NATIONAL LIBRARY OF MEDICINE Washington Founded 1836 U. S. Department of Health, Education, and Welfare Public Health Service 6/6 Z 0 0 N 0 M I A; OR, The Laws of Organic Life. /$ Ayf— PART SECOND. ^ S • ————— in the fame manner as more violent exertions of* volition deftroy greater pains ; and the pulfe in con- fluence fubfides along with the increafe of heat; if more violent efforts of volition are exerted, the fyftem becomes ftill lefs affected by fenfation or irritation. Hence the fever and vertigo of intoxication are leffened by intenfe thinking, Sect. XXI. 8 ; and infane people are known to bear the pain of cold and hunger better than others, Sect. XXXIV. 2. 5 ; and laftly, if greater voluntary efforts exift, as in violent anger or violent exercife, the whole fyftem is thrown into more ener- getic action, and a voluntary fever is induced, as ap- pears by the red fkin, 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 diminiflies the increafed fenfibility, and irritability, and probably the increafed aflbciability, which occurs during fleep; and thus reduces the fre- quency of the pulfe in the feverifh fleep after a full meal. In its more powerful ftate of exertion, it dimi- Vol. II. B nifties i8 DISEASES [Class III. 2. t. nifties or deftroys fenfations and irritations, which are ftronger than natural, as in intoxication, or which precede convulfions, or infanity. In its ftill more powerful degree, the fuperabundance of this fenforial power actuates and invigorates the whole moving fyftem, giving ftrength and frequency to the pulfe, and an univerfal glow both of colour and of heat, as in violent anger, or outrageous infancies. If, in the feverifh fleep above defcribed, the fkin becomes cooled by the evaporation of much perfpira- ble matter, or by the application of cooler air, or thinner clothes, the actions of the cutaneous capillaries are leffened by defect of the ftimulus of heat, which counteracts the increafe of fenfibility during fleep, and the pulfations of the heart and arteries become flower from the leffened ftimulus of the particles of blood thus cooled in the cutaneous and pulmonary veffels. Hence the admiflion of cold air, or ablution with fub- tepid or with cold water, in fevers with hot fkin, whe- ther they be attended with arterial ftrength, or arte- rial debility, renders the pulfe flower ; in the former cafe by diminifhing the ftimulus of the blood, and in the latter by leffening the expenditure of fenforial power. See Suppl. I. 8. and 15. 13. Incubus. The night-mare is an i rpcrfcT: ikep, where the defire of locomotion is vehement, but the mufcles do net obey the will; it is attended with ercat mieafmefs, a fenfe of fuffocation, and frequently with fear. It is caufed by viclent fctlrue, or druzikerjnef*, cr Class III. 2. 1.] OF VOLITION. i9 or indigeftible food, or lying on the bnck, or nerhaps from many other kinds of uneafmefs 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' fyftem 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 accumulate in them, and a painful oppreflion fupervene ; as in fome haemorrhages of the lungs, which occur during fleep ; and in patients much debi- litated by fevers. See Somnus interruptus, Clafs I. 2. 1. 3. and I. 2. J. 9. Great fatigue with a full fupper and much wine, I have been well informed by one patient, rlways produced this difeafe in himfelf to a great degree. Now the general irritability of the fyftem is much de- creafed by fatigue, as it exhaufts the fenforial power; and fecondly, too much wine and ftimulating food will again diminifli the irritability of fome parts of the fyftem, by employing a part of the fenforial power, which is already too fmall, in digefting a great quan- tity of aliment; and in increafing the motions of the organs of fenfe in confequence of fome degree of intoxication, whence difficulty of breathing may occur from the inirritability of the lungs, as in Clafs I. 2. M. M. To fleep on a hard bed with the head raifed. Moderate fupper. The bark. By fleeping on a harder be.! the patient will turn himfelf more frequently, B 2 and xa DISEASES {Class III. 2. r. and not be liable to fleep too profoundly, or lie too long in one pofture. To be awakened frequently by an alarm clock. 