or through a moift
membrane; from which they are believed to acquire oxygene, and
thence to become fome kinds of animal acids. As the preparations of
mercury cure venereal ulcers ; as a quarter of a grain of fublimate
diffolved in wine, and given thrice a day ; this effe&. feems to be pro-
duced either by its ftimulating the abforbents in the ulcer to abforb
the venereal matter before it has acquired oxygene ; or by afterwards
uniting with it chemically, and again depriving it of its acquired
acidity. On either fuppofition it might probably be given with ad-
vantage in fmall-pox, and in all infectious difeafes, both previous to
their commencement, and during their whole progrefs.

8. The cold fits of intermittent fevers are caufed by the torpor of
fome part owing to deficient irritation, and of the other parts of the
iyftem from deficient affociation. The hot fits are owing firft to the
accumulation of irritation in the part primarily affeded, if it recovers

4 K 2, , its

620 THEORY OF FEVER. Sup. I. 16.

its adllon, which does not always happen ; and fecondly to the accu-
mulation of aflbciation in the other parts of the fyflem, which during
health are fubjeft to perpetual a£tion ; and laftly alfo to the greater
excitement of the power of aflbciation, when the part primarily af-
fedled recovers its irritabiHty, and adts with greater energy than na-
tural.

The deficient fecretions in the cold fit depend on the torpor of the
glandular fyftem ; and the increafed fecretions in the hot fit on their
more energetic adlion. The thirft in the cold fit is owing to the de-
ficient abforption from the Ikin, cellular membrane, and bladder;
the third in the hot fit is owing to the too great diffipation of the
aqueous part of the blood. The urine is pale and in fmall quanity in
the cold fit from deficient fecretion of it, and from deficient abforp-
tion of its aqueous parts ; it is high coloured, and fometimes depofits
a fediment, in the hot fit from the greater fecrdtion of it in the kid-
neys, and the greater abforption of its aqueous and faline part in the
bladder. The drynefs and fcurf on the tongue and noflrils is owing
to the increafed heat of the air expired from the lungs, and confequent
greater evaporation of the aqueous part of the mucus.. The fweats ap-
pear in confequenceof the declenfion of the hot fit, owing to the abfor-
bentveflels of the Ikin lofing their increafed a£lion fooner than the fe-
cerning ones ; and to the evaporation lefTening as the fkin becomes
cooler. The returns of the paroxyfms are principally owing to the
torpor of fome lefs efiential part of the fyftem remaining after the
termination of the laft fit ; and are alfo dependeat on folar or lunar
diurnal periods.

The torpor of the part, which induces the cold paroxyfm, is ow-
ing to deficient irritation occafioned either by the fubdudion of the
natural ftimull of food, or water, or pure air, or by deficiency of ex-
ternal influences, as of heat, or of folar or lunar gravitation. Or fe-
condly, in confequence of the exhauilion of fenforial power by great
previous exertions of fome parts of the fyflem, as of the limbs by

Cr

o

preat

Sup. I. 1 6. THEORY OF FEVER. 621

great labour or exercife, or of the ftomach by great ftimulus, as by
contagious matter fwallowed with the faliva, or by much wine
or opium previoufly taken into it. Or laftly a torpor of a part
may be occafioned by fome mechanic injury, as by a compref- /

fion of the nerves of the part, or of their origin in the brain ; as
the fitting long with, one leg crofTed over the other occafions numb-
nefs, and as a torpor of the flomach with vomiting frequently pre^
cedes paralytic ftrokes of the limbs.

As fleep is produced, either by defe6l of ftimulus, or by previous
exhauftion. of fenforial powerj fo the accumulation of the feaforial
power of volition in thofe mufcles and organs of fenfe, which are o-e-
nerally obedient to it, awakens the deeping perfon ; when. it has in-
ci'eafed the quantity of voluntarity (o much as to overbalance the de-
fedl of ftimulus in one cafe, and the exhauflion of fenforial power in
the other; which latter requires a much longer time of fleep than
the former. So the cold paroxyfm of fever is produced either by de-
feat of ftimulus, or by previous exhauftion of the fenforial power of
Ibme part of the fyflem ; and the accumulation of the fenforial power
of irritation in that part renews the a£lion of it, when it has increafed
its irritabiUty fo much as to overbalance the defe6l of ftimulus in one
eafe, and the exhauHion of fenforial power in the other; which
latter requires a much longer torpor or cold fit than the former.

But in. the cold paroxyfm of fever befides the torpor of one part of
the fyfiiem from defedl of irritation, the remainder of it becomes tor-
pid owing to defedl of excitement of the fenforial power of affociation
by the leflened adtion of the part firft alFedled. This torpor of the
general fyftem remains, till the accumulation of the fenforial power
of affociation has increafed the affociability fo much as to overbalance
the defedl of the excitement of affociation ; then the torpor ceafes,
and if the firft affedled part has recovered its adlivity the other parts
are all thrown into excefs of adlion by their increafed alTociability, and
the hot fit of fever is produced,

.- ■■^. 9. In

622 THEORY OF FEVER. Sup. I. 1 6,

9. In the continued fevers with flrong pulfe the fton:iach is af-
fe£led fecondarily, and thus ads feebly from deficient excitement of
the power of aflbciation ; but the accumulation of the power of af"
fociation thus produced in an organ fubje6t to perpetual and energetic
aftion, is fo great as to affeft the next link of the aflbciate train,
which confifls of the heart and arteries ; thefe therefore are exerted
perpetually with increafe of aftion.

In continued fevers with weak pulfe the torpid ftomach is afFefted
primarily by previous exhauftion of its irritability by ftimulus, as of
contagious matter fwallowed into it. The heart and arteries adt

to

feebly from deficient excitement of the power of aflbciation, owing to
the torpor of the flomach, with which they are catenated; but the
accumulation of the power of aflbciation, thus produced in organs
fubjeft to perpetual and energetic motion, is fo great, as to affe6l the
iiex:t link of the aflbciate train ; which confifts of the capillaries of
the flcin or other glands ; thefe therefore are exerted perpetually with
great increafe of aftion.

The continued fevers with flrong pulfe terminate by the reduc-
tion or exhauftion of the fenforial power by violent a6tion of the
whole fyftem ; which is followed either by return of health with the
natural quantity of irntabihty, and of aflbclability, or by a total de-
flrudion of them both, and confequent death.

In continued fevers with weak pulfe the flromach remains torpid
during the whole courfe of the fever ; and at length by the recovery
of its irritability and fenfibility efFedls the cure of it. Which gene-
rally happens about the firft, fecond, or third quarter of the lunar pe-
riod, counted from the com'mencement of the difeafe, or continues a
whole lunation, and fometimes more ; which gave rife to what are
termed critical days. See Se£t. XXXVI. 4. on this fubjeft. If the
ftomach does not recover from its torpor, the patient becomes ema-
ciated, and dies exhaufted by the continuance of the increafed aftion
of the capillaries and abforbents, and the want of nourifliment.

8 The

Sv?.. I. i6. THEORY OF FEVER. 623^

The cure of corit:r>ued fever with weak pulfe confifts firfl: in weak-
ening the undue adtion of the cnpillaries of the Ikin by ablution with
cold water from 32 to 80 degrees of heat ; or by expofnig them to
cool air. Secondly by invigorating the anions of the fl:omach,'by de-
creafing them for a time, and thence accumulating the power of
irritation, as by an emetic, or by iced water, or iced wine. Or '
by incre.afe of: ftimuhis, as by bark, wine, opium, and food, in fmall ■
quantities frequently repeated^. Or by renewing the adion of the
flomach by flight eledric fhocks. Or by fomenting it frequently
with v/ater heated to 96 or 100 degrees. Or laiUy by exciting its
power of: affociation with, other parts of the fyfirem, .as by a blifter ;
which fucceeds beft when .the extremities are cool ; or by fwinging.

as in vertigo rotatoria..

If by the flimulus of the Peruvian bark on the fibres of the fto--
mach, they regain their due aftion, the heart and arteries alfo regain
their due a£i:ion ; as their fenforial power of affociation is nowexcited, .
and expended as ufual. And as there is then no accumulation of fen-
forial power in the heart; and arteries, the capillaries ceafe to a£l with
too great energy, and the fever is cured.

Thirdly. If the heart and arteries could be themfelves fli-
mulated into- greater adlion, although the fbomach remained torpid,
they might probably by expending a greater quantity of the fenforial
power of irritation, prevent an accumulation of the fenforial power
of affociation, (for thefe may poffibly be only different modes of
a6tion of the fpirit of animation,) and. thus the too great aftion of
the capillaries might be prevented and the fever ceafe. This new
mode of cure might poffibly be accomplifhed, if the patient was to
breathe a gallon or two of pure or diluted oxygene gas frequently in a
day ; .which by pafling through the moifi: membranes of the luno-s
and uniting with the blood might render it more ftimulant, and thus
excite the heart 'and arteries into greater adion.

Fourthly. Greater energy might probably be given to the whole
fyftem, and particularly to thofe parts which a£l too feebly in fevers,

as

634 THEORY OF FEVER. Sup. I. t6.

as the ftomach and the heart and arteries, if the a(^ion of the fe-
cerning velTels of the brain could be incrcafed in energy ; this is pro-
bably one effeft of all thofe drugs, which when given in large quan-
tity induce intoxication, as wine and opium. And when given with
great caution in fmall quantities uniformly repeated, as from three
drops to five of the tindlure of opium, but not more, every fix hours,
I believe they fupply an efficacious medicine in fevers with great arte-
rial debility ; and the more fo, if the Peruvian bark be exhibited al-
ternately every fix hours along with them. There are other means of
exciting the veflels of the brain into a£lion ; as firft by decreafing
the ftimulus of heat by temporary cold fomentation ; fecondly, in-
creafing the ftimulus of heat by long continued warm fomentation ;
thirdly, by electricity, as very fmall (hocks pafTed through it in all
directions •, and laftly by blifters on the head. All thofe require to
be ufed with great cautioJi, and efpecially where there exifts an evi-
dent ftupor, as the removing of that is I believe frequently injurious.
See ftupor, Clafs I. 2. 5, 10.

The cure of fever with ftrong pulfe confiftsin the repeated u(e of
venefedion, gentle cathartics, diluents ; medicines producing fick-
nefs, as antimonials, digitalis j or the refpiration of carbonated hydro-
gen ; or by refpiration of atmofpheric air lowered by a mixture of
hydrogen, azote, or carbonic acid gas, or by comprefling the brain
by whirling in a decumbent pofture, as if lying acrofs an hori-
zontal mill-ftone. See the former parts of this fupplement for the
methods of cure both of fevers with ftrong and weak pulfe.

10. When any difficulty occurs in determining the weak pulfe
from the ftrong one, it may generally be aflifted by counting its fre-
quency. For when an adult patient lies horizontally in a cool room,
and is not hurried or alarmed by the approach of his phyfician, nor
ftimulated by wine or opium, the ftrong pulfe feldom exceeds 1 18 or
120 in a minute; and the weak pulfe is generally not much below

Sup. I. 17, THEORY OF FEVER. 625

130, and often much above that number. Secondly in fitting up in
bed, or changing the horizontal to a perpendicular pofture, the quick-
nefs of the weak pulfe is liable immediately to increafe 10 or 20
sulfations in a minute, which does not I believe occur in the flrong
pulfe, when the patient has reded himfelf after the exertion of rifing.

XVII. Conclufion,

■ Thus have I given an outline of what may be termed the fympa-
thetic theory of fevers, to diftinguifh it from the mechanic theory of
Boerhaave, the fpafmodic theory of Hoffman and of CuUen, and the
putrid theory of Pringle. What I have thus delivered, I beg to be
confidered rather as obfervations and conje(3:ures, than as things ex-
plained and demonftrated ; to be confidered as a foundation and a
fcaffolding, which may enable future induftry to eredt a folid and a
beautiful edifice, eminent botli for its fimplicity and utility, as well
as for the permanency of its materials, — which may not moulder,
like the flrudtures already ereded, into the fand of which they were
compofed ; but wLich may fland unimpaired, like the Newtoniaa
jfhilofophy, a rock amid the wafte of ages I

Vol. II. 4L ADDITIONS,

ADDITIONS.

ADDITION L

AT the end of the article Canities, in Clafal. 2. 2. 1 1. pleafe to add
the following : .

As mechanical injury from a percufHon, or a wound, or a
cau{lic, is liable to occafion the hair of the part to become grey j.
fo I fufpeil the comprefTion of parts againft each other of fome
animals in the womb is liable to render the hair of thofe
parts of a lighter colour; as feems often to occur in black cats
and dogs. A fmall terrier bitch now frauds by me, which is
black on all thofe parts, which were external, when fhe was wrapped
up in the uterus, teres atque rotunda ; and thofe parts white, which
were moft conftantly preffed together ; and thofe parts tawny^
which were generally but lefs conflantly prefied together. Thus
the hair of the back from the forehead to the end of the tail is black,,
as well as that of the fides, and external parts of the legs, both before
and behind.

As in the uterus the chin of the whelp is bent down, and lies in
eontadt with the fore part of the neck and breaft ; the tail is applied
elofe againfl the diviiion of the thighs behind ; the infide cf the

kinder

Add. I. ADDITIONS. ttj

hinder thighs are preffed clofe to the fides of the belly, all thefe parts
have white hairs.

The fore-legs in the uterus lie on each fide of the face ; fo that
the feet cover part of the temples, and comprefs the prominent part
of the upper eye-brows, but are fo placed as to defend the eye-balls
from pretiiire ; it is curious to obferve, that the hair of the fides of
the face, and of the prominent upper eye-brov/s, are tawny, and
of the infide of the feet and legs, which covered them; for as this
pollure admitted of more change in the latter weeks of geflation,
the colour of thefe parts is not fo far removed from black, as of thofe
parts, where the contad or compreflion was more uniform.

Where this uterine comprefilon of parts has not been fo great as to
render the hair white in other animals, it frequently happens, that
the extremities of the body are white, as the feet, and nofes, and
tips of the ears of dogs and cats and horfes, where the circulation is
naturally weaker ; whence it would feem, that the capillary glands,
which form the hair, are impeded in the firft inflance by compreflion,
and in the laft by the debility of the circulation in them. See Clafsl.
I. 2. 15.

This day, Auguft 8th, 1794, I have feen a negro, who was born
(as he reports) of black parents, both father and mother, at Kingfton
in Jamaica, who has many large white blotches on the fkin of his
limbs and body ; which I thought felt not fo foft to the finger, as
the black parts. He has a white divergent blaze from the fummit of
his nofe to the vertex of his head ; the upper part of which, where
it extends on the hairy fcalp, has thick curled hair, like the other part
of his head, but quite white. By thefe marks I fuppofed him to be
the fame black, who is defcribed, when only two years old, in the
Tranfaflions of the American Philofophical Society, Vol. II. pao-e
292, where a female one is likewife defcribed with nearly fimilar
marks.

The joining of the frontal bones, and the bregma, having been

4 I-' 2 , later

62f ADDITION S; Add. IE

later than tRat of the other futures of the cranium, probably gave
caufe to the whitenefs of the hair on thefe parts by delaying or ina-
peding its growth.

ADDITION II.

The following extrad from a letter of Dr. Beddoes on- hydro=»-
cephalus internus, I efteem a valuable additioa.to- the article on that
fubjed at Clafs I. 2. 3. 12.

*' Mafter L , aged 9 years, Became fuddenly ill in the night

about a week before I faw him. On the day before the attack, he

had taken opening medicines, and had bathed afterwards. He had

complained of violently acute pain in his. head, flideked frequently,,.

o-round his teeth hard, ."ould not bear to have his head raifed from

the pillow, and was torpid or deaf. His tongue was white, pulfe

1 10 in the evening and fulL As yet the pupil of the eye was irrir

table, and he had no ftrabifmus. He had been bled with leeches

about the head, and bUftered. I diredted mercurial inundion, and

calomel from 3 to 6 grains to be taken at firfl every fix, and aftei*^

wards every three hours. This plan produced no fenfible efFed,

and the patient died on the i8th day after the feizure. He had con^

vulfion fits two days preceding his death, and the well-known fymp'-

toms of hydrocephalus internus all made their appearance. From

what I had feen and read of this difeafe, I beheved it to belong to

inflammations, and at an earlier period I fhould be tempted to bleed

.as largely as for pneumonia. The fluid found after death in the

ventricules of the brain I impute to debility of theabforbents-induced

by inflammation. My reafons are briefly thefe; i. The acutenefs

of the pain. 2. The ftate of the pulfe. In the above cafe for the

iirft 9 or 10 days it did not exceed no, and was full and flrong.

3- To

Add. m ADDITIONS. 629

3. To find out whether any febrile alternations took place, Mafter
Lf.'s feet were frequently felt, and they were found at times cold,
and at other times of a dry heat. I have many times feen this dif-
eafe, but the patients were too young, or too far advanced, to in-
form me,, whether they had chillnefs fucceeded by heat at its onfet.

4. The diforders to which the young are more peculiarly liable afford-
a prefumptlon, that hydrocephalus internus is an inflammatory dif-
eafe; and this is confirmed by the regularity of the period, within-
which it finiflies its courfe. And laftly, does it not happen more
frequeatly than is fufpe£led from external injury f

I have jufl: now been well informed, that Dr. Rufh has lately
cured five out of fix patients by copious bleedings. I relate here the
reafons for an opinion without pretending to a difcovery. Something
like this do(Strine may be found in certain modern publications, but it
is delivered in that vague and difFufe ftyle, which I truft your ex^
ample will banifli from medical literature,"

Clifton, near Briftol,.
July 2^, 1795.

To this idea of Dr. Beddoes may be added, that the hydrocele ge-
nerally fucceeds an injury, and confequent inflammation of the bag,
which contains it. And that other dropfies, which principally attend
inebriates,, are confequent to too great adion of the mucous mem-
branes by the ftimulus of beer, wine, and fpirits. And laftly, that
as thefe cafes of hydrocephalus end fo fatally, a new mode of treating
them is much to be defired, and deferves to be ferioufly attends*
ed to..

ADDITION

630 ADDITIONS. Add, III.

ADDITION III. On Vertigo.

To he pla,ced after the additional Note at the end of Vol. I. en

this Subject.

Having reperufed the ingenious Eflay of Dr. Wells on Single Vi-
lion, and his additional oblervatrons in the Gentleman's Magazine on
the apparent retrogreflion of objeds in vertigo, I am induced to be-
lieve, that this apparent retrogreffion of objedls is not always ov^'ing
to the fame caufe.

When a perfon revolves with his eyes clofed, till he becomes ver-
tiginous, and then Hands ftill without opening them, he feems for a
while to go forward in the fame direftion. This hallucination of his
ideas cannot be owing to ocular fpedra, becaufe, as Dr. Wells ob-
ferves, no fuch can have been formed ; but it muft arife from a fimi-
lar continuance or repetition of ideas belonging to the fenfe of touch,
inftead of to the fenfe of vifion ; and fhould therefore be called a tan-
gible, not a vifual, vertigo. In common language this belief of con-^
tinuing to revolve for fome time, after he ftands flill, when a perfon
has turned round for a minute in the dark, would be called a decep-
tipii of imagination.

Now at this time if he opens his eyes upon a gilt book, placed with
other books on a (half about the height of his eye, the gilt book feems
to recede in the contrary diredion ; though his eyes are at this time
kept quite fiill, as well as the gilt book. For if his eyes were not
kept ftill, other books would fall on them in fucceflion; which,
when I repeatedly made the experiment, did not occur ; and which
thus evinces, that no motion of the eyes is the caufe of the apparent
jetroceffion of the gilt book. Why then does it happen ? — Certainly
8 from

Add. Iir. ADDITIONS. 631

from an hallucination of ideas, or in common language the deception
of imagination.

The Vertiginous perfon flill imagines, that he continues to revolve
forwards, after he has opened his eyes ; and in confequence that the
obje61:s, which his eyes happen to fall upon, are revolving backward;
as they would appear to do, if he was adlually turning round with
his eyes open. For he has been accuftomed to obferve the motions
of bodies, whether apparent or real, fo much more frequently by the
eye than by the touch ; that the prefent belief of his gyration, occa-
fioned by the hallucinations of the fenfe of touch, is attended with
ideas of fuch imagined motions of vifible objeds, as have always ac-
companied his former gyrations, and have thus been aflbciated with
the mufcular adlions and perceptions of touch, which occurred at the
fame time.

When the remains of colours are feen in the eye, they are termed
ocular fpedlra ; when remaining founds are heard in the ear, they
may be called auricular murmurs ; but when the remaining motions,
or ideas, of the fenfe of touch continue, as in this vertigo of a blind-
folded perforr, they have acquired no name, but may be termed eva-
nefcent titillations, or tangible hallucinations.

Whence I conclude, that vertigo may have for its caufe either the
ocular fpedlra of the {cafe of viiion, 'whena perfon revolves with
his eyes open ; or the auricular murmurs of the fenfe of hearing, if he
is revolved near a cafcade ; or the evanefcent titillations of the {cnfe of
touch, if he revolves blindfold. All thefe I fhould wifh to call va-
nifhing ideas, or fen fual motions, of thofe organs of fenfe; which
ideas, or fenfual motions, have lately been affociated in a circle, and
therefore for a time continue to be excited. And what are the ideas
of colours, when they are excited by imagination or memory, but
the repetition of finer ocular fpedra ? What the" idea of founds, but •
the repetition of finer auricular murmurs?' And what the ideas of
tangible objedts, but the repetition of finer evanefcent titillations ?

The

632 ADDITIONS. Add. IV.

The tangible, and the auricular, and the vlfual vertigo, are all
perceived by many people for a day or two after long travelling in a
boat or coach ; the motions of the veffel, or vehicle, or of the fur-
rounding objefts, and the noife of the wheels and oars, occur at in-
tervals of reverie, or at the commencement of fleep. See Se£t. XX. 5.
Thefe ideas, or fenfual motions, of fi^ht, of hearing, and of touch,
are fucceeded by .the fame efFefts as the ocular fpedlra, the auricular
murmurs, and the evanefcent titillations above mentioned ; that is,
by a kind of vertigo, and cannot m that refped be diftinguifhed from
them. Which is a further confirmation of the truth of the doctrine
delivered in Seft. III. of this worlc, that the colours remaining in th©
eyes, which are termed ocular fpedlra, are ideas, or fenfual motions,
belonging to the feiife of vifiooj which for too long a time continue
iheiv adivitj:.

ADDITION IV. Of Voluntary Motions.

A correfpondent acquaints me, that he finds difficulty in under-
ilanding how the convulfions of the limbs in epilepfy can be induced
by voluntary exertions. This I fufpeft firft to have arifen from the
double meaning of the words " involuntary motions ;" which are
fometimes ufed for thofe motions, which are performed without the
interference of volition, as the pulfations of the heart and arteries ;
and at other times for thofe a£lions, which occur, where two coun-
ter volitions oppofe each other, and the flronger prevails ; as in en-
deavouring to fupprefs laughter, and to flop the fhudderings, when
£xpofed to cold. Thus when the poet writes,

video meliora, proboque,

Deteriora feqvior.——

4 The

Add. V. ADDITIONS. 633

The ftronger volition adluates the fyftem, but not without the
counteraftion of unavailing fmaller ones ; which conftitute delibera-
tion.

A fecond difficulty may have arifen from the confined ufe of the
words " to will," which in common difcourfe generally mean to
choofe after deliberation ; and hence our will or volition is fuppofed
to be always in our own power. But the will or voluntary power,
acts always from motive, as explained in Se£t. XXXIV. i. and in
Clafs IV. I. 3. 2. and III. 2. i. 12. which motive can frequently be
examined previous to aftion, and balanced againft oppofite motives,
which is called deliberation ; at other times the motive is fo powerful
as immediately to excite the fenforial power of volition into aftion,
without a previous balancing of Oppofite motives, or counter volitions.
The former of thefe volitions is exercifed in the common purpofes
of life, and the latter in the exertions of epilepfy and infanity.

It is difficult to think without words, which however all thofc muft
do, who difcover new truths by reafoning ; and flill more difficult,
when the words in common ufe deceive us by their twofold mean-
ings, or by the inaccuracy of the ideas, which they fuggeft.

ADDITION V. Of Figure.

I feel myfelf much obliged by the accurate attention given to the
firft volume of Zoonomia, and by the ingenious criticifms bellowed
on it, by the learned writers of that article both in the Analytical and
Englifli Reviews. Some circumftances, in which their fentiments do
not accord wi^th thofe exprefled in the work, I intend to reconfider,
and to explain further at fome future time. One thing, in which
both thefe gentlemen feem to diffent from me, 1 fliall now mention,
it is concerning the manner, in which we acquire the idea of figure ;
acircumftance of great importance in the knowledge of our intelledt,

Vol. II. 4 M as

634 ADDITIONS. Add. V.

as it {hews the caufe of the accuracy of our ideas of motion, time,
fpace, number, and of the mathematical faiences, which are concern-
ed in the menfurations or proportions of figure.

This I imagine may have in part arifen from the prepoffeflion,
which has almoft univerfally prevailed, that ideas are immaterial
beings, and therefore poffefs no properties in common with folid mat-
ter. Which I fuppofe to be a fanciful hypothefis, like the flories of
ghofts and apparitions, which have fo long amufed, and ftill amufe,
the credulous without any foundation in nature.

The exiftenee of our own bodies, and of their folidity, and of their
figure, and of their motions, is taken for granted in my account of
ideas ; becaufe the ideas themfelves are believed to coniift of motions
or configurations of folid fibres ; and the queflion now propofed is,
how we become acquainted with the figures of bodies external to our
organs of fenfe ? Which I can only repeat from what is mentioned in
Se£l. XIV. 2. 2. that if part of an organ of fenfe be Simulated into
a£tion, as of the fenfe of touch, that part fo flimulated into adtion
mufl poffefs figure, which mufl be fmiilar to the figure of the body,,
which ftimulates it.

Another previous prepofTeffion of the mind, which may have ren-
dered the manner of our acquiring the knowledge of figure lefs intel-
ligible, may have arifen from the common opinion of the perceiving-
faculty reliding in the head ; whereas our daily experience fhews,
that our perception (which confifts of an idea, and of the pleafure or
pain it occafions) exifts principally in the organ of fenfe, which is Si-
mulated into adion ; as every one,, who burns his.finger in the candle,
rauft be bold to deny.

When an ivory triangle is prelTed on the palm of the hand, the
figure of the furface of the part of the organ of touch thus comprefTed
is a triangle, refembling in figure the figure of the external body,
which comprefTes it. The a£lion of the flimulated fibres, which con-
ftitute the idea of hardnels and of figure, remains in this part of the

fenforium.

Add. V. ADDITIONS. 635

fenforium, which forms thefenfe of touch ; but the fenforlal motion,
which conHitutes pleafure or pain, and which is excited in confe-
quence of thefe fibrous motions of the organ of fenfe, is propagated to
the central parts of the fenforium, or to the whole of it ; though
this generally occurs in lefs degree of energy, than it exifts in the
ftimulated organ of fenfe ; as in the inftance above mentioned of burn-
ing a finger in the candle.

Some, who have efpoufed the doctrine of the immateriality of ideas,
have ferioufly doubted the exiftence of a material world, with which
only our fenfes acquaint us ; and yet have affented to the exiftence of
fpirit, with which our fenfes cannot acquaint us ; and have finally
allowed, that all our knowledge is derived through the medium of our
fenfes! They forget, that if the fpirit of animation had no proper-
ties in common with matter, it could neither afte£t nor be afFefted by
the material body. But the knowledge of our own material exiftence
being granted, which I fufpedt {ew rational perfons will ferioufly
deny, the exigence of a material external world follows in courfe ;
as our perceptions, when we are awake and not infane, are diftin-
guifhed from thofe excited by fenfation, as in our dreams, and from
thofe excited by volition or by affociation as in infanity and reverie,
by the power we have of comparing the prefent perceptions of one
fenfe with thofe of another, as explained in SeQ.. XIV. 2. 5. And
alfo by comparing the tribes of ideas, which the fymbols of piftures,
or of languages, fuggeft to us, by intuitive analogy with our previous
experience, that is, with the common courfe of nature. See Clafs III.
2. 2. 3. on Credulity.

M 2 ADDITION

e^e ADDITIONS. Add. VI.

ADDITION VI.

Pkafe to add the following in page 14, after line 20.

Cold and hot Fit.

As the torpor, with which a. fit of fever commences, is fometimes
owing to defedl of ftimulus, as in going into the cold-bath ; and
fometimes to a previous exhauftion of the fenforial power by the ac-
tion of fome violent ftimulus, as after coming out of a hot room into
cold air J a longer time muft elapfe, before there can be a fufficient
accumulation of fenforial power to produce a hot fit in one cafe than
in the other. Becaufe in the latter cafe the quantity of fenforial power
previoufly expended muft be fupplied, before an accumulation can.
begin.

The cold paroxyfm commences, when the torpor of a part becomes
fo great, and its motions in confequence fo flow or feeble, as not to
excite the fenforial power of affociation ; which in health contributes
to move the reft of the fyftem, which is catenated with it. And the
hot fit commences by the accumulation of the fenforial power of irri-
tation of the part firft affeded, either fo as to counteracfl its deficient
ftimulus, or its previous wafte of fenforial power ; and it becomes
o-eneral by the accumulation of the fenforial power of afifociation ;
which is excited by the renovated aftions of the part firft afFefted ; or
becomes fo great as to overbalance the deficient excitement of it. On
allthefe accounts the hot Jit cannot be fuppofed to bear any propor-
tion to the cold one in length of time, though the latter may be the
confequence of the former. See Suppl. I. 16. 8.

ADDITION

Add. VII. A D D I T I ON S, 6^y

ADDITION VII. On Warmth.
7b be added at the end of the Species Sudor Calidus^ in Clafs I. i. 2. 3.

When the heat of the body in weak patients in fevers is increafed
by the ftioiulus of the points of flannel, a greater confequent debility
fucceeds, than when it is produced by the warmth of fire; as in the
former the heat is in part owing "to the increafed activity of the fkin,
and confequent expenditure of feniorial power ; whereas in the latter
cafe it is in part owing to the influx of the fluid matter of heat.

So the warmth produced by equitation, or by rubbing the body and
limbs with a fmooth brufh or hand, as is done after bathing in fome
parts of the Eaft, does not expend nearly fo much fenforial power, as
when the warmth is produced by the locomotion of the whole weight
of the body by rriufcular aftion, as in walking, or running, or fwim-
ming. Whence the warmth of a fire is to be preferred to flannel fhirts
for weak people, and the agitation of a horle to exercife on foot. And
I fuppofe thofe, who are unfortunately loft in fnow, who are on foot,
are liable to perifh fooner by being exhauifed by their mufcular ex-
ertions ; and raiglit frequently preferve themfelves by lying on the
ground, and covering themfelves with fnow, before they were too
much exhaufted by fatigue. See Botan. Garden, Vol. II. the note on
Barometz.

ADDITION

638 ADDITIONS. Add. VIII.

ADDITION VIII. Puerperal Fever.
To bs added to Clajs II. i. 6. 16.

A very interefting account of the puerperal fever, which was epi-
demic at Aberdeen, has been lately published by Dr. Alexander Gor-
don. (Robinfon, London.) In feveral dlfleftions of thofe, who died
of this difeafe, purulent matter was found in the cavity of the abdo-
men ; which he afcribes to an eryfipelatous inflammation of the pe-
•riton<Eum, as its principal feat, and of its produflions, as the omen-
tum, mefentery, and peritonaeal coat of the inteftines.

He believes, that it was infeftious, and that the contagion was al-
ways carried by the accoucheur or the nurfe from one lying-in woman
to another.

The difeafe began with violent unremitting pain of the abdomen
on the day of delivery, or the next day, with (huddering, and very
quick pulfe, often 140 in a minute. In this fituation, if he favv the
patient within \^ or 24 hours of her feizure, he took away from 16
to 24 ounces of blood, which was always fizy. He then immedi-
ately gave a cathartic confining of three grains of calomel, and 40
orains of powder of jalap. After this had operated, he gave an opiate
at night ; and continued the purging and the opiate for feveral days.

He aflerts, that almoll all thofe, whom he was permitted to treat
in this manner early in the difeafe, recovered to the number of 50;
and that almoft all the reft died. But that when two or three days
were elapfed, the patient became too weak for this method ; and the
matter was already formed, which deftroyed them. Except that he
faw two patients, who recovered after dilcharging a large quantity of
matter at the navel. And a few, who were relieved by the appearance
of external eryfipelas on the extremities.

This

Add. Vnr. ADDITIONS. 639

This difeafe, confifting of an eryfipelatous inflammation, may oc-
cafion the great debility fooner ta occur than in inflammation of the
uterus ; which, latter is neither eryfipelatous, I fuppofe, nor contagi-
ous. And the fuccefs of Dr. Gordon's praftice feems to correfpond
with that of Dr. Rufli in the contagious fever or plague at Philadel-
phia ; which appeared to be much affifted by early evacuations. One
cafe I faw fome time ago, where violent unceafjng pain of the whole
abdomen occurred a few hours after delivery, with cjuick pulfe ;
which ceafed after the patient had twice lofl: about eight ounces o£
blood, and had taken a moderate cathartic with calomel.

This cafe induces me to think, that it might be fafer and equally,
efficacious, to take lefs blood at firfi:,. than Dr..Gordon mentions, and
to repeat the operation in a few hours, if the continuance of the fymp-
toms (hould require it. Aiid the fame in refpeil to the cathartic,.,
which might perhaps be given in lefS (^antity, and repeated every two
Of three hours.

Nor (hould I wifli to give an opfate after the fi'rft- venefedion
and cathartic; as I fufpe6l that this might be. injurious,, except
thofe evacuations^ had emptied the velTels fo much, that the ftimulus
of the opiate fliould a£l. only, by increaling the abforption of the new
veflels or fluids produced on the furfaces of the inflamed membranes..
In other inflammations of the bowels, and in acute rheumatifm, I
have feen the difeafe much prolonged, and I believe fometimes ren-
dered fatal, by the too early adminifi:ration of opiates, either along,
with cathartics, or at their intervals; while a fmall. dofe of opium.-
given after fufncient evacuations produces abforption only by. its fli-
mulus, and much contributes to the cure of the patient. We mayv
have vifible teftimony of this efFeft of opiums when a folutionof.it is
put into an inflamed eye ; if it be thus ufed previous to fufficient eva-
cuation, it increafes the inflammation ; if it be ufed. after fufficient:
evacuation, it increafes. abforption only, and clears the eye in a very

fmall time.

6. - ' I. cannot

o

640 ADDITIONS. Add. VIII.

I cannot omit obferving, from confiderlng thefe circumftances, how
unvvife is the common pradlice of giving an opiate to every woman
immediately after her delivery, which muft often have been of dan-
gerous confequence.

END OF THE SECOND PART.

ZOONOMIJE AUCTORI

S. p. D.

AMICUS.

CURRUS TRIUMFMALIS MEDICINM.

Currus it Hygeiae, Medicus movet arma tiiumplians,
Undique vifta fugit lurida turma mail.

Laurea dum Phcebi viridis tua tempora cingit,
Nee mortale fonans Fama coronat opus ;

Poft equitat trepidans, repetitque Sene6tus in aurem,
Voce canens ftridula, " fis memor ipfe mori !"

I N D EX

OF THE

CLASSES.

A.

Abortion, i. 2. i. 14.

from fear, iv. 3.1.7.

not from epilepfy, iii. i, I. 7.

not from hepatitis, ii. i . -2. . I2.

Abforption of folids, i. 2. 2. 14.

of matter, ii. 1.6. 2. and 6.

cellular, iv. I. I. 6.

from the lungs, iv. 3- 1 ■ 5. Suppl.

i. 8. 6.
Abftinence of young ladies, ii. 2. 2. I.
Accumulation of feces, ii. 2. 2. 7.
Acupundure, iii. 1. I. .8.
Adipfia, ii. a. 2. 2.
jiEgritudo ventriculi, i; 2. 4. 4. ,v

See Sicknefs.

Agrypnia. See Vigilia.

Ague-cakes, Suppl. i. 2. 3.

Alum in ulcers of the mouth, ii. 1.3. i.

Ambition, iii. I. 2. g.

Amaurofis, i. 2. 5- 5.

Anafarca of the lungs, i. 2. 3. 16.

Anger, iii. i. 2. 17.

Anger, tremor of, iv. 2. 3. 4.

blufli.of, iv. 2. 3. 5.

Angina. See TonfiUitis.

i pe£toris. See Afthma painful.

Vol. II.

Anhelitus, ii. r. r. 4.
Anhelatio fpafmodica, i. 3. 3. 3,
Annulus repens, ii. i. 5. 10.
Anorexia, ii. 2. 2. i.

maniacalis, Suppl. i. 14. 3.

epileptica, ii. 2. 2. i. iii. i. i, 7,

Apepfia, i. 3. i. 3. Suppl. i. 8. 11.
Aphtha, ii. i. 3. 17.
Apoplexy, iii. 2. 1. 16.
Appetite defective, ii. 2. 2. r.

depraved, iii. 1.2. 19.

from abftinence, ii. 2. 2. I.

deftroyed, iii. i. 2. 20.

from epilepfy, ii. 2. 2. i.

Arm, pain of, iv. 2. 2. 13.
.... palfy of, iii. 21.4.
Arfenic in tooth-ach, i. 2. 4. 12.

in head-ach, i. 2.4. 11.

Arthrocele, ii. 1.4. 17.

Arthropuofis, ii. i. 4. 18.

Arthritis. See Gout.

Afcarides, i. I. 4. 12. iv. 2. I. g.

Afcites, i. 3. 3. 13.

Aflbciations affedled four ways, iv. i. i. G.

how produced, iv. i. i. H.

dlftincSl: from catenations, iv, i ,

I. A.

4 N Aflbciations,

642

INDEX OF THE CLASSES.

Aflbciatlons, three kinds of, iv. i. i. B.

tertian, iv. I. i. K.

of the fauces and pubis, iv. 1 .

2.7.
fenfitive, a law of,, iv. 2.

2. 2.

fenfitive, iv. 2. i.

accumulates, Suppl. i. 8. 3. i.

11.4.
Afthma humoral, ii. i. i. 7. i. 3. 2. 8.

of infants, i. i. 3. 4.

convulfive, iii. i. I. 10.

painful, iii. i. I. 11.

Auditus acrior, i. 1.5. 2.

imminutus, i. 2. 5. 6.

Azote, Suppl. i. 9. 3. i. 11. 4.

B.

Bandages, ill eiFefl of, ii. i. i. 1.3.

promote abforption, i. i. 3, 13.

Bath, cold, i. 2. 3. i.
.... warm, Addit. vii.
Beauty,, iii. r. 2.. 4.

lofs of, iii. I. 3. 13.

Bile-dua,,pain of, iv. 2. 2. 4.
Bile cry ftalized, i. 1.3.8. . '
Bitter tafle, i. 1. 3. 1.

not from bile, i. I. 3. i.

Bleeding. See Haemorrhage.
Bladder, .diftention of, ii. 2. 2. 6.

Hone of, i. i. 3. 10.

catarrh of, ii. i. 4. 11.

Ellndnefs, i. 2. 5. 5.

Blufli of anger, iv. 2. 3. 5. Suppl. i. 12. 7.

of guilt, iv. 2. 3.. 6. Suppl. i. 12. 7.

Bones, innutrition of, i. 3. 2. 14.

..... caries of, ii. 1 . 4. 1.9. .

Borborigmus, i. 3. i. 9..

Bougies, ii. 1.4. 11.

Brachiorum paralyfis, iii. 2. i. 4.

Brain Simulated, Suppl. i. 16. 9.

Bronchocele, i. 2. 3. 20.

Burns, i. I. 3. 13.

Butterflies, experiment on, i. i. 2. 3.

Cacofitia, iii. i. 2. 20.
Calculi pro4u£lio, i. i. 3. g. ii. i, 2. 14.
•■....'. renis, i. i. 3. 9. iv. 2. 3. 3.
veficse, i. 1.3. 10. iv. 2. 2. 2.

Callico fhirts, i. I. 3. 3.

Callus, i. 2. 2.12.

Canities. See Hair grey.

Calor febrilis, i. i. 3. i.

Calves fed on gruel, i. i. 2. 5..

..... hydatides of, T. a. 5. 4.

Cancer, ii. 1. 4. 16. ii. 1.6. ij.

Cantharides, large dofe of, iv. 3. 3. 3.

Carbonic acid gas, Suppl. i. 9. 3.

Cardialgia, i. 2.4. 5.

Carcinoma, ii. i. 4. 16. ii. I. 6. 13,

Caries offium, ii. i. 4. 19.

Cataradl, i. 3. 2. 13.

Catarrh, warm, i. i. 2. 7.

cold, i. 2. 3. 3.

lymphatic, i. 3. 3. i.

fenfitive, ii. 1. 3. 5.

epidemic, ii. 1 . 3. 6.

of dogs and horfes, ii. i. 3. 6.

....;.,.. from coldlkin, iv. i. i. 5,

periodic, iv. 3.^ 4. i.

Catamenia, i. 2.. i. 10. iv. a. 4. 7.
Catalepfis, iii> 2. r., 9..
Cats, mumps of, ii. i. 3. 4.
Cephalffia frigida, i. 2. 4. 11. iv. 2. 2. 7.
Charcoal tooth-powder, i. 3.4. 12.
Cheek, torpor of, iv. 2. 2. i.
Chicken-pox, ii. i. 3. i^.
Chin-cough, ii. i. 3.8.
Child-bed fever, ii. .1. 6. 16.
Children, rtew-born, ii. i. i. 13.

gripes and purging of, i i. 2. 5.

Chlorofis, i. 2. 3. 10. Suppl. i. 8. 11,
Chorea St. Viti, iv. 3. 3. 2.
Citta, iii. 1. 3. 19.
Clamor, iii. 1.1.3.
Clavicular animals, ii. i. 3. 6.
Clavus hyflericus, iv. 2. 3. 8.
Claudicatio coxaria, i. 3. 2. 17.
Cold in the head. . See Catarrh.
Colic, flatulent, i. 2. 4. 7.

Colie

INDEX TO THE CLASSES.

643

Colic from lead, i. 2. 4. 8.

.... hylteric, i. 2. 4. 7. lii. I. 1.8.

Cold air in fevers, iii. 2, i. 12. iv. 2. 4. 11.

.... effects of, iii. 2. I. 17.

.... how to be ufed, iv. i. 1.4.

Compaffion, iii. i. 2. 24..

Confumption, ii. i. 6. 7.

Convulfion, iii. i. 1.5.

weak, iii. i. I. 5.

from bad air, iii. I . I. ^,

painful, iii. 1. i. 6. iv. 2.

4- 5-
Conflernation, i. i. 5. 12.
Conftipation, i. i. 3. 5. ii. 2. i. 7.
Contagious matter of two kinds, ii, 1.3.

is oxygenated, ii. i. ^.

produces fever, how, Suppl. i.

16. 7.
Cornea to perforate, i. 1.3. 14..

fears of feen on milk, i. i. 3. 14.

Corpulency, i. 2. 3. 17.
Coryza. See Catarrh.
Coflivenefs, i. i. 3 5. ii. 2. I. 7.
Cough of drunkards, ii. r. i. 5.

hooping, ii. i. 3 8.

hepatic, iv. 2. I. 8.

gouty, iv. i. I. 9.

periodic, iv. 2 4. 6. iv. 3. 4. 2^

from cold feet, iv. 2. I. 7.

Cows, peftilence of, ii. i. 3. 13.

bloody urine of, ii. 1. 3. 13.

Cramp, iii. i. i. 13.

painful, ill. i. i. 14.

in diarrhoea, iv. I. 2. 10.

Crab-lice, i. 1. 4. 14.

Credulity, iii. 2. 2. 3.

Crines novi, i. i. 2. 15.

Croup, i. 1. 3. 4. ii. i. 2. 4. ii. I. 3. 3.

Crufta laftea, ii. 1. 5. 12.

Cutis arida, i. i. 3. 6.

Cynanche. See Tonfillitis.

• parotidasa. See Parotitis.

D.

Darknefs in fevers, i. 2. 5. 3.
Deafnefs, two kinds of, i. 2.5. 6.
Debility, diree kinds of, i. 2. i.

Debility and ftrength metaphors, i. 2, i.
Decuffation of nerves, iii. 2. I. 10.
Deglutition, ii. i. I. i.

involuntary, iv. i. 3. i.

Dentition, i. i. 4. 5.
Dentium dolor a ftridore, iv. r. 2. 3.
Defcent of the uterus, i. i. 4. 8.
Diabetes, i. 3. 3 6.

foul tongue in, i. 1.3. I.

irritative, iv. 3. i. i,

from fear, iv. 3. 1.3.

Diarrhoea warm, i. 1.2. 5.

of infants, i. i. a. i,

. lymphatic, i. 3. 2. 4,

chyliferous, i. 3. 2.^.

cold, i 2. 3. 6.

rheumatic, iv. 2. I. 16.

from fear, iv. 3. I. 4.

from toothing, iv. 3. 2. 14.

in fevers, Suppl. i. 3. 4.

cure of, iv. I. I. f.

Digeflion increafed by cold, iv. I. I, 4,

decreafed by cold, iv. i. 2. 5.

Dilirium febrile, ii. i. 7. i.

of drunkennefs, ii. i. 7. 3.

maniacal, ii. i. 7. 2.

in parotitis, iv. 2. i. Ig.

Diluents, ufe of, ii. i. 2. i.

Diftention of the nipples, ii. i. 7, 10. iv. 1.

Diuretics ufelefs in dropfy, i, 1.3, 7.
Dizzinefs. See Vertigo.
Dogs, catarrhof, ii. I. 3. 6.
Dolor digiti fympathet, iv. 2. 3. 12.

duftus choledochi, iv. 2. 2. 4.

humeri in hepatidite, iv. 2. 2. g.

pharyngis ab acido, iv. 2. 2. 5.

teilium nephriticus, iv. 2. 2. II.

urens, i. i. 5. 10.

Dracunculus, i. 1.4. 13.

Dreams, ii. i. 7. 4.

Dropfy of the brain, i. 2. 3. 12.

of the belly, i. 2. 3. 13.

of thecheft, i. 2. 3. 14.

of the ovary, i. 2. 3. 15.

of the lungs, i. 2. 3. 16.

of the fcrotum, i. 2. 3. 11,

Dyfentery, ii. 1.3. 18.
Dyfmenorrhagia, i. 2. I, la.

4 N 2 Dyfpncea

644-

INDEX OF THE CLASSES.

Dyfpnosa from cold bath, iv. 2. 1.5.

rheumatica, iv. 3. i. 16.

Dyfpepfia, i. 3- i. 3-

a frigore, iv. 2. 1.6.

Pyfuria infenfitiva, ii. 2. 2. 6.

E.

Ears, dilcharge behind, i. I. 3. 9.

.... noife in them, iv. 3. I. 15-

Ear-ach, iv. 3. 2. 8.

Ebrietas, i. i. i. 2.

Education, iii. 2. i. 8. iil. i. 3. 24.

heroic, iii. i. 2. 35.

F,gg boiltd for inflamed eyes, ii. I. 4. i.
. . . boiled iboneft, Suppl. i. 7.
. . . life of, iv. I. 4. I.
Ele6lric ihocks, iv. i. 4- 5-
Eleftrized zinc and filver, i. 2, 5. -5.

in paralyfis, ii. i. 1.9.

in fcrophula, i. 2. 3.21.

in hoarfenefs, iii. 2. I. 5.

Empyema, ii. i. 6. 4.

Enteralgia rheumatica, iv. I. 2. 16.

Enteritis, ii. I. 2. 11. _

fuperficialis, ii. I. 3. 20.

Epilepfy, iii. i- I- 7- i^- 3- ^- ^•

, .'. painful, iii. I. i. 8. iv. 2. 4. 4.

terminates with fleep, iii. I. I.

in parturition, iii. i . 1.7.

with indigellion, ii. 2. 2. I.

Epiftaxis. See Ha^morraghia.
Epoulofis. -See Cicatrix.
Erotomania, iii. I. 2. 4.
Eru6tation, voluntary, iv. 3. g. ^.
Eruption of fmall-pox, iv. 2. I. 12. iv. 2.

3. 10.

Eryfipelas, iv. I. 2. 17. ii. i. 3- 2. iv. 2.

4. 10.

feldom fuppurates, why, ii. i.

J. z.
Efurles, 1. 2. 4. 2.
p.vil, i. 3. 3- 21. .

Expeftoration, warm, i. I. 2. 8.

folid, i. 1.34."

cold, i. 2. 3. 4.

Exfudation behind the ears, i. I. 2. 9.
Eyes, blue under the, i. a. 2,. 2. ii. i. 4. 4.

Eyelid inverted, cure of, il. 1. 1.8.
coloured with antimonv, ii. i. 4. 3-

F.

Face, pimpled, ii. i. 4. 6.

.... red after meals, Suppl. i, 12. 7.

.... flufhed after dinner, iv. i . 1. r.

Fat people why fhort breathed, ii. i. i. 4.

Fear, fyncope from, i. 2. i. 4.

.... abortion from, iv. 1.3. 7.

.... produces abforption, ii. i. 6. 4..

.... palenefs in, iv. 1. 3. 5.

.... of death, iii. I. 2. 14.

.... of hell, iii. i. 2. 15.

... .of poverty, iii. I. 2. 13.

Feet cold produces heartburn. Suppl. i.

8-5.,.
.... tetid, 1. I. 2. 14.

.... cold in fmall-pox, iv. 2. 2. 10.

Fevers, five kinds, ii. I. 2. Suppl..i. r. 2.

irritative, i. I. I. I. iv. i. j. 8.

inirritative, i. 2. I. I. iv 3. i. 19.

Suppl. i. I. 3-

fenfitive, ii. i. 5. i.

fenfitive irritated, ii. 1.2.1.

fenfitive inirritated, ii. I. 3. i,

intermit, why, Suppl. i.

continue, vvhy, Suppl, i,

periods of, iv. 2. 4. II.

fimple, Suppl. i. I.

compound, Suppl. i. 2.

termination of cold fit, Suppl. i. 3.

return of cold fit, Suppl. i. 3.

fenfation in, Suppl. i. 5.

...... circles of motions in, Suppl. i. 6.

cold and hot fits, Suppl. i. 7.

continued, Suppl. i 8.

torpor of lungs in, Suppl. i. 9. I.

not determinable in cold fit, i. I.

I. I.

frequency of pulfe in, i. I. i. i.

not an effort to cure, i. I. 3. 3.

perpetual, ii. I. 6. 16. i. 2. 4- 9.

...... from inclofed matter, ii. I. 6. 2.

from aerated matter, ii. I. 6. 6.

from contagious matter, ii. 1.6. 11.

from contagious fanies, ii. I. 6. 15.

Fever,

INDEX OF THE CLASSES.

6^S

Fever, torpor of the flomach, Suppl. i. 12.
. . . • . cafeof, Suppl. i. 13.

termination of, Suppl. i. 14.

inflammation excited, Suppl. i, 15,

returns of, Suppl. i. 4.

when cold air in, Suppl. i. 2. 2.

..... fympathetic, theory of, Suppl. i.

duration of explained, Suppl. i

Fingers, playing with, iv. i. 3. 4.

pain of, iv. 2. 2. 12.

Fifti live longer with injured brain,

5. 10.
Fiftula in ano, ii. 1.4. 10.

lacrymalis, ii. i. 4. 9.

urethra, ii. i. 4. 11.

Flannel fhirt in diarrhoea, iv. 1. I. 3.

injurious in fummer, i. 1.2.

Fluor albus warm, i. i, 2. 11.

cold, i. 2. 3. 7.

Frigus febrile, i. 2. 2. i. ,
chronicum, i. 2. 2. 2»

Gutta rofea, ii, i. 4. 6. iv. 1. 2. 13. and

14.
ferena, i. 2.5. 5.

H.

^•5' Hemorrhage arterial, i. i. i. 3.

of the lungs, i. i. i. 4.

of the nofe, i. i. 1.5.

'• venous, i. 2. I. 5.

of the recStum, i. 2. I. 6.

of the kidnies, i. 2. 1.7.

of the liver, i. 2. i. 8.

Haemoptoe arterial, i. i. 1.4.

venous, i. 2. i. 9.

3* Hsmorrhois cruenta, i. 2. i. 6. iv. 2. 4. 8.

alba, i. I. 2. 13.

Hair, grey, i. 2. a. 11.

.... new, i. 1.2. 15.

.... white by uterine preffure, Addit. i.

Hallucination of fight, ii. i. 7. ^.

of hearing, ii. i . 7. 6.

^' . maniacal, iii, i. 2. i.

ftudiofa, iii. i, 2. 2.

Gall-flone, i. i. 3. 8. Harroga'e water fa£t, i. i. 4. 12

Gangreen, ii. !. 6. 17. Head-ach. See Hemicranla and CephalEea.

Gargles, ii. I. 3. 3. Hearing acnter, i. 1. 5. 2.

Gaflritis, ii. i. 2. 10. diminiflied, i. a. ^. 6.

fuperficialis, ii. I. 3. ig. Heart-burn, i. a. 4 . 5.

Genu tumor albus, i. 2. 3.-i9. Heart flimulated, Suppl. i. 11, 7. i, 16. g.

Gleet. See Gonorrhoea. Heat, animal, i. r. 2. 1. i. i. 3. 3,

Globus hyflericus, i. 3. I. 7. .... fenfe of acuter, i. i. 5. 6.

Gonorrhoea warm, i. i. 2. 10. .... elemental, iv. 2. 4.

cold, i. 2. 3. 8. .... heStiC leffened by fwinging, iv. 2. I.

Gout, iv. 1. 2. 15. iv. 2. 4. 9. 10.

of the liver, ii. i. I. 7. .... not perceived by the lungs, iii. i. i.

cafes of, iv. i, 2. 15. 10.

cough, iv. 2. I. 9. .... not eftimated by thermometers, Suppl.

of tlie ftomach, i. 2. 4. 6. i. 7. •

hemorrhage in, i. i. I. 4. .... of the breath, Suppl. i. a. 2.

Grace defined, iii. i. 2. 4 Hemicranla, iv. 2. 2, 8. iv. 2. 4. 3.

Gravel diflinguifhed from falts, i. 1.3. lO relieved by mercury, iv. 2,.

Gravitation, iv. 2. 4. 2. 8.

Green-ficknefs. See Chlorofis. Hemiplegia, iii. 2. i. 10.

Grief, iii. i. 2. 10. Hepatis tumor, i. 3. 3. 9.

Gripes of children, i. i. 2. 5. iv. 2. 1. 3. Hepatitis, ii. i 2. 12.

Gufius acrior, i. i. 5. 4. chronica, ii. i, 4. 12.

imraiputus, i. 2. 5. 8. Herpes, ii. i. 5. 8.

Herpes

646

INDEX GF THE CLASSES.

Herpes nephritica^iv. i. 2. 11.
Hiccough, ii. I. i. 6. iv. i. i. 7. ,
Hip-joint injured, i. 2. 2. 17.
Hoarfenefs, ii. i. 3. 5 iii 2 I. 4.
Horfes, broken wind of, i. 2, 4, 9.
Hume£i:ation of the body, iv. 1. 4. 7.
Hunger, i. 2. 4. 2.
Hydatides in calves, i. 2. 5. 2.
Hydrocele, i. 2. 3. 11.
Hydrocephalus inter, i. 2. 3. 12. i. 2. 5. 4.

iii. 2. 1. 10.

from inflammation, Addit. ii.

Hydrogene gas, Suppl. i. 9. 3. i. 11. 4.
......... in fevers, Suppl. i, 11. 6. i.

16. 9.
Hydrothcrax, i. 2, 3. 14. cafe of, iv. 3. 2.

Hydro-carbonate gas, Suppl. i. 9. i. Suppl.

Hydrops ovarii, i. 2. 3. 15.

Hydrophobia, i. 3. i. n. iii. I. I, 15. iv.

1.2.7.
Hypochondriafis, i. 2.4. lo.
Hyfteralgia frigida, i. 2. 4. 17.
Hyfteria, i. 3. i. 10. Suppl. i. 8. i f .

from fear, iv. 3. i. 8.

from cold, iv. 3. 3. 3.

convulfions in, iii. i. i. 5.

laughter in, iii. 1.1.5.

Hyfleritis, ii. 1.2. i6.

I.

Jadlitatio, iii. I. I. I. ^

Jaundice, i. I. 3. 8 i. 2. 4. 19.

Iderus, i. i. 3 8. i. 2. 4. 19.

Ileus, i. 3. I. 6. ii. 1 . a. 11.

Impotentia, ii. 2. 1. 3.

Indigeflion, i. 3. i. 5.

......... See Anoj-cxia and Apepfla.

from cold feet, iv. 2. i. 6, Sup.

^ i 8. 5.

Incubus, iii. 2. 1. 13.

Infants, green flools of, i. 1.2. 5.

new born, ii. i. I. 12.

Inflammation of the eye, ii. j. 3. 2.

. fuperficial, ii. i. 4. i.

» . e of the brain, ii. 1.2.3,

Inflammation c,f the lungs, ii. I. 2.4,

fuperficial, ii, i. j. 7.

of the pleura, ii. I. 3. 5.

of the diaphragm, ii, i. 2. 6.

of the heart, ii. i . 1. 7 .

of the peritoneum, ii. 1.2.8.

of the mefentery, ii. 1.2 9.

of the flomach, ii. 1.3 10.

fuperiicial, ii. I. 3. 19.

of the bowels, ii. I. 2. 3.

fuperficial, ii. i. 3. 30.

of the liver, ii. 1.2 12.

chronical, ii. i. 4. 12.

of the fpleen, ii. 1.2.13. Sup.

i. 16.6.

of the kidnies, ii. 1.3. 14.

of the bladder, ii i. 3. 15.

, of the womb, ii. 1.2. 16,

of the tonfils, ii. i. 3. 3.

of the parotis, ii. i. 3. 4.

Ininitabilityof lafleals, i. 2 3. 26.

of lymphatics, i. 2. 3. 37.

of the gall-bladder, i. 3. 4. 19.

of the kidney, i. 2. 4. 20.

of the fpleen, Suppl. i. 16. 6.

.^. . . . viciffitudes of, i. i . i .

Inoculation, ii. t. 3. g.
Innutrition of bones, i. 2. 2. 14,
Infanity, quick pulfe in, iii. i. i.

from parturition, iii. 1. 3.

with fever, iii. i. 3.

cure of, iii. i. 3.

confinement in, iii. i. 2.

Infenfibility, ii. 2. 1. I.

Ira, iii. i. 3. 17.

Ifchias, ii. i. 2. 18. i. 2.4. 15.

Iffues, ufe of, i. 1.3. 9. iii. 1. 1. 11.

Itch, ii. I. 5. 6.

Itching, i. I. 5. 9,

of the nofe, iv. a. 2. 6.

L.

Lacrymarum fluxus fym. iv. i. a. i.
Lamenefs of the hip, i. 2. 2. 17.
Laffitude, iii. 3. I. I.
Laughter, iv, 2. 3. 3. iii. 1. 1. 4. iv. I. 33.

, See Rifus.

Leg,

INDEX OF THE CLASSES.

647

Leg, one fhorter, i. 2. 2. 17.

Lepra, ii. 1.5. 3.

Lethargus, iii. 2- i. 14-

Lethi timor, iii. I. 2. 14.

Lice, i. I. 4. 15.

Lientery, i. 2. 3. 6.

Light debilitates in fevers, i. 3. 5. 3-

Lingua arida, ii I. 3. i. iv. 2. 4. ilo

Liver, torpor of, i. 3, 2. 6.,

tumor of, i. 2. 3. 9..

..... inflamed, ii. I. 3. 12.
Lochia nimia, i. 2.
Locked jaw, iii. i. i. 13.
Love, fentimental, iii. i. 2. 4.
Lues venerea, ii. i. 5. 8.
.... imaginaria,- iii. i. 3. 31.
Lumbago, ii. i. 2. 17. iii. i. j. i.

cold, i. 2. 4. 16.

Lumbricus, i. I. 4. 10,

Lunar influence on thc' folids, 1. 3. I; 1 1.; .

Lungs, adhefions of, ii. i. 2. 5.

not fenfible to heat, iii. I. I. lO.,

Lufus digitorum invitus, iv. i. 3. 4. :

M..

Maculae vultus, i. 2. i. g.
Madnefs, mutable, iii. i. 2. I.
Mammarum tumor, iv. 2. I. ig.-,
Mammularum tenfio, iv. 2. i. 6^ L I.

4-.7-
Mania mutabilis, iii. I. 2. I.
Matter variolous, ii. i. 3. g.

contagious, ii, I. 3. ii. I. 6. 1 1„

•. inclpfed, ii. i. 6. 3.

..■,... oxygenated, ii. i. 6. 6-.-

fanious, ii. i. 6. J5.

Meafles, ii. I. 3. 10.

Membranes, what, iv. j. 2.

Menorrhagia, i. 2. i. 11.

Mercury crude, as a clyfler, i. 3. I. 6.

in all contagions, Suppl. i, 16. 7.

in vertigo, iv. i. 2. ii.

Miliaria, ii. i. 3. 12.
Milk new, for children, i. i. 2. 5,
.... old, induces coftivenefs, ii. 2, 3. 7.
Milk-cruft, ii. i.e. 13.
8

Mifcarriage. See Abortion.
Maeror, iii. i. 3. 10.
Mobility, iv. i. 2.

;'...., of the fldn, Suppl. i. 7.
Mollities ofEum, i. 3. 2. 14.
Moon, effeft of, iv. 3. 4.
Morbilli. See Rubeola.
Mortification, ii. i. 6. 17. .
Morpiones, i. I. 4. 14. .
Mucus diminifhed,i. 2. 3.-4..

of the throat cold, i. 2. 3. I.

of the bowels, i. 3. 3. 6. i. I. 2. 12.

of the lungs, i. i. 3. 4.

forms flones, i. I. 3.'^.

.... . . diftinguifhed from pus, ii. i. 6. 6./.

Mumps, ii. i. 3. 4.

Murmur aurium, iv. 2. I. 15.,

Mufcffi volitantes, i. 2. 5. 3. .

N/.

Nails, biting of, iv. I. 3. 5,;.
Nares aridi, i. I. 3. 3.
Naufea, dry, i. 2.4. 3.

humid, i. 3. 3. 3.

ideal, iv. 3. 3.. i.

from conception, iv. 3. 2. 2.'

Navel-Uring of infants, ii. i. i. 13.

cut too foon, ii. i. i. 13,-

Neck thickens at puberty, iv. I. 2. 7.

Neck-fwing, i. 3^ 3. 16.

Nephritis, ii. i. 3. 14. i. i. 3. 9, iii. 3. i,

14.
Nerves decuffate, iii. 2. i. 10.
Niftitation irritative, i. 1. 4. i.

fenfitive, ii. i. i. 8.

. , involuntary, iv. i. 3. 2,

Night-mare, iii. 3. i. 1^.

Nipples, tenfion of, i. i, 4. 7. iv. 2. i. 6.

Nollalgia, iii. i. 3. 6.-

Noftrils, dry, i. i. 3. 3.

o.

Obefitas, i. 2. 3. 17.
Odontitis, ii, i. 4. 7.

Odontalgia,

648

INDEX OF THE CLASSES.

Odontalgia, i. 2. 4. I2-
CEfophagi fchirms, i. 2. 3. 25.
Olfaftus acrior, i. i. 5 3.

imminutus, i. 2. 5. 7.

Oil deftroys infefts, i i. 4. J4.
... effential of animals, i. 1.2. 14.
. . . why injurious in eryfipelas, ii. r. 3. 2.
Opium in catarrh, i. 2. 3. 3.

in diaphragmitis, ii. I. 2. 6.

Ophthalmy, internal, ii. i. 2. 2.

fuperficial, ii. I. 4. X.

Orci timor, iii. i. 2. 15.

Ofcitatio, ii. i. 1. 9.

Offium innutrltio, i. 2. 2. 14.

Otitis, ii. I 4. 8.

Otalgia, i. 2. 4. 13. iv. 2. 2. 8.

Otopuofis, ii I 4. 8.

Ovary, drppfy of, i. 2. 3. 15.

exfeftion of, i. 2. 3. 15.

Oxygenation of blood, iv. i. 4. 6.

Oxygen gas, Suppl. i. 9. 3.

in fevers, Suppl. i. 11. 7. i. 16. 9.

Pain exkaufts fenforial power, iv. 2. 2-.

. . greater prevents lets, iv. 2. 2. 2.

. . nervous, i. 2. 4

. . of the little finger, fymptom, iv. 2.

2. 12.

, . -of arm in hydrothorax, iv. 2. 2. 13.

. . of the bile-duft, iv. 2. 2. 4.

. . of the fhoulder, iv. 2. 2. g.

. . of the pharynx, iv. 2. a 5.

. . of the teftls, iv, 2. 2. 11.

. . fmarting, i. i. 5. 10.

. . of the fide, i. 2 4. 14. iv. i. 2. 16.

.. of menilruation, i. a. i- i2.

. . ufe of, iii. I. I. II. i. I. 2. g.
.... of the uterus, i. 2. 4. 17.
Paint, white, dangerous, ii. i. 4. 6.
Palate, d--fcft of, i. 2. 2, ;o. ,
Palenefs, i. 2. 2. 2.
..'.... from fear, iv. 3. 1. 5.

-from iicknefs, iv 2. i 4.

....... of urine after dinner, iv. 2. i. 3.

Palenefs from cold fkin, iv. 2. r. r.
Palpitation of h-art, i. 3 3. 2, i. 2. I. id

from fear, iv. 3. 1.6.

. . relieved by arfenic, iv. a. r. 18.

Pancreas, torpor of, i. 2. 3. 7.
Pandiculatio, ii. i. I. 9.
Panting, ii. I. r, 4 i. 3. 3. 3.
ParacenteCs at the navel, i. 2, 3. 13.
Paralyfis, iii. 2. I. 10.

of the bladder, iii. 2. I. 5.

....... of the reftum, iii. 2. I. 7.

, of the hands, iii. 2. I. 4.

cure of, iii. a. i. 4.

Paraplegia, iii. 2. i. 11.

Parefis inirritativa, i. 3. I. 3. Suppl, i. 8.

10.

fenfitiva, i. 2. i. 3.

..... voluntaria, iii. 3. i. 8.
Paronychia internal, ii. I. a. 19.

fuperficial, ii. j. 4. 5.

Parturition, ii. i. i. 13. ii. i. 3. 16.
niore fatal in high life, ii. i.

1. 12.
with convulfion, iii. i. i. iii. I.

I. 7.
Parotitis, ii. i. 3, 4.

Paffions depreffing and exciting, iv. 3, I. 5.
Paupertatis timor, iii. i. 3. 13.
Pediculus, i. i. 4. 15.
Pemphigus, ii. i. 3. 14.
Penetration of animal bodies, iv. I. 4. 7.
Peripneumony, ii. i. 2. 4.

tracheal, ii. I. 2. 4.

-,. . . fuperficial, ii. 1.3. 7.

inirritated, ii. I. 3. 4.

Peritonitis, ii. i. 3. 8

Perfpiration not an excrement, i. I. 2. 14,

greatell in the hot fit, 1. 1.

2. 3.

fetid, i. I. 2. 14.

Pertuffis, ii. i- 3. 8.
Peitis, ii. I, 3. 13.
Petechiae, i. 2. 1. 17.

cure of, Suppl. i. 3. 7.

Pharvnx, pain of, iv. 2. 2. 5.
Phthifis, pulmonary, ii. i. 6. 7.
Pimples on tlie face, ii. i. 4, 6,
Piles, bleeding, i. 2. i. 6.
.... white, i. 1, a. 12.

Placenta,

INDEX OF THE CLASSES. 649

Placenta, il. I. i. 12. ii. I. 2. 16. Raucedo paralytic, iii. 2. i. 5.

Plague, ii. i. 3. 13.- Recolledlion, lols of^ iii. 2. 2. I.

Plalters, why moift, i. I. 3. 6. Re6li paralyfis, iii. 2; I. 7.

Pleuiify, ii. i. 2, 5. .... fchirius, i. 2. 3. 23.

Pleurodyoe chronica, i. 3. 4. 14. Red-gum, ii. i. 3. 12. i. i. 2. 3.

rheumatica, iv. i. 2. i5. Rednefs from heat, ii. i. 7. 7.

Podagra^ iv. i. 2. 15. iv. 3. 4. 9. . . . . . . of joy, ii. I. 7. 8.

Polypus of the lungs, i. i. 3. 4. after dinner, iv. i. i r.

of the nofe from worms, iv. i. 3. 9. ...... of anger, iv. 2. 3. 5.

Pregnancy, ii. I. I. 12. of guilt, iv. 2. 3. 6.

Priapifmus, i. 1.4. 6. ii. I. 7. 9. of modelly, iv. 2. 3. 6.

Proftalgia, i. 2. 4. 18. Refpiration, ii. i. i. 2,

Prolapfus ani, i. i. 4. g, quick in exercife, ii. r. r. 3.

Pruritus, i. i. 5. 9. " in foftnefs of bones, i. 2. 2.

narium a vermibus, iv. 3. 2. 6. 14.

Pfora, ii. i. 5. 6. Reftleffnefs, iii. i. i. r.

imaginaria, iii. i. 2. 33. Reverie, iii. i. 2. 2. iv. 2. 4. 3.

Ptyalifmus. See Sallvatio. Rhaphania, iii. r. 1.6.

Pubis and throat fympathize, iv. 2. I. 7. Rheumatifm, iv. i. 2. 16.

Puerperal fever, i. 2. 4. 9. ii. 1.6. 16. Add. 8 of the joints, iv. i. 2. 16. ■

infanity, iii. i. 2. I. of the bowels, iv. I. 2. i6.

Pulchrltudinis defiderium, iii. I. 2. 13. of the pleura, iv. I. 3. 16,

Pullulation of trees, iv. i. 4. 3. , fuppurating, iv. i. 2. 16.

Pulfe full, why, i. i. i. i. from fympathy, iv. 2. 2 13.

.... flrong, how determined, i. i. i. i. chronical, i. i. 3. 12. iii. I.

Suppl. i. 16. 10. I. 6.

.... foft in vomiting, iv. 2. i. 17. Rickets, i. 2. 2. 15.

.... intermittent, iv. 2. i. 18. Ring-worm, ii. i. 5. 10.

.... quick from paucity of blood, Suppl. Rifus, iii. I. i. 4. iv. 2. 3. 3,

i. II. 4. fardonicus, iv. i. 2. 4.

.... quick fometimes in fleep, iii. 3. i. ..... invitus, iv. i. 3. 3.

13. Rubeola, ii. i. 3. 10.

.... quick in weak people, iii. 2. i. Sup. Rubor a calore, ii. i. 7. 7.

i. 1 1. 4. jucunditatis, ii. I. 7. 8.

.... flower by fwinging, iv. 2. I. 10. pranforum, iv. i. i. i.

.... quick in chlorofis, i. 2. 3. lO. Rudtus, i. 3. i. 2.

Pundlffi mucofffi vultus, i. 2. 3. 9. Run>inatio, i, 3. i. i. iv. 3. 3, i.

Purging. See Diarrhoea.

Pus diminifhed, i. 3. 3. 3.

. . . diftinguiilied from mucus, ii, 1. 6. 6. .

R.

Rabies, iii. I. 2. 18.
Rachitis, i. 2. 2. 15.
Raucedo catarrhal, ii. I. 3. 5.
Vol. ii.

Sailing in phthifis, ii. i. 6. 7.
Salivation warm, i. i. 2. 6.

lymphatic, i. 3. 2. 2.

fympathetic, iv. i. 2. 5.

in low fevers, i. i. 2. 5.

Salt of urine, i. i. 2, 4, i. i. 3. g,

4 O Satyrlafis,

650

INDEX OF THE CLASSES.

Satyriafis, iii. i. 2. 16.
Scabies. See Pfora.
Scarlatina, ii. 1.3. 11.
Scarlet fever, ii. i. 3. ir.
Scald-head, ii. 1.5. 11.
Sciatica frigida, i. 2.4. I c.
Schirms, i. 3. 3. 2a.

fuppurans, ii. I. 4. 15.

of the reftum, i. 2. 3. 23.