14. Letkargus. The lethargy is a fighter apo- plexy. It is fuppofed to originate from univerfal preffure on the brain, and is faid to be produced by compreffing the fpinal marrow, where there is a defici- ency of the bone in the fpina bifida. See Sect. XVIII. 20. Whereas in the hydrocephalus there is only apartial p/efLre of the brain ; and probably in nervous fevers with ftupor the preffure on the brain may affect only the nerves of the fenfes, which lie within the fkull, and not thofe nerves of the medulla oblongata, which principally contribute to move the heart and arteries ; whence in the lethargic or apoplectic ftupor the pulfe is flow as in fleep, whereas in nervous fever the pulfe is very quick and feeble, and generally fo in hydroce- phalus. In cafes of obftrudted kidneys, whether owing to the tubuli uriniferi being totally obftrudted by calculous matter, or by their paralyfis, a kind of drowfinefs or lethargy comes on about the eighth or ninth day, and the patient gradually finks. See Clafs I. 1. 3- 9* 15. Syncope epileptica, is a temporary apoplexy, the pulfe continuing in its natural ftate, and the voluntary power fufpended. This terminates the paroxyfms of cpilepfy. When Class III. 2. 1.] OF VOLITION. 21 When the animal power is much exhaufted by the preceding convulfions, fo that the motions from fenfa- tion as well as thofe from volition 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 fucceeded again by a fyncope. See Epilepfy, Clafs III. 1. 1. 7. 16. Apoplexia. Apoplexy may be termed an uni- verfal palfy, or a permanent fleep. In which, where the pulfe is weak, copious bleeding muft be injurious; as is well obferved by Dr. Heberden, Tranf. of the College. Mr.-----, about 70 years of age, had an apoplectic 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 re- ceive no benefit from this operation; but gradually £ 1:1k, and lived but a day or two. If apoplexy arifes from the preffure of blood extra- yafated on the brain, one moderate venefection may be of fervice to prevent the further effufion of blood ; but copious venefection muft be injurious by weakening the patient; iince the elfufed blood muft have time, as in common vibices or bruifes, to undergo a che- mico-animal procefs, fb to change its nature as to fit it for abforption ; which may take two or tuiee weeks, which time a patient weakened ay repeated venefection or arterioiomy may not furvive. B3 Mrs, 22 DISEASES [Class III. 2. i. Mrs.-----, about 40 years old, had an apoplectic 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 flie might more eafily fwallow the liquid.—This was done every hour, with broth, and wine and water inter- vening, till evacuations were procured ; which with other means had good effect, and flie recovered, ex.. cept that a confiderable degree of hemiplegia remain- ed, and fome imperfection of her fpeech. Many people, who have taken fo much vinous fpirit as to acquire the temporary apoplexy of intoxication, and are not improperly faid to be dead-drunk, have 4'ed after copious venefection, I fuppofe in confc*. qucnce of it. I once faw at a public meeting two gentlemen in the drunken apoplexy ; they were to- tally infenfible with low pulfe, on this account they were directed not to lofe blood, but to be laid on a bed with their heads high, and to be turned every half hour ; as foon as they could fwallow, warm tea was given them, which evacuated their ftomachs, and they gradually recovered, as people do from lefs der grees of intoxication. M. M. Cupping on the occiput. Venefection once in moderate quantity. Warm fomentations long con- tinued and frequently repeated on the fliaved head, Solution of aloes. Clyfters with folution of aloe and oil of amber. A blifter on the fpine. An emetic. Afterward.; Class III. 2. 1.] OF VOLITION. 23 Afterwards the bark, and fmall does of chalybeates. Small electric fhocks through the head. Errhines. If fmall dofes of opium ? 