.' of the urethra, i. 2. 3. 24-.

of the cefophagus, i. 2. 3. 25.

Scorbutus,- i. 3. i. 15.

fuppurans, ii. 1. 4. 14.

Scrophula, i. 2. 3. 21.

fuppurating, ii. 1.4. 14.

produces infanity, iii. I. 2*

Scurvy, i. 2. I. 15.

fuppurating, ii. I. 4. 14.

Scurf of the head, i. i. 3. 6.
.... of the tongue, i. 1.3. r.
Sea-air in phthifis, ii. i. 6. 7.
Seat, defcent of, i. i. 4. g.
Seed, eje£lion of, ii. i. i. 11.
Sea-ficknefs, iv. 2. I. 10. Suppl. i. 8. 3.
See-faw of old people, iii. 2, i. 2.
Senfitive aflbciation, law of, iv. a. 2. 2.
Senfation inert, Suppl. i. 6. 4.
Setons, ii. i. 6.
Shingles, ii. i. 5. 9.
Shoulder, pain of, iv, 2. 2. g.
Shrieking, iii. I. 1. 3.
Sicknefs, i. 2 4. 4. i. 3. 2. 3.

cured by a.bliiter, iv. i. 1.3.

by warm fkin, iv. i. 2. 2._ Suppl.

i. 1 1. 4.

by whirling, i. t. i. 4.

by fvvlnging, Suppl. i. i^. 3.

by hydrocarbonate gas, Suppl, i,

IS- 3- ^

See Naufea,

Sight acuter, i. 1.5. i,
.... impaired, i, 3. 5. 2.
Side, chronical pain of, i. 2. 4. 14,
Sighing and fobbing, iii. i. z. 10,
.Sitis calida, i. 2. 4. i.
.... frigida, i. 3. 4. I.
.... defeftus, ii. 2. 2. ?..
Skin pale in old age, i. 3. 2. 2.
.... from cold, 1. 2. 3. 2.
8

Skin dry, i. I. 3. 6.

.... yellowiHi, i. 2. 2. 2.

.... bluifh and fhrunk, i. 2. i. i,

.... reddifli, ii. i. 3. i.

.... cold after meals, iv. 2. I. i.

Sleep, iii. 2. I. 12.

interrupted, i. 2. r. 3.

periods in, iv. 2. 4. I,

..... with quick pulfe, iii. 3. i. 12.

diliurbed by digeflion, iii. 2. I. 12.

Sleep-walkers, iii. i. i. 9,

Small-pox, ii. i. 3. 9.

why diflind and confluent, Sup,

i. 15. 2.

fecondary fever of, ii. i. 6. 12.

eruption of, iv. I. 3. 12.

Smarting, i. 1.5. 10.
Smell acuter, i. 1.5. 3.
..... impaired, i. 3. 5. y.
Sneezing, ii. 1.1.3. i^- ^' 2- 2.
Snow in fcrophula, i. 2. 3. 21.

in paralyfis, iii. 2. 1.4.

SnufFin hydrocephalus, i. 2. 3. 12.
Somnambulifm, iii. i. i.g.
Somnium, ii. 1.7.4.
Somnus, iii. 2. i. 12. iv. 2.4. i.

interruptus, i, 2.13.

Softnefs of bones, i. 2. 3. 14.

Spafm of diaphragm, iii. i. r. 11,

..... of the heart, iii.,1. i. n.

Spine diflorted, i. 3. 2. 16.

.... protuberant, i. a. 2. 18.

.... bifid, i. 3. 2. 19.

Spitting blood, i. 1. i. 4. i. 3. I. 9.

Spleen fwelled,, i. ,3. 3. 18. Suppl. i, 16. 6.

Splenitis, ii. 2. 3. 13.

Spots on the face, i. 3. 3. 9.

Spots fcen on bed-clothes, i. 3. 5. 3.

Squinting, i. 2. 5. 4.

in hydrocephalus, i. 2. 5. 4.

Stammering, iv. 2.3. I.

Stays tight, injurious, ii. I. I. 12.

Sterility, ii. 2. 2. 4.

Sternutatio, ii. i. i. 3. iv. i. 2. 2.

a lumine, iv. 3. i. 2.

Stimulants, their twofold eiJedl, ii. I. 2. 6.
Stocks for children dangerous, ii. 3. 2. 17.
Stomach, torpor of, Suppl. i. 10. i.

16. 6..

Stomachy

INDEX OF THE CLASSES.

651

Stomach, inflammation of, ii. i. 3. 10. ii. i.

3- ■9-
its affociation, iv. I. i.

caufe of fever, Suppl, i. 8. 8.

Stones in tlie bladder. See Calculi,

..... ui horfes, i. i- 3- 5- *• i • 3 10.

Strabifmus, i. 2. 5. 4.

Strangury, ii. i. i. 11. iv. 2. 1. 2.

convulfive, iv, a. a. 3.

Strength and debility metaphors, i. 2. I.

Stridor dentium, iii. i. i. X2.

Studium inane, iii. I. 2. 2. iv. 3. 4. 2.

Stultitia inirrltabilis, i. 2. 5. I.

infenfibilis, ii. a. I. I.

voluntaria, iii. 2. 2. 2.

Stupor, i. 3 5- 10. Suppl. i. 15.

Subfultus tendinum, iii. i, i. 5.

Sudor. See Sweats.

-Suggeftion, {[ovf,

3urprife, i. i. 5. 12.

Sweats, warm, i. i. 2. 3.

cold, i. 2. 3. 3.

lymphatic, i. 3. 2. 7.

afthmaiic, i 3 2. 8. iv. 3. I. s.

covered in bed, iv. i. 1.3. Suppl. i.

II. 6.

in fever fits, why, i. i. 2. 5.

from exercife, i. 1.2. 3.

from heat, i. i . 3. 3.

....... from medicines, i. I. 2. 3.

Sweaty hands cured, i. 3, 2. 7.

Swinging, ii. i. 6. 7.

makes the pulfe flower, \r. 2. I.

10.

Swing centrifugal, Suppl. i. 15 and 3.

Sympathy dirctt and reverfe, iv. I. I. f.

with others, iii. I. 3. 24.

of various parts, Suppl. i. 1 1. 5.

reverfe of ladleals and lymphatics,

Suppl, i. II. 5. ,

of capillaries, Suppl. i. 11. 5.

direft of ftomach and heart, Sup.

i. II. 5.

of throat and pubis, iv. %. i."].-

Syncope, i. 3. i. 4-

epileptic, iii. 3. i. 15.

Syngultus, ii. I. 1.6.

nephriticus, iv. I I. 7.

SyphiJis, ii. i, 5. 2.

Syphilis imaginaria, iii I. S,- 21.
Syphon capillary of cloth, ii. I.

Ta£tus acrior, i. X. 5. 5.

imminutus, i. 3- 5. 6.

Tape-worm, i. I. 4. 11.

Tapping at the navel, i: 2- 3. 13.

Tafte. See Guftus.

..... bitter, not from bile, i. 1.3. t.

Taedium vitas, ii. 3. I. 2.

Tsenia, i, 1.4. 11.

Tears fympathetic, iv. 1.2. i. iii. i. i.-

10.
Teethj to preferve, i. i. 4. 5.

fall out whole, ii. i . 4. 7.

Tenefmus, ii. i. i. lO-

cakulofus, iv. i. 2. 8.

Tellium dolor nephriticus, iv. 2. 2. 11.
....... tumor in gonorrhoea, iv. I. 2.

18.

tumor in parotitide, iv. i. 2. ig.

Tetanus trifraus, iii. i. i: 13.

dolorificus, iii. i. i. 14.

Thirfl:. See Sitis and Adipfia.
Thread-worm, i. i. 4. 12.
Throat fwelled, i. 2. 3. 20.

thickens at puberty, iv. a. i. 7.

grown up, i. 2. 3. 25.

Thrufli, ii. I. 3. 17.
Tickling, i. 1. 5. 8.
Timor orci, iii. I. 2. 15.

lethi, iii. 1.2. 14.

paupertatis, iii. i. 2. 13.

Tinea, ii. i. 5. x i.

Tinnitus aurium, iv. i. i. 15.

Titillatio, i. 1.5. 8.

Titubatio linguae, iv. 2. 3. I.

Tobacco, fmoke of in piles, i. 2. 1.6,

Tongue dry, i. i. 3. i. Suppl. i. 3.

coloured mucus, i. 1.3. i.

Tonilllitis, ii. I. 3. 3.

Toniils fwelled from bad teeth, i. a. 3- 21.

ii. I. 3-3-
Torpor of the liver, i. i. 3. 6.

4 O a Torpor

65'2

INDEX OF THE CLASSES.

Torpor of the pnncreas, i. 2. 2. 7*

of the lungs, SuppL i. 9.

of the ftomnch, Suppl i. ro.

^. of the heart, Suppl. i. 10.

Tooth-ach, i. %. 4. 12. h. i- 4= 7-

Tooth-edge, iv. ] . 3. 3.

Toothing, i. I. 4. 5-

Tooth-powder, i. 1.4. 5.

Touch. See Taflus.

...... deceived three ways, i. 2. 5. 9. iv. 2.

I. lO

Transfufion of blood, i. a. 3. 25. Suppl. i.

14. 4.
Tranflation of matter, i. 3. 2. 9.

of milk, i. 3. 2. 10.

of urine, i. 3. 2. 11.

Tranfparency of cornea, i. 1.4.1.
of cryftalline, i. 2. 2.

of air before rain, i
Tremor of old age, iii. 2. 1.3.

of fever, iii. T. i. 2.

of anger, iv. 3. 1.4.

of fear, iv. i. a. 5.

Tuffis ebriorum, ii. i. 1.5.

convulfiva, ii. i. 3. 8.

hepatica, iv. i. a- 7-

arthritica, iv. i. 2. 8.

periodica, iv. i. 2. g.

..... a pedibus frigidis, iv. I. 2. 6
Tympany, i. 2 4. 9.

u.

1.4.

Ulcers, healing of, i. i. 3. 13.

of the cornea, i. 1.3. 14.

from burns, i. I. 3. 13.

fcrophulous, ii. 1.4. 13.

of the throat, ii. 1. 3. 3. ii. f. 3.

of the legs, ii. 1.4. 13.

Unruium morfiuncula, iv. i. 3. 5.
Urethra, fcirrhus of, i. 2. 3. 24.

fiftula of, ii. I. 4. II.

Urine copious, coloured, i. 1.2. 4.

copious, pale, i. 2. 3. 5.

diminiflied, coloured, i. 1.3. 7.

diminiflied, pale, i. 2. a. 5-

its mucus, falts, Pruffian blue, i. i.

2.4.

7

II.

Urine why lefs and coloured in dropfies, i.

I- 3- 7-
tranflation of, i. 3- 2. 11.

difficulty of, iii. 3. I. 6.

„ . , , . not fecreted, i. a. 2. 8.

pale after meals, iv. 2. 1.2.

pale from cold Ikin, iv. 2. i. 3.

fediment in fevers, Suppl. i. 2. 3.

pale in fevers,. SuppL i. 2. 3. and 5.

Urticaria, ii. i. 3. 16.

Uteri defcenfus, i. i. 4. 8.

V.

Vacillatio fenilis, iii. 2. i. 3.
Varicella, ii. 1.3 15.
Variola, ii. i. 3 9.

eruption of, iv. 2. i. X2.

Vaforum capil retrogreffio, i. 3. 3. I.
A^enereal orgafm, iv. 1.4. 4.

difeafe, ii. I. 5. 2.

imaginary, iii. I. a. 21.

Ventriculi aegritudo, i. a 4. 4.

vehcatorio fanata, iv. 1. I. 3.

Vermes, i. 1.4. 10.
Vertigo rotatory, iv. 2.1. 10.

of light, iv. a. I. II.

inebriate, iv. a. i- 12.

of fever, iv. a. i. 13.

from the brain, iv. 2. I. 14.

of the ears, iv. a. i. 15.

...... of the touch, Addit. iii.

of the touch, talte and fmell, iv. 2.

16.

with vomiting, iv. 3. 3. 2.

produces flow pulfe, iv. 2. I.

of blind men, iv. a. I. iO.

ufe of mercurials in it, iv. 2.

from ideas, Addit. iii.

Vibices, I. 3. t. 16. Suppl. i. 2. 7.
Vigilia, iii. I. 2. 3. iv. I. 3. 6.
Vihon acuter, i. 1.5. I.

diminiihed, i. 2. 5. 2.

expends much fenforial power,

5-3'
Vita ovi, iv. I. 4. I.

. . . hiemi-dormientium, iv. 1.4. 2.

Vitus's dance, iv. 2. 3. 3.

10.

1. II.

Volition

INDEX OF THE CLASSES.

653

Volition, three degrees of, iii. 2. r. 13.
leffens fever, iii. 2. 1. 12. Suppl, i.

ir.6.

produces fever, iii. 2. i. 12.

without deliberation, iv. 1.3. a.

Addit. iv.
Vomica, ii. I. 6. 3.
Vomitus, i. 3. I. 4.
Vomendi conamen inane, i. 3. i. 8.
Vomiting llopped, iv. i. 1.3. iv. I. I. f.

voluntary, iv. 3. 3. a.

how acquired, iv. 1.1.2.

vertiginous, iv. 3. 3. 3.

from ftone in ureter, iv. 3. 2 4.

from paralytic ftroke, iv. 3. 2. 5.

from tickling the throat, iv. 3. 2. 6.

fympathizes with the ikin, iv. 3.

3.7.

in hffimoptoe, i. I. i. 4.

from defedt of affociation, iv. 2. i.

10.
Vulnerum cicatrix, i. 1. 3. 13.

Weaknefs, three kinds of, i. 3. It
Whirling-chair, Suppl. i. 15. 3.
Whirling-bed, Suppl. i. j^. 7.
White fwelling of the knee, i. 2. 3. 19.
Winking, ii. i. i. 8. i. i. 4. i. iv. 3. 2. 3.
Wine in fevers, ii. i. 3. i. iv. 2. i. 12.
Winter-fleeping animals, iv. 1. 4. 2.
Witlow, fuperficial, ii. 1. 4. 5.

internal, ii. I. 3. iq.

Womb, defcent of, i, 1.4. 8.
...... inflammation of, ii. 1.8. 16.

Worms, i. 1.4. 10.

mucus counterfeits, i. 1.3. 4.

in fheep, i. 2. 3. 9.

Wounds, healing of, i. i. 3. 13.

Y.

Yawning, ii. i. i. 9.
Yaws, ii. i. 5. 5.

w.

z.

Watchfulnefs, iii. i. 2.3.
Water-qualm, i. 3. i. 3.

IV.

3.5-

Zona ignea, ii. i. ij. 9. iv. I. 2. ri. ii, i. 3.
14.

Z O O N O M I A ;

OR,

THE LAWS OF ORGANIC LIFE.

PART III.

CONTAINING

THE ARTICLES OF THE MATERIA MEDICA,

WITH AN ACCOUNT OF THE

OPERATION OF MEDICINES.

IN VIVUM CORPUS
AGUNT MEDICAMENTA.

>*

PREFACE.

Th e Materia Medica ineludes all thofe fubftances, which
may contribute to the reftoration of health. Thefe may be
conveniently diftributed under feven articles according to the
diverfity of their operations.

I. Nutrientia, or thofe things which preferve in their
natural flate the due exertions of ail the irritative motions.

1. Incitantia, or thofe things which increafe the exer-
tions of all the irritative motions.

3. Secernentia, or thofe things which increafe the irri-
tative motions, which conftitute fecretion.

4. Sorbentia, or thofe things which increafe the irrita-
tive motions, which conftitute abforption.

5. Invertentia, or thofe things which invert the natural
order of the fucceffive irritative motions.

6. Revertentia, or thofe things which reftore the natu-
ral order of the inverted irritative motions>

Vol. II. 4 P 7. Torpentia,

658 PREFACE.

7. ToRPENTiA, thofe things which diminifh the exertions
of all the irritative motions.

It is neceffary to apprize the reader, that in the following
account of the virtues of Medicines their ufual dofes are always
=fuppofed to be exhibited ; and the patient to be expofed to the
degree of exterior heat, which he has been accuftomed to,
(where the contrary is not mentioned), as any variation of
either of thefe circumftances varies their effedts.

ARTICLES

ARTICLES

OF THE

MATERIA MEDIC A.

Art. I,
NUTRIENTIA.

1. I. Those things, which preferve in their natural ftate the
due exertions of all the irritative motions, are termed nutrientia ; they
produce the growth, and reftore the wafte, of the fyftem. Thefe
confift of a variety of mild vegetable and animal fubftances, water,
and air.

2. Where ftronger ftimuli have been long ufed, they become ne-
neffary for this purpofe, as muftard, fpice, fait, beer, wine, vinegar,
alcohol, opium. Which however, as they are unnatural ftimuli, and
difficult to manage in refpedl to quantity, are liable to fhorten the
fpan of human hfe, fooner rendering the fyftem incapable of being
ftimulated into adtion by the nutrientia. See Sed. XXXVII. 4. On
-the fame account life is fhorter in warmer climates than in more tem-
perate ones.

- 4 P 2 II. OSSEK-

66o NUTRIENTIx^. Art. I. 2.1.

II. Observations ON the Nutrientia»

I. I. The fiefli of animals contains more nourifliment, and Simu-
lates our abforbent and fecerning velTels more powerfully, than the
vesdtable productions, \4hich'lwe ufe as '-food-; for the carnivorous
animals can faft longer without injury than the graminivorous ; and
we feel ourfelves warmer and ftronger after a meal of fiefh than of
grain. Hence in difeafes attended with cold extremities and general
debility this kind of diet is preferred ; as in rickets, dropfy, fcrophula,
and in hyfteric and hypochondriac cafes, and to prevent the returns of
agues. Might not flefh in fmall quantities bruifed to a pulp be more
advantageoufly ufed in fevers lattended with debility than vegetable
diet ?

That flefh, which is of the darkeft. colour, generally contains more
nourifhment, and Simulates our veffels. more powerfully, than the
white kinds. The flefh of the carnivorous and pifcivorous animals ~
is fo ftimulating, that it feldom enters into the food of European na-
tions, except the fwine, the Soland goofe (Pelicanus Baffanus), and
formerly the fwan. Of thefe the fwine and the fvvan are fed previ-
oufly upon vegetable aliment ; and the Soland goofe is taken in very
fmall quantity, only as a whet to the appetite. Next to thefe are the
birds, that feed upon infefts, which are perhaps the mofl ftimulating
and the moft nutritive of our ufual food.

It is faid that a greater quantity of volatile alkali can be obtained
from this kind of flefh, to which has been afcribed its ftimulating
quality. But it is more probable, that frefh flefh contains only the
elements of volatile alkali.

2. Next to the dark coloured flefh of animals, the various tribes of
fliell-filTi feem to claim their place, and the wholefome kinds of

mufhrooms.

Art.I. 2. I. - NUTRIENTIA. 66i

mufhrooms,^which muft be efteemed animal food, both for their al-
kalefcent tendency, their ftimulating quality, and the quantity of
nourifhment, which they afford ; as oyfters, lobfters, crabfifli,
fhrimps ; mu(hrooms ; to which perhaps might be added fome of
the Hih without fcales ; as the eel, barbolt, tench, fmelt, turbot,
turtle.

The flefh of many kinds of fiOi, when it is fuppofed to have un-
dergone a beginning putrefa£lion, becomes luminous in the dark.
This feems to fhew a tendency in the phofphorus to efcape, and com-
bine with the oxygen of the atmofphere ; and would hence fhew,
that this kind of flefh is not {o perfedlly animalized as thofe before
mentioned. This light, as it is frequently feen on rotten wood, and
fometimes on veal, which has been kept too long, as I have been
told, is commonly fuppofed to have its caufe from putrefaftion ; but
is neverthelefs moft probably of phofphoric origin, like that feen in
the dark on oyfler-lliells, which have previoufly been ignited, and
afterwards expofed to the funfhine, and on the Bolognian ftone. See
Botan. Gard. Vol. I. Cant. I. line i and 2, the note.

3. The flefh of young animals, as of lamb, veal, and fucking
pigs, fupplies us with a flill lefs flimulating food. The broth of
thefe is faid to become four, and continues fo a confiderable time be-
fore it changes into putridity ; fo much does their flefh partake of
the chemical properties of the milk, with which thefe animals are
nourifhed.

4. The white meats, as of turkey, partridge, pheafant, fowl,
with their eggs, feem to be the next in mildnefs ; and hence are ge-
nerally firft allowed to convalefcents from inflammatory difeafes,

5. Next to thofe fhould be ranked the white river-fifh, which have
fcales, as pike, perch, gudgeon.

ILi.Milk

662 NUTRIENTIA. Art.I.2.2.

II. I. Milk unites the animal with the vegetable fource of our
noun(hn:ient, partaking of the properties of both. As it contains
fugar, and will therefore ferment and produce a kind of wine or fpi-
rit, which is a common liquor in Siberia ; or will run into an acid by
fimple agitation, as in the churning of cream ; and laftly, as it con-
tains coagulable lymph, which will undergo the procefs of putrefac-
tion like other animal fubftances, as in old.cheefe.

2. Milk may be feparated by reft or by agitation into cream, butter,
butter-milk, whey, curd. The cream is eafier of digeftion to adults,
becaufe it contains lefs of the coagulum or cheefy part, and is alfo
more nutritive. Butter confifting of oil between an animal and vege-
table kind contains ftill more nutriment, and in its recent ftate is not
difficult of digeftion if taken in moderate quantity. See Art. I. 2, 3. 2.
Butter-milk if it be not bitter is an agreeable and nutritive fluid, if it
be bitter it has fome putrid parts of the cream in it, which had been
kept too long ; but is perhaps Jiot lefs wholefome for being four to a
certain degree : as the inferior people in Scotland choofe four milk iu
preference to Ikimmed milk before it is become four. Whey is the
leaft nutritive and eafieft of digeftion. And in the fpring of the year,
when the cows feed on young grafs, it contains fo much of vegetable
properties, as to become a falutary potation, when drank to about a
pint every morning to thofe, who during the winter have taken too
little vegetable nourifhment, and who are thence liable to bilious cou-
icretlons.

3. Cheefe is of various kinds, according to the greater or lefs quan-
'tlty of cream, which it contains, and according to its age. Thofe
cheefes, v/hich are eafieft broken to pieces in the mouih, are gene-
rally eafieft of digeftion, and contain moft nutriment. Some kinds
4if cheele, though flow of digeftion, are alfo flow in changing by che-
mical

Art. I. 2.3. NUTRIENTIA. 66

o

, mical proceffes in the ftomach, and therefore will frequently agree
well with thofe, who have a weak digeftion ; as I have (e&w toafled
cheefe vomited up a whole day after it was eaten without having un-
dergone any apparent change, or given any uneafinefs to the patient.
It is probable a portion of fugar, or of animal fat, or of the gravy of
boiled or roafted meat, mixed with cheefe at the time of making it,
might add to its pleafant and nutritious quality.

4. The reafon, why autumnal milk is fo much thicker or coagu-
lable than vernal milk, is not eafy to underftand, but as new milk is
in many refpedls fimilar to chyle, it may be confidered as food already
in part digefted by the animal it is taken from, and thence fupplies a
nutriment of eafy digeftion. But as it requires to be curdled by the •
gaftric acid, before it can enter the lafteals, as is feen in the ftomachs
of calves, it feems more fuitable to children, whofe ftomachs abound
more with acidity, than to adults; but never.thelefs fupplies good
nourifliment to many of the latter, and particularly to thofe, who
ufe vegetable food, and whofe ftomachs have not been much accuf-
tomed to the unnatural ftimulus of fpice, fait, and fpirit. See Clafsl.
I. 2. 5.

III. I. The feeds, roots, leaves, and fruits of plants, conftitute
the greateft part of the food of mankind ; the refpedive quantities of
nounfhment, which thefe contain, may perhaps be eftimated from
the quantity of ftarch, or of fugar, they can be made to produce : in
farinaceous feeds, the mucilage feems gradually to be converted into
ftarch, while they remain in our granaries j and the ftarch by the
germination of the young plant, as in making malt from barley, or
by animal digeftion, is converted into fugar. Hence old wheat and:
beans contain more ftarch than new ; and in our ftomachs other ve-
6 getable

664 NUTRIENTIA. Art. I. 2.3.

getable and animal materials are converted into fugar ; which confti-
tutes in all creatures a part of their chyle.

Hence It is probable, that fuga-r is the moll nutritive part of vege-
tables ; and that they are more nutritive, as they are convertible in
greater quantity into fugar by the power of digeftion ; as appears from
fugar being found in the chyle of all animals, and from its exifting in
great quantity in the urine of patients in the diab^etes, of which a
curious cafe is related in Se£l. XXIX. 4. where a man labouring un-
der this malady eat and drank an enormous quantity, and fometimes
voided fixteen pints of water in a day, with an ounce of fugar in each
pint.

2. Oil, when mixed with mucilage or coagulable lymph, as in
cream or new milk, is eafy of digeftion, and conftitutes probably the
mofl nutritive part of animal diet ; as oil is another part of the chyle
of all animals. As thefe two materials, fugar and butter, contain
much nutriment under a fmall volume, and readily undergo fome che-
mical change fo as to become acid or rancid ; they are liable to diflurb
weak ftomachs, when taken in large quantity, more than aliment,
which contains lefs nourifhment, and is at the fame time lefs liable to
chemical changes ; becaufe the chyle is produced quicker than the
torpid ladeals can abforb it, and thence undergoes a further chemical
procefs. Sugar and butter therefore are not fo eafily digefted, when
taken in large quantity, as thofe things, which contain lefs nutriment ;
hence, where the ftomach is weak, they muft be ufed in lefs quan-
tity. But the cuftom of fome people in reftraining children entirely
from them, is depriving them of a very wholefome, agreeable, and
fubftantial part of their diet. Honey, manna, fap-juice, are different
kinds of lefs pure fugar.

3. All the efculent vegetables contain a bland oil, or mucilage, or

4 ' flarch,

Art. I. 2.3. NUTRIENTIA, 66^

ftarch, or fugar, or acid ; and, as their ftimulus is moderate, are pro-
perly given alone as food in inflammatory difeafes ; and mixed with
milk conftitute the food df thoufands. Other vegetables poffefs vari-
ous degrees and various kinds of ftimulus ; and to thefe we are be-
holden for the greater part of our Materia Medica, which produce
naufea, ficknefs, vomiting, catharfis, jntoxication, inflammation,
and even death, if unflcilfuUy adminiflered.

, The acrid or intoxicating, and other kinds of vegetable juices, fuch
as produce ficknels, or evacuate the bowels, or fuch even as are only
difagreeable to the palate, appear to be a part of the defence of thofe
vegetables, which pofTefs them, from the gffaults of larger animals or
of infects. As mentioned in. the Botanic Garden, Part II. Cant. I.
line i6i, note. This appears in aforcible manner from the pcrufal of
fome travels, which have been publiflied of thofe unfortunate people,
who have fuffered fliipwreck on uncultivated countries, and have
with difficulty found food to fubfifl, in otherwife not inhofpitable
climates.

4. As thefe acrid and intoxicating juices generally refide in the
mucilage, and not in the fliarch of many roots, and feeds, according
to the obfervation of M. Parmentier, the wholefome or nutritive parts
of fome vegetables may be thus feparated from the medicinal parts of
them. Thus if the root of white briony be rafped into cold water,
by means of a bread-grater made of a tinned iron plate, and agitated
in it, the acrid juice of the root along with the mucilage will be dif-
folved, or fwim, in the water; while a ftarch perfeftly wholefome
and nutritious will fubfide, and may be ufed as food in times of
fcarcify.

M. Parmentier further obferves, that potatoes contain too much
mucilage in proportion to their ftarch, which prevents them from being
converted into good bread. But that if the flarch be colle£led from

Vol. II. 4 Q^ ten

t(>(> NUTRIENTIA. Art.I. 2.3.

ten pounds of raw potatoes by grating them' into cold water, and agi-
tating them, as above mentioned ; and if the Itarch thus procured be
mixed with other ten pounds of boiled potatoes, and properly fub-
je6led to fermentation like wheat flour, that it will make as good
bread as the finefh wheat.

Good bread may alfo be made by mixing wheat-flour with boiled
potatoes. Eighteen pounds of wheat flour are faid to make twenty-
two pounds and a half of bread. Eighteen pounds of wheat-flour
mixed with nine pounds of boiled potatoes, are faid to make twenty-
nine pounds and a half of bread. This difference of weight muffc
arife from the difl'erence oP the previous drynefs of the two materials.
The potatoes might probably make better flour, if they were boiled
in fleam, in a elofe vefl'el, made fome degrees hotter than common
boilino; water.

Other vegetable matters may be deprived of their too great acri-
mony by boiling in water, as the great variety of the cabbage, the
young tops of white briony, water-crefles, afparagus, with innu-
merable roots, and fome fruits. Other plants have their acrid juices
or bitter particles diminifhed by covering them from the light by what
is termed blanching them, as the fl:ems and leaves of cellery, endive,
fea-kale. The former method either extracts or decompofes the acrid
particles, and the latter prevents them from being formed. See
Botanic Garden, Vol. I. additional note XXXIV". on the Etiolation of
vegetables.

5. The art of cookery, by expofing vegetable and animal fubflances
to heat, has contributed to increafe the quantity of the food of man-
kind by other means befides that of deftroying their acrimony. One
of thefe is by converting the acerb juices of fome fruits into fugar, as
in the baking of unripe pears, and the bruifing of unripe apples; in
both which lituations the life of the vegetable is deftroyed, and the
4 converfion

Art. 1.2.3. NUTRIENTIA. 667

converfion of the harfli juice into a fweet one muft be performed by a
chemical procefs ; and not by a vegetable one only, as the germina-
tion of barley in making malt has generally been fuppofed.

Some circumftances, which feem to injure the life of feveral fruits,
feem to forward the faccharine procefs of their juices. Thus if fome
kinds of pears are gathered a week before they would ripen on the
tree, and are laid on a heap and covered, their juice becomes fweet
many days fooner. The taking off a circular piece of the bark from a
branch of a pear-tree caufes the fruit of that branch to ripen fooner
by a fortnight, as I have more than once obferved. The wounds
made in apples by infe£ts occafion thofe apples to ripen fooner ; capri-
fication, or the piercing of figs, in the ifland of Malta, is faid to
ripen them fooner j and I am well informed, that when bunches of
grapes in this country have acquired their expe(3:ed iize, that if the
ftalk of each bunch be cut half through, that they will fooner ripen.

The germinating barley in the ma-lt-houfe I believe acquires little
fweetnefs, till the life of the feed is deftroyed, and the faccharine pro-
cefs then continued or advanced by the heat in drying it. Thus in
animal digeftion, the fugar produced in the flomach is abforbed by
■the la<3:eals as fafl as it is made, otherwife it ferments, and produces
flatulency ; fo in the germination of barley in the malt-houfe, fo lono-
as the new plant lives, the fugar, I fuppofe, is abforbed as fafl as it is
made ; but that, which we ufe in making beer, is the fugar pro-
duced by a chemical procefs after the death of the young plant, or
which is made more expeditioufly, than the plant can abforb it.

It is probably this faccharine procefs, which obtains in new hay-
ilacks too haftily, and which by immediately running into fermenta-
tion produces fo much heat as to fet them on fire. The greateft part
of the grain, or feeds, or roots, ufed in the diftilleries, as wheat, ca-
nary feed, potatoes, are not I believe previoufly fubje<a:ed to ger-
mination, but are in part by a chemical procefs converted into
fugar, and immediately fubjeAed to vinous fermentation ; and it
is probable a procefs may fometime be difcovered of producino- fugar

4 0^2 , from

668 NUTRIENTIA. Art. 1. 2. 3,

from ftarch or meal ; and of feparating it from them for domcftic pur-
pofes bj alcohol, which difTolves fugar but not mucilage ; or by other
means.

Another method of increafing the nutriment of mankind by cook-
ery, is by diffblving cartilages and bones, and tendons, and probably
fome vegetables, in fteam or water at a much higher degree of heat
than that of boiling. This is to be done in a clofe veffel, which is
called Papin's digefter ; in which, it is faid, that water may be made
red-hot, and will then diflblve all animal fubftances ; and might thus
add to our quantity of food in times of fcarcity. This veffel fhould be
made of iron, and fhould have an oval opening at top, with an oval
lid of iron larger than the aperture ; this lid fhould be flipped in end-
ways, when the veffel is filled, and then turned, and raifed by a
fcrew above it into contaft with the under edges of the aperture.
There fhould alfo be a fmall tube or hole covered with a weighted
valve to prevent the danger of burfling the digefler.

Where the powers of digeftion are weakened, broths made by boil-
ing animaland vegetable fubftances in water afford a, nutriment;
though I fuppofe not fo great as the flefh and vegetables would afford,
if taken in their folid form, and mixed with faliva in the a£t of maf-
tication. The aliment thus prepared fhould be boiled but a fhort
time, nor fhould be fuffered to continue in our common kitchen- uten-
lils afterwards, as they are lined with a mixture of half lead and half
tin, and are therefore unwholefome, though the copper is completely
covered. And thofe foups, which have any acid or wine boiled in
them, unlefs they be made in filver, or in china, or in thofe pot-vef-
fels, which are not glazed by the addition of lead, are truly poifonous ;
as the acid, as lemon-juice or vinegar, when -made hot, erodes or
diflblves the lead and tin lining of the copper- veffels, and the leaden
glaze of the porcelain ones. Hence, where filver cannot be had, iron
veffels are preferable to tinned copper ones ; or thofe made of tinned
iron-plates in the common tin-fhops, which are faid to be covered
with pure or block tin.

6 6. Another

Art.I.2.3. NUTRIENTIA. 669

6. Another circumftance, which facilitates the nourifhment of
mankind, is the mechanic art of grinding farinaceous feeds into powder
between mill-ftones ; which may be called the artificial teeth of fo-
ciety. It is probable, that fome foft kinds of wood, efpecially when
they have undergone a kind of fermentation, and become of loofer
texture, misrht be thus ufed as food in times of famine.

Nor is it improbable, that hay, which has been kept in ftacks, {o
as to undergo the laccharine procefs, may be fo managed by grinding
and by fermentation with yeaft like bread, as to ferve in part for the
fuflenance of mankind in times of great fcarcity. Dh. Prieftley gave
to a cow for fome time a ftronginfufion of hay in large quantity for
her drink, and found that (he produced during this treatment above
double the quantity of milk. Hence if bread cannot be made from
ground hay, there is great reafon to fufpeft, that a nutritive beverage
,may be thus prepared either in its faccharine ftate, or fermented into
a kind of beer.

In times of great fcarcity there are other vegetables, which though
not in common ufe, would mofl: probably afford wholefome nourifli-
ment, either by boiling them, or drying and grinding them, or by
both thofe procefles in fucceffion. Of thefe are perhaps the tops and
the bark of all thofe vegetables, which are armed with thorns or
prickles, as goofeberry trees, holly, gorfe, and perhaps hawthorn.
The inner bark of the elm tree makes a kind of gruel. And the roots
of fern, and probably of very many other roots, as of grafs and of
clover taken up in winter, might yield nourifhment either by boiling
or baking, and feparating the fibres from the pulp by beating them ;.-
or by getting only the ftarch from thofe, which poffefs an acrid mu^
cilage, as ctie white briony»

7. However the arts of cookery and of grinding may Increafe or
facilitate the nourlfhment of mankind, the great fource of it is from
agriculture. In the favage flate, where men livefolely by hunting,,

I. was

(^^6 \ NUTRIENTIA. Art.I.2.3.-

I was informed by Dr. Franklin, that there was feldom more than
one family exifted in a circle of five miles diameter ; which in a ftate
of pafturage would fupport fome hundred people, and in a ftate of
agriculture many thoufands. The art of feeding mankind on fo fmall
a grain as wheat, which feems to have been difcovered in Egypt by
the immortal name of Ceres, flie\yed gr-ieater ingenuity than feeding
them with the large roots of potatoes, which feem to have been a dif-
covery of ill-fated Mexico.