17. Mors a frigors. Death from cold. The un- fortunate travellers, who almoft every winter perifli in the fnow, are much exhauftsd by their efforts to pro- ceed on their journey, as well as benumbed by cold. And as much greater e:\ercife can be borne without fatigue in cold weather than in warm ; becaufe the exceffive motions of the cutaneous veffels are thus prevented, and the confequent waftc of fenforial power ; it may be inferred, that the fatigued traveller becomes p:\ralytic from violent exertion as well as by the application of cold. Great degrees of cold affect the motions of thofe veffels moft, which have been generally excited into action by irritation ; for when the feet are much be- numbed by cold, and painful, and at the fame time almoft infenfible to the touch of external objects, the voluntary mufcles retain their motions, and we conti- nue to walk on ; the fame happens to the fingers of children in throwing fnow-balis, the voluntary mo- tions of the mufcles continue, though thofe of the cutaneous veffels are benumbed into inactivity. Mr. Thompfon, an elderly gentleman of Shrews- bury, wras 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 in (lance g'v n of Mr. Nairn, who, by the J3 4 exertion 24 DISEASES- [Class III. 2. 1. exertion to fave his relation, perifhed himfelf. See Sect. XXXIV. 1. 7. Whence I conclude, that though heat is a fluid ne- ceffary tomufcular motion, both perhaps by its ftimu- lus, and by its keeping the minute component parts of the ultimate fibrils -of 'the mufcles or organs of fenfe at a proper diftance from each other; yet that para- lyfis, properly fo called, is the confequence of exhauf- tion of fenforial power by exertion. And that the accumulations of it during the torpor of the cutaneous veffels by expofure to cold, or of fome internal vif- cus 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. 1. additional note xii. But if thefe increafed exertions be too violent, fo as to ex* hauft the fenforial power in producing unneceffary motions, the animal will probably fooner perifli. 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 exceffivc cold, both by in- creifing the action of the capillary veffels, and thus producing heat, and perhaps by increafing in fome degree the fecretion of fenforial power in the brain, Put the contrary muft happen when taken immode- rately, and not at due intervals. A well attefted Jiiitory was o'^ce r.Lted to me of two men, who fet put Class III. 2. i.] OF VOLITION. a 5 out on foot to travel in the fnow, one of whom drank. two or three glaffes of brandy before they began their journey, the other contented himfelf with his ufual diet and potation; the former of whom pc- riflied 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 ex- haufted by the unneceffary - motions of incipient in- toxication 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 fufficient muf- cular or arterial action, and in confequence fufficient heat, to fupply the great expenditure of it. Hence the capillaries of the fkin firft ceafe to act, and become pale and empty ; next thofe which are immediately affociated with them, as the extremities of the pul- monary artery, as happens on going into the cold bath. By the continued inaction of thefe parts of the vafcular fyftem the blood becomes accumulated in the internal arteries, and the brain is fuppofed to be af- fected by its compreffion; becaufe thefe patients are faid to fleep, or to become apoplectic, before they die. I overtook a fifhman alleep on his panniers on a very cold frofty night, but on waking him he did not ap- pear to be in any degree of ftupor. See Clafs I. 2. 2. 1. When travellers are benighted in deep fnow, they miqht frequently be faved by covering themfelves in it, except a fmall aperture for air ; in which fitua- {ion the lives of hares, fhcep, and other animals, are (9 26 DISEASES [Class III. i.'u fo often preferved. The fnow, both in refpect to its component parts, and to the air contained in its pores, is a bad conductor of heat, and will therefore well keep out the external cold; and as the water, when part of it diffolves, 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 contact with the earth, he is in a degree of heat between 48, the medium heat of the earth, and 32, the freezing point ; that is, in 40 degrees of heat, in which a man thus covered will be as warm as in bed. See Botan. Garden, V. II. notes