This greater production of food by agriculture than , by pafturage,
fhews that a nation nouriflied by animal food will be lefs numerous
than if nourilhed by vegetable ; and the former will therefore be li-
able, if they are engaged in war, to be conquered by the latter, as
Abel was (lain by Cain. This is perhaps the only valid argument
againft inclofing open arable fields. The great produ6tion of human
nourifliment by agriculture and pafturage evinces the advantage of
fociety over the favage flate ; as the number of mankind becomes in-
creafed a thoufand fold by the arts of agriculture and pafturage; and
their happinefs is probably under good governments improved in as
great a proportion, as they become liberated from the hourly fear of
hearts of prey, from the daily fear of famine, and of the occafional in-
curfions of their cannibal neighbours.

But pafturage cannot exift without property both in the foil, and
the, herds which it nurtures ; and for the invention of arts, and pro-
duction of tools neceflary to agriculture, fome muft think, and others
labour; and as the efforts, of fome will be crowned with greater fuc-
cefs than that of others, an inequality of the ranks of fociety muft
fucceed ; but this inequality of mankind in the prefent ftate of the
world is too great for the purpofes of producing the greateft quantity
of human nourifliment, and the greateft fum of human happinefs ;
there fliould be no flavery at one end of the chain of fociety, and no
'defpotifm at the other. — By the future improvements of human rea-
tbn facb governments may poflibly hereafter be eftablifhed, as may a

hundred-

Art. I. 2.4. ^ NUTRIENTIA. 671

hundred-fold increafe the numbers of mankind, and a thoufand-fold
their happinefs.

IV. I. Water muft be confidered as a part of our nutriment, be-
caufe fo much of it enters the compbfition of our folids as well as of
our fluids ; and becaufe vegetables are now believed to draw almoft the
whole of their nourifhmefit from this fource. As in them the water
is decompofed, as it is perfpired by them in the funfhine, the oxygen
gas increafes the quantity and the purity of the atmofphere in their vi-
cinity, and the hydrogen feems to be retained, and to form the nu-
tritive juices, and confequent fecretions of rofin, gum, wax, honey,
oil, and other vegetable produdions. See Botanic Garden, Part I.
Cant. IV. line 25, note. It has however other ufes in, the fyftem,
befides that of a nourifliing material, as it dilutes our fluids, and lu-
bricates our folids ; and on all thefe accounts a daily fupply of it is
required.

2. River-water is in general purer than'fpring-water ; as the neutral
falts waflied down from the earth decompofe each other, except per-
haps the marine fait ; and the earths, with which fpring-water fre-
quently abounds, is precipitated ; yet it is not improbable, that the
calcareous earth diffolved in the water of many fprings may contribute
to our nourifliment, as the water from fprings, which contain earth,,
is faid to conduce to enrich thofe lands, which are flooded with it,
more than river water.

3. Many arguments feem to fhew, that calcareous earth contributes
to the nourifhment of animals and vesretables. Firft becaufe calcare-
ous earth conflitutes a confiderable part of them, and mufl therefore
either be received from without,, or formed by them, or both, as
milk, when taken as food by a ladlefcent woman, is decompofed la-
the ftomach by the procefs of digefhon, and again in part converted

iiito

672 NUTRIENTIA. Art.I. 2.4.

into iiiilk by the peroral glands. Secondly, becaufe.frona the ana-
logy of all organic life, whatever has cooipofed a part of a vegetable
or animal may again after its chemical folution become a part of an-
other vegetable or animal, fuch is the general tranfmigratiou of mat-
ter. And thirdly, becaufe the great ufe of lime in agriculture on al-
moft all kinds of foil and fituation cannot be fatisfaclorily explained
from its chemical properties alone. Though thefe may alfo in certain
foils and Situations have confiderable effeiS.

The chemical ufes of lime in agriculture may be, i. from its de-
ftroying in a fliort time the cohefion of dead vegetable fibres, and thus
reducing them to earth, which otherwife is effected by a flow procefs
either by the confumption of infects or by a gradual putrefadion.
Thus I am informed that a mixture of lime with oak bark, after the
tanner has extraded from it whatever is folubie in water, will in two
or three months reduce it to a fine black earth, which, if only laid
in heaps, would require as .many years to effe6l by its own fpontane-
ous fermentation or putrefadion. This efFe£l of lime muft be particu-
larly advantageous to newly inclofed commons when firfl broken up.

Secondly, lime for many months continues to attraft moifture from
the air or earth, which it deprives I fuppofe of carbonic acid, and
then fufFers it to exhale again, as is feen on the plaftered walls of new
■houfes. On this account it muft be advantageous when mixed with
dry or fandy foils, as it attrafts moiflure from the air above or the
earth beneath, and this moifture is then abforbed by the lymphatics
of the roots- of vegetables. Thirdly, by mixing lime with clays it is
believed to make them lefs cohefive, and thus to admit of their being
more eafily penetrated by vegetable fibres. A mixture of lime with
clays deftroys their fuperabundancy of acid, if fuch exifts, and by
uniting with it converts it into gypfum or alabafler. And laftly,
frefh lime deftroys worms, fnails, and other infefts, with which it
happens to come in conta£t.

Yet do not all thefe chemical properties feem to account for the

great

Art. I. 2. 4. NUTRIENTIA. (^-jy

great ufes of lime in almoft all foils and fituations, as it contributes fo
mucli to the melioration of the crops, as well as to their increafe in
quantity. Wheat from land well limed is believed by farmers, mil-
lers, and bakers, to be, as they fuppofe, thinner ikinned ; that is, it
turns out more and better flour ; which I fuppofe is owing to its con-
taining more flarch and lefs mucilage. In refpeil to grafs-ground I
am informed, that if a fpadeful of lime be thrown on a tuiTock, which
horfes or cattle have refufed to touch for years, they will for many
fucceeding feafons eat it quite clofe to the ground.

One property of lime is not perhaps yet well underftood, I mean
its producing fo much heat, when it is mixed with water; which
may be owing to the elementary fluid of heat confolidated in the lime.
It is the fteam occafioned by this heat, when water is fprinkled upon
lime, if the water be not in too great quantity or too cold, which
breaks the lime into fuch fine powder as almoft to become fluid,
which cannot be efFe(fted perhaps by any other means, and which I
fuppofe muft give great preference to lime in agriculture, and to the
folutions of calcareous earth in water, over chalk or powdered lime-
ftone, when fpread upon the land.

4. It was formerly believed that waters replete with calcareous
earth, fuch as incruft the infide of tea-kettles, or are faid to petrify
raofs, were liable to produce or to increafe the fl:one in the bladder.
This miftaken idea has lattly been exploded by the improved che-
miftry, as no calcareous earth, or a very minute quantity, was found
in the calculi analyfed by Scheel and Bergman. The waters of Mat-
lock and of Carlfbad, both which cover the mofs, which they pafs
through, with a calcareous cruft, are fo far from increafing the ftone
of the bladder or kidnies, that thofe of Carlfbad are celebrated for
giving relief to thofe labouring under thefe difeafes. Philof. Tranf.
Thole of Matlock are drank in great quantities without any fufpicion
of injury-; and 1 well know a perfon who for above ten years has

Vol.. II. 4 R drank

674 NUTRIENTIA. Art. I. 2.5.

drank about two pints a day of cold water from a fpring, which very
much incrufts the veflels, it is boiled in, with calcareous earth, and
affords a copious calcareous fediment with a folution of fait of tartar,
and who enjoys a ftate of uninterrupted health.

V. I. As animal bodies confift. much both of oxygen and azote,
which make up the compofition of atmofpheric air, thefe Ihould be
counted amongft nutritious fubftances, Befides that by the experi-
ments of Dr. Prieftley it appears, that the oxygen gains admittance
into the blood through the moift membranes of the lungs ; and feems
to be of much more immediate confequence to the prefervation of our
lives than th^ other kinds of nutriment above fpecified.

As the bafis of fixed air, or carbonic acid gas, is carbone, which
alfo conftitutes a great part both of vegetable and animal bodies ; this
air fliould likewife be reckoned amon2:ft nutritive fubftances. Add to
this, that when this carbonic acid air is fwallowed, as it efcapes from
beer or cyder, or when water is charged with it as detruded from
limeftone by vitriolic acid, it affords an agreeable fenfation both to
the palate and ftomach, and is therefore probably nutritive.

The immenfe quantity of carbone and of oxygen which conftitute
fo o-reat a part of the limeftone countries is almoft beyond conception,
and, as it has been formed by animals, may again become a part of
them, as well as the calcareous matter with which they are united.
Whence it may be conceived, that the waters, which abound with
limeftone in folution, may fupply nutriment both to animals and to
vegetables, as mentioned above.

VI. I. The manner, in which nutritious particles are fubftituted
in the place of thofe, which ,are mechanically abraded, or chemi-
cally decompofed, or which vanifh by animal abforption, muft be
owino^ to animal appetency, as defcribed in Seft. XXXVII, 3. and is
probably fimilar to the procefs of inflammation, which produces new

8 veffels

Art.I. 2. 6. NUTRIENTIA. .675

veflels and new fluids ; or to that which conftitutes the growth of
the body to maturity. Thus the granulations of new flefli to repair
the injuries of wounds are vifible to the eye ; as well as the callous
matter, which cements broken bones ; the calcareous matter, which
repairs injured fnail-fhells ; and the threads, which are formed by filk-
worms and fpiders ; which are all fecreted in a fofter ftate, and harden
by exficcation, or by the contadl of the' air, or by abforption of their
more fluid parts.

Whether the materials, which thus fupply the wafte of the fyftem,
can be given any other way than by the ftomach, fo as to prefer ve
the body for a length of tirfie, is worth our inquiry ; as cafes fome-
times occur, in which food cannot be introduced into the ftoraach,
as in obftrudtions of the oefophagus, inflammations of the throat, or
in hydrophobia ; and other cafes are not unfrequent in which the
power of digeftion is nearly or totally deftroyed, as in anorexia epilep-
tica, and in many fevers.

In the former of thefe circumftances liquid nutriment may foiJe-
times be got into the ftomach through a flexible catheter ; as d^^icribed
in ClafsIII. i. i. 15. In the latter many kinds of mild aiiment, as
milk or broth, have frequently been injedled as cl; iters, together
with a fmall quantity of opium, as ten drops of the tincture, three or
four times a day ; to which alfo might be added very fmall quantities
of vinous Ipirit. But thefe, as far as I have obferved, will not long
fuftain a perfon, who cannot take any fuftenance by the ftomach.

2. Another mode of applying nutritive fluids might be by extenfivb
fomentations, or by immerging the whole body in a bath of broth,~
or of warm milk, which might at the fame time be coagulated by
rennet, or the acid of the calf's ftomach ; broth or whey might thus
probably be introduced, in part at leaft, into the circulation, as a fo-
lution of nitr€ is faid to have been abforbed in a pediluvium, whieh "
was afterwards. difcovered by the manner in which paper dipped fre-

4 R 3 quently

t-16 NUTRIENTIA. Art. I. 2. 7.

qiiently in the urine of the patient and dried, burnt and fparkled like
touch-paper. Great quantity of water is alfo known to be abforbed
by thofe, who have bathed in the warm bath after exercife and ab-
ftlnence from liquids. Cleopatra was faid to travel with 4000 milch-
affes in her train, and to bathe every morning in their milk, which
iJie probably might ufe as a cofmetic rather than a nutritive.

3, The transfufion of blood from another animal into the vein of
one, who could take no fuftenance by the throat, or digeft none by
the flomach, might long continue to fupport him j and perhaps other
nutriment, as milk or mucilage, might be this way introduced into
the fyftem, but we have not yet fufficlent experiments on this fub-
je(Sl. See Se£l. XXXII. 4. and Clafs I. 2. 3. 25. and Sup. I. 14, 2.

VII. Various kinds of condiments, or fauces, have been taken
along with vegetable or animal food, and have been thought by fome
*•- ftrengthen the procefs of digeftion and confequent procefs of nu-
trition.. Of thele wine, or other fermented liquors, vinegar, fait,
fpices, aM ixiuftard, have been in moft common ufe, and I believe
to the injury of thoufands. As the flomach by their violent ftimulus
at length lofes its natural degree of irritability, and indigefliou is the
confequence ; which is attended with flatulency and emaciation.
Where any of thefe have teen taken fo long as to induce a habit, they
muft either be continued, but not increafed ; or the ufe of them
fhould be gradually and cautioufly diminifhed or difcontinued, as di-
refted in Sed, XII. 7. 8.

III. Catalogue

Art.I. 3- 1— 7- NUTRIENTIA. 677

III. Catalogue of the Nutrientia.

I. I. Venifon, beef, mutton, hare, goofe, duck, woodcock,
fnipe, moor-game.

2. Oyfters, lobfters, crabs, fhrimps, mufhrooms, eel, tench,

barbolt, fmelt, turbot, fole, turtle.

3. Lamb, veal, fucking-pig.

4. Turkey, partridge, pheafant, fowl, eggs.

5. Pike, perch, gudgeon, trout, grayling.

II. Milk, creamj butter, buttermilk, whey, cheefe.

III. Wheat, barley, oats, peas, potatoes, turnips, carrots, cabbage,
afparagus, artichoke, fpinach, beet, apple, pear, plum,
apricot, ne£larinej peach, ftrawberry, grape, orange, melon,
cucumber, dried figs, raifins, fugar, honey. With a great
variety of other roots, feeds, leaves, and fruits.

- IV. Water, river-water, fpring-water, calcareous earth.

V. Air, oxygene, azote, carbonic acid gas.

VI. Nutritive baths and clyfters, transfulion of blood.

VII. Condiments.

Art,

67S, INCITANTIA. Art.II. 2. 1.

Art. II.
INC IT ANT I A.

1. I. Those things, which increafe the exertions of all the irri-
tative motions, are termed iucitantia. As alcohol, or the fpirituous
part of fermented liqaors, opium, and many drugs, whidh are ftill
efteemed poifons, their proper dofes not being afcertained. To thefe
Ihould be added the exhilarating paffions of the mind, as joy, love :
and externally the application of heat, ek£tricity, aether, .effential
oils, fridion, and exercife.

2. Thefe promote both the fecretions and abforptions, increafe the
natural heat, and remove thofe pains,, which originate from the de-
feat of irritative rpotions, termed nervous pains.; a,nd prevent the con-
vulfions confequent to them. .When given internally they induce
coftivenefs, and deep coloured urine ; and by a greater dofe intoxica-
tion, and its confequences.

II.^.Observ:atio'NS ON THE 1ncitan;ti4. ,! '

I. I. Opium and alcohol increafe all the fecretions and abforptioQS.
The increafe of the fecretion of fenforial power appears from the vio-
lent exertions of drunken people ; the fecretion of fweat is more cer-
tainly excited by opium or wine than by any other medicine ; and
the increafe of general heat, which thefe drugs produce, is an evi-
dence of their effect in promoting all the fecretions ; fince an increafe

of

Art.II. 2. I. INCITANTIA. b'jr)

of fecretion is always attended with increafe of heat iti the part, as in
hepatic and other inflanamations.

2. But as they at the fame time promote abforption ; thofe fluids,
which are fecreted into receptacles, as the urine, bile, inteftinal and
pulmonary mucus, have again their thinner parts abforbed ; and
hence,' though the quantity of fecreted fluid was increafed, yet as
the abforption was alfo increafed, the excretion from thefe receptacles
is lefTened ; at the fame time that it is deeper coloured or of thicker
confiflence, as the urine, alvine feces, and pulmonary mucus. Where-
as the perfpiration being fecreted on the furface of the body is vifible
in its increafed quantity, before it can be reabforbed ; whence arifes
that erroneous opinion, that opium increafes the cutaneous fecretion,
and lefl^ens all the others.

3. It muft however be noted, that after evacuations opium feems
to promote the abforptions more than the fecretions ; if you except
that of the fenfprial power in the brain, which probably fuffers no
abforption. Hence its efficacy in reftraining hemorrhages, after the
veflels are emptied, by promoting venous abforption.

4. In ulcers the matter is thickened by the exhibition of opium
from the increafed abforption of the thinner parts of it ; but it is
probable, that the whole fecretion, including the part which is ab-
forbed, is increafed ; and hence new fibres are fecreted along with the
matter, and the ulcer fills with new granulations of flefh. But as no
ulcer can heal, till it ceafes to difcharge ; that is, till the abforption
becomes as great as the excretion ; thofe medicines, which promote
abforption only, are more advantageous for the healing an ulcer after
it is filled with new flefh ; as the Peruvian bark internally ; with
bandages and folutions of lead externally.

5. There

68o INCITANTIA. Art. II. 2.1.

5. There are many pains which originate from a want of due mo-
tion in the part, as thofe occafioned by cold ; and all thofe pains whlck
are attended \^■ith cold extremities, aud are generally termed nervous.
Thefe are relieved by whatever excites the part into its proper adions,
and hence by opium and alcohol ; which are the moft univerfal fti-
mulants we are acquainted with. In thefe cafes the efFeft of opium
is produced, as foon as the body becomes generally warm ; and a de-
gree of intqxication or fleep follows the ceffation of the pain.

Thefe nervous pains (as they a^e called) frequently return at cer-
tain periods of time, and are alfo frequently fucceeded by convulfions;
in thefe cafes if opium removes the pain, the convulfions do not come
on. For this purpofe it is befl to exhibit it gradually, as a grain
every hour, or half hour, till it intoxicates. Here it muft be noted,
that a much lefs quantity will prevent the periods of thefe cold pains,
than is necellary to relieve them after their accefs. As a grain and
half of opium given an hour before the expelled paroxyfm will pre-
vent the cold fit of an intermittent fever, but will not foon remove
it, when it is already formed. For in the former cafe the ufual or
healthy affociations or catenations of motion favour the elFecl of the
medicine ; in the latter cafe thefe affociations or catenations are dif-
ordered, or interrupted, and new ones are formed, which fo far coun-
teract the efFedl of the medicine.

When opium has been required in large dofes to eafe or prevent
convulfions, fome have advifed the patient to omit the ufe of wine,
as a greater quantity of opium might then be exhibited ; and as opium
feems to increafe abforption more, and fecretion lefs, than vinous
fpirit; it may in fome cafes be ufeful to exchange one for the other ;
as in dlfeafes attended with too great evacuation, as diarrhoea, and dy-
fentery, opium may be preferable ; on the contrary in tetanus, or
loclced-jaw, where inflammation of the fyftem might be of fcrvice,
wine may be preferable to opium; feeClafsIH. i. i. 12. I have
o-enerally obferved, that a mixture of fpirit of wine and warm water.

given

Art. II. 2. I. INCITANTIA. ^ -^"gi

given alternately with the dofes of opium, has foonefl: and moll: cer-
tainly produced that degree of intoxication, which was neceflary to
relieve the patient in the epilepfia dolcrofica.

6. There is likewife fome relief given by opium to inflammatory
pains, or thofe from excefs of motion in the afFefted part ; but with
this difference, that this relief from the pains, and the fleep, which
it occafions, does not occur till fome hours after the exhibition of the
opium. This requires to be explained ; after the ftimulus of opium
or of alcohol ceafes, as after common drunkennefs, a confcquent tor-
por comes on ; and the whole habit becomes lefs irritable by the na-
tural ftimuli. Hence the head-achs, ficknefs, and languor, oa the
next day after intoxication, with cold fkin, and general debility.
Now in pains from excefs of motion, called inflammatory pains, when
opium is given, the pain is not relieved, till the debility comes on
after the flimulus ceafes to a6t ; for then after the greater flimulus of
the opium has exhaufted much of the fenforial power ; the lefs fti-
mulus, which before caufed the pain, does not now excite the part
into unnatural a£lion.

In thefe cafes the flimulus of the opium firft increafes the pain ; and
it fometimes happens, that fo great a torpor follows, as to produce
the death or mortification of the affe6led part ; whence the danger of
giving opium in inflammatory difeafes, efpecially in inflammation of
the bowels ; but in general the pain returns with its former violence,
when the torpor above mentioned ceafes. Hence thefe pains attended
with inflammation are bed relieved by copious venefedtion, other eva-
cuations, and the clafs of medicines called torpentia.

7. Thefe pains from excefs of motion are attended with increafed
heat of the whole, or of the affeded part, and a ftrong quick pulfe ;
the pains from defeat of motion are attended with cold extremities.

Vol. H, 4 S and

682 INCITANTIA. Art. II. 2.1:

and a weak pulfe ; which is alfo generally more frequent than natural,
but not always fo.

8. Opium and alcohol are the only two drugs, we are much ac-
quainted with, which intoxicate ; and by this circumflance are eafily
diftinguifhed from the fecernentia and forbentia. Camphor, and ci-
cuta, and nicotiana, are thought to induce a kind of intoxication ;
and there are many other drugs of this clafs, whofe efFeds are lefs
known, or their dofes not afcertained ; as atropa belladonna, hyocy-
amus, ftramonium, prunus laurocerafus, menifpermum, cynoglof-
fum, fome fungi, and the water diftilled from black cherry- ftones;
the laft of which was once much in ufe for the convuifions of chil-
dren, and was faid to have good efFe£l j but is now improvidently left
out of our pharmacopias. I have known one leaf of the laurocerafus,
fhred and made into tea, given every morning for a week with no ill
confequence to a weak hyfteric lady, but rather perhaps with ad-
vantage. .

^. The pernicious effects of a continued ufe of much vinous fpirit
is daily feen and lamented by phyficians ; not only early debility, like
premature age, but a dreadful catalogue of difeafes is induced by this
kind of intemperance ; as dropfy, gout, leprofy, epilepfy, infanity,
as defcribed in Botanic Garden, Part II. Canto III. line 357. The
ftronger or lefs diluted the fpirit is taken, the fooner it feems to de-
ftroy, as in dram-drinkers ; but ftill fooner, when kernels of apricots,
or bitter almonds, or laurel-leaf, are infufed in the fpirit, which is
termed ratafia ; as then two poifons are fwallowed at the fame time.
And vinegar, as it contains much vinous fpirit, is probably a noxious
part of our diet. And the diftilled vinegar, which is commonly fold
in the (hops, is truly poifonous, as it is generally diftilled by means of
a pewter or leaden alembic-head or worm-tube, and abounds with
4 lead ;

Art. II. 2.2. _ INCITANTIA. 683

lead ; which any one may dete6l by mixing with it a folution of liver
offulphur. Opium, when taken as a luxury, not as a medicine, is
as pernicious as alcohol j as Baron de Tott relates in his account of
the opium-eaters iii Turkey.

10. It muft be obferved, that a frequent repetition of the ufe of
this clafs of medicines fo habituates the body to their ftimulus, that
their dofe may gradually be increafed to an aftonifhing quantity, fuch
as otherwife would inftantly deftroy life ; as is frequently feen in
thofe, who accuftom themfelves to the daily ufe of alcohol and opi-
um ; and it would feem, that thefe unfortunate people become dif-
eafed as foon as they omit their ufual potations ; and that the confe-
quent gout, dropfy, palfy, or pimpled face, occur from the debility
occafioned from the want of accuftomed ftimulus, or to fome change
in the contractile fibres, which requires the continuance or increafe
of it. Whence the cautions neceflary to^be obferved are mentioned in
Se£t. XII. 7. 8.

11. It is probable, that fome of the articles in the fubfequent cata-,
logue do not induce intoxication, though they have been efleemed to
do fo ; as tobacco, hemlock, nux vomica, flavifagria ; and on this
account (hould rather belong to other arrangements, as to the fecer-
nentia, or forbentia, or invertentia.

II. I. Externally the application of heat, as the warm bath, by its
flimulus on the Ikin excites the excretory du£ls of the perfpirative
glands, and the mouths of the lymphatics, which open on its furface,
into greater action ; and in confequence many other irritative motions,
■which are affociated with them. To this increafed adlion is added
pleafurable fenfation, which adds further a£livity to the fyftem ; and
thus many kinds of pain receive relief from this additional atmofphere
of heat,

4S 2 The

684 INCITANTIA. .Art. II. 2. 2.

The life of a warm bath of about 96 or 98 degrees of heat, far
.half an hour once a day for three or four months, I have known of
great fervice to weak people, and is perhaps the leaft noxious of all
unnatural flim nil ; which however, like all other great excitement,
inay be carried to excefs, as complained of by the ancients. The un-
meaning application of the words relaxation and bracing to warm and
cold baths has much prevented the ufe of this grateful ftimulus ; and
the mifufe of the term warm-bath, when applied to baths colder than
the body, as to thofe of Buxton and Matlock, and to artificial baths
of lefs than 90 degrees of heat, which ought to be termed cold ones,
has contributed to miflead the unwary in their application.

The ftimulus of wine, or fpice, or fait, increafes the heat of the
fyftem by increafing all or fome of the fecretions ; and hence the
flrength is diminiflied afterwards by the lofs of fluids, as well as by
the increafed aftion of the fibres. ' But the ftimulus of the warm-
bath, fupplies heat rather than produces it ; and rather fills the fyftem
by increafed abforption, than empties it by increafed fecretion ; and
may hence be employed with advantage in almoft all cafes of debility
with cold extremities, perhaps even in anafarca, and at the approach
of death in fevers. In thefe cafes a bath much beneath 98 degrees, as
of 80 or 85, mi'ght do injury, as being a cold-bath compared
with the heat of the body, though luch a bath is generally called a
warm one.

The adivity of the fyftem thus produced by a bath of 98 degrees
of heat, or upwards, does not feem to render the patients liable to
take cold, when they come out of it; for the fyftem is lefs inclined
to become torpid than before, as the warmth thus acquired by com-
munication, rather than by increafed aftion, continues long without
any confequent chillnefs. Which accords with the obfervation of
Dr. Fordyce, mentioned in Sup. I. 5. i. who fays, that thofe who
are confined fome time in an atmofphere of 120 or 130 degrees of
heat, do not feel cold or look pale on coming into a temperature of

30

Art. II. 2. 2. INCITANTIA. 6S5

30 or 40 degrees ; which would produce great palenefs and fenfatioii
of coldnels in thole, who had been fome time confined in an atmo-
fphere of only 86 or 90 degrees of heat. Treatife on Simple Fever,
p. 168.

Hence heat, where it can be confined on a torpid part alono- with
moiflure, as on a fcrophulous tumour, will contribute to produce fup-
puration or refolution. This is done by applying a warm poultice,
which (hould be frequently repeated ; or a plafter of refin, wax, or
fat ; or by covering the part with oiled filk ; both which lafl: prevent
the perfpirable matter from efcaping as well as the heat of the party
as thefe fubftances repel moifture, and are bad conduftors of heat.
Another great ufe of the ftimulus of heat is by applyino- it to
torpid ulcers, which are generally termed fcrophulous or fcorbutic,
and are much eafier inclined to heal, when covered with feveral folds
of flannel.

Mr. had for many months been affli6ted with an ulcer in pc-

rin^eo, which communicated with the urethra, through which a part
ofhis urine wasdaily evacuated with confiderable pain ; and was re-
duced to a great degree of debility. He ufed a hot-bath of 96 or 98
degrees of heat every day for half an hour during about fix months.
By this agreeable ftimulus repeated thus at uniform times not only
the ulcer healed, contrary to the expedlation of his friends, but he
acquired greater health and ftrength, than he had for fome years pre-
vioufly experienced.

Mrs. was afFe<£led with tranfient pains, which were called

nervous fpafms, and with great fear of difeafes, which (he did not
labour under, with cold extremities, and general debility. She ufed
a hot-bath every other day of 96 degrees of heat for about four
months, and recovered a good ftate of health, with greater fiirencrth
and courage, than fhe had polTefied for many months before.

Mr. Z. a gentleman about 65 years of age, who had lived rather
intemperately in refped: to vinous potation, and had for many years ■

had

686 INCITANTIA. Art,1I.2.2.

had annual vifits of the gout, which now became irregular, and he
appeared to be lofing his llrength, and beginning to feel the efFefts of
ao-e. He ufed a bath, as hot as was agreeable to his fenfations, twice a
week for about a year and half, and greatly recovered his health and
flTen<nh with lefs frequent and lefs violent returns of regular gout,
and is now near 80 years of age.

When Dr. Franklin, the American philofopher, was in England
many years ago, I recommended to him the ufe of a warm-bath
twice a week to prevent the too fpeedy accefs of old age, which he
then thought that he felt the approach of, and I have been informed,
that he continued the ufe of it till near his death, which was at an
advanced age.

All thefe patients were advifed not to keep themfelves warmer than
their ufual habits, after they came out of the bath, whether they
went into bed or not ; as the defign was not to promote perfpiration,
which weakens all conftitutions, and feldom is of fervice to any.
Thus a flannel fhirt, particularly if it be worn in warm weather, oc-
eafions weaknefs by ftimulating the Ikin by its points into too great
action, and producing heat in confequence ; and occafions emaciation
by increafing the difcharge of perfpirable matter ; and in both thefe
refpe6ts differs from the effedl of warm bathing, which communicates
heat to the fyftem at the fame time that it Simulates it, and caufes
abforption more than exhalation.

2. The effe£t of the paffage of an ele£lric fliock through a paralytic
limb in caufmg it to contract, belides the late experiments of Galvani
and Volta on frogs, intitle it to be clafTed amongft univerfal flimu-
lants. Electric (hocks frequently repeated daily for a week or two
remove chronical pains, as the pleurodyne chronica, Clafs I. 2.4. 14.
and other chronic pains, which are termed rheumatic, probably by
promoting the abforption of fome extravafated material. Scrophulous

tumours

(7rt. //. 2.2.2. /?aye 6.9/.

kV

Ful.lijheJ U .JJ^h.uton S: fauL- C/uu-di yai-d, Mm-ch iO^lQO.

'79"

Art.il 2. 2. INCITANTIA. 687

tumours are fometimes abforbed, and fometimes brought to fiippurate
by pafling eledtric fhocks through them dailj for two or three
weeks.

Mifs , a young lady about eight years of age, had a fweUinsi;

about the fize of a pigeon's egg on her neck a little below her ear,
which long continued in an indolent ftate. Thirty or forty fmall
eledric fhocks were pafTed through it once or twice a day for two or
three weeks, and it then fuppurated and healed without difficulty.
For this operation the coated jar of the eledlric machine had on its top
an eleArometer, which meafured the {hocks by the approach of a brafs
knob, which communicated with the external coating to another,
which communicated with the internal one, and their diflance was
adjufted by a fcrew. So that the fhocks were fo fmall as not to alarm
the child, and the accumulated eleftricity was frequently difcharged,
as the wheel continued turning. The tumour was inclofed bet\Yeea
two other brafs knobs, which were fixed on wires,- which paffed
through glafs tubes, the tubes were cemented in two grooves on a
board, fo that at one end they were nearer each other than at the
other, and the knobs were puftied out fo far as exadlly to include the
tumour, as defcribed in the annexed plate, which is about half the
fize of the original apparatus.

Inflammations of the eyes without fever are frequently cured by
taking a ftream of very fmall eleflric fparks from them, or giving the
eledric fparks to them, once or twice a day for a week or two ; that
is, the new vefl'els, which conftitute inflammation in thefe inirritable
conftitutions, are abforbed by the aftivity of the abforbents induced
by the flimulus of the eledlric aura. For this operation the eafieft
method is to fix a pointed wire to a flick of fealing wax, or to an in-
fulating handle of glafs, one end of this wire communicates with the
prime condudlor, and the point is approached near the inflamed eye
in every dire<5liono

III. Externally

688 INCITANTIA; Art.II. 2. 3.4.

III. Externally the application of ether, and of effential oils, as of
cloves or cinnanrion, feetn to poffefs a general Simulating effe£V. As
they inftantly relieve tooth-ach, and hiccough, vi'hen thefe pains are
not in violent degree ; and camphor in large dofes is fa id to produce
intoxication ; this effefl however 1 have not been witnefs to, and have
reafon to doubt.

The manner in which ether and the effential oil operate on the
fyflem when applied externally, is a curious queftion, as pain is fo
immediately relieved by them, that they muft feem to penetrate by
the great fluidity or expanfive property of a part of them, as of their
odoriferous exhalation or vapour, and that they thus ftimiilate the
torpid part, and not by their being taken up by the abforbent veffels,
and carried thither by the long courfe of circulation ; nor is it pro-
bable, that thefe pains are relieved by the fympathy of the torpid
membrane with the external fkin, which is thus ftimulated into ac-
tion ; as it does not fucceed, unlefs it is applied over the pained part.
Thus there appears to be three different modes by which extraneous
bodies may be introduced into the lyftem, befides that of abforption.
ift. By ethereal tranfition, as heat and eleftricity ; 2d. by chemical
attraftion, as oxygen ; and 3d. by expanfive vapour, as ether and ef-
fential oils.

IV. The perpetual neceffity of the mixture of oxygen gas with the
blood in the lungs evinces, that it muft aft as a ftimulus to the fan-
guiferous fyftem, as the motions of the heart and arteries prefently
ceafe, when animals are immerfed in airs which poffefs no oxygen.
It may alfo fubfequently anfwer another important purpofe, as it
probably affords the material for the produdion of the fenforial
power ; which is fuppofed to be fecreted in the brain or medullary
part of the nerves ; and that the perpetual demand of this fluid in re-
fpiration is occafioned by the fenforial power, which is fuppofed to be

produced

Art.1I. 2.4. INCITANTIA. 6R9

produced from it, being too fubtle to be long confined in any part of
tiie fyftem.

Another proof of the ftimulant quality of oxygen appears from the
increafed acrimony, which the matter of a common abfcefc- poflefTes,
after it has been expofed to the air of the atmr phere, but not be-
fore ; and probably all other contagious matters owe their fever-pro-
ducing property to having been converted into acids by their union
with oxygen.

As oxygen penetrates the fine moift membranes of the air-veflels
of the lungs, and unites with the blood by a chemical attraction, as is
feen to happen, when blood is drawn into a bafon, the lower furface
of the cralTamentum is of a very dark red fo long as it is covered from
the air by the upper furface, but becomes florid in a fhort time on
its being expofed to the atmofphere ; the manner of its introdudion
into the fyftem is not probably by animal abforption but by chemical
attradion, in which circumftance it differs from the fluids before
mentioned both of heat and eledricity, and of ether and efTential
oils.

As oxygen has the property of pafling through moift animal mem-
branes, as firft difcovered by the great Dr. Prieftley, it is probable it
might be of ufe in vibices, and petechise in fevers, and in other
bruifes ; if the fkin over thofe parts was kept moift by warm water,
and covered with oxygen gas by means of an inverted glafs, or even
by expofing the parts thus moiftened to the atmofphere, as the dark
coloured extravafated blood might thus become florid, and by its in-
-creafe of ftimulus facilitate its reabforption.

Two weak patients, to whom I gave oxygen gas in as pure a ftate
as it can ealily be procured from Exeter manganefe, and in the quan-
tity of about four gallons a day, feemed to feel refrefhed, and ftronger,
and to look better immediately after refpiruig it, and gained ftrength
in a fhort time. Two others, one of whom laboured under con-

VoL. IL 4 T firmed

690 INC IT ANT I A. Art.il 2. 5. 6.

firmed hydrothorax, and the other u;ider a permanent and uniform
difficulty of refplration, were not refrefhed, or in any way ferved by
the ufe of oxygen in the above quantity of four gallons a day for a fort-
night, which 1 afcribed to the inirritability of the dilealed lungs.
For other cafes the reader is referred to the publications of Dr. Bed-
does ; Confiderations on the Ufe of Faditious Airs, fold by Johnfon,
LfOndon.

Its effefts would probably have been greater in refpeift to the quan-
tity breathed, if it had been given in a dilute ftate, mixed with 10
or 20 times its quantity of atmofpheric air, as otherwife much of it-
returns by expiration without being deprived of its quality, as may
be feen by the perfoa breathing on the flame of a candle, which it
enlarges. See the Treatife of Dr. Beddoes above mentioned.

V. Thofe paffions, which are attended with pleafurable fenfation,
excite the fyfteni into increafed a£lion in confequence of that fenfa-
tion, as joy, and love, as is feen by the flufli of the flcin. Thofe
paffions, which are attended with difagreeable fenfation, produce tor-
por in general by the expence of fenforial power occafioned by inac-
tive pain ; unlefs volition be excited in confequence of the painful fen-
fation ; and in that cafe an increafed adlivity of the fyftem occurs ;
thus palenefs and coldnefs are the confequence of fear, but warmth
and rednefs are the confequence of anger.

VI. Befides the exertions of the fyflem occafioned by increafed fll-
muli, and confequent irritation, and by the paffions of the mind
above defcribed, the increafed a£tions occalioned by exercife belong to
this article. Thefe may be divided into the adlions of the body in
confequence of volition, which is generally termed labour ; or fe-
condly, in confequence of agreeable fenfation, which is termed play

8 or

Art.II. 2. 6. INCITANTiA. 691

or fport ; thirdly, the exercife occafioned. by agitation, as in a car-
riageor on horfeback ; fourthly, that of friftion, as"\yith a b/ufli or
hand, fo much ufed in the baths of Turkey ; ancj-vlaflly, the exercife

of fwirtcriDO". ' - < , • ,

The firft of thefe modes of ex^rcirfe^ia. .frequently carried to gretit
excefs even amongfl: our own labourers,: and. mare ■fo .under the- la(h
of flavery ; fo that the body becomes emaciated and finks under either
the prefent'hardfliips,, or by .a prernatur.^pld.age. . The fecohd mode
of exercife is feen in the .play of all youtig.aniji^ais, as kittqns,, and
puppies, and children'; , and, is i^ necefl|ry to their "health as well as
to their pleafure, that thofe children, y^'hich. are too much confined
from it, not only become pale-faced and bloated, \vit"h tufnid- bellies,
and confequent worms, but are liable to get habits of unnatural ac-
tions, as twitching of their limbs, or of fome prats of their counte-
nance; together with an ill-humoured or difcontented mind.

Agitation in a carriage or on horfeback, as it requires fome little
voluntary exertion to preferve the body perpendicular, but much
lefs voluntary exertion than' in walking, feems the befl adapted to
invalids ; who by thefe means obtain exercife principally by the
flrength of the horfe, and do not therefore too much exhaufl their
own fenforial power. The ufe of frifcion with a brufn or hand, for
half an hour or longer morning and evening, is flill better adapted
to thofe, who are reduced to extreme debility; and none of their own
fenfoiial power is thus expended, and affords fomewhat like the warm-
bath activity without felf-exertion, and is ufed as a luxury after warnti
bathing in many parts of Afia.

Another kind of exercife is that of fwinging, which requires fome
exertion to keep the body perpendicular, or pointing towards th-e
center of the fwing, but is at the fame time attended with a degree
of vertigo ; and is defcribed ia Clafs 11. i. 6. 7. IV. 2. i. 10. Sup. I.
3. and 15.

' 4 T 2 The

6^2 INCITANTIA. ART.n.3. i.

The neceffity of much exercife has perhaps been more infifted
upon by phyficians, than nature feems to demand. Few animals ex-
ercife themfelvefi fo as to induce vifible Iweat, unlefs urged to it
by mankind, or by fear, or hunger. And numbers of people in our
market towns, of ladies particularly, with fmall fortunes, live to old
age in health, without any kind of exercife of body, or much a£tiyity
of mind.

In fummer weak people cannot continue too long in the air, if it
can be done without fatigue ; and in winter they fhould go out feveral
times in a day for a few minutes, ufing the cold air like a cold -bath,
to invigorate and render them more hardy.

Ill, Catalogue of the Incitantia.

I. Papaver fomniferum ; poppy, opium.
Alcohol, wine, beer, cyder.

Prunus lauro-cerafus ; laurel, diftilled water from the leaves,
Prunus cerafus ; black cherry, diftilled water from the kernels,
Nicotiana tabacum ; tobacco ? the efTential oil, deco£lion of the

leaf.
Atropa belladona ; deadly nightfhade, the berries.
Datura ftramoneum ; thorn-apple, the fruit boiled in milk.
Hyofcyamus reticulatus ; henbane, the feeds and leaves.
Cynogloflum ; hounds tongue.
Menifpermum, cocculus ; Indian berry.
Amygdalus amarus ; bitter almond,

Cicuta %

Art. II. 3- I— 6. INCITANTIA. (>gs

- Cicuta ; hemlock. Conium maculatum ?
Strychnos nuc vomica ?
Pelphinium ftavifagria }

II. Externall/, heat, eledtricitys

III. Ether, effential oils.

IV. Oxygen gas.

v. Paflions of love, joy, anger.

VI. Labour, play, agitation, fridtioa^^iiji?;-.

Art.

694 SECERNENT I A. Art. III. i . 6.

Art. m.
SECERNENTIA.

, I. Those things which increafe the irritative motions, which
conftitute fecretion, are termed fecernentia ; which are as various as
the glands, which they ftimulate into aftion.

1. Diaphoretics, as aromatic vegetables, effential oils, ether, vola-
tile slcali, neutral falts, antimonial preparations, external heat, ex-
ercife, fri6lion, cold water for a time with fubfequent warmth, blif-
ters, electric fluid.

2. Sialagogues, as mercury internally, and pyrethrum externally.

3. Expedorants, as fquill, onions, gum ammoniac, feneka root,
mucilage: fome of thefe increafe the pulmonary perfpiration, and
perhaps the pulmonary mucus.

4. Diuretics, as neutral falts, fixed alcali, balfams, refins, afpara-
gus, cantharides.

5. Cathartics of the mild kind, as fena, jalap, neutral falts, manna.
They increafe the fecretions of bile, pancreatic juice, and inteftinal
mucus.

6. The mucus of the bladder is increafed by cantharides, and per-
haps by oil of turpentine.

7. The

Art. III. I. 12. SECERNENTIA. 695

7. The mucus of the redium by aloe internally, by clyfters and
fuppofitories externally.

8. The mucus of the cellular membrane is increafed by blifters and
finapifms. , ^

9. The mucus of the noftrils is increafed by errhines of the milder
kind, as marum, common fnufF..

ID. The fecretion of tears is increafed by volatile falts,' the vapour
'of onions, by grief, and joy. •

II. All thofe medicines in-creafe the heat of the body,, and remove
thofe pains, w^hich originate from a defe£l of motion in the velTelSy
which perform fecretion ; as pepper produces a glow on the fkin,
and balfam of Peru is faid to relieve the flatulent cholic. But thefe
medicines differ from the preceding clafs, as they neither induce cof-
tivenefs nor deep coloured urine in their ufual dofe, nor intoxication.
in any dole..

12., Yet if any of thefe are ufed unneceflarily, it is obvious, like
the incitantik, that they muft contribute to (horten our lives by fooner
rendering peculiar parts of the fyftem difobedient to their natural fti—
muli. Of thofe in daily ufe the great excefs of common fait is pro-
bably the mofl: pernicious, as it enters all our cookery, and is probably
one caufe of fcrophula, and of fea-fcurvy, when joined with other
caufes of debility. See Botanic Garden, Part II. Canto IV. line 221..
Spices taken to excefs by Simulating the ftomach, and the vefi'els of
the Ikin by aiibciation, into unneceffary adioi], contribute to weaken
thefe parts of the fyftem, but are probably lefs noxious than the general
ufe of fo much fait.

■ ■ II. Observatians

69^ SECERNENTIA. Art.III. 2.1.

II. Observations on the Secernentia,

I. I. Some of the medicines of this clafs produce abforption in
fome degree, though their principal efFe£t is exerted on the fecerning
part of our fyftem. We fliall have occafion to obferve a fimilar cir-
cumftance in the nest clafs of medicines termed Sorbentia ; as of thefe
fome exert their effe(5ls in a fmaller degree on the fecerning fyftem.
Nor will this furprife any one, who has obferved, that all natural
objeds are prefented to us in a ilate of combination ; and that hence
-the materials, which produce thefe different effects, are frequently
found mingled in the fame vegetable. Thus the pure aromatics in-
creafe the a6tion of the veflels, which fecrete the perfpirable matter ;
and the pure aftringents increafe the adtion of the veffels, which ab-
forb the mucus from the lungs, and other cavities of the body ;
hence it mull: happen, that nutmeg, which poffefles both thefe qua-
lities, fhould have the double effedt above mentioned.

Other drugs have this double effeO:, and belong either to the clafs
of Secernentia or Sorbentia, according to the dofe in which they are
exhibited. Thus a fmall dofe of alum increafes abforption, and in-
duces coftivenefs ; and a large one increafes the fecretions into the
inteftinal canal, and becomes cathartic. And this accounts for the
conftipation of the belly left after the purgative quality of rhubarb
ceafes, for it increafes abforption in a fmaller dofe, and fecretion in
a greater. Hence when a part of the larger dofe is carried out of the
habit by flools, the fmall quantity which remains induces coftivenefs.
Hence rhubarb exhibited in fmall dofes, as 2 or 3 grains twice a day,
ftrengthens the fyflem by increafing the acflion of the abforbent vef-
fels, and of the inteftinal canaL

7 3. Diaphoretics,

Art.III.2.1. SECERNENTIA. 697

2. Diaphoretics. The perfpiration is a fecretion from the blood iti'
its palTage through the capillary veffels, as other fecretions are pro-
duced in the termination of the arteries in the various glands. After
this fecretion the blood lofes its florid colour, which it regains in its
paffage through the lungs ; which evinces that fomething belides wa-
ter is fecreted on the fkins of animals.

No ftatical experiments can afcertain the quantity of our perfpira-
tion ; as a continued abforption of the moifture of the atmofphere
exifts at the fame time both by the cutaneous and pulmonary lym-
phatics.

3. Every gland is capable of being excited into greater exertions by
an appropriated ftimulus applied either by its mixture with the blood
immediately to the fecerning vefTel, or applied externally to its excre-
tory du£l. Thus mercury internally promotes an increafed falivation,
and pyrethrum externally applied to the excretory du£ls of the falival
glands. Aloes ftimulate the reclum internally mixed with the cir-
culating blood ; and fea-falt by injection externally. Now as the ca-
pillaries, which fecrete the perfpirable matter, lie near the furface of
the body, the application of external heat adts immediately on their
excretory du£ts, and promotes perfpiration ; internally thofe drugs
which poffefs a fragrant efTential oil, or fpiritus re6tor, produce
this efFed, as the aromatic vegetables, of which the number is very
great.

4. It muft be remembered, that a due quantity of fome aqueous
vehicle muil: be given to fupport this evacuation ; otherwife a burning
heat without much vifible fweat muft be the confequence. When
the Ikin acquires a degree of heat much above 108, as appears by Dr.
Alexander's experiments, no vifible fweat is produced ; which is
owing to the great heat of the Ikin evaporating it as haftily, as it is

Vol, II. 4 U fecteted ;

698 SECERNENTIA. Art.III. 2. i.

fecreted ; and, where the fweat is fecreted in abundance, its evapora-
tion cannot carry off" the exuberant heat, hke the vapour of boiling
\vater; becaufe a great part of it is wiped off, or abforbed by the bed-
clothes ; or the air about the patient is not changed fufficiently often,
as it becomes faturated with the perfpirable matter. And hence it is
probable, that the wafte of perfpirable matter is as great, or greater,
when the Ikin is hot and dry, as when it ftands in drops on the Ikin ;
as appears from the inextinguifliable thirft.

Hence Dr. Alexander found, that when the heat of the body was
greater than 108, nothing produced fweats but repeated draughts of
cold water ; and of warm fluids, when the heat was much below that
degree. And that cold water which procured fweats inftantaneoufly
when the heat was above io8, flopped them as certainly when it
was below that heat ; and that flannels, wrung out of warm water
and wrapped round the legs and thighs, were then moil certainly pro-
dudive of fweats.

5. The diaphoretics are all faid to fucceed much better, if given
early in the morning, about an hour before fun-rife, thaa at any
other time ; which is owing to the great excitability of every part of
the fyflem after the fenforial power has been accumulated during
fleep. In thofe, who have hedlic fever, or the febricula, or nocturnal
fever of debility, the morning fweats are owing to the decline of the
fever-fit, as explained in Se£l. XXXII. 9. In fome of thefe patients
the fweat does not occur till they awake ; becaufe then the fyftem is
ftill more excitable than during fleep, becaufe the afliflance of the vo-
luntary power in refpiration facilitates the general circulation. See
Clafs I. 2. I. 3.

6. It muft be obferved, that the Ikin is very dry and hard to the
touch, where the abforbents, which open on its furface, do not aft ; as

in

ART.III.2.ii. SECERNENTIA. 699

in fome dropfies, and other difeafes attended with great thirft. This
drynefs, and Ihrivelled appearance, and roughnefs, are owing to the
mouths of the abforbents being empty of their accuftomed fiuid, and
is diflinguiihable from the drynefs of the £kin above mentioned in the
hot fits of fever, by its not being attended with heat.

As the heat of the (kin in the ufual temperature of the air always
evinces a,n increafed perfpiration, whether vifible or not, the heat
being produced along with the increafe of fecretion ; it follows, that
a defe6l of perfpiration can only exift, when the fkin is cold.

7, Volatile alcali is a very powerful diaphoretic, and particularly if
exhibited in wine-whey ; 20 drops of fpirit of hartfhorn every half
hour in half a pint of wine-whey, if the patient be kept in a mode-
rately warm bed, will in a few hours elicit moil: profufe fweats.

Neutral falts promote invifible perfpiration, when the fkin is not
warmed much externally, as is evinced from the great thirft, which
fucceeds a meal of fait provifions, as of red herrings. When thefe
are fufficiently diluted with water, and the ikin kept warm, copious
fweats without inflaming the habit, are the confequence. Half an
ounce of vinegar faturated with volatile alcali, taken every hour or
two hours, well anfwers this purpofe ; and is preferable perhaps in
general to all others, where fweating is advantageous. Boerhaave
mentions one cured of a fever by eating red- herrings or anchovies,
which, with repeated draughts of warm water or tea, would I fuppofe
produce copious perfpiration*

Antimonial preparations have alfo been of late much ufed with
great advantage as diaphoretics. For the hiftory and ufe of thefe pre-
parations I (hall refer the reader to the late writers on the Materia
Medica, only obferving that the flomach becomes fo foon habituated
to its ftimulus, that the fecond dofe may be confiderably increafed, if
the firfl had no operation,

4 U 2 Where

700 SECERNENTIA. Art.IIL 2. r.

Where it b advlfable to procure copious fweats, the emetics, as
ipecacuanha, joined with opiates, as in Dover's powder, produce this
efFe£t with greater certainty than the above.

8. We muft not difmifs this fubjeft without obferving, that per-
fpiration is defigned to keep the Ikin flexile, as the tears are intended
to clean and lubricate the eye ; and that neither of thefe fluids can be
confidered as excretions in their natural ftate, but as fecretions. Sec
Clafs I. I. 2. 3. And that therefore the principal ufe of diaphoretic
medicines is to warm the (kin, and thence in confequence to produce
the natural degree of infenfible perfpiration in languid habits,

9. When the (kin of the extrenalties is cold, which is always a (ign
of prefent debility, the digeftion becomes frequently impaired by af-
fociatlon, and cardialgia or heartburn is induced from the vinous or
acetous fermentation of the aliment. In this difeafe diaphoretics,
which have been called cordials, by their aftion on the flomach
reftore its exertion, and that of the cutaneous capillaries by their
affociation with it, and the (Kin becomes warm, and the digeftion

more vigorous.

10. But a blifter a£ls with more permanent and certain effe£l by
ftimulating a part of the (kin, and thence affefting the whole of it,
and of the ftomach by alTociation, and thence removes the moft ob-
flinate heartburns and vomitings. From this the principal ufe of blif-
ters is underftood, which is to invigorate the exertions of the arterial
and lymphatic vefTels of the (kin, producing an increafe of infenfible
perfpiration, and of cutaneous abforption ; and to increafe the zAion
of the (lomach, and the confequent power of digeftion; and thence
by fympathy to excite all the other irritative motions : hence they re-
lieve pains of the cold kind, which originate from defed of motion 1

not

Art.III. 2. 2. SECERNENTIA. 701

not from their introducing a greater pain, as fome have imagined, but
by ftimulating the torpid veflels into their ufual adlion ; and thence
increafing the aftion and consequent warmth of the whole Ikin, and
of all the parts which are affociated with it.

II. I. Sialagogues. The preparations of mercury confifl: of a fa-
lution or corrofion of that metal by fome acid ; and, when the dofe
is known, it is probable that they are all equally efficacious. As
their principal ufe is in the cure of the venereal difeafe, they will be
mentioned in the catalogue amongft the forbentia. Where falivatioa
is intended, it is much forwarded by a warm room and warm clothes ;
and prevented by expofing the patient to his ufual habits of cool air
and drefs, as the mercury is then more liable to go off by the bowels.

2. Any acrid drug, as pyrethrum, held in the mouth a£ls as a fia-
lagogue externally by ftimulating the excretory du6ts of the falivary
glands ; and the filiqua hirfuta applied externally to the parotid gland,
and even hard fubftances in the ear, are faid to have the fame effedL
Maftich chewed in the mouth emulges the falivary glands.

3. The unwife cuftom of chewing and fmoking tobacco for many
hours in a day not only injures the falivary glands, producing drynefs
in the mouth when this drug is not ufed, but I fufpe6l that it alfo
produces fchirrhus of the pancreas. The ufe of tobacco in. this immo-
derate degree injures the power of digeftion, by occafioning the pa-
tient to fpit out that faliva, which he ought to fwailow ; and hence
produces that flatulency, which the vulgar unfortunately take it to
prevent. The mucus, which is brought from the fauces by hawking,
Ihould be Ipit out, as well as that coughed up from the lungs ; but
that which comes fpontaneoufly into the mouth from the falivary

glands^

702 SECERNENTIA. Art. III. 2.3.

glands, fhould be fwallowed mixed with our food or alone for the
purpofes of digeftion. See Clafs I. 2. 2. 7.

III. I. Expe£torants are fuppofed to increafe the fecretion of mucus
in the branches of the windpipe, or to increafe the perfpiration of the
lungs fecreted at the terminations of the bronchial artery.

2. If any thing promotes expedloration toward the end of pe-
ripneumonies, when the inflammation is reduced by bleeding and
gentle cathartics, fmall repeated bliflers about the cheft, with tepid
aqueous and mucilaginous or oily liquids, are more advantageous than
the medicines generally enumerated under this head ; the blifters by
Simulating into adion the veffels of the (kin produce by affociation a
greater a£livity of thofe of the mucous membrane, which lines the
branches of the windpipe, and air-cells of the lungs ; and thus after
evacuation they promote the abforption of the mucus and confequent
healing of the inflamed membrane, while the diluting liquids prevent
this mucus from becoming too vifcid for this purpofe, or facilitate its
expuition.

Blifters, one at a time, on the fides or back, or on the fternum,
are alfo ufeful towards the end of peripneumonies, by preventing the
evening accefs of cold fit, and thence preventing the hot fit by their fti-
mulus on the fkin ; in the fame manner as five drops of laudanum by its
ftimulus on the ftomach. For the increafed anions of the vefTels of the
Ikin or ftomach excite a greater quantity of the fenforial power of affo-
ciation, and thus prevent the torpor of the other parts of the fyftem ;
which, when patients are debilitated, is fo liable to return in the evening.

3. Warm bathing Is of great fervice towards the end of peripneu-
mony to promote expe£loration, efpecially in thofe children who
drink too little aqueous fluids, as it gently increafes the adion of the

pulmonary

Art.III. 2.4- SECERNENTIA« 703

pulmonary capillaries by their confent with the cutaneous ones, and
fupplies the fyftem with aqueous fluid, and thus dilutes the fecreted
mucus.

Some have recommended oil externally around the cheft, as well as
internally, to promote expe£toration ; and upon the nofe, when its
mucous membrane is inflamed, as in commou catarrh.

IV. I. Diuretics. If the fkin be kept warm, mofl: of thefe medi-
cines promote fweat inftead of urine ; and if their dofe is enlarged, moft
of them become cathartic. Hence the neutral falts are ufed in general
for all thefe purpofes. Thofe indeed, which are compofed of the vege-
table acid, are moft generally ufed as fudorifics ; thofe with the nitrous
acid as diuretics ; and thofe with the vitriolic acid as cathartics : while
thofe united with the marine acid enter our common nutriment, as a
more general ftimulus. All thefe increafe the acrimony of the urine,
hence it is retained a lefs time in the bladder j and in confequence lefs
of it is reabforbed into the fyftem, and the apparent quantity is great--
er, as more is evacuated from the bladder ; but it is not certain from
thence, that a greater quantity is fecreted by the kidnies. Hence nitre,
and other neutral falts, are erroneoufly given in the gonorrhoea ; as
they augment the pain of making water by their ftimulus on the exco-
riated or inflamed urethra. They are alfo erroneoufly given in catarrhs
or coughs, where the difcharge is too thin and faline, as they increafe
the frequency of coughing.

2. Balfam of Copaiva is thought to promote urine more than the
other native balfams ; and common refin is faid to adt as a power-
ful diuretic in horfes. Thefe are alfo much recommended in gleets,
and in fluor albus, perhaps more than they deferve ; they give a
violet fmell to the urine, arid hence probably increafe the fecretioa

of it. ' , '

4 Calcined

;;o4 SECERNENTIA. Art. I. 2.5.

Calcined egg-fhells are faid to promote urine, perhaps from the
phofphoric acid they contain.

3. Cold air and cold water will increafe the quantity of urine by
decreafino- the abforption from the bladder ; and neutral and alcalious
falts and cantharides by ftimulating the neck of the bladder to dif-
charge the urine as foon as fecreted ; and alcohol as gin and rum at
the beo-inning of intoxication, if the body be kept cool, occafion much
urine by inverting the urinary lymphatics, and thence pouring a fluid
into the bladder, which never pafled the kidnies. But it is probable,
that thofe medicines, which give a fcent to the urine,^ as the balfams
and refins, but particularly afparagus and garlic, are the only drugs,
which truly increafe the fecretion of the kidnies. Alcohol however,
yfed as above mentioned, and perhaps great dofes of tindure of can-
tharides, may be confidered as draftic diuretics, as they pour a fluid
into the bladder by the retrograde adion of the lymphatics, which
are in great abundance fpread about the neck of it. See Sed.
XXIX. 3.

V. Mild cathartics. The ancients believed that fome purges eva-
cuated the bile, and hence were termed Cholagogues ; others the
lymph, and were termed Hydragogues ; and that in ftiort each ca-
thartic feleded a peculiar humour, which it difcharged. The mo-
derns have too haftily rejeded this fyftem ; the fubjedl well deferves
further obfervation.

Calomel given in the dofe from ten to twenty grains, fo as to in-
duce purging without the afliftance of other drugs, appears to me to
particularly increafe the fecretion of bile, and to evacuate itj aloe
feems to increafe the fecretion of the inteflinal mucus ; and it is
probable that the pancreas and fpleen may be peculiarly ftimulated
into adtion by fome other of this tribe of medicines ; whilft others of

them

Art. III. 2. 7. 8. SECERNENTIA. 705

them may fimply Simulate the inteffinal canal to evacuate its con-
tents, as the bile of animals. It mufl be remarked, that all thefe
cathartic medicines are fuppofed to be exhibited in their ufual dofes,
otherwife they become draflic purges, and are treated of in the Clafs
of Invertentia.

VI. The mucus of the bladder is feen in the urine, when cantha-
rides have been ufed, either internally or externally, in fuch dofes as
to induce the flrangury. Spirit of turpentine is faid to have the fame
efFe6l. I have given above a dram of it twice a day floating on a glafs
of water in chronic lumbago without this efFedl, and the patient gra-
dually recovered.

VII. Aloe given internally feems to adl chiefly on the re^lum and
fpindler ani, producing tenefmus and piles. Externally in clyfters or
fuppofitories, common fait feems to adt on that bowel with greater
certainty. But where the thread- worm or afcarides exift, 60 or 100
grains of aloes reduced to powder and boiled in a pint of gruel, and
ufed as a clyfler twice a week for three months, has frequently de-
ftroyed them.

VIII. The external application of cantharides by fllmulating the
excretory duds of the capillary glands produces a great fecretion of
fubcutaneous mucus with pain and inflammation ; which mucaginous
fluid, not being able to permeate the cuticle, raifes it up ; a fimilar
fecretion and elevation of the cuticle is produced by a6tual fire ; and
by cauftic materials, as by the application of the juice of the root of
white briony, or bruifed mufl:ard-feed. Experiments are wanting to
introduce fome acrid application into practice inflead of cantharides,
which might not induce the flrangury.

Vol. II. 4 X Muftard-

7o6 SECERNENTIA. Art. III. 2. 9. ro. if,

Muftard-feed alone is too acrid, and if it be fufFered to lie on the
fkin many minutes is liable to produce a flough and confequent ulcer,
and fliould therefore be mixed with flour when applied to cold extre-
mities. Volatile alkali properly diluted might ftimulate the Ikin with-
out inducing ftrangury. -

IX. The mild errhines are fuch as moderately ftimulate the mem-
brane of the noftrils, fo as to increafe the fecretion of nafal mucus j
as is feen in thofe, who are habituated to take fnufF. The ftronger
errhines are mentioned in Art. V. 2. 3.

X. The fecretion of tears is Increafed either by applying acrid fub-
ftances to the eye ; or acrid vapours, which ftimulate the excretory
du& of the lacrymal gland ; or by applying them to the iioftrils, and
ftimulating the excretory duel of the lacrymal fack, as treated of in
the Sedlion on Inftinil.

Or the fecretion of tears is increafed by the affociation of the mo-
tions of the excretory duft of the lacrymal fack with ideas of tender
pleafure, or of hopelefs diftrefs, as explained in Seft. XVI. 8. 2.
and 3.

XI. The fecretion of fenforial power in the brain is probably in-
creafed by opium or wine, becaufe when taken in certain quantity an
immediate increafe of ftrength and adivity fucceeds for a time, with
confequent debility if the quantity taken be fo great as to intoxicate
in the leaft degree. The neceflity of perpetual refpiration fliews,
that the oxygen of the atmofphere fupplies the fource of the fpirit of
animation ; which is conftantly expended, and is probably too fine
to be long contained in the nerves after its 'produdlion in the
brain. Whence it is probable, that the refpiration of oxygen

gas

Art.III. 3.2, SECERNENTIA. 707

gas mixed with common air may increafe the fecretloti of fenforial
power ; as indeed would appear from its exhilarating effe£t on mofl:
patients.

III. Catalogue of the Secernentia.

I. Diaphoretics.

1. Amomum zinziber, ginger. Caryophyllus aromaticus, cloves.

Piper Indicum, peppei. Capficum. Cardamomum. Pimento,
myrtus pimenta. Canella alba. Serpentaria virginiana,
' ariftolochia ferpentaria, guaiacum. Saffafras, laurus fafla-
fras. Opium. Wine.

2. Effential oils of cinnamon, lauruS cinnamomum. Nutmeg,

myriftica mofchata. Cloves, caryophyllus aromaticus.
Mint, mentha. Camphor, laurus camphora. Ether.

3. Volatile falts, as of ammoniac and of hartfhorn. Sal cornu

cervi.

4. Neutral falts, as thofe with vegetable acid ; or with marine

acid, as common fait. Halex. Red-herring, anchovy.

5. Preparations of antimony, as emetic tartar, antimonium tar-

tarizatum, wine of antimony. James's powder.

6. External applications. Blifters. Warm bath. Warm air.

Exercife. Friftion.

7. Cold water with fubfequent warmth.

il. Sialagogues. Preparations of mercury, hydrargyrus. Pyrethrum,
anthemis pyrethrum, tobacco, cloves, pepper, cowhage, fti-
zolobium filiqua hirfuta. Maftich, piftacia lentifcus.

4X2 , III. Expedorants.

y^Z SECERNENTIA. Art. III. 3. 5.

III. Expedorants;

1. Squill, fcilla maritima, garlic, leek, onion, alHum, afafoetlda,

ferula afafoetida, gum ammoniac, benzoin, tar, pix liquida,
balfam of Tolu.

2. Root of feneka, polygala feneka, of elicampane, inula he-

lenium.

3. Marfh-mallow, althsa, coltsfoot, tuffilago farfara, gum arable,

. mimofa nilotica, gum tragacanth, aftragalus tragacantha.
Decodion of barley, hordeum diftichon. Expreffed oils.
Spermaceti, foap. Extrad of liquorice, glycyrrhiza glabra.
Sugar. Honey.

4. Externally blifters. Oil. Warm bath.

IV. Mild diuretics.

1. Nitre, kali acetatum, other neutral falts.

2. Fixed alkali, foap, calcined egg-fliells.

3. Turpentine. Balfam of Copaiva. Refm. Olibanum,

4. Afparagus, garlic, wild daucus. Parfley, apium. Fennel

faeniculum, pareira brava, Ciflampelos ?

5. Externally cold air, cold water.

6. Alcohol. Tindlure of cantharides. Opium.

V. Mild cathartics.

1. Sweet fubacid fruits. Prunes, prunus domeftica. Caflia fif-

tula. Tamarinds, cryflals of tartar, unrefined fugar. Manna.
Honey.

2. Whey of milk, bile of animals.

3. Neutral falts, as Glauber's fait, vitriolated tartar, fea-water,

magnefia alba, foap.

4 4» Guna

Art.III. 3- ir. SECERNENTIA. 709

4. Gum gualacum; Balfam of Peru. Oleum ricini, caftor-oil,

oil of almonds, oil of olives, fulphur.

5. Senna, caffia fenna, jalap, aloe, rhubarb, rheum palmatum.

6. Calomel. Emetic tartar, antimonium tartarizatum.

VI. Secretion of mucus of the bladder is increafed by cantharides, by
fpirit of turpentine ?

VII. Secretion of mucus of the reftum is increafed by aloe internally,
by various clyfters and fuppofitories externally.

VIII. Secretion of fubcutaneous mucus is increafed by blifters of can-
tharides, by application of a thin flice of the frelh root of white
briony, by finapifms, by root of horfe-radifh, cochlearia armo-
racia. Volatile alcali.

IX. Mild errhines. Marjoram. Origanum. Marum, tobacco.

X. Secretion of tears is increafed by vapour of fliced onion, of vola-
tile alcali. By pity, or ideas of hopelefs diftrefs.

XI. Secretion of fenforial power in the brain is probably increafed by
opium, by wine, and perhaps by oxygen gas added to the com-
mon air in refpiration.

Art,

710 SORBENTIA. Art.1V. 1.4.

Art. IV.
SORBENTIA.

I. Those things which Increafe the irritative motions, which
conftitute abforption, are termed forbentia; and are as various as the
abforbent velTels, which they Simulate into a£tioa.

1. Cutaneous abforption is increafed by auftere acids, as of vitriol ;
hence they are beheved to check colUquative fweats, and to check
the eruption of fmall-pox, and contribute to the cure of the itch, and
tinea ; hence they thicken the faliva in the mouth, as lemon-juice,
crab-juice, floes.

2. Abforption from the mucous membrane is increafed by opium,
and Peruvian bark, internally ; and by blue vitriol externally. Hence
the expeftoration in coughs, and the mucous difcharge from the ure-
thra, are thickened and leflened.

3. Abforption from the cellular membrane is promoted by bitter
vegetables, and by emetics, and cathartics. Hence matter is thick-
ened and leflened in ulcers by opium and Peruvian bark ; and ferum
is abforbed in anafarca by the operation of emetics and cathartics.

4. Venous abforption is increafed by acrid vegetables ; as water-
crefs, cellery, horfe-radifh, muftard. Hence their ufe in fea-
fcurvy, the vibices of which are owing to a defeft of venous ab-
forption ; and by external ftimulants, as vinegar, and by eledricity,
and perhaps by oxygen.

5. Inteftinal

Art.IV.i.io. SORBENTIA. 711

5. Inteftinal abforption is increafcd by aftringent vegetables, as
rhubarb, galls ; and by earthy falts, as alum ; and by argillaceous and
calcareous earth.

6. Hepatic abforption is increafed by metallic falts, hence calo-
mel and fal martis are fo efficacious in jaundice, worms, chlorofis,
<lrop(y._

7. Venereal virus in ulcers is abforbed by the flimulus of mercury^
hence they heal by the ufe of this medicine.

8. Venefedion, hunger, third:, and violent evacuations, increafe
all abforptions ; hence fweating produces coflivenefs.

9. Externally bitter aftringent vegetables, earthy and metallic
falts, and bandages, promote the abforption of the parts on which
they are applied.

10. All thefe in their ufual dofes do not increafe the natural
heat ; but they induce coflivenefs, and deep coloured urine with
earthy fediment.

In greater dofes they invert the motions of the flomach and ladleals ;
and hence vomit or purge, as carduus benedidus, rhubarb. They
promote perfpiration, if the fkin be kept warm; as camomile tea,
and teflaceous powders, have been u^ed as fudorifics.

The preparations of antimony vomit, purge, or fweat, either ac-
cording to the quantity exhibited, or as a part of what is given is eva-
cuated. Thus a quarter of a grain of emetic tartar (if well prepared)
will promote a diaphorefis, if the ikin be kept warm ; half a grain
will procure a flool or two firft, and fweating afterwards; and a graia
will generally vomit, and then purge, and laftly fweat the patient.
In lefs quantity it is probable, that this medicine ads like other me-
tallic

712 SORBENTIA. Art. IV. 2.1.

tallic falts, as fteel, zinc, or copper in fmall dofes j that is, that it
ftrengthcns the fyftem by its flimulus. As camomile or rhubarb ia
different dofes vomit, or purge, or a£t as ftimulants fo as to flrengthen
the fyftem.

II. Observations on the Sorbentia.

I. I. As there is great difference in the apparent flrudure of the
various glands, and of the fluids which they feledl from the blood,
thefe glands muft poflefs different kinds of irritability, and are there-
fore ffimulated into ftronger or unnatural aftions by different articles
of the materia medica, as fhewn in the fecernentia. Now as the ab-
forbent veffels are likewife glands, and drink up or feledt different
fluids, as chyle, water, mucus, with a part of every different fecre-
tion, as a part of the bile, a part of the faliva, a part of the urine, &:c.
it appears, that thefe abforbent veffels muft likewife poffefs different
kinds of irritability, and in confequence mufl require different articles
of the materia medica to excite them into unufual adtion. This part
of the fubjeft has been fo little attended to, that the candid reader
will find in this article a great deal to excufe.

It was obferved, that fome of the fecernentia did in a lefs degree
increafe abforption, from the combination of different properties in
the fame vegetable body ; for the fame reafon fome of the clafs of for-
bentia produce fecretion in a lefs degree, as thofe bitters which have
alfo an aroma in their compofition ; thefe are known from their in-
creafing the heat of the fyflem above its ufual degree.

It muft alfo be noted, that the atSlions of every part of the abfor-
bent fyflem are fo affociated with each other, that the drugs which
Simulate one branch increafe the a6lion of the whole ; and the torpor
or quiefcence of one branch weakens the exertions of the whole ; or

when

Art. IV. 2. I. SORBENTIA. 713

when one branch is excited into ftronger ailion, fome other branch
has its adions weakened or inverted. Yet though peculiar branches
of the abforbent fyftem are ftimulated into adlion by peculiar fub-
ilances, there are other fubftances which feem to Simulate the whole
fyftem, and that without immediately increafing any of the fecretions ;
as thofe bitters which poflefs no aromatic fcent, at the head of which
ilands the famed Peruvian bark, or cinchona,

2. Cutaneous abforption. I have heard of fome experiments, in
which the body was kept cold, and was thought to abforb more moif-
ture from the atmofphere than at any other time. This however
cannot be determined by ftatical experiments ; as the capillary veffels^
which fecrete the perfpirable matter, muft at the fame time have been
benumbed by the cold ; and from their inaftion there could not have
been the ufual wafte of the weight of the body j and as all other muf-
cular exertions are befl performed, when the body pofTefles its ufual
degree of warmth, it is conclufive, that the abforbent fyftem fhould
likewife do its office beft, when it is not benumbed by external
cold.

The auftere acids, as of vitriol, lemon-juice, juice of crabs and
floes, ftrengthen digeftion, and prevent that propenfity to fweat fo
ufual to weak convalefcents, and diminifti the colliquative fweats in
heftic fevers ; all which are owing to their increafing the adlion of
the external and internal cutaneous abforption. Hence vitriolic acid
is given in the fmall-pox to prevent the too hafty or too copious erup-
tion, which it efFeds, by increafing the cutaneous abforption. Vi-
negar, from the quantity of alcohol which it contains, exerts a con-
trary efFe£l to that here defcribed, and belongs to the incitantia ; as
an ounce of it promotes fweat, and a flufhing of the Ikin ; at the fame
time externally it aits as a venous abforbent, as the lips become pale
by moiftening them with it. And it is faid, when taken internally in

Vol. II. 4 Y great

714 SORBENTIA. Art. IV. 2.1.

great and continued quantity, to induce palenefs of the fkin, and foft-
nefs of the bones.

The^fweet vegetable acids, as of feveral ripe fruits, are among the
torpentia ; as they are lefs ftimulating than the general food of this
climate, and are hence ufed in inflammatory difeafes.

Where the quantity of fluids in the fyftem is much leflened, as iii
heftic fever, which has been of fome continuance, or in fpurious pe-
ripneumony, a grain of opium given at night will fometimes prevent
the appearance of fweats ; which is owing to the flimulus of opium
increafing the adions of the cutaneous abforbents, more than thofe of
the feccrning veiTels of the fkin.' Whence the fecretion of perfpirable
matter is not decreafed, but its appearance on the ikin is prevented by
its more facile abforption.

3. There is one kind of itch, which feldom appears between the
fingers, is the leaft infeftious, and moft difficult to eradicate, and
which has its cure much facilitated by the internal ufe of acid of vi-
triol. This difeafe confifts of fmall ulcers in the fliin, which are
healed by whatever increafes the cutaneous abforption. The external
application of fulphur, mercury, and acrid vegetables, a6ls on the
fame principle ; for the animalcula, which are feen in thefe puf-
tules, are the effedV, not the caufe, of them ; as all other ftagnating
animal fluids, as the femen itfelf, abounds with fimilar microfcopic
animals.

4. Young children have fometimes an eruption upon the head
called Tinea, which difcharges an acrimonius ichor inflaming the
parts, on which it falls. This eruption I have feen fubmit to the
internal ufe of vitriolic acid, when only wheat-flour was apphed
externally. This kind of eruption is likewife. frequently cured
by teilaceous powders ; two materials fo widely different in their

4 • chemical

Art. IV. 2. a. SORBENTIA. yi^

chemical properties, but agreeing in their power of promoting cuta-
neous abforption.

II. Abforption from the mucous membrane is increafed by applying
to its furface the auftere acids, as of vitriol, lemon-juice, crab-juice,
floes. When thefe are taken into the mouth, they immediately
thicken, and at the fame time leffen the quantity of the faliva ; v.'hich
laft circumftance cannot be owing to their coagulating the faliva, but
to their increafing the abforption of the thinner parts of it. So alum
applied to the tip of the tongue does not flop in its adlion there, but.
independent of its diffufion it induces cohellon and corrugation over
the whole mouth. (CuUen's Mat. Med. Art. Aflringentia.) Which
is owing to the afTociation of the motions of the parts or branches of
the abforbent fyftem with each other.

Abforption from the mucous membrane is increafed by opium taken
internally in fmall dofes more than by any other medicine, as is feen
in its thickening the expeftoration in coughs, and the difcharge
from the noftrils in catarrh, and perhaps the difcharge from the
urethra in gonorrhoea. The bark feems next in power for all thefe
purpofes.

Externally flight folutions of blue vitriol, as two or three grains
to an ounce of water, applied to ulcers of the mouth, or to chancres
on the glans penis, more powerfully induces them to heal than any
other material.

Where the lungs or urethra are inflamed to a confiderable de-
gree, and the abforption is fa great, that the mucus is already
too thick, and adheres to the membrane from its vifcidity, opiates
and bitter vegetable and auftere acids are improper ; and mucila-
ginous diluents fhould be ufed in their ftead with venefedion and
torpentia.

4Y2 III. i.Ab-

7i6 SORBENTIA. Art. IV. 2,3,

III. I. Abforption from the cellular membrane, and from all the
other cavities of the body, is too (lowly performed in fome conftitu-
tions ; hence the bloated pale complexion ; and when this occurs in
its greateft degree, it becomes an univerfal dropfy. Thefe habits are
liable to intermittent fevers, hyfteric paroxyfms, cold extremities,
indigeftion, and all the fymptoms of debility.

The abforbent fyftem is more fubjedt to torpor or quiefcence than
the fecerning fyftem, both from the coldnefs of the fluids which are
applied to it, as the moifture of the atmofphere, and from the cold-
nefs of the fluids which we drink ; and alfo from its being ftimulated
only by intervals, as when we take our food ; whereas the fecerning
fyftem is perpetually excited into a£tion by the warm circulating bloodj
as explained in Seft. XXXIL

2. The Peruvian bark, camomile flowers, and other bitter drugs,
by ftimulating this cellular branch of the abforbent fyftem prevents it
from becoming quiefcent ; hence the cold paroxyfms of thofe agues,,
which arife from the torpor of the cellular lymphatics, are prevented,
and the hot fits in confequence. The patient thence preferves
his natural heat, regains his healthy colour, and his accuftomed
ftrength.

Where the cold paroxyfm of an ague originates in the abforbents
of the liver, fpleen, or other internal vifcus, the addition of fteel to
vegetable bitters, and efpecially after the ufe of one dofe of calomel,,
much advances the cure»

And where it originates in any part of the fecerning fyiliem, as is.
probably the cafe in fome kinds of agues, the addition of opium in
the dofe of a grain and half, given about an hour before the accefs of
the paroxyfm, or mixed with chalybeate and bitter medicines, enfures
the cure. Or the fame may be efFe6led by wine given inftead of opi<=-
v.m before the paroxyfm, fo as nearly to intoxicate*

Thefg'

Art.IV, 2.3. SORBENTIA. 717

Thefe three kinds of agues are thus diftinguiflied ; the firft is not
attended with any tumid or indurated vifcus, which the people call-
an ague cake, and which is evident to the touch. The fecond is ac-
companied with a tumid vifcus ; and the laft has generally, I believe,
the quartan type, and is attended with fome degree of arterial
debility.

3. This clafs of abforbent medicines arc faid to decreafe irritability.
After any part of our fyftem has been torpid or quiefcent, by what-
ever caufe that was produced, it becomes afterwards capable of being
excited into greater motion by fmall ftimuli ; hence the hot fit of
fever fucceeds the cold one. As thefe medicines prevent torpor or
quiefcence of parts of the fyftem, as cold hands or feet, which per-
petually happen to weak conftitutions, the fubfequent increafe of irri-
tability of thefe parts is likewife prevented.

4. Thefe abforbent medicines, including both the bitters, and me-
tallic falts, and opiates, are of great ufe in the dropfy by their pro-
moting univerfal abforption ; but here evacuations are likewife to be
produced, as will be treated of in the Invertentia.

5. The matter in ulcers is thickened, and thence rendered lefs
corrofive, the faline part of it being reabforbed by the ufe of bitter
medicines i hence the bark is ufed with advantage in the cure of
ulcers,

6. Bitter medicines ftrengthen digeftion by promoting the abforp-
tion of chyle ; hence the introduftion of hop into the potation ufed at
our meals, which as a medicine may be taken advantageoufly, but,
like other unneceffary ftimuli, muft be injurious as an article of our
daily diet.

The

7i8 SOREENTIA. Art. IV; 2. 3.

The hop may perhaps in fome degree contribute to the produ£tion
of gravel in the kidnies, as our intemperate wine-drinkers are more
fubjeft to the gout, and ale-drinkers to the gravel ; in the formation
of both which difeafes, there can be no doubt, but that the alcohol is
the principal, if not the only agent. /sq-'f r.r=ti;''':

7. Vomits greatly increafe the abforption from the cellular mem-
brane, as fquill, and foxglove. The fquill fhould be given in the
dofe of a grain of the dried rdot every hour, till it operates upwards
and downwards'. Four ounces of the frelh leaves of the foxglove
lliould be boiled from two pounds of water to one, and half an ouhce
of the decoilion taken every two hours for four or more dofes. This
medicine by ftimulating into inverted action the abforbents of the fto-
mach, increafes the dire£t a£lion of the cellular lymphatics.

Another more convenient way of afcertaining the dofe of foxglove
is by making a faturated tindure of it in proof fpirit ; which has the
twofold advantage of being invariable in its original ftrength, and of
keeping a long time as a Ihop-medicine without lofing any of its
virtue. Put two ounces of the leaves of purple foxglove, digitalis
purpurea, nicely dried, and coarfely powdered, into a mixture of
four ounces of redified fpirit of wine and four ounces of water ; let
the mixture ftand by the fire-fide twenty-four hours frequently
fhakino- the bottle, and thus making a faturated tindlure of digitalis ;
which muft be poured from the fediment or paffed through filtering

paper.

As the fize of a drop is greater or lefs according to the fize of the
rim of the phial from which it is dropped, a part of this faturated tinc-
ture is then dire£led to be put into a two-ounce phial, for the purpofe
of afcertaining the fize of the drop. Thirty drops of this tindlure is
direifled to be put into an ounce of mint- water for a draught to be
taken twice or thrice a day, till it reduces the anafarca of the limbs,

or

Art.1V. 2.3- SORBENTIA. ;i9

or removes the difficulty of breathing in hydrothorax, or till it in-
duces ficknefs. And if thefe do not occur in two or three days,
the dofe muft be gradually increafed to forty or flxty drops, or
further.

From the great ftlmulus of this medicine the flomach is rendered
torpid with confequent ficknefs, which continues many hours and
even days, owing to the great exhauftion of its fenforial power of ir-
ritation ; and the a£lion of the heart and arteries becomes feeble from
the deficient excitement of the fenforial power of affociation j and
laftly, the abforbents of the cellular membrane adl more violently in
confequence of the accumulation of the fenforial power of affociation
in the torpid heart and arteries, as explained in Suppl. I, 1 2.

A circumftance curioufly fimilar to this occurs to fome people on
fmoking tobacco for a fnort time, who have not been accuftomed to
it. A degree of ficknefs is prefently induced, and the pulfations of
the heart and arteries become feeble for a fliort time, as in the ap-
proach to fainting, owing to the direct fympathy between thefe and
the ftortiach, that is from" defed of the excitement of the power of
affociation. Then there fucceeds a tingling^, and heat, and fometimes
fweat, owing to the increafed adlion of the capillaries, or perfpirative
and mucous glands ; which is oeeafioned by the accumulation of the
fenforial power of affociation by the weaker adion of the heart and
arteries, which now increafes the adlion of the capillaries.

8. Another method of increafing abforption from the cellular
membrane is by v.'arm air, or by warm fleam. If the fvvelled legs
of a dropfical patient are inclofed in.a box, the air of which is made
warm by a lamp ox two, copious fweats are foon produced by the in-
creafed adion of the capillary glands, which are feen'to ftand on the
(kin, as it cannot readily exhale in fo fmall a quantity of air, which
is only changed {o faff as may be neceffary to permit the lamps to
burn. At the fame time the lymphatics of the cellular membrane are

ffimulated

720 SORBENTIA. . Art. IV. 2.4,

Simulated by the heat into greater a£lion, as appears by the fpeedy
redu£tion of the tumid leg-s.

It would be well worth trying an experiment upon a perfon labour-
ing under a general anafarca by putting him into a room filled with
air heated to 120 or 130 degrees, which would probably excite a
great general diaphorefis, and a general cellular abforption both from
the lungs and every other part. And that air of fo great heat may
be borne for many minutes without great inconvenience was fliewn
by the experiments made in heated rooms by Dr. Fordyce and others.
Philof. Tranf.

Another experiment of ufing warmth in anafarca, or in other dif-
eafes, might be by immerfing the patient in warm air, or in warm
fleam, received into an oil-fkin bag, or bathing-tub of tin, fo ma-
naged, that the current of warm air or fleam Ihould pafs round and
cover the whole of the body except the head, which might not be
expofed to it ; and thus the abforbents of the lungs might be induced
to a£l more powerfully by fympathy with the fkin, and not by the
flimulus of heat. See Ufes of Warm Bath, Clafs IV. 2. 2. i.

IV. I. Venous abforption. Cellary, water-crefTes, cabbages, and
many other vegetables of the Clafs Tetradynamia, do not increafe the
heat of the body (except thofe whofe acrimony approaches to cor-
rofion), and hence they feem alone, or principally, to ad: on the ve-
nous fyftem ; the extremities of which we have (hewn are abforbents
of the red blood, after it has pafled the capillaries and glands.

2. In the fea-fcurvy and petechial fever the veins do not perfeflly
perform this office of abforption ; and hence the vibices are occalioned
by blood flagnating at their extremities, or extravafated into the cel-
lular membrane. And this clafs of vegetables, flimulating the veins
to perform their natural abforption, without increafing the energy of

the

Art.IV.2.4. SORBENTIA. 721

the arterial adion, prevents future petechiae, and may aflift the ab-
forption of the blood already ftagnated, as foon as its chemical change
renders it proper for that operation.

3. The fluids, which are extravafated, and received into the cells
of the cellular membrane, feem to continue there for many days, fo
as to undergo fome chemical change, and are then taken up again by
the mouths of the cellular abforbents. But the new vefTels produced
in inflamed parts, as they communicate with the veins, are probably
abforbed again by the veins along with the blood which they contain
in their cavities. Hence the blood, which is extravafated in brulfes
or vibices, is gradually many days in difappearing ; but after due eva-
cuations the inflamed velTels on the white of the eye, if any ftimu-
lant lotion is applied, totally difappear in a few hours.

Amongft abforbents affe£ting the veins we fhould therefore add the
external application of ftimulant materials ; as of vinegar, which
makes the lips pale on touching them. Fridion, and eledlricity.

4. Haemorrhages arc of twd kinds, either arterial, which are at-
tended with inflammation ; or venous, from a deficiency in the ab-
forbent power of this fet of veffels. In the former cafe the torpentia
are eflficacious ; in the latter fteel, opium, alum, and all the tribe of
forbentia, are ufed with fuccefs.

5. Sydenham recommends vegetables of the clafs Tetradynamia in
rheumatic pains left after the cure of intermittents. Thefe pains are
perhaps fimilar to thofe of the fea-fcurvy, and feem to arife from
want of abforption in the affedted part, and hence are relieved by the
fame medicines.

Vol. II. A Z V. I. In-

722 SORBENTIA. Art.IV. 2. 5.

V. I. Inteftinal abforption. Some aftringent vegetables, as rhu-
barb, may be given in fuch dofes as to prove cathartic ; and, after a
part of it is evacuated from the body, the remaining part augments
the abforption of the inteftines ; and adls, as if a fimilar dofe had been
exhibited after the operation of any other purgative. Hence 4 grains
of rhubarb flrengthen the bowels, 30 grains firft empty them.

2. The earthy falts, as alum, increafe the inteftinal abforption, and
hence induce conftipation in their ufual dofe ; alum is faid fometimes to
cure intermittents, perhaps when their feat is in the inteftines, when
other remedies have failed. • It is ufeful in the diabaetes by exciting
the abforbents of the bladder into their natural adion ; and combined
with refin is efteemed in the fluor albus, and in gleets. Lime-ftone
or chalk, and probably gypfum, poflefs efFe£ls in fome degree fimilar,
and increafe the abforption of the inteftines ; and thus in certain dofes
reftrain fome diarrhoeas, but in greater dofes alum I luppofe will a£l
as a cathartic. Five or ten grains produce conftipation, 20 or 30
grains are either emetic or cathartic.

3. Earth of alum, tobacco-pipeclay, marl, Armenian bole, lime,
crab's eyes or claws, and calcined hartfhorn, or bone afties, reftrain
fluxes; either mechanically by fupplying fomething like mucilage, or
oil, or rollers to abate the friction of the aliment over inflamed mem-
branes; or byincreafing their abforption. The two laft confift of
calcareous earth united to phofphoric acid, and the Armenian bole
and marl may contain iron. By the confent between the inteftines
and the fkin 20 grains of Armenian bole given at going into bed to
heftic patients will frequently check their tendency to fweat as well
as to purge, and the more certainly if joined with one grain of
opium.

VI. i.Ab-

ART.iV. 2.6. SORBENTIA. ^ 723

VI. I. Abforptlon from thejiver, flomach, and other vifcera.
When inflammations of the liver are fubdued to a certain degree by
venefeftion, with calomel and other gentle purges, fo that the arte-
rial energy becomes weakened, four or eight grains of iron-filings, or
of fait of ftcel, with the Peruvian bark, have wonderful effe6l in
curing the cough, and reftoring the liver to its ufual fize and fanity ;
which it feems to effedl by increafing the abforption of this vifcus.
The fame I fuppofe happens in refpeft to the tumours of other vif-
cera, as of the fpleen, or pancreas, Ibme of which are frequently en-
larged in agues.

2. Haemorrhages from the nofe, re6lum, kidnies, uterus, and
other parts, are fi'equently attendant on difeafed livers ; the blood
being impeded in the vena portarum from the decreafed power of ab-
forption, and in confequence of the increafed fize ,of this vifcus.
Thefe haemorrhages after venqfe£lion, and a mercurial cathartic, are
rnoft certainly reflrained by fleel alone, or joined with an opiate ;
which increaie the abforption, and diminifh the fize.of the liver.

Chalybeates may alfo reflrain thefe haemorrhages by their promoting
venous abforption, though they exert their principal efFe£l upon the
liver. Hence alfo opiates, and bitters, and vitriolic acid, are advan-
tageoufly ufed along with them. It muft be added that fome hemor-
rhages recur by periods like the paroxyfms of intermittent fevers, and
are thence cured by the fame treatment.

3. The jaundice is frequently caufed by the inlipidity of the bile,
which does not ftimulate the gall-bladder and bile-du£ls into their due
adlion ; hence it Magnates in the gall-bladder, and produces a kind of
cryflallization, which is too large to pafs into the inteftines, blocks
up the bile-du6l, and occalions a long and painful difeafe. A para-
lylis of the bile-du6l produces a fimllar jaundice, but without pain.

4 Z 2 "4. Worms

7-24 SORBENTIA. Art. IV. 2.6.

4. Worms in fheep called flukes are owing to the dilute flate of
the bile ; hence they originate in the inteflines, and thence migrate
into the biliary dudls, and corroding the liver produce ulcers, cough,
and hedic fever, called the rot. In human bodies it is probable the
inert ftate of the bile is one caufe of the production of worms ; which
inlipid ftate of the bile is owing to deficient abforption of the thinner
parts of it ; hence the pale and bloated complexion, and fwelled up-
per lip, of wormy children, is owing to the concomitant deficiency of
abforption from the cellular membrane. Salt of fteel, or the ruft of
it, or filings of it, with bitters, increafe the acrimony of the bile by
promoting the abforption of its aqueous part ; and hence deftroy
worms, as wall as by their immediate adlion on the inteftines, or on
the worms themfelves. The cure is facilitated by premifing a purge
with calomel. See Clafs I. 2. 3. 9.

5. The chlorofis is another difeafe owing to the deficient adion of
the abforbents of the liver, and perhaps in fome degree alfo to that
of the fecretory veffels, or glands, which compofe that vifcus. Of
this the want of the catameniae, which is generally fuppofed to be a
caufe, is only a fymptom or confequence. In this complaint the bile
is deficient perhaps in quantity, but certainly in acrimony, the thin-
ner parts not being abforbed from it. Now as the bile is probably of
great confequence in the procefs of making the blood ; it is on this
account that the blood is fo deftitute of red globules ; which is
evinced by the great palenefs of thefe patients. As this ferous
blood muft exert lefs ftimulus on the heart, and arteries, the pulfe
in confequence becomes quick as well as weak, as explained in Sedt.

■Xll.1.4.

The quicknefs of the pulfe is frequently fo great and permanent,
that when attended by an accidental cough, the difeafe may be mif-
taken for he£lic fever ; but is cured by chalybeates, and bitters ex-
hibited twice a day ; with half a grain of opium, and a grain of aloe
8 every

Art.IV. 2. 6. SORBENTIA. 725

every night ; and the expefted catamenia appears In confequence of a
reftoration of the due quantity of red blood. This and the two
former articles approach to the difeafe termed paralyfis of the liver.
Seft. XXX. 4.

6. It feems paradoxical, that the fame treatment with chalybeates,
bitters, and opiates, which produces menftruation in chlorotic pa-
tients, fliould reprefsthe too great or permanent menftruation, which
occurs in weak conftitutions at the time of life when it (hould ceafe.
This complaint is an haemorrhage owing to the debility of the ab-
forbent power of the veins, and belongs to the paragraph on venous
abforption above defcribed, and is thence curable by chalybeates,. alum,
bitters, and particularly by the exhibition of a grain of opium every
night with five grains of rhubarb.

7. Metallic falts fupply us with very powerful remedies for pro-
moting abforption in dropfical cafes j which, frequently are caufed by
enlargement of the liver. Firft, as they may be given in fuch quan-
tities as to prove ftrongly cathartic, of which more will be faid in the
article on inverteritia ; and then, when their purgative quality ceafes,
like the efFeft of rhubarb, their abforbent quality continues to aft. •
The falts of mercury, filver, ' copper, iron,, zinc, antimony, have all
been ufed in the dropfy ; either fingly for the former purpofe, or
united with bitters for the latter, and occafionally with moderate but
repeated opiates.

8. From a quarter of a grain to half a grain of blue vitriol given
every four or fix hours, is faid to be very efficacious in obftinate interr
mittents ; which alfo frequently arife from an enlarged vifcus, as the
liver or fpleen, and are thence owing to the deficient abforption of the
lymphatics of that vifcus. A quarter of a grain of white arfenic, as
I was informed by a furgeon of the army, cures a quartan ague with

great

726 SORBENTIA. Art.1V. 2. 6.

great certainty, if it be given an hour before the expelled fit. This
dofe he faid was for a robuft man, perhaps one eighth of a grain
might be given and repeated with greater fafety and equal efficacy.

Dr. Fowler has given many fuccefsful cafes in his treatife on this
fubjeft. He prepares it by boiling fixty-four grains of white arfenic
in a Florence flalk along with as much pure vegetable fixed alcali in
a pint of diftilled water, till it is diiFolved, and then adding to it as
much diftlUed water as will make the whole exactly fixteen ounces.
Hence there are four grains of arfenic in every ounce of the folution.
This fhould be put into a phial of fuch a lize of the edge of its aper-
ture, that fixty drops, may weigh one dram, which will contain half
a grain of arfenic. To children from two years old to four he gives
from two to five drops three or four times a day. From five years
old to feven, he diredts feven or eight drops. From eight years old
to twelve, he direfts from feven to ten drops. From thirteen years
old to eighteen he direfts from ten to twelve drops. From eighteen
upwards, twelve drops. In fo powerful a medicine it is always
prudent to begin with fmaller dofes, and gradually to increafe
them.

A faturated folution of arfenic in water is preferable I think to the
above operofe preparation of it ; as no error can happen in weighing
the ingredients, and it more certainly therefore pofi'efles an uniform
flrength. Put much more white arfenic reduced to powder into a
given quantity of diftilled water, than can be difTolved in it. Boil it
for half an hour in a Florence flafk, or in a tin fauce-pan ; let it
ftand to fubfide, and tiiter it through paper. My friend Mr. Greene,
a lurgeon at Brewood in StafFordfhire, affured me, that he had cured
in one feafon agues without number with this faturated folution ; that
he found ten drops from a two-ounce phial given thrice a day was
a full dofe for a grown perfon, but that he generally began with
five.

9. The

Art.IV. 2. 6. SORBENTIA. 727

9. The manner, in which arfenic a6ls in curing intermittent
fevers, cannot be by its general flimulus, becaufe no intoxication or
heat follows the ufe of it ; nor by its peculiar fbimulus on any part
of the fecreting fyftem, fince it is not in fmall dofes fucceeded by any
increafed evacuation, or heat, and mufl: therefore exert its power,
like other articles of the forbentia, on the abforbent fyftem. In what
manner it deftroys life fo fuddenly is difficult to underftand, as it does
not intoxicate like many vegetable poifons, nor produce fevers like
contagious matter. When applied externally it feems chemically to
deflroy the part like other cauftics. Does it chemically deflroy the
ftomach, and life in confequence ? or does it deftroy the adlion of
the ftomach by its great ftimulus, and life in confequence of the
fympathy between the ftomach and the heart ? This laft appears to be
the moft probable mode of its operation.

The fuccefs of arfenic in the cure of intermittent fevers I fufpedt
to depend on its ftimulating the ftomach into ftronger adlion, and
thus, by the aflbciation of this vifcus with the heart and arteries, pre-
venting the torpor of any part of the fanguiferous fyftem. I was led
to this conclufion from the following conliderations.

Firft. The ciFeds of arfenic given a long time internally in fmall
dofes, or when ufed in larger quantities externally, feem to be fimilar
to thofe of other great ftimuli, as of wine or alcohol. Thefe are a
bloated countenance, fwelled legs, hepatic tumours, and dropfy, and
fometimes eruptions on the fkin. The former of thefe I have feen
where arfenic has beeri ufed externally for curing the itch ; and the
latter appears on evidence in the famous trial of Mifs Blandy at Chelmf-
ford, about forty years ago.

Secondly. I faw an ague cured by arfenic in a child, who had in
vain previoufly taken a very large quantity of bark with great reo-u-
larity. And another cafe of a young officer, who had lived intem-
perately, and laboured under an intermittent fever, and had taken the
bark repeatedly in confiderable quantities, with a grain of opium at

night.

728 SORBENTIA. Art. IV. 2.6.

night, and though the paroxyfms had been thrice thus for a time
prevented, they recurred in about a week. On taking five drops of a
Saturated folution of arfenic thrice a day the paroxyfms ceafed, and re-
turned no more, and at the fame time his appetite became much im-
proved.

Thirdly. A gentleman about 65 years of age had for about ten
years been fubje£l to an intermittent pulfe, and to frequent palpita-
tions of his heart. Lately the palpitations feemed to obferve irregular
periods, but the intermiffion of every third or fourth pulfation was
almofl perpetual. On giving him four drops of a faturated folution of
arfenic from a two-ounce phial about every four hours for one day,
not only the palpitation did not return, but the intermiflion ceafed
entirely, and did not return fo long as he took the medicine, which
was three or four days.

Now as when the ftomach has its a£tion much weakened by an
over-dofe of digitalis, the pulfe is liable to intermit, this evinces a
dire£l fympathy between thefe parts of the fyftem, and as I have re-
peatedly obferved, that when the pulfe begins to intermit in elderly
people, that an eruiSlation from the ftomach, voluntarily produced,
will prevent the threatened ftop of the heart ; I am induced to think,
that the torpid ftate of the flomach, at the inftant of the production
of air occalioned by its weak a£tion, caufed the intermiffion of the
pulfe. And that arfenic in this cafe, as well as in the cafes of agues
above mentioned, produced its efFe£ls by ftimulating the flomach into
more powerful a6lion ; and that the equality of the motions of the
heart was thus reftored by increafing the excitement of the fenforial
power of affociation. See Sedl. XXV. 17. Clafs IV. 2. i. 18.

10. Where arfenic has been given as a poifon, it may be difcovered
in the contents of the ftom.ach by the fmell like garlic, when a few
grains of it are thrown on a red-hot iron. 2. If a few grains are
placed between two plates of copper, and fubjeded to a red heat,.

the

Art.IV. 2. 7- SORBENTIA. 729

the copper becomes whitened. 3. Diffolve arfenic in water along
with vegetable alcali, add to this a folution of blue vitriol in water,
and the nnixture becomes of a fine green, which gradually precipitates,
as difcovered by Bergman. 4. Where the quantity is fufficient,
fome wheat may be fteeped in a folution of it, which given to fpar-
rows or chickens will deftroy them.

VII. Abforption of the matter from venereal ulcers. No ulcer can
heal, unlefs the abforption from It is as great as the depofition in it.
The preparations or oxydes of mercury in the cure of the venereal
difeafe feem to a£t by their increafing the abforption of the matter in the
ulcers it occafions ; and that whether they are taken into the ftomach,
or applied on the {kin, or on the furface of the ulcers. And this in
the fame manner as fu gar of lead, or other metallic oxydes, promote
fo rapidly the healing of other ulcers by their external application ;
and probably when taken internally, as ruft of iron given to children.
afFefted with fcrophulous ulcers contributes to, heal them, and folu-
tions of lead were once famous in phthifis.

The matter depofited in large abfcefles does not occafion hedlic fe-
ver, till it has become oxygenated by being expofed to the open air,
or to the air through a moift membrane ; the fame feems to happen
to other kinds of matter, which produce fever, or which occafion
fpreading ulcers, and are thence termed contagious. See Clafs II.
1.3. II. I. 5. II. I. 6. 6. This may perhaps occur from thefe mat-
ters not being generally abforbed, till they become oxygenated ; and
that it is the ftimulus of the acid thus formed by their union with
oxygen, which occafions their abforption into the circulation, and
the fever, which they then produce. For though colleclions of mat-
ter, and milk, and mucus, are fometimes fuddenly abforbed during
the action of emetics or in fea-ficknefs, they are probably eliminated
from, the body v/ithout entering the circulation ; that is, they are

Vol. II. 5 A taken

730 SORBENTIA. Art.IV.2. 7.

taken up by the increafed a6lion of one lymphatic branch, and eva-
cuated by the inverted a£lion of feme other lymphatic branch, and
thus carried off by ftool or urine.

But as the matter in large abfceffes is in general not abforbed, till
it becomes by fome means expofed to air, there is reafon to conclude,
that the ftimulus of this new combination of the matter with oxygen
occafions its abforptioti ; and that hence the abforption of matter in
ulcers of all kinds, is ftill more powerfully effeded by the external
application or internal ufe of metallic oxydes ; which are alfo acids
confifting of the metal united with oxygen ; and laftly, becaufe ve-
nereal ulcers, and thofe of itch, and tinea, will not heal without
fome. flimulant application ; that is, the fecretion of matter in them
continues to be greater, than the abforption of it ; and the ulcers at
the fame time continue to enlarge, by the contagion affefting the
edges of them ; that is, by the ftimulus of the oxygenated matter
Simulating the capillary veffels in its vicinity into adlions iimilar to
thofe of the ulcer, which produces it.

This eSh&. of the oxydes of mercury occurs, whether falivation at-
tends its ufe or not. Salivation is much forwarded by external
M'armth, when mercury is given to promote this fecretion j but as
the cure of venereal complaints depends on its abforbent quality, the
^£1 of falivation is not neceflary or ufefuL A quarter of a grain of
good corrofive fublimate twice a day will feldom fail of curing the
moft confirmed pox ; and will as feldom falivate, if the patient be
kept cool. A quarter of a grain thrice a day- 1 believe to be infallible,
if it be g;ood fublimate.

Mercury alone when fwallowed does not afl beyond the inteftines,
its aftive preparations are the falts formed by its union with the va-
rious acids, as mentioned in the catalogue. Its union with the ve-
getable acid, when triturated with manna, is faid to compofe Keyfer's
Pill. Triturated with gum arable it is much recommended by Plenk;
and triturated with fugar and a little effential oil, as direded in a
6 ' former

Art. IV. 2. 8. SORBENTIA. 7|i

former Edinburgh Difpenfatory, it probably forms fome of the fyrups
fold as noftrums.

United with fulphur it feldom enters the circulation, as when cin^
nabar, or ^thiop's mineral, are taken inwardly. But united with
fat and rubbed on the flcin, it is readily abforbed, I know not whe-
ther it can be united to charcoal, nor whether it has been given in-
ternally when united with animal fat.

VIII. I. Abforptions in general are increafed by inanition; hence
the ufe of evacuations in the cure of ulcers. Dr. Jurin abforbed in
one night, after a day's abftinence and exercife, eighteen ounces from
the atmofphere in his chamber ; and every one muft have obferved,
how foon his Iheets became dry, after having been moiftened by
fweat, if he throws off part of the bed-clothes to cool himfelf ; which
is owing to the increafed cutaneous abforption after the evacuation by
previous fweat.

2. Now as opium is an univerfal ftimulant, as explained in the
article on Incitantia, it muft ftimulate into increafed aftion both the
fecretory fyftem, and the abforbent onej but after repeated evacua-
tion by venefeflion, and cathartics, the abforbent fyftem is already
inclined to a<fl more powerfully j as the blood- veftels being lefs dif-
tended, there is lefs refiftance to the progrefs of the abforbed fluids
into them. Hence after evacuations opium promotes abforption, if
given in fmall defes, much more than it promotes fecretion ; and is
thus eminently of fervice at the end of inflammations, as in pleurify,
or peripneumony, in the dofe of four or five drops of the tinfture,
given before the accefs of the evening paroxyfm ; which I have feen
fucceed even when the rifus fardonicus has exifted. Some convul-
sions may originate in the want of the abforptioti of fome acrid

j; A 2 ^ fecretion,

732 SORBENTIA. Art. IV. 2.9.

fecretion, which occafions pain ; henee thefe difeafes are fo .much
more certainly relieved by opiuin after venefe6lion or other eva-
cuations.

IX. I. Abforption is increafed by the calces or folutions of mer-
cury, lead, zinc, copper, iron, externally applied; and by arfenic,
and by fulphur, and by the application of bitter vegetables in fine
powder. Thus an ointment confiding of mercury and hog's fat rub-
bed on the fkin cures venereal ulcers ; and many kinds of herpetic
eruptions are removed by an ointment confifling of 60 grains of white
precipitate of mercury and an ounce of hog's fat.

2. The tumours about the necks of young people are often pro-
duced by the abforption of a faline or acrid material, which has been
depofited from eruptions behind the ears, owing to deficient abforp-
tion in the furface of the ulcer, but which on running down on the
ikin below becomes abforbed, and fwells the lymphatic glands of the
neck ; as the variolous matter, when inferted into the arm, fwells
the gland of the axilla. Sometimes the perfpirative matter produced
behind the ears becomes putrid from the want of daily waftiing them,
and may alfo caufe by its abforption the tumours of the lymphatics of
the neck. In the former cafe the application of a cerate of lapis ca-
laminaris, or of cerufla applied in dry powder, or of rags dipped in a
folution of fugar of lead, increafes the abforption in the ulcers, and
prevents the efFufion of the faline part of the fecreted material. The
latter is to be prevented by cleanlinefs.

After the eruptions or ulcers are healed a folution of corrofive fubli-
mate of one grain to an ounce of water applied for fome weeks behind
the ear, and amongfi: the roots of the hair on one fide of the head,
where the mouths of the lymphatics of the neck open themfeives,
frequently removes thefe tunaours.

3. Linea

Art.IV. 2. 10. SORBENTIA. 733

3. Linen rags moiftened with a folution of half an ounce of fugar
of lead to a pint of water applied on the erylipelas on anafarcous legs,
which have a tendency to mortification, is more efficacious than
other applications. White vitriol fix grains diflblved in one ounce of
rofe-water removes inflammations of the eyes after evacuation more
certainly than folutions of lead. Blue vitriol two or three grains dif-
folved in an ounce of water .cures ulcers in the mouth, and other
mucous membranes, and a folution of arfenic externally applied cures
the itch, but requires great caution in the ufe of it. See Clafs II.
I. 5. 6.

4. Bitter vegetables, as the Peruvian bark, quilted between two
ihirts, or flrewed in their beds, will cure the ague in children fome-
times. Iron in folution, and fome bitter extract, as in the form of
ink, will cure one kind of herpes called the ringworm. And I have
feen kven parts of bark in fine powder mixed with one part of cerufs,
or white lead, in fine powder, applied dry to fcrophulous ulcers, and
renewed daily, with great advantage.

5. To thefe fhould be added eledric fparks and fliocks, which
promote the abforption of the veflels in inflamed eyes of fcrophulous
children ; and difperfe, or bring to fuppuration, fcrophulous tumours
about the neck. For this laft purpofe fmart fhocks fhould be paffed
through the tumours only, by inclofing them between two brafs knobs
communicating with the external and internal coating of a charged
phial. See Art. II. 2. 2. 2.

X. I. Bandages increafe abforption, if they are made to fit nicely
on the part ; for which purpofe it is necefTary to fpread fome mode-
rately adhefive plafter on the bandage, and to cut it into tails, or into
fhreds two inches wide ;,the ends are to be wrapped over each other;
and it muft be applied when the part is leaft tumid, as in the morn-
.8 ing

734

SORBENTIA. Art.IV. 2. ii.

ing before the patient rifes, if on the lower extremities. The em-
plaflrum de rninio made to cover the whole of a fwelled leg in this
manner, whether the fwelling is hard, which is ufually termed fcor
butic ; or more eafily com prefix ble, as in anafarca, reduces the limb
in two or three days to its natural fize ; for this purpofe I have fome-
times ufed carpenter's glue, mixed with one twentieth part of honey
to prevent its becoming too hard, inftead of a refinous plafler ; but
the minium plafter o{^ the (hops is in general to be preferred. No-
thing fo much facilitates the cure of ulcers in the legs, as covering
the whole limb from the toes to the knee with fuch a plafter-
.bandage ; which increafes the power of abforption in the furface of
the fore.

2. The lymph is carried along the abforbent veflels, which are
.replete with valves, by the intermitted preffure of the arteries in their
neighbourhood. Now if the external fkin of the limb be lax, it rifes,
and gives way to the preffure of the arteries at every pulfation ; and
thence the lymphatic veffels are fubjeft to the preffure of but half the
arterial force. But when the external fkin is tightened by the fur-
Tounding bandage, and thence is not elevated by the arterial diaftole,
the whole of this power is exerted in compreffing the lymphatic vef-
fels,. and carrying on the lymph already abforbed ; and thence the ab-
forbent power is fo amazingly increafed by bandage nicely applied.
Pains are fometimes left in the flefhy parts of the thighs or arms,
after the inflammation is gone, in the acute rheumatifm, or after the
patient is too vi'eak for further evacuation ; in this cafe after internal
abforbent medicines, as the bark, and opiates, have been ufed in vain,
I have fuccefsfuUy applied a plafler- bandage, as above defcribed, fo as
to comprefs the pained part.

XI. I. We fhall conclude by obferving, that the forbentia
^[trengthen the whole habit by preventing the efcape of the fluid part

of

Art.IV.2.11. SORBENTIA. 735

of the fecretions out of the body, before it has given up as much
nourifhment, as it is capable ; as the hquid part of the fecretion of
urine, fweat, faUva, and of all other fecretions, which are poured
into receptacles. Hence they have been faid to brace the body, and
been called tonics, which are mechanical terms not applicable to the
living bodies of animals i as explained in Seft. XXXII. 3. 2.

2. A continued ufe of bitter medicines for years together, as of
Portland's powder, or of the bark, is fuppofed to induce apoplexy, or
other fatal difeafes. Two cafes of this kind have fallen under my
obfervation ; the patients were both rather, intemperate in refpe£bto-
the ufe of fermented liquors, and one of them had. been previoufly
fubjefl to the gout. As I believe the gout generally .originates from,
a torpor of the liver, which inftead of being fucceeded by an inflamr
mation of it, is fucceeded by an inflammation of fome of the joints;,
or by a pimpled face, which is another mode, by which the. difeafe of
the liver is terminated. I conceive, that the daily ufe of bitter me-
dicine had in thefe patients prevented the removal of a gouty inflam--
mation from the liver to the membranes of the joints of the extremii^
ties, or to the fkin of the face, by preventing the neceffary torpor of
thefe parts previous to the inflammation of them ; in the fame man-
ner as cold fits of fever are prevented by the fame medicines ; and,,
as I believe, the returns of the gout have fometimes for two or three,
years been prevented by. them.

One of thefe patients died of the apoplexy in a few hours;; and-
the other of an inflammation of the liver, which I believe was called'
the gout, and in confequence was not treated by venefe£lion, and',
other evacuations. From hence it appears, that the daily ufe of hop
in our malt liquor muft add to the noxious quality of the fpirit in it,
when taken to excefs, and contribute to the produ6lion of apoplexy-g.,
or.inflamm^ation.of the liver..

IIL Catalogue..

736 SORBENTIA. Art. IV. 3. 1—4.

III. Catalogue OF the Sorbentia.

I. Sorbentia affeding the fkin.

1. Acid of vitriol, of fea-falt, lemons, floes, prunus fpinofa,
crabs, pyrus, quince, pyrus cydonia, opium.

2. Externally calx of zinc, of lead, of mercury.

II, Sorbentia aiFe£ling the mucous membranes.

1. Juice of floes, crabs, Peruvian bark, cinchona, opium.

2. Externally blue vitriol.

III. Sorbentia affefling the cellular membrane.

1. Peruvian bark, wormwoods, artemifla maritima, artemifia
abfynthium, worm-feed, artemifia fantonicum, chamomile,
anthemis nobilis, tanfey tanacetum, bogbean, menyanthes
trifoliata, centaury, gentiana centaurium, gentian, gentiana
lutea, artichoke-leaves, cynara fcolymus, hop, humulus
lupulus.

2. Orange-peel, cinnamon, nutmeg, mace.

3. Vomits, fquill, digitalis, tobacco.

4. Bath of warm air, of fteam.

rV. Sorbentia afFefting the veins.

I, Water-crefs, fifymbrium nafturtium aquaticum, muftard,
finapis, fcurvy-grafs cochlearia hortenfis, horfe~radi(h
cochlearia armoracia, cuckoo-flower, cardamine, dog's-grafs,
dandelion, leontodon taraxacon, cellery apium, cabbage
bralfica.

2. Chalybeates,

Art. IV. 3. 5— 7- SORBENTIA. 737

2. Chalybeates, bitters, and opium, after fufficlent evacuation.
5. Externally vinegar, fridion, eledlricity.

V. Sorbentia affeding the inteftines.

1. Rhubarb, rheum palmatum, oak-galls, gallse quercinae,

tormentil, tormentilla erecla, cinquefoil potentilla, red-
rofes, uva urfi, fimarouba.

2. Logwood, haematoxylum campechianum, fuccus acacia,

dragon's blood, terra japonica, mimofa catechu.

3. Alum, earth of alum, Armenian bole, chalk, creta, crab's
claws, chel-ce cancrorum, white clay, cimolia, calcined
hartfliorn, cornu cervi calcinatum, bone-a{Hei,

VI. Sorbentia afFeding the liver, ftomach, and other vlfcera. Ruft
of iron, filings of iron, fait of fteel, fal martis, blue vitriol,
white vitriol, calomel, emetic tartar, fugar of lead, white

arfenic.

VII. Sorbentia affeding venereal ulcers. Mercury diffolved or cor-
roded by the following acids :

1. Diffolved in vitriolic acid, called turpeth mineral, or hy-

drargyrus vitriolatus.

2. Diffolved in nitrous acid, called hydrargyrus nitratus ruber.

3. Diffolved in muriatic acid, mercurius corrofivus fublimatus,
or hydrargyrus muriatus.

4. Corroded by muriatic acid. Calomel,

5. Precipitated from muriatic acid, mercurius precipitatus albus,

calx hydrargyri alba.

6. Corroded by carbonic acid ? The black powder on crude
mercury.

7. Calcined, or united with oxygen.

Vol. II. 5 B . 8, United

738 SORBENTIA. Art. IV. 3. 8— ii.

8. United with animal fat, mercurial ointment.

9. United with fulphur. Cinnabar.

10. -Partially united with fulphur. i^^thiops mineral.

I r. Divided by calcareous earth. Hydrargyrus cum creta.

12. Divided by vegetable mucilage, by fugar, by balfams.

yill. Sorbentia afFe£ling the whole fyftem.. Evacuations by venefec-
tion and catharfis, and then by the exhibition of opium.

IX. Sorbentia externally- applied. ,

Ii Solutions of mercury^ lead, zinc, copper, iron, arfenic; or
metallic calces applied in dry powder, as cerulTa, lapis cala-
minaris.

2. Bitter vegetables in decoctions and in dry powders, applied
externally, as Peruvian bark, oak bark, leaves of worm-
wood, of tanfey, camomile flowers or leaves.

3. _Ele£tric fparks, or fhocks.

X. Bandage fpread with emplaftrum ,e minio, or with carpenter's
glue mixed with one twentieth part of honey.

XI. Portland's powder its continued ufe pernicious, and of hops in
beer.

Art.

Ar-t. V. I. I N V E R T E N T I A. 739

A ^ T. V.
INVERTENTIA.

, I. IjHosE THINGS, which iuvert the natural ovder of the fucceffive
irritative motipnsij^ u&to-nnQd ij^^Vfrtentia.

I. Emetics invert the motions of the ftomach, duodenum, and
oeipphagus. •

'2. Violent cathartics invert the motions of the la£leals, and intcfti-
nal lymphatics.

3. Violent errhines invert the nafal lymphatics, and thofe of the
frontal and maxillary fmufes. And medicines producing naufea, in-
vert the motions of the lymphatics about the fauces.

4. Medicines producing much pale urine, as a certain quantity of
alcohol, invert the motions of the urinary abforbents ; if the dofe of
alcohol is greater, it inverts the flomach, producing the drunken fick-
nefs.

5. Medicines producing cold fweats, palpitation of the heart, globus
hyftericus ; as violent evacuations, fome poifons, fear, anxiety, adt
by inverting the natural order of the vafcular motions.

5 B 2 II. Obser-

740 INVERTENTIA. Art. V. 2. i.

II. Observations on the Invertentia.

1. I. The afllon of vomiting feems originally to have been occa-
fioned by dlfagreeable fenfation from the diftention or acrimony of the
aliment ; in the fame manner as when any difguftful material is taken
into the mouth, as a bitter drug, and is rejefted by the retrograde
motions of the tongue and lips ; as explained in Clafs IV. i.i. 2. and
mentioned in Se61:. XXXV. 1.3. Or the difagreeable fenfation may
thus excite the power of volition, which may alfo contribute to the
retrograde adtions of the ftomach and oefophagus, as when cows bring
up the contents of their firift ftomach to re-maflicate it. To either of
thefe is to be attributed the a6bion of mild emetics, which foon ceafe
to operate, and leave the ftomach ftronger, or more irritable, after
their operation ; owing to the accumulation of the fenforial power of
irritation during its torpid or inverted a£lion. Such appears to be the
operation of ipecacuanha, or of antimonium tartarizatum, in fmall
dofes.

2. But there is reafon to believe, that the ftronger emetics, as di-
gitalis, firft ftimulate the abfo^bent veflels of the ftomach into greater
adion ; and that the inverted motions of thefe abforbents next occur,
pouring the lymph, lately taken up, or obtained from other lympha-
tic branches, into the ftomach : the quantity of which in fome dif-
eafes, as in the cholera morbus, is inconceivable. This inverted mo-
tion, firft of the abforbents of the ftomach, and afterwards of the
ftomach itfelf, feems to originate from the exhauftion or debility,
which fucceeds the uiuiatural degree of adtion, into which they had
been previoufly ftimulated. An unufual defed of ftimulus, as of food
without fpice or wine in the ftomachs of thofe, who have been much

7 _ accuftcmcd

Art. V. 2.1. INVERTENTIA. 74.1

accuftomed to fpice or wine, will induce ficknefs or vomiting ; in
t;his cafe the defeftive energy of the f1:on:iach is owing to defeft of ac-
cuftomed ftimulus ; while the adion of vomiting from digitalis is
owing to a deficiency of fenforial power, which is previoufly ex-
haufted by the excefs of its flimulus. See Se(^. XXXV. i. 3. and
Clafs IV. I. I. 2.

For firft, no increafe of heat arifes from this aftion of vomiting ;
which always occurs, when the fecerning fyftem is ftimulited into
adllon. Secondly, the motions of the abforbent veflels are as liable
to inverfion as the ftomach itfelf ; which laft, with the cefophagus,
may be confidered as the abforbent mouth and belly of that great
gland, the inteftinal canal. Thirdly, the clafs of forbentia, as bitters
and metallic falts, given in large dofes, become invertentia, and vo-
mit, or purge. And laftly, the ficknefs and vomiting induced by
large potations of wine, or opium, does not occur till next day in
fome people, in none till fome time after their ingurgitation. And
tin<^ure of digitalis in the dofe of 30 or 60 drops, though applied in
folution, is a confiderable time before it produces its effed: ; though
vomiting is inftantaneoufly induced by a naufeous idea, or a nauleous
tafte in the mouth. At the fame time there feem to be fome mate-
rials, which can immediately flimulate the ftomach into fuch power-
ful aftion, as to be immediately fucceeded by paralyfis of it, and con-
fequent continued fever, or immediate death ; and this without ex-
citing fenfation, that is, without our perceiving it. Of thefe are the
contagious matter of fome fevers fwallowed with the faliva, and pro-
bably a few grains of arfenic taken in folution. See Suppl. I. 8. 8.
Art. IV. 2. 6. 9.

3. Some branches of the lymphatic fyftem become inverted by
their fympathy with other branches, which are only ftimulated into
too violent abforption. Thus when the ftomach and duodenum are
much ftimulated by alcohol, by nitre, or by worms, in fome perfons

the

e

..74,2 INVERTENTIA. Art.V. 2. i_.

,the urinary lymphatics have their motion inverted, and pour tliat ma,-
terial into, thp, bladder, which is abforbed from the inteftines. • Hence
the drunken diabetes is produced; and hence chyle is feen inihe
urine in worm cafes. . ,.■.,,

When on the contrary fome branches of the abforbent iyflem^
have their motions inverted in confequence of the previous exhauflijOi,!
of their fenforial power by any violent fUmul as, other bra^i^cljes of it
'have their abforbent power greatly increafed. Hence ciontipued vq-
miting,'' or violent cathartics, produce gr,eat abforption firopn the tel-
lular membrane In cafes of dropfy; and the fluids thus abforbe^^ are
poured into the ftomach and inteilines by the invciited fr^otipns of th
ladeals and lymphatics. SeeSedl^ XXlX. 4. and^ c. . •. . ' f

4. The quantity of the dofe of an emetic is not of fo great confe-
quence as of other medicines, as the greatefl part of it is rejected wifA
the firft effort. All emetics are faid to aft with greater certainty
when given in a morning, if an opiate had been given the night be-
fore. For the fenforial power of irritation of the ftomach had thus
been in fome meaRire previoufly exhaufted by the flimulus of the
opium, which thus facilitates the a£tion of the emetic ; and which,
when the dofe of opium has been large^, is frequently followed on
the next day by fpontaneous ficknefs and vomitings, as .^fter' violent
intoxication.

Ipecacuanha is the mofl: certain in its effedl from five grains to
thirty ; white vitriol is the mod expeditious in its efFe6l, from twenty
o-rains to thirty diffolved in warm water ; but emetic tartar, antimo-
nium tartarizatum, from one grain to four to fane people, and from
thence to twenty to infane patients, will anfwer moft of the ufeful
purpofes of emetics ; but nothing equals the digitalis purpurea for the
' purpofe of abforbing water from the cellular membrane in the anafarca
pulmonum, or hydrops pectoris. See Art. II. 3, 7.

II. Violent

Art.V. 2. 2. 3- INVERTENTIA. - 743

II. Violent cathartics, i. Where violent cathartics are required;
as in dtopfies, the fquill in dried powder made into fmall pills of a-
grain, or a grain and a half, one to be given every hour till they
operate brifkly, is very efficacious ; or half a grain of emetic tartar
diffolved in an ounce of peppermint-water, and given every hour, till
it operates. Scammony, and other ftrong purges, are liable to pro-
duce hypercatharfis, if they are not nicely prepared, and accurately
weighed, and are thence dangerous in common practice. Gamboge
is uncertain in its e-fFeds, it has otherwife the good property of being
taftelefs ; and on that account fome preparation of it might be ufeful
for children, by which its dofe could be afcertained, and its effedts
rendered more uniform.

2. In inflammations of the bowels with conftipation calomel, given
in the dofe from ten to twenty grains after due venefedion, is moft
efficacious ; and if made into very fmall pills is not liable to be re-
jefited by vomiting, vvhich generally attends fhofe cafes* When this-
fails, ^ grain of aloes every hotir will find its way, if the bowel is not
deftroyed ; and fometimes, I believe, if it be, when the mo^'tification
is not extenfive. If the vomiting Continues after the painiceafes, aiid
efpecially if the bowels become tumid with air, which founds on
being ftruck with the finger, thefe patients feldom recover. Opiates
given along with the cathartics I believe to be frequently injurious in
inflammationpf the bowels,- though they may thus be given with ad^
vantage in the faturnine colic;, the pain and conftipation in which
difeafe are owing, to torpor, . jar iaadtvity, 'and. jnot,.t9 ;, too great
adtion.

III. Violent errhinesi and. fialagogues. 1,. Turpeth mineral iii the
quantity of one grain mi^ied w^ith ten grains' of fugar anfwers every
purpofe to be axpefitfedfronrierrhines. Their ioperation is by inverting

8 the

744 INVERTENTIA. Art. V. 2,4.

the motions of the lymphatics of the membrane, which hnes the
noftrils, and the caverns of the forehead and cheeks ; and may thence
poffibly be of fervice in the hydrocephalus internus.

Some other violent errhines, as the powder of white hellebore, or
Cayan pepper, diluted with fome lefs acrid powder, are faid to cure
fome cold or nervous head-achs ; which may be efte6led by inflaming
the noflrils, and thus introducing the fenforial power of fenfation, as
well as increafing that of irritation ; and thus to produce violent ac-
tion of the membranes of the noftrils, and of the frontal and maxillary
finufes, which may by aflbciation excite into adion the torpid mem-
branes, which occafion the head-ach.

2. A copious falivation without any increafe of heat often attends
hyfteric difeafes, and fevers with debility, owing to an inverfion of
the lymphatics of the mouth, fee Clafs I. i. 2. 6. The fame occurs
in the naufea, which precedes vomiting ; and is alfo excitable by dif-
agreeable tafles, as by fquills, or by naufeous fmells, or by naufeous
ideas. Thefe are very fimilar to the occafional difcharge of a thia
fluid from the noftrils of fome people, which recurs at certain periods,
and differs from defedtive abforption.

IV. Violent diuretics, i. If nitre be given from a dram to half an
ounce in a morning at repeated draughts, the patient becomes fickifli,
and much pale water is thrown into the bladder by the inverted ac-
tion of the urinary lymphatics. Hence the abforption in ulcers is in-
creafed and the cure forwarded, as obferved by Dr. Rowley.

2. Cantharides taken inwardly fo ftimulate the neck of the bladder
as to Increafe the difcharge of mucus, which appears in the urine 5
but I once faw a large dofe taken by miftake, not lefs than half an
©unce or an ounce of the tin<5lure, by which I fuppole the urinary

lymphatics

Art. V. 2.5- INVERTENTIA/ 745

lymphatics were thrown into violent inverted motions, for the pa-
tient drank repeated draughts of fubtepid water to the quantity of a
gallon or two in a few hours ; and during the greateft part of that
time he was not I believe two entire minutes together without raakinrr
water. A little blood was feen in his water the next day, and a fore-
nefs continued a day longer without any other inconvenience.

3. The decodllon of foxglove fliould alfo be mentioned here, as
great effufions of urine frequently follow its exhibition. See Art. IV.
2. 3. 7. And an infufion or tindure of tobacco as recommended by
Dr. Fowler of York.

4. Alcohol, and opium, if taken fo as to induce flight intoxication,
and the body be, kept cool, and much diluting Uquids taken along
with them, have fimilar efFeft in producing for a time a greater flow of
urine, as mofl: intemperate drinkers mufl: occafionally have obferved.
This circumfl:ance feems to have introduced the ufe of gin, and other
vinous fpirits as a diuretic, unfortunately in the gravel, amongft ig-
norant people ; which difeafe is generally produced by fermented or
fpirituOus liquors, and always increafed by them.

5. Fear and anxiety are well known to produce a great frequency
of making water. A perfon, who believed he had made a bad pur-
chafe concerning an efl:ate, told me, that he made five or fix pints of
water during a fleeplefs night, which fucceeded his bargain ; and it
is ufual, where young men are waiting in an anti-room to be examin-
ed for college preferment, to fee the chamber-pot often wanted.

V. Cold fweats about the head, neck, and arms, frequently attend

thofe, whofe lungs are opprefl!ed, as in fome dropfies and afl:hma. A

Vol. II. ^ C cold

746- I N V E R T E N T I-% _ Art, V. 3.-1—5.

cold fweat Is alfo frequently theharbinger of deat.hv Thefe are from,
the inverted motions of tl^e cutaneous lymphatic branches of- thofe
parts.

III. Catalogue of Invertentia.

I. Emetics, ipepacuanha, emetic tartar,. -a^i^timoniurn, tartarifatqm,.
fquill, fcilia rnaritima, carduus benedi£|:us, cnicus acarna, char
mcemile, anthemis nobilis, white vitriol, vitriplunv zinci, fox-
glove, digitalis purpurea, clyfters of tobacco. .

II. Violent cathartics, emetic tartar, fqyilli buckthorn,, rhamnu^
catharticus, fcanimonium, convolvulusj fcammonia, gamboge^
elaterium, colocynth, cucumis colocynthis, veratrurpi

III, Violent: errbines, and {ialagpgues, Turpetji miiieral, hydragyrus,

vitriolatus, afarjjm ,e,uropaeum, euphorbium, CApficum, yera-
trum, nayfeoua fmells, naufequs :ideas.- ;, ,, . . 1, ,

IV. Violent diuretics, nitre, fquill, leneka, cantbarides, alcohol;,

foxglove, tobacco, anxiety.

V. Qol^ ^«#fl^cs,.;,fOJ^oa,s^, %^j,^;^^

Art,

Art.VI. 2. I. REVERTENTIAI ^ "^47

A R T. vi.
REVERTENTIA.

I. Those things, which reftore the natural order of the inverted
irritative nnotipns, are termed Revertentia.

1. As mulk, caftor, afafoetida, valerian, eftentlal oils.

2. Externally the vapour of burnt feathers, of volatile falts, or
oils, blifters, iinapifms.

Thefe reclaim the inverted motioiis without increaling the heat of
the body above its natural ftate, if given in their proper dofes, as in
the globus hyftertcus, and palpitation of the h^ar't.

The incitantia reiv^rt thefe morbid motions more certainly, as opi-
um and alcohol : and reftore the natural heat more ; but if they in-
duce any degree of intoxication, they are fucceeded by debility, when
their ftimulus ceafes.

II. Observations on the REVERTENTiAii

I. The hyfteric difeafe is attended with inverted motions feebly
exerted of the oefophagus, inteftinal canal and lymphatics of the blad-
der. Hence the borborigmi, or rumbling of the] bowels, owing to
their fluid contents delcending as the air beneath afcends. The glo-
bus hyflericus coufifts in the retrograde motion of the oefophagus,
and the great flow of urine from that of the lymphatics fpread on the
neek of the bladder ; and a copious falivation fometimes happens to

5 C 2 thefe

748 REVERTENTIA. Art. VI. 2. 2.

thefe patients from the inverfion of the lymphatics of the mouth ;
and palpitation of the heart owing to weak or incipient inverfion of.
its motions ; and fyncope, when this occurs in its greateft degree.

Thefe hyfteric atFedlions are not neceffarily attended with pain ;
though it fometimes happens, that pains, which originate from qui-
efcence, afflict thefe patients, as the hemicrania, which has errone-
oufly been termed the clavus hyftericus ; but which is owing folely to
theinadion of the membranes of that part, like the pains attending
the cold fits of intermittents, and which frequently returns like them
at very regular periods of time.

Many of the above fymptoms are relieved by mulk, caftor, the
foetid gums, valerian, oleum animale, oil of amber^ which zdi in the
ufual dofe without heating the body. The pains, which fometimes
attend thefe conflitutions, are relieved by the feceruentia, as effential
oils in common tooth-ach, and balfam of Peru in the flatulent colic.
But the incitantia, as opium, or vinous fpirit, reclaim thefe morbid
inverted motions with more certainty, than the foetids ; and remove
the pains, which attend thefe con ftitut ions, with more certainty than
the fecernentia ; but if given in large dofes, a debility and return of
the hyfteric fymptoms occurs, when the eiFe£t of the opium or al-
cohol ceafes. Opiates and foetids joined feem befl to anfwer the pur-
pofe of alleviating the prefent fymptoms ; and the forbentia, by fti-
mulating the lymphatics and ladeals into continued adlion, prevent a
relapfe of their inverfion, as Peruvian bark, and rufi: of iron. See
Clafs I. 3. r. 16.

II. Vomiting confifts in the inverted order of the motions of the
ftomach, and oefophagusi and is alfo attended with the inverted mo-
tions of a part of the duodenum, when bile is ejeded ; and of the
lymphatics of the ftomach and fauces, when naufea attends, and when
much lymph is evacuated. Permanent vomiting is for a time relieved
by the incitantia, as opium or alcohol ; but is liable to return, when

their

Art. VI. 2.3. 4. REVERTENTIA. 749

their adion ceafes. A bliftcr on the back, or on the ftoraach, is more
efficacious for reflraining vomiting by their ftimulating into aftion the
external fkin, and by fympathy afFetfling the membranes of the fto-
mach. In fome fevers attended with inceffant vomiting Sydenham,
advifed the patient to put his head under the bed-clothes, till a fvifcat
appeared on the Ikin, as explained in Clafs IV. i. i. 3.

In chronical vomiting I have obferved crude mercury of good efFedl
in the dofe of half an ounce twice a day. The vomitings, or vain
efforts to vomit, which fometimes attend hyfteric or epileptic patients,,
are frequently inftantly relieved for a time by applying flour of muf-
tard-feed and water to the fmall of the leg ; and removing it, as foon
as the pain becomes confiderable. If finapifms lie on too long, ef-
pecially in paralytic cafes, they are liable to produce troublefome ul-
cers. A plafler or cataplafm, with opium and camphor on the regior*
of the rtomach, will fometimes revert its retrograde motions.

III. Violent catharfis, as in diarrhoea or dyfentery, is attended
with inverted motions of the lymphatics of the inteftines, and is ge-
nerally owing to fome ftimulating material. This is counteradled by
plenty of mucilaginous liquids, as folutions of gum arable, or fmall
chicken broth, to wafli.away or dilute the ftimulating material, whicb
caufes the difeafe. And then by the ufe of the inteftinal forbentia.
Art. IV. 2. 5. as rhubarb, deco£lion of logwood, calcined hartfhorn,
Armenian bole ; and laftly, by the incitantia, as opium..

IV. The diaboetes confifts in the inverted* motions of the urinary
lymphatics, which is generally I fuppofe owing to the too great ac-
tion of fome other branch of the abforbent fyftem. The urinary
branch ftiould be ftimulated by cantharides, turpentine, refin (whicb
when taken in larger dofes may pofTibly excite it into inverted ac-
tion), by the forbentia and opium. The inteftinal lymphatics ftiould

be-

750 REVERTENTIA. Art. VI. 2. 5.

be rendered lefs adive by torpentia, as calcareous earth, earth of alum ;
and thofe of the Ikin by oil externally applied over the whole body;
and by the warm-bath, which fhould be of 96 or 98 degrees of heat,
and the patient fliould fit in it every day for half an hour;

V. Inverted motions of the inteftinal canal with all the lymphatics,
which open into it, conftitute the ileus, or iliac paffion ; in which
difeafe it fometimes happens, that clyflers are returned by the mouth.
After veneleftion from ten grains to twenty of calomel made into
very fmall pills ; if this is reje£led, a grain of aloe every hour ; a blif-
ter ; crude mercury ; warm-bath ; if a clyfter of iced water ?

Many other inverted motions of different parts of the fyftem are
defcribed in Clafs I. 3. and which are to be treated in a manner fimi^
lar to thofe above defcribed. It mufl be noted, that the medicines
mentioned under number one in the catalogue of revertentia are the
true articles belonging to this clafs of medicines. Thofe enumerated
in the other four divifions are chiefly fuch things as tend to remove
the ftimulating caufes, which have induced the inverfion of the mo-
tions of the part, as acrimonious contents, or inflammation, of the
bowels in diarrhoea, diabetes, or in ileus. But it is probable after
thefe remote caufes are deftroyed, that the fetid gums, mulk,
caftor, and balfams, might be given with advantage in all thefe
cafes.

III. Cata-

Ar,t..VI. 3- I— 4- REVERTENTrA. T'Sf

III. Catalogue of Revertentia.

X. Inverted motions, which attend the hyfleric difeafe, are reclaim-
ed, I. By muik, caftor. 2. By afafoetida, galbanum, fagapae-
num, ammoniacum, valerian. 3, ElTentlal oils of cinnanion,
nutmeg, cloves, infuiion of penny-royal, mentha, pulegium,
peppermint, mentha piperita, ether, camphor. 4. Spirit of
hartfliorn, oleum animale, fpungc burnt to charcoal, black-
fnuffs of candles, w^hich confift principally of animal charcoal,
wood-foot, oil of amber. 5. The incitantia, as opium, al-
cohol, vinegar. 6. Externally the fmoke of burnt feathers,
oil of amber, volatile fait applied to the noftrils, bliflers,
iinapifms.

II. Inverted motions of the flomach are reclaimed by opium, alcohol,
blifters, crude mercury, finapifms, camphor and opium exter-
nally, clyfters with afafoetida,

III. Inverted motions of the inteftlnal lymphatics are reclaimed by

mucilaginous diluents, and by inteftlnal forbentia, as rhubarb,
logwood, calcined hartfhorn, Armenian bole; and laftly by in-
citantia, as opium.

IV. Inverted motions of the urinary lymphatics are reclaimed by

cantharides, turpentine, rofin, the forbentia, and opium, with
calcareous earth, and earth of alum, by ©11 ^externally, warm-
bath.

4 V. Inverted

752 REVERTENTIA. Art.VI. 3. 5.

V. Inverted motions of the inteftinal canal are reclaimed by calomel,
aloe, crude mercury, blifters, warm-bath, clyfters with afafoe-
tida, clyfters of iced water ? or of fpring water further cooled
by fait diffolved in water contained in an exterior veffel ? Where
there exifts an introfufception of the bowel In children, could
the patient be held up for a time by the feet with his head down-
wards, or be laid with his body on an inclined plane with his
head downwards, and crude mercury be injeded as a clyfter to.
the quantity of two or three pounds ?

Art.

Art. VII. 1,. r. TORPENTIA. ysi

Art. VII.
TORPENTIA.

I. Those things, which diminlfli the exertion of the irritative
motions, are termed torpentia.

1. As mucus, mucilage, water, bland oils, and whatever poflefles
lefs ftimulus than our ufual food. Diminution of heat, lieht.
found, oxygen, and of all other flimuli ; venefeftion, naufea, and
anxiety.

2. Thofe things which chemically deftroy acrimony, as calcare-
ous earth, foap, tin, alcalies, in cardialgia ; or which prevent che-
mical acrimony, as acid of vitriol in cardialgia, which prevents the
fermentation of the aliment in the ftomach, and its confequent acidity.
Secondly, which deftroy worms, as calomel, iron filings or ruft of
iron, in the round worms ; or amalgama of quickfilver and tin, or tin
in very large dofes, in the tape-worms. Vvill ether in clyfters de-
ftroy afcarides ? Thirdly, by chemically deftroying extraneous
bodies, as cauftic alcali, lime, mild alcali in the ftone. Fourthly,
thofe things which lubricate the veflels, along which extraneous
bodies Aide, as oil in the ftone in the urethra, and to expedite the ex-
pedtoration of hardened mucus ; or which leffen the friftion of the
contents in the inteflinal canal in dyfeutery or aphtha, as calcined
hartftiorn, clay, Armenian bole, chalk, bone-afties. Fifthly, fuch
things as foften or extend the cuticle over tumors, or phlegmons, as
warm water, poultices, fomentations, or by confining the perfpirable

Vol. II. 5 D matter

754 TORPENTIA. Art. VII. 2. i. 2.

matter on the part by cabbage-leaves, oil, fat, bee's-vvax, plafters,
oiled filk, externally applied.

Thefe decreafe the natural heat and remove pains occafioned by ex-
cefs of irritative motions.

II. Observations on the Torpentia.

I. As the torpentia confifl of fuch materials as are lefs ftimulatlng
than our ufual diet, it is evident, that where this clafs of medicines
is ufed, fome regard muft be had to the ufual manner of living of the
patient both in refpedl to quantity and quality. Hence wounds iu
thofe, who have been aceuftomed to the ufe of much wine, are
very liable to mortify, unlefs the ufual potatioa of wine be allowed
the patient. And in thefe habits I have feen a delirium in a fever
cured almoft immediately by wine ; which was occafioned by the too
mild regimen direfted by the attendants. On the contrary in great
inflammation, the fubdudion of food, and of fpirituous drink, con-
tributes much to the cure of the difeafe. As by thefe means both
the fliraulus from diflention of the veflels, as well as that from the
acrimony of the fluids, is decreafed ; but in both thefe refpedls the
previous, habits of diet of the patients muft be attended to. Thus if
tea be made ftronger, than the patient has ufually drank it, it
belongs to the article forbentia ; if weaker, it belongs to the torr
pentia.

II. 2. Water in a quantity greater than ufual diminifiies the ac-
tion of the fyftem not only by diluting our fluids, and thence leflen-
ing their llimulus,, but by lubricating the folids ; for not only the

parts.

Art.VII, 2. 3- TORPENTIA. 755

parts of our folids- have their fliding over each other facilitated by the
interpofition of aqueous particles ; but the particles of mucaginous or
faccharine lolutions flide eafier over each other by being mixed with
a greater portion of water, and thence ftimulate the veffels lefs.

At the fame time it muft be obferved, that the particles of M'ater
thernfelves, and of animal gluten diiTolved in water, as the glue ufed
by carpenters, flide eafier over each other by an additional quantity of
the fluid matter of heat.

Thefe two fluids of heat and of water may be efteemed the univer-
fal folvents or lubricants in refpe£t to animal bodies, and thus facilitate
the circulation, and the fecretion of the various glands. At the fame
time it is poffible, that thefe two fluids may occafionally aflume an
aerial form, as in the cavity*of the chefl, and by comprefling the
lungs may caufe one kind of afthma, which is relieved by breathino-
colder air. An increafed quantity of heat by adding flimulus to every
part of the fyftem belongs to the article Incitantia.

III. 3. I. The application of cold to the fkin, which is only an-
other expreffion for the diminution of the degree of heat v/e are ac-
cuftomed to, benumbs the cutaneous abforbents into inaftion ; and by
fympathy the urinary and inteftinal abforbents become alfo quiefcent,'
The fecerning veffels continuing their adlion fomewhat longer, from
the warmth of the blood. Hence the ufual fecretions are poured into
the bladder and inteftines, and no abforption is retaken from them.
Hence fpriakling the fliin with cold water increafes the quantity of
urine, which is pale ; and of flool, which is fluid ; thefe have er-
roneoufly been afcribed to increafed fecretion, or to obflruded per-
fpiration.

The thin difcharge from the noftrils of fome people in cold v/eather
is owing to the torpid fliate of the abfbrbent veflels of the membrana
fneideriana, which as above are benumbed fooner than thofe, which
perform the fecretion of the mucus.

^ D 2 The

756 TORPENTIA. Art. VII. 2. 3,

-The quick anhelation, and palpitation of the heart, of thofe, who
are immerfed in cold water, depends on the quiefcence of the exter-
nal abforbent vefTels and capillaries. Hence the cutaneous circulation
is diminifhed, and by affociation an almofl: univerfal torpor of the fyf-
tem is induced ; thence the heart becomes incapable to pufti forwards
its blood through all the inadtive capillaries and glands; and as the
terminating veflels of the pulmonary artery fufFer a fimilar inac-
tion by affociation, the blood is with difficulty pulhed through the
lunsfs.

Some have imagined, that a fpafmodic conflriftion of the fmaller
veflels took pliace, and have thus accounted for their refinance to the
force of the heart. But there feems no neceffity to introduce this
imaginary fpafm ; fince thofe, who are converfant in injecting bodies,
find it neceffary firfl: to put them into warm water to take away the
ftiiFnefs of the cold dead velFels ; which become inflexible like the
other mufcles of dead animals, and prevent the injeded fluid from
paffing.

All the fame fymptoms occur in the cold fits of intermittents ; in
thefe the coldnefs and palenefs of the flcin with thirft evince the di-
minution of cutaneous abforption ; and the drynefs of ulcers, and
fmall fecretion of urine, evince the torpor of the fecerning fyllem ;
and the anhelation, and coldnefs of the breath, {hew the terminations
of the pulmonary artery to be likewife affected with torpor.

After thefe veflels of the whole furface of the body both abforbent
and fecretory have been for a time torpid by the application of cold
water ; and all the iniernal fecerning and abforbent ones have been
made torpid from their aflx)ciation with the external ; as foon as their
ufual ftimulus of warmth is renewed, they are thrown, into more
than their ufual energy of aftion ; as the hands become hot and pain-
ful on approaching the fire after having been immeried fome time in
fnow. Hence the face becomes of a red colour in a cold day on turn-
ing from the wind, and the infenfible perfpiratioii increafed by re-
peatedly

Art. VII. 2. 3. TORPENTIA. y^^,

peatedly going into frofly air, but not continuing in it too lono- at a
time.

2. When by the too great warmth of a room or of clothes the fe-
. cretion of perfpirable matter is much increafed, the ftrength of the
patient is much exhaufted by this unneceflary exertion of the capillary
fyftem, and thence of the whole fecerning and arterial fyftem by af-
fociation. The diminution of external heat immediately induces a
torpor or quiefcence of thefe unnecefTary exertions, and the patient
inflantly feels himfelf flrengthened, and exhilarated ; the animal
power, which was thus wafted '\\\ vain, being now "applied to more
ufeful purpofes. Thus when the limbs on one fide are difabled by a
ftroke of the palfy, thofe of the other fide are perpetually in mo-
tion. And hence all people bear riding and other exercifes beft in
cold weather.

Patients in fevers, where the fkin is hot, are immediately ftrength-
ened by cold air.; which is therefore of great ufe in fevers attended
with debility and heat ; but may perhaps be of temporary difiervice,
if too haftily applic-d in fome fituations of fevers attended with internal
topical inflammation, as in peripneumony or pleurify, where the ar-
terial ftrength is too great already, and the increafed a6tion of the ex-
ternal capillaries being deftroyed by the cold, the action of the inter-
nal inflamed part may be fuddenly increafed, unlefs venefedion and
other evacuations are applied at the fame time. Yet in moft cafes the
application of cold is neverthelefs falutary, as by decreafino- the heat
of the particles of blood in the cutaneous veffels, the flimulus of them
and the diflention of the veffels becomes confiderably le/Tened. In
external inflammations, as the fmall-pox, and perhaps the o-out and
rheumatifm, the application of cold air muft be of great fervice by
decreafing the a<5lion of the inflamed fkin, though the contrary is too
frequently the practice in thofe difeafes. It muft be obferved, that
for all thefe purpofes the application of it Ihould be continued a lono-
® ' time.

758 TORPENTIA. Art. VII. 2. 3.

time, otherwile an Increafed exertion follows the temporary torpor,
before the difeafe is deftroyed.

3. After immerfion in cold water or in cold air the whole fylleni
becomes more exciteable by the natural degree of ftimulus, as appears
from the fubfequent glow on the Ikin of people othervvife pale; and
even by a degree of ftimulus lefs than natural, as appears by their
becoming warm in a fhort time .during their continuance in a bath, of
about 80 degrees of heat, as in Buxton bath. See Seft. XII. 2. i,
XXXII. 3.3.

This increafed exertion happens to the abforbent veiTels more par-
ticularly, as they are firft and mod affedled by thefe temporary dimi-
nutions of heat ; and hence like the medicines, which promote ab-
forption, the cold-bath contributes to {Irengthen the cbnflitutiou,
that is to increafe its irritability ; for the difeafes attended with weak-
nefs, as nervous fevers and hyfteric difeafes, are fhewri in Seftion
XXXII. 2. I. to proceed from a want of irritability, not from an ex-
cefs of it. Hence the digeftion is;greatel' in frofty weather, and the
quantity of perfpiration. For thefe purpofes the application of cold
mufl: not be continued too long. For in riding a journey in cold wea-
ther, when the feet are long kept too cold, the digeftion is impaired,
and cardialgia produced.

4. If the diminution of external heat be too great, produced too
haftily, or continued too long, the torpor of the fyftem either be-
comes fo great, that the animal ceafes to live; or fo great an energy
of motion or orgafm of the Veffels fucceeds, as to produce fever or in-
flammation. This moft frequently happens after the body has been
temporarily heated by exercife, warm rooms, anger, or intemperance.
I-Ience colds are produced in the external air by refting after exercife,
or by drinking cold water. See Clafs I. 2. 2. i.

Frequent cold immerfions harden or invigorate the conftitution,
I ' . which

Art.VII. 2.4. TORPENTIx'\. 759

which they efFeft by habituating the body to bear a dimiuution of
heat on its furface without being thrown into fuch extenfive torpor
or quieicence by the confent of the veliels of the Ikin with the pul-
monary and glandular fyftem ; as thofe experience, who frequently
ufe the cold^bath. At firft they have great anhelation and palpita-
tion of heart at their ingrefs into cold water ; but by the habit of a
few weeks they are able to bear this diminution of heat, with little or
no inconvenience ; for the power of volition has fome influence over
the mufcles fubfervient to refpiration, and by its counter efforts gra-
dually prevents the quick breathing, and diminiflies the affociations
of the pulmonary veffels with the cutaneous ones.. And thus thougb
the fame quantity of heat is fubdudted from the fkin, yet the torpor
of the pulmonary veflels and interna] glands does not follow. Hence
during cold immerlion' lefs fenforial power is accumulated, and in
confequence, lefs exertion of it fucceeds on emerging from the bath.
Whence fuch people are efleemed hardy, and bear the common vari-
ations of atmofpheric temperature without inconvenience.. See Se6t»
XXXII. 3. 2.

IV. Venefe(3:ion has a juft title to be claffed amongffc the torpentia
in cafes of fever with arterial flrength, known by the fulnefs and,
hardnefs of the pulfe. In thefe cafes the heat becomes lefs by its ufe,,
and all exuberant fecretions, as-ofbileor fw'eat, are diminifhed, and
room is made in the blood-veffels for the abforption of mild fluids ;,
and hence the abforption alfo of new veffels, or extravafated fluids, the
produce of inflammation, is promoted. Hence venefeftion is pro-
perly claffed amongft the forbentia, as like other evacuations it pro-
motes general abforption, reftrains haemorrhages, and cures thofe
pains, which- originate from the too great adion of the fecerning vef-
fels, or from the torpor of the abforbents.^ I have more than once
been witnefs to the fudden removal of nervous head-achs by venefec-

tion^,

76o TOUPENTIA. Art VII. 2. 5. 6.

tion, though the patient was already exhaufted, pale, and feeble; and
to its great ufe in convulfions and madnefs, whether the patient was
ftrong or weak ; which difeafes are the confequence of nenvous pains ;
and to its flopping long debilitating haemorrhages from the uterus,
when other means had been in vain eflayed. In inflammatory pains,
and inflammatory haemorrhages, every one juftly applies to it, as the
certain and only cure.

V. When the circulation is carried on too violently, as in inflam-
matory fevers, thofe medicines, which Invert the motions of fome
parts of the fyftem, retard the motions of fome other parts, which
are affociated with them. Hence fmall dofes of emetic tartar, and
ipecacuanha, and large dofes. of nitre, by producing naufea debilitate
and leffen the energy of the circulation, and are thence ufeful in in-
flammatory difeafes. It muft be added, that if nitre be fwallowed in
powder, or foon after it is diflolved, it contributes to leffen the cir-
culation by the cold it generates, like ice- water, or the external appli-
cation of cold air.

VI. The refpiration of air mixed with a greater proportion of azote
than is found jn the common atmofphere, or of air mixed with hy-
drogen, or with carbonic acid gas, fo that the quantity of oxygen
might be lefs than ufual, would probably a6l in cafes of inilamm.ation
with great advantage. In confumptions this might be mofl conveni-
ently and efFeftually applied, if' a phthifical patient could refide day
and night in a porter or ale brewery, where great quantities of thoie
liquors were perpetually fermenting in vats or open barrels ; or in
fome great man ufaftory of wines from raifins or from fugar. .

Externally the application of carbonic acid gas to cancers and other
ulcers inflead of atmofpheric air may prevent their enlargement, by

preventing

Art. VII. 3, i'-^9' TORPENTIA. 761

preventing the union of oxygen with matter, and thus producing
a new contagious animal acid.

Ill, Catalogue of Torpentia.

1. Venefe6:ion. Arteriotomy.

2. Cold water, cold air, refpiration of air with Icfs oxygen.

3. Vegetable mucilages. • ^

a. Seeds. — Barley, oats, rice, young peas, flax, cucumber,

melon, &c.
i>. Gums.-— Arabic, Tragacanth, Senegal, of cherry-trees.

c. Roots. — Turnip, potatoe, althea, orchis, fnow-drop.

d. Herbs.— -Spinach, brocoli, mercury.

4. Vegetable acids, lemon, orange, currants, goofeberries, apples,

grape, &c. &c.

5. Animal mucus, hartfhorn jelly, veal broth, chicken water, oil ?

fat ? cream ?

6. Mineral acids, of vitriol, nitre, fea-falt.

7. Silence, darknefs, ,

8. Invertentia in fmall dofes, nitre, emetic tartar, ipecacuanha

given fo as to induce naufea.

9. Antacids. — Soap, tin, alcalies, earths.

Vol. II. - , 5 E 10. Medicines

>r62 T O R P E N T I A. Art. VII. 3. 10— 1 3.

10. Medicines preventative of fermentation, acid of vitriol.

11. Anthelmintics. — Indian pink, tin, iron, cowhage, amalgama,

fmoak of tobacco.

12. Lithonthriptics, lixiv. faponarium, aqua calcis, fixable air.

12. Externally, -warm bath, and poultices, oil, fat, wax, plafters,
oiled filk, cai-bonic acid gas on cancers, and other ulcers.

ADDENDA.

Page 625, line i, after ' fiumier'' pleafe to add, ' except when the patient has naturally a
pulfe flower than ufual in his healthy ftate.'

Page 197, after line 8, pleafe to add, ' Where the difficulty of breathing is very urgent in
the croup, bronchotomy is recommended by Mr. Field.' Memoir of a Medical So-
ciety, London, 1773, Vol. IV.

ADDITION.

ADDITION.

INABILITY TO EMPTY THE BLADDER.

To be Introduced at the end of Clafs III. 2. 1.6. on Paralyfis

Veficae Urinarige.

An Inability to empty the bladder frequently occurs to elderly
jmen, and is often fatal. This fometimes arifes from their having
too long been reftrained from making water from accidental confine-
ment in public fociety, or otherwife ; whence the bladder has become
fo far diflended as to become paralytic ; and not only this, but the
neck of the bladder has become contradted fo as to refift the intro-
duftion of the catheter. In this deplorable cafe it has frequently
happened, that the forcible efforts to introduce the catheter have per-
forated the urethra ; and the Inftrument has been fuppofed to pafs
into the bladder when it has only pafled into the cellular mem-
brane along the fide of it ; of .which I believe I have feen two or
three inftances ; and afterwards the part has become fo much in-
flamed as to render the introdudion of the catheter into the bladder
impracticable.

In this fituation the patients are in imminent danger, and fome
have advifed a trocar to be introduced into the bladder from the

5 E 2 redlum ;

764 ADDITION.

redlum ; which I believe is generally followed by an incurable ulcer.
One patient, whom I faw in this fituation, began to make a fpoonful
of water after fix or feven days, and gradually in a few days emptied
his bladder to about half its fize, and recovered ; but I believe he
never afterwards was able completely to evacuate it.

In this fituation I lately advifed about tvi'o pounds of crude quick-
filver to be poured down a glafs tube, which was part of a baro-
meter tube, drawn lefs at one end, and about two feet long, into
the urethra, as the patient lay on his back ; which I had previoufly
performed upon a horfe ; this eafily paffed, as was fuppofed, into
the bladder; on flanding ere6t it did not return, but on kneeling
dov^'n, and lying horizontally on his hands, the mercury readily re-
turned ; and on this account it was believed to have pafl'ed into the
bladder, as it fo eafily returned, when the neck of the bladder was :
lower than the fundus of it. But neverthelefs as no urine followed
the mercury, though the bladder was violently diftended, I was
led to believe, that the urethra had been perforated by the pre-
vious efforts to introduce a catheter and bougee ; and that the
mercury had paffed on the outfide of the bladder into the cellular
membrane.

As the urethra is fo liable to be perforated by the forcible efforts
to introduce the catheter, when the bladder is violently dif-
tended in this deplorable difeafe, I fhould ftrongly recommend the
injedlion of a pound or two of crude mercury into the urethra
to open by its weight the neck of the bladder previous to any vio-
lent or very frequent effays with a catheter whether of metal or of
elaftic refin.

•LINES,

LINE S,

TO BE PLACED AT THE END OF

ZOONOMIA.

BT A FRIEND.

JAMCiUE OPUS EXEGI.

The work is done ! -nor Folly's aftive rage,
Nor Envy's felf, fliall blot the golden page ;
Time lliall admire, his mellowing touch employ,
And mend the immortal tablet, not deftroy.

INDEX

OF THE

ARTICLES.

A.

Absorption, iv. 2. i.

cutaneous, mucous, cellular,

iv. 3. 2.

of the veins, iv. 2. 4.

of inflamed veffels, iv. 2.4. 3.

of inteftines and liver, iv. 2,'5.

of venereal ulcers, iv. 2. 7.

not increafed by cold, iv. 2. I.

increafed by opium after evacu-
ation, ii. 2. I.

Acacia, iv. 3. 5. 2.

Acids auftere, iv. 2. i. 2. iv. 3. i.

.... vegetable, fwect, vii. 3. 4. iv. 2.
I. 2.

.... mineral, vii. 3. 6.

Acrid plants, iv. 2. 4.

Agriculture, i. 2. 3. 7.

Agues, three kinds, iv. 2. 3. 2. iv. 2. 5. iv.
2.68.

Air nourifhes, i. 3. 5.

• . . wrarm bath of, iv. 2. 3. 8.

Alcali vol. iii. 3. 3.

Alcohol, ii. 2. I. V. 2. 4,

Almond, bitter, ii. 3, i.

Althaea, iii. 3. 3. 3,

Allium, iii. 3. 3.

Aloe, iii. 2. 5. iii. 2. 7. iii. 3. 5. 5. vi.

2.5.
Alum, iii. 2. i. iv. 2. i. iv. 2. 5. 2. iv. 3.

5- 3-
Amalgama in worms, vii. 2. 2.

Amomum zinziber, iii. 3. I.

Amber, oil of, vi. 3. 4.

Ammoniac gum, vi. 3. i. iii. 3. 3.

fait or fpirit, iii. 3. 3.

Anafarca, vyarm bath in, ii. 2. 3.

Anchovy, iii. 2. i. iii. 3. 1.4.

Animal food, i. 2. 1. i^

Antimony prepared, iii. 3. i. 5> hi. 2. I. iv..

I. 10.

Anthemis nobilis, iv. 3. 3.

........ pyrethum, iii. 3. 2.

Anxiety, v. 2. 4-

Apium, petrofelinum, iii. 3. 4. 4.

Apoplexy, iv. 3. 11.

Ariftolochia ferpentaria, iii. 3. i.

Armenian bole, vi. 2. 3. vi. 3. 5. 3.

Arfenic in ague, iv. 3. 6. 8. iv. 3. 6.

faturated folution of, iv. 3. 6. 8.

in itch, iv. 2. g.

how it aits, iv. 2. 6. 9.

Arfenic,

INDEX OF THE ARTICLES.

767

Arfenic, how to dcte£l; it, iv. 2. 6. 10.
Avtemifia maritlma, iv. 3. 3.

abfynthium, iv. 3. 3.

. fantonicum, iv. 3, 3,

Artichoke-leaves, iv. 3. 3.
Afa fctida, ii. 3. vi. 3. i-
Afarum Europeum, v. 3. 3.
Afcarides, vii. I. 2 iii. 2. g. 7;
Afparagus, iii. 3. 4. 4,
Aftragalus tragacanth, iii. 3. 3.-3.;
Atiopa belladona, ii. 3. i.
Azote, h a. 55

B,.

Balfams diuretic, iii. 3. 4;

Bandages promote abforption, iv. 2. Id

Bark, Peruvian, iv. 2. 2.

.... long ufed noxious, iv. 3; II.

Barley, iii. 3. 3.3.

Bath, warm, ii..2, 2. i, iii. 3. 1.-6. iii. 3. 3.

4. iii. 3-3.3,
..... of warm air, iv. 2, 3. 8,
.... of fteam, iv. 2. 3. 8.
.... cold, vii. 2. 3.
..... nutritive, i. 2, 6. I4
Benzoin, iii. 3. 3.
Bile of animals, iii, 2. 5. 2 i
. . . dilute ftate of, iv. 2. .6.
'Blifters, how they a£l:, iii. 2. I. lo.-

cure heart-burn, iii. 3, i. lOi

flop vomiting, vi. 2, 3.

...... produce expefroration, iii. 3. 3. 3;

increafe perfpiration, iii, 2, I. 10.,

Blood, transfufion of, i. 2, 6., 2.

Bog-bean, iv. 3.. 3.

Bole armeniE, iv. 3. 5. 3..

Bone-aflres, iv. 3. 5. 3.

Bowels, inflammation of, v. 2. 2. 2,:

Bryony, white, iii. 3. 8.

as a blifter, iii. 2, 9.;

Butter, i. 2. 3. 3.
Butter-milk, i. 3. 3, 2*

Cabbage-leaves, vii. 1. 2.
Calcareous earth, i. 3. 4- 3.^
8

Calomel, iii. 2. 5. vi. 2. ^.

.- in. enteritis, v. 2. 2. 2.

Camphor, iii. 3. I.

Canella alba, iii. 3. i.

Cantharides, iii. 2. 6. iii. 2. 8. v. 2. 4. vi.

Capillary aftion increafed , by tobacco, iv. 3.

Capficum, iii. 3. i;.
Carbonic acid gas, vii. 3. .6.
Cardamomum, iii. 3. i.
Caryophyllus aromat. iii. 3. li
Cardamine, iv. 3.4.
Caffia liftul, iii. 3. 5. i,
.... . . fenna, iii. 3-55,

Caftor, vi..3. I. vi. 3. I..
Cathartics, mild, iii. 2. 5,
.,. . ...... violent, v. 2. 3.

Ceruffa in ulcers, iv. 3. g. iv. 2. 7;

Chalk, iv. 3. 5. 3.

Chalybeates, iv. 3. 4. 2.

Cheele, i. 2. 2, 3.

Cherries, black, ii. 3. 1.8*.

Chlorofis, iv. 2. 6. 5.

Cicuta, ii. 3. i,

Cinchona, iv. 2. 2.

Cinnamon, iii. 3 3..

Clay, iv. 3. 5.3.

Cloves, iii. 3. i. iii. 3.- 2..

Cnicus acarna, v. 3. i.

Cocculusindicus, ii, 3. I.

Cochlearia armocacia, iii. 3. 8, iv. 3.- 4.

hortenfis, iv; 3. 4.

Cold, continued application of, vii. 3. 3,
.... interrupted, vii. 2. 3. iii. 3 1.7.
, . . . exceffive, vii. 2. 3.
.... firft affects lymphatics, vii. 2. 3.
.....produces rheum from the nofe, vii,

• « • quick anhelation, vii. 2. 3.

.. . . increafes digeftion, vii. 2. 3.
Cold-fit, eafier prevented than xemov.ed, ii.

3,. I.
Colie from lead, v. 3. 2, 2.
Condiments, i. 2. 7.
Convolvulus fcammonium, v. 3. 2,
Convulfions, iv. 3. 8.
Cookery, i. 2. 3. 5.
Cppaiva.balfam, iii. 3. 4. 3.

Cowhage^

?63

INDEX OF THE ARTICLES,

Cowhage, ill. 3. a.
Crab-juice, iv. 2. 2.
Cream, i. 2. 3. 2. i 2. 2. 2.
Cucumis colocyntliis, v. 3. 2.
Cynara fcolymus, iv. 3. 3.
Cynogloflum, ii. 3. f.

D.

Dandelion, iv. 3. 4.
Datura Itramonium, ii. 3. i.
Daucus lylveftris, iii. 3. 4- 4-
Delphinium ftavifagria, ii. 3. I.
Dialjetes, iv. 2.5.

warm bath in, vi. 2. 4

Diaphoretics, iii. 3. I. iii. 2. I. 2.

befl; in a morning, iii. 2. I. 5.

Diarrhcea, vi. 2. 3.

Digeftion injured by cold, iii. 2. I.

increafed by cold, vii. 2. 3.

Digitalis, iv. 2. 3. 7. v. 2. 1.3.

tinfture of, iv. 2. 3. 7.

Dragon's blood, iv. 3. 5. 2.
Dropfy, iv. 2. 3. 4. iv, a. 6. 7.

E.

Ears, eruption behind, iv. a. 9. 2.

Earth of bones, iv. 2. 5.

..... of alum, vi. 2. 4.

calcareous, iv. 2. 5. 3. vi. 2. 4. i. 2.

4-3-
Eggs, 1. 2. 1.4.
Egg-fhells diuretic, iii. 2. 4.
Eleftricity, ii. 2. a. a. iv. 2. 9.
Emetics, how they aft, v. 2. I.
Errhines mild, iii. 2. 9.

in hydrocephalus, v. 2» 3. i.

violent, v. 2. 3.

in head-ach, v. a. 3. I.

Eryfipelas, iv. 2. 9.

Effential oils, ii. 2. 3.

Ether, vitriolic, ii. 2. 3. iii. 3. I. vi. 3« 3.

in afcarides, vii. 1.2.

Etiolation, i. 2. 3. 4.
Euphorbium, v. 3. 3.
,6

Exercife, iii. 3. i. 6. ii. 2.^.
Eyes inflamed, il. 2, 2. 2, iv. 2. 3.

Famine, times of, i. 2. 3. 5. and 6.
Fear, v. a. 4.

Feathers, fmoke of, vi. 3. 6.
Fennel, iii. 3. 4. 4.
Ferula afafcetida, iii. 3. 3,
Fifli, i. 3. I. 2. i. 2. I. 5.
Flannel fliirt, ii.'a. a. I.
Flefli of animals, i. a. I.
. Fluke-worm, iv. 2. 6.
Foxglove, iv. 2. 3. 7. v. 2. i. v. 2. 4,

tindture of, iv. a. 3. 7.

Fxi6tlon, ii. a. 5. iii. 3. I. 6.

G.

Galanthus nivalis, vii. 3. 3.

Galbanum, vi. 3. i.

Gall-flones, iv. 2. 6.

Galls of oak, iv. 3. 5.

Garlic, iii, 3.3.

Gentiana centaurium, iv. 3. 3.

lutea, iv. 3^ 3.

Ginger, iii. 3. I. iii. 3. 4.
Gonorrhoea, iv. a. 2. iii. 2. 4.
Gout, iv. a II. 2.
Guaiacum, iii. 3. i.
Gum arable, iii. 3. 3. 3.
-'. . . tragacanth, iii. 3. 3. 3.
Glycyrrhiza glabra, iii. 3. 3. 3.
Gravel, v. a. 4. 4.

H.

Hartfliorn, fpirit and fait of, ill. 3. 3. iii. 3,
I. vi. 3. 4.

calcined, iv. a. 5. vi. 2. 3.

Haemorrhages, iv. 2. 4 4. iv. a. 6. a.
Haematoxylon campechianum, iv. 3. 5. 2.
Hay, infufion of, i. 2. 3. 6.
Head-ach, fnuiFin, v. 3. 3. i.

Heat,

INDEX OF THE ARTICLES.

7^9

Heat, li. 2. 2. i. See Bath.

.... an univerfal folvent, vii. 2. 3.

Heleaium, iii. 3.3. a- ,

Herpes, iv. 3. i. iv. 2. 9.

Herrings, red, iii. 3. I. 4.

Honey,-iii. 3.3.3. iii. 3- 5; i'

Hop in beer, why noxious, iv. 2. 3. 6. iv. 2.

II. 2.
Hordeum diftichon, iii. 3. 3. 3.
Humulus lupulus, iv. 3. 3. iv. 2. 11.
Hydrargyrus vitriolatus, v. 3. 3.
Hyfteric difeafe, vi. 2. I.

, pains, vi. 2. i.

convulfions, vi. 2. i.

I.

Jalapium, iii. 3. 5. 5.
Japan earth, iv. 3. 5. 2.
jaundice, iv. 2. 6. 3.
Ileus, vi. 2. 5.
Incitantia, ii.

Intermittents. See Agues.
Inverted motions, vi. 2. i.

in hyfteric difeafe, vi. 2. I.

. . , ^. . of the ftomach, vi. 2. 2.

inteftinal canal, vi. 2. 5.

of lymphatics, vi. 2.-3.

Inula helenium, iii. 3. 3. 3.
Ipecacuanha, v. 2. i.
Iron, ruftof, iv. 3. 6.
Irritability prevented, iv. 2. 3. 3.
Itch, iv. 2. I. 3.

L.

Laurus camphora, iii. 3. i.

cinnamomum, iii. 3. i.

faflafras, iii, 3. I.

Lead, iv. 3. 6.

colic from, v. 2. 2. 2.

., . . . fugar of, iv. 3. 9.
Leeks, iii. 3. 3. I.
Legs, ulcers of, iv. 2. 10,
Lemon-juice, iv. 3. I. iv- 2. 2.
Leontodon taraxacum, iv. 3. 4.
Vol. II.

Life fhortened by great flimulus, i. i.

Lime, i. 2 4. 3.

Liquorice, iii. 3. 3. 3.

Liver inflamed, iv. 3. 6.

Logvifood, iv. 3 5. 3.

Lymphatics, inverted motions of, v. 2. I.

M.

Magnefia alba, iii. 3 • 5. 3-
Malt, i. 2. 3.5.
Manaa, iii. 3. 5.
Marlh-mallovvs, iii. 3. 3. J.
Marjoram, iii. 3. 9.
Marum, iii. 3. 9.
Maftich, iii. 3. 2. ill. 3. 3.
Menianthes trifoliata, iv. 7. 3.
Menifpermum cocculus, ii. 3. I.
Menftruation promoted, iv. 3. 6. 6.

reprefled, iv. 2. 6. 6.

Mercury, iii. 3. 2. vi. 2. 3.

preparations of, iv. 3. 7. iv. 2. 7;

iv. 3. 9.

injefted as a clyfter, vi. 3. 5-

Metallic falts, iv. 2. 6.

Milk, i. 3. 3.

Mimofa nilotica, iii. 3. 3. 3.

catechu, iv. 3. 5. 2.

Mint, vi. 3. 3.
Mortification, iv. 3. 9.
Mucilage, vegetable, vii. 3. 3,
Mucus, animal, vii. 3. 5.
Mufhrooms, i. 2. i. 2.
Mufk, vi. 2. I. vi. 3. I.
Muftaid, iv. 3. 4. See Sinapifm.

N.

Naufea in fevers, vii. 2. 5.

Neutral falts diuretic, why, iii. 2. 4.

increafe fome coughs, iii. 2. 4*

...... increafe heat of urine, iii. 3. 4.

Nicotiana tabacum, iii. 3. 9. ii, 3. I.
Nitre, iii. 3. 4. v. 2. 4.
Nutmeg, iii. 2.. i.
Nutrientia, i,

5 F O. Oil

77<>

INDEX OF THE ARTICLES.

O.

Oil of almonds, iii. 3. 5. 4.

... in cream, i. 2. 3. 2.

. . . of amber, vi. a. i.

. . . exprefled externally, iii. 2. 3.

. . . effential, ii. 2. 3. iii. 3. 2.

Oiled filk, vii. 3. 13.

Oleum, animale, vi. 2. I. vi. 3. 4'

ricini, iii. 3. 5. 4.

Onions, iii. 3.3.

Opium, ii. 2. I. 2. iv. i. 2.

in nervous pains, ii. 2. !■ 5*

in inflammatory pains, ii. 2. I. 6.

increafes all (ecretions and abforp-

tions, ii. 3. I. I.
abforption after evacuation, iv. 2,. 8.

2. ii. 3. I. 3.

flops fvveats, iv. 2. 1.3.

into;cicates, ii. 2. I. I.

Oranges, their peel, iv. 3. 3.

Orchis, vii. 3. j.

Oxygen gas, ii. 2. 4. i. 2. 5- i"- 2. II. iv.

I. 4.
produces and heals ulcers, iv.

3.7.

Piafter-bandage, iv. 2. 10.

Pleurify, iv. 2. 8. 2.

Polygala feneka, iii. 3. 3. 2.

Poppy. See Papaver

Portland's powder noxious, why, Iv. 2. il. 2.

Potatoe-bread, i. 2. 3. 4.

Potentilla, iv. 3. 5.

Prunes, iii. 3. 5. i.

Prunus domeftica, iii. 3. 5. i.

fpinofa, iv. 3. i.

lauro-cerafus, ii. 3. I.

Puleglum, vi. ?. 3.

Pulfe, intermittent, relieved by arfenic, iv.

2. 6.
Pyrethrum, iii. 3. 2.
Pyrus malus, vii.
cydonia, iv. 3. I .

Q^

Quaffia, iv. 2. 2.
Quince, iv. 3. i.
Quinquefolium, iv. 3. 5.

R,

P.

Papin's digefter, i. 2. 3. 5.
Papaver fomniferum, ii. 3. i. iv. 3.

Opium
Pains, periodic, cured by opium, ii. 2. I.
Pareira brava, iii. 3. 4. 4.
Parfley, iii. 3. 4.
Paflions, iL 2.5.
Pafturage, i. 2. 3. 7.
Pepper, iii. 3. I-
Peripneumony, iv. 3. 8. 3.
Perfpiration in a morning, iii. 2. I.

not an excrement, iii. 2.1.

Peru, balfam of, iii. 3. 5. 4,
Petechiae, iv. 2. 4. 2.
Pimento, iii. 3- i.
Piper indicum, iii. 3. i.
Pillacia lentiicus, iii. 3. 2.
Pix liquids, iii. 3. 2.

Ratafie, why deftruftive, ii. 3. i.
Refm diuretic, iii. 2. 4. vi. 2. 4.
Rhamnus catharticus, v. j. 2.
See Rlieumatifm, iv. 2. 4. 5, iv. 2. 10. 2.
Rheum palinatum. See Rhubarb.
Rhubarb, iii. 2. i. iv. 2. 5. i. iii. 3. 5, ^.

caufes conftipation, why, iii. a.

I. I.
Rice, vii.
Rofes, iv. 3. 5.
Rot in flieep, iv. 2. 6.

Sago, vii. 3.
Sagopsnum, vi. 3. i.
Sahvation not neceffary, iv. 2. 7.
<. hyfteric, v. 2. 3.

Salt,

INDEX OF THE ARTICLES. 771

Salt, common, unwbolefome, iii. i. 12. Sugar nourirtiing, i. 2. 3. r. and'5. iii. 3. 3.3.

muriatic, ill. ■. I. formed atter the death of the plant, i.

.... in clyfters, iii. 2. 7. 2. 3. 5. _ _ .

Salts, whv diuretic, iii. 2.4. aperient, iii. 3. 5. r.

neutral, iii. 3. 5. 3. iii. 2. 4. Sulphur, iii. 3, 5. 4.

.... improper in coughs and gonorrhoea, iii. Sv/eats in a morning, iii. 2. r. I.

2. 1. on waking, iii. 2. I. i.

Salt fifh and fait meat increafe perfpiration, cold, v. 2. 5. _

iii. 2. I. ..... flopped by opium, iv. %. i. 2.

Saffafras, iii. 3. I.

Scammony, v. 2. 3.

Scarcity, times of, i. 2. 3. 5. and ^. " T

Scilla maritima, v. 2. 2. iv. 2. 3. iii. 3. 3. V. *

2. '^.

Scorbuticlegs, iv. 2. 10. Tasnia, vermes. See Worms.

Scrophulous tumours, ii. 2. 4. iv. 2. g. Tamannds, iii. 3. 5. i.

Sea-water, iii. 3. 5. 3. ' Tanfey, tanacetum, iv.3. 3.

Secernentia, iii. Tar, ui. 3. 3.

Secretion of the bladder, iii. 2. 6. Tartar, cryjlalsof, iii. 3. 5. i. Clafs i. 2.3. 13.

of the reaum, iii. 2.7, vitriolate, iii. 3. 5. 3.

of the fkin, iii. 2. 8. emetic, v. 3, i. v. 2. 2.

Seneka, iii. 3. 3. 2. Tea, vii. 2. I.

Senna, iii. ;. 5. 5. Tears, iii. 2. lO.

Serpentaria virginiana, iii. 3. I. Teftaceous powdere, iv. 2. 2.

Sialagogues, iii. 2. 2. v. 3. 3. Tetradynamia, plants of, iv. 2. 4.

Simarouha, iv. 3. 5. Tindure of digitalis, iv. 2.

Sinapi. iv. ?. 4 ^ Tinea, herpes, iv. 2. 1.4.

Sinapifms, vi. 3. 3. iii. 3- 8. vi. 3. 3. Tobacco, ii. 3. 1. iii. ;■. 9. iv. 2. 3. 8.

Sifymbrium nafturtium, iv. 3. 4. injures digeflion, iii. 3. 2. 3.

Sloes, IV. 2. 2. Tolu balfam, iii.3. 3.

SnufFs of candles, vi. 3. 4. Tormentilla ereda, iv. 3. 5.

Society, i. 2. 3. 7. Torpentia, vii.

Soot, vi 3. 4. Tragacanth gum, ni. 3. 3. 3.

Sorbentia, various kinds, iv. 2. I. Turpentine, vi. 3. 4. _ _

Spafraodic doftrine exploded, vii. 2.3. fpu'it of, m. 2. 6.

Spermaceti, iii. 3. 3. 3. Turpeth mineral, v. 2. 3.

Spice noxious, iii. i. 13. Tuffilago farfara, iii. 3. 3. 3.

Spirit of wine noxious, ii. 2. I.

Sponge, burnt, vi. 3.4.

Squill. See Scilla. tt

Starch, i. 2. 3. i. - *

from Doifonous roots, i. 2. 3. 4- ^^, . . , .

Steam, bath of, iv. 2. 3. 8. Ulcers, fcrophulous, iv. 2. 9.

Steel, iv. 2.6. ...... ot the mouth, iv. 2. 2.

. . . .'forwards and reprefles menflruation, iv. ^^"•'ed by abforption, ii. 2. i. 4. iv. 2.

3. 6. 3' 5-
Stizolobium filiqua hirfuta, iii. 3. 2. vii. 3. 11. ^"^^ ^^''"» '^- 3- 5'
Strychnos nux vomica, ii. 3. i.

Sublimate of mercury, iv. 2. 7. iv. 3. g.

8 V. Valerian,

772

INDEX OF THE ARTICLES.

V.

Vomiting flopped by mercury, vi. 2. 2.
Vomits, "iv. 3. 3. 7.

Valerian, vi. 3. 3.
Vegetable acids, iv. 2. I.

food, i. 3. I. %•

Venereal ulcers, iv. 2. 7.
Venefeftion, vii. 2. 4. iv. 2. 8.

diminiflies fecretions, vii. 2. 4.

increafes abforptions, vii. 3- 4-

Veratrum, v. 3. 3.

Vibices, iv. 2. 4. 3.

Vinegar, iv. 2. I. 9. iv. 3. 4. 3. ii. 2. I. 9.

Vitriol blue in agues, iv. 2. 6. iv. 2. 2.

in ulcers, iv. 3. g.

white, iv. 3. 6. v. 2. I.

„ acid of, iv. 2. I.

in fweats, iv. i. I.

in fmall-pox, iv. I. I,

Volatile fait, vi. 3.6.
Vomiting, v. 2. 3.

w.

Warm bath, ii. 3. 3. i.

in diabastes vi. 2. 4.

Water, i. 2. 4.

...... dilutes and lubricates, vii. 2. 2.

cold, produces fweats, iii. 2.x.

iced, in ileus, vi. 2. 5.

creffes, iv 3. 4.

Whey of milk, iii. 3. 5. 2. i. 2. 3. 2.
Wine, ii. j'. i.

Worms, vii. i. 2. iii. 3. 7. iv. 2. 6. 4,
in flreep, iv. 2. 6. 4.

z.

Zinc, vitriol of, v. 3. i^

THE END.

■V*'W-f_- >'

't

^M>'S

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