on Anemone, Barometz, and Mufchus. If thefe facts 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 expofed 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 exertion of thofe veffels, w hen again expofed to a moderarte degree of warmth. See Sect. XII. 5. Whence the propriety of applying but very low de- grees of heat to limbs benumbed with cold at flrft, as of fnow in its ftate of diffolving, which is at 32 de- crees of heat, or of very cold water. A French writer has obferved, that if frozen apples be thawed gradually by covering them with thawing fnow, or immerfing them in very cold water, that they do not lofe their tafte ; if this fact was well afcertained, it might teach us how to preferve other ripe fruits in ice-houfes for » winter confumption. ORDO Class III. 2. 2] OF VOLITION. 27 ORDO II. Decreafed Volition. GENUS II. With decreafed Aclions of the Organs ofSenfe, SPECIES. r. Recolleclionis jaclura. Lofs of recollection. This is the defect of memory in old people, who forget the actions of yefterday, being incapable of voluntary recollection, and yet remember thofe of their youth, which by frequent repetition are introduced by af- fociation or fuggeftion. This is properly the para~ lyfis of the mind ; the organs of fenfe do not obey the voluntary power ; that is, our ideas cannot be re- collected, or acted over again by the will. After an apoplectic attack the patients, on begin- ning to recover, find themfelves moft at a lofs in re.- collecting 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 lan- guage. Mr.-------, a man of ftrong mind, of a fhort necked family, many of whom had fuffered by apoplexy, after an apoplectic fit on his recovering 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 affected me.—* Not 23 DISEASES [Class III. 2. 2. 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, active, and even vigo- rous ; but fhewed that kind of furprife, which novelty excites, at every object it viewed ; and that as often as it viewed it. I never heard the termination of the cafe. 2. Stultitia voluntaria. Voluntary folly. The ab- fence of voluntary 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 action only by their prefent painful or pleafurable fenfations. Hence though they are liable to furprife, when their paffing trains of ideas are diffevered by violent ftimuli; yet are they not affected with wonder or aftonifhment at the novel- ty of objects; as they poffefs but in a very inferior degree, that voluntary power of comparing the pre- fent ideas with thofe previoufly acquired, which diftin- guifhes mankind ; and is termed analogical reafoning, 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 Sect. XVII. 3. 7. 3. Credulitas. Credulity. Life is fliort, oppor- tunities of knowledge rare ; our fenfes are fallacious, pur reafonings uncertain, man therefore ftruggles with Class III. 2. 2] OF VOLITION. 29 with perpetual error from the cradle to the coffin. He is neceffitated to correct experiment by analogy, and analogy by experiment; and not always to reft fatisfied in the belief of facts even with this two-fold teftimony, till future opportunities, or the obferva- tions of others, concur in their fupport. Ignorance and credulity have ever been companions, and have milled and enflaved mankind; philofophy has in all ages endeavoured to oppofe their progrefs, and to loofen the fhackles they had impofed ; philofo- phers have on this account been called unbelievers: unbelievers of what ? of the fictions of fancy, of witch- craft, hobgobbiins, apparitions, vampires, fairies; of the influence of ftars on human actions, miracles wrought by the bones of faints, the flights of ominous birds, the predictions from the bowels of dying ani- mals, expounders of dreams, fortune-tellers, conju- rors, 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 refpect to the facility of their belief or conviction into two claffes ; thofe, who are ready to affent to fingle facts from the evi- dence of their fenh\s, or from the ferious affertions of others; and thofe, who require analogy to corrobo- rate or authenticate them. Our firft knowledge is acquired by our fenfes; but thefe are liable to deceive us, and we learn to detect thefe deceptions by comp ;ng the ideas prefented to us by one fenfe "with thofe prefented by another. Thus 3» DISEASES [Class III. 2. 2. Thus when we firft view a cylinder, it appears to the eye as a flat furface with different fliades on it, till we correct this idea by the fenfe of touch, and find its furface to be circular ; that is, having fome parts gra- dually receding further from the eye than others. So when a child, or a cat, or a bird, firft fees its own image in a looking-glafs, it believes that another ani- mal exifts before it, and detects this fallacy by going behind the glafs to examine, if another tangible ani- mal 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 inftructors, which affect all our future reafoning by their perpetual in- trufions; as thofe habits of mufcular actions of the face or limbs, which are called tricks, when contract- ed in infancy continue to the end of our lives. A third great fource of error is the vivacity of our ideas of jmagination, which perpetually intrude them- felves by various affociations, and compofe the farrago of our dreams ; in which, by the fufpenfion of voli- tion, we are precluded from comparing the ideas of one fenfe with thofe of another, or the incongruity of their fucceffions with the ufual courfe of nature, and thus to detect their fallacy. Which we do in our waking hours by a perpetual voluntary exertion, a procefs of the mind above mentioned, which we have termed intuitive analogy. Sect. XVII. 3. 7. This analogy prefuppofes an acquired knowledge of things, hence children and ignorant people are the moft credulous, as not poffeffmg much knowledge of the Class III. 2.2 ] OF VOLITION. 31 the ufual courfe of nature; and fecondly, thofe are f moft credulous, whofe faculty of comparing ideas, or the voluntary exertion of it, is flow or imperfect. Thus if the power of the magnetic needle of turning towards the north, or the fhock given by touching both fides of an electrized coated jar, was related for the firft time to a philofopher, and to an ignorant perfon ; the former would be lefs ready to believe them, than the latter; as he would find nothing fimi- lar in nature to compare tfiem to, he would again and again repeat the experiment, before he woulcfy give it his entire credence; till by thefe repetitions it would ceafe to be a fingle fact, and would therefore gain the evidence of analogy. But the latter, as having lefs knowledge of nature, and lefs facility of voluntary exertion, would more rqfdity believ#w*tiC • affertions of others, or a fingle fa£tas prefjutf^ to t his own obfervationl Of thi#kiiw are tfaj^KlK of mankind; they continue throughout their iWs in a ftate of childhood, 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 intel- lectual cowardice inftilled into the minds of the people from their infancy, which prevents their inquiry: credulity is made an indifpenfible virtue; to inquire or exert their reafon in religious matters is denounced as finful; and in the catholic church is punifhed with more fevere penances than moral crimes. But in re- fpect to our belief of the fuppofed medical facts, which are $2 DISEASES [Class III. 2. 2. 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 ad- vantage. " When two miraculous affertions oppofe each othfcr, believe the lefs miraculous." Thus if a pcrfon is faid to have received the fmall-pox a fecond time, and to have gone through all the ftages of it, one may thus reafon : twenty thoufand people have been expofed to the variolous contagion a fecond time without receiving the Variolous fever, to every one who has been faid to have thus received it; it ap- pears therefore lefs miraculous, that the afferter of this fuppofed fact has been deceived, or wifhes to de- ceive, than that it has fo happened contrary to the long experienced order of nature. M. M. The Method of cure is to increafe our know- ledge of the la*fs\pf nature, and our habit of com- pariac whatever pleas are prefented to us with thofe knov^fews, and thus to counteract the fallacies of our fenfes, to emancipate ourfelves from the falfe im- preffions which we have imbibed in our infancy, and to fet the faculty of reafon above that of imagination. i TI£ Class IV.J OF ASSOCIATION. 33 THE ORDERS AND GENER4 OF THE FOURTH CLAtt OF DISEASES. CLASS IV. DISEASES OF ASSOCIATION. OR DO I. Increafed Affociate Motions. GENERA. i. Catenated with irritative motions. 2. Catenated with fenfitive motions. 3. Catenated with voluntary motions. 4. Catenated with external influences. ORDO II. Decreafed Affociate Motiqps. GENERA. * 1. Catenated with irritative motions. 2. Catenated with fenfitive motions. 3. Catenated with voluntary motions. 4. Catenated with external influences. ORDO III. Retrograde Affociate Motions. GENERA. 1. Catenated with irritative motions. 2. Catenated with fenfitive mations. 3. Catenated with voluntary motions. 4. Catenated with external influences. Vol. II. C the [ DISEASES [Class IV. i. i. THE GRLZl^, GL^FP.A, AXD SPECIES, OF THE FOURTH CLASS OF DISEASES. CLASS IV. DISEASES OF ASSOCIATION. O R D O I. Increafed Affociate Motions. GENUS I. Catenated with Irritative Motions. SPECIES. i. Rubor vtdtuspranforum. Flufliing of the face after dinner. 2. Sudor Jlragulis immer- Sweat from covering the forum. • face in bed. 3. Ceffatio agrikidinis cute Cure of ficknefs by ftiffiu- excitata. lating the fkin. 4. Digeflio aucla frigore Digeftion increafed by cold- cutaneo. nefs of the fkin. 5. Catarrhus a frigore cu- Catarrh from cold fkin. taneo. 6. Abforptio ccllularis aucla Cellular abforption increaf- vomitu. ed by vomiting. 7. Svn^ultus nephriticus. Nephritic hiccough. 8. Febris irrilaiha. Irritative fever. GENUS Class IV. i. 2.3 OF ASSOCIATION. 3* GENUS II. Catenated with Senfitive Motions. SPECIES. 1. Lacrymarumfuxusfym- Sympathetic fears. patheticus. 1. Sternutatio a limine. Sneezing from light. 3. Dolor dentium ajlridore. Tooth*edge from : grating founds. 4. Rifus fardonicus. Sardonic fmile. 5. Salivafluxus cibo vifo. Flux of faliva at fight of food. 6. Tenfio mamularum vifo Tenfion of the nipples of puerulo. lactefcent women at fight of the child. 7. Tenfio penis in hydropho- Tenfion of the penis in hy- bia. drophobia. 8. Tcnefmus calculofus. Tenefmus from ftone. 9. Polypus narium ex afca- Polypus of the nofe from ride. afcandes.• 10. Grampus fur arum in Cramp from diarrhoea. diarrhoea. 11. Zo?ia ignca nephritica. Nephritic fliingles. 12. Eruptio variolarum.,. Eruption of fmall-pox. 13. Gutta rofea Jlomatica. Stomatic rofy drop. I4.---------hepatka. Hepatic rofy drop. 15. Pcd^gra. Gout. 16. Rheum atifnus. Rheumatifm. 17. EnlipcLis. F.ryfipdas. C 2 iS. T-f- 36 DISEASES [Class IV. i. j. 4. 18. Tedium tumor ingonor- Swelled teftes in gonorrhoea. rhcea. 19.-----------inparoti* <-----------in mumps. tide. GENUS HI. Catenated with Voluntary Motions* SPECIES. J« Dtgltttiifo invit*. Involuntary deglutition. 2. Niclitatio invita* ----------nictitation. 3. Rifus invitus* -------—— laughter. 4. Lufus digiterum invitus.--------.— affions with the fingers. 5* Unguium. morfiimid& ■ biting the nails, invita. 6. Vfgilia invito* ----------watchfulnefs. GENETS IV. Catenated with. External Influences.* SPECIES. 1. Vita ovi. Life of an egg, 2. Vita- hiemi-dvrrftientrum. Life of winter-fleepers. 3. Pullulatio arborum. Budding of trees. 4. Orgafmain venereiptri- Feriedfe of venereal* ctefire. OutCS* 5. Brachii cmcuffio eke- Eteftric ffiocfc through the tries-. arm. 6. Oxygenatiofanguinis* Oxygenation of the bibod, 7. Humeclatio corporis. Humcctatioi* ©f the body. ORDO Cla.m IV. 2. i.] OF ASSOCIATION. 57 ORDO II. Decreafed Affociate Motions, GENUS I. Catenated with Irritative Motions, SPECIES. z. Cutis frigida pranforum* Chillnefs after dinner. i. Pallor urinapranforum. Pale urine after dinner. 3.---------. a frigore--------from cold fkin. cutanea. 4. Pallor ex agritudine. Palenefs from ficknefs. 5. Dyfpnoea a balneifrigido. Shortnefs of breath from cold bathing. 6. Dyfpepfta a pedibus fri* Indigeftion from cold feet. gidis. j. Tuffis a pedibus frigidis. Cough from cold feet. 8.----hepatica. Liver-cough. arthritica. Gout-cough. io. Vertigo rotatoria. Vertigo rotatory. 11.-----vifualis.------vifual. 12.-----ebriofa.-------inebriate. 13.-----febriculofa*------feverifh. 14. - - cerebrofa.-------from the brain. 15. Murmur aurium verti- Noife in the ears. ginofum. i6.Taclus,gufus9olfaclus Vertiginous touch, tafte, vertiginoft. fmell. 17. Pulfus mollis a vomitione. Soft pulfe in vomiting. C 3 18. Pulfus -j 8 DISEASES [Class IV. z. f. 18. Pulfus intermittens a Intermittent pulfe from the ventriculo. ftomach. 19. Febris inirritativa. Inirritative fever. GENUS II. Catenated with Senfitive Motions. SPECIES. 1. Torpor gena a dolore Coldnefs of the cheek from dentis. tooth-ach. 2. Stranguria a dolore ve- Strangury from pain of the fica. bladder. n ---------convulfiva. Convulfive ftrangury. 4. Dolor termini duclus Pain of the end of the bile- choledochi. duct. 5. Dolcr pharyngis ab aci- Pain of the throat from do gcfrico. gaftric acid. 6. Pruritus narium a ver- Itching of the nofe from mibus. worms. 7. Ccphalaa. Head-ach. 8. He mi'lrania et oiakla. Partial head-ach, and ear- ach. 9. Do!or humeri in hepati- Pain of fhoulder in hepatitis. didc. 10. Torpor pedum variola Cold feet in eruption of erumpenie. fmall-pox. 11. leftlum dolor nephriti- Nephritic pain of tetis. cus. 12. Dolor digiti minimiTjvn-Fain of little finger from pathciicus. fvmpathy. 13. Dolor Class IV. 2. 4.] OF ASSOCIATION. 39 13. Dolor brachii in bydrope'Pa.m of the arm in dropfy pecloris. of the cheft. 14. Diarrhxa a dentitione. Diarrhoea from toothing. GENUS III. Catenated with Voluntary Motions. SPECIES. 1. Titubatio lingua. 2. Chorea fancli viti. 3. Rifus. ' 4. Tremor ex ird. 5. Rubor ex ird. 6.------criminati* 7. Tarditas paralytica. 8. -fenilis. Impediment of fpeech. St. Vitus' dance. Laughter. Trembling from anger. Rednefs from anger. Blufh of guilt. Slowncfs from palfy. --------of age. GENUS IV. Catenated with Exterrtal Influences. ": SPECIES. 1. Somni periodus. . . Periods of fleep. 2. Studii inanis periodus.------- of reverie. 3. Hemicrania periodus. ■-------of head-ach. 4. Epilepfia dolorifica pe-------- of painful epilepfy. riodus. 5. Convulfionis dolorifica — — of painful convul- periodus. fi°n« 6. Tuffisperiodicaperiodus. —-----of periodic cough. C 4 7- Cala' |o DISEASES [Class IV. i. 3. 7. Catamenia periodus* Periods of catamenia. 8. Hamorrhoidis periodus* ■ ■ of the piles, 9. Podagra periodus* —-----of the gout. jo. Erylipelatisperiodus. ■— of eryfipelas. 11. Febrium periodus, ——— of fevers. ORDO III. Retrograde Affociate Motions. GENUS I. Catenated with Irritative Motions. SPECIES. j. Diabates irritata* Diabetes from irritation. 2. Sudor frigidus in afih. Cold fweat in afthma. mate* 3. Diabates a timore. Diabetes from fear. 4 Diarrhoea a timore* Diarrhoea from fear. 5. Pallor et tremor a ti' Palenefs and trembling from more. fear, 6. Palpitatio cordis # ti- Palpitation of the heart more. from fear. 7. Abortio a timore. Abortion from fear. %, HyQeria. a timore. Hyfterics from fear. GENUS Class IV. 5. *. 3.] OF ASSOCIATION. 4* GENUS n. Catenated with Senfitive Motions. SPECIES. 1. Naufea idealis. Naufea from ideas. 2.------a conceptu* Naufea from conception. 3. Vomitio vertiginofa. Vomiting from vertigo. 4.------a calculo in ure---------from ftone in the tere. ureter. c..------ab infultupara---------fromftrokc of pal- lytico. fy. 6..-----a titilatione fau- Vomiting from tickling the cium. throat. 7.-----cutefympathetica*-------- from fympathy with the fkin. GENUS III. Catenated with voluntary Motions. SPECIES. I. Ruminatio. Rumination. 2. Vomitio voluntaria. Voluntary vomiting. 3. Eruftatio voluntaria* --------— eructation. GENUS ** DISEASES [Class IV. 3. GENUS IV. Catenated with external Influences* SPECIES. 1. Catarrhus periodicus* Periodical catarrh. 2. Tuffs periodica. Periodic cough. 3. Hy/leria afrigore. Hyfterics from cold. 4. Naufea piuvialis. Sicknefs againft rain. CLASS Class IV. i. i.] OF ASSOCIATION. 43 CLASS IV. DISEASES OF ASSOCIATION, ORDO I. Licrcnfd Affelate Motions. GENUS I. Catenated with Irritative Met ion. The importance of the fubfequent clafs not only confifts in its elucidating all the fympathetic ciiieaia:', but in its openings road to the knowledge of fever. The difficulty and novelty of the fubject mult p'.-aJ in excufe for the prefent imperfect ftate of it. T* reader is entreated previoufly to attend to the fol- lowing circumftances for the greater facility of in\ de- gating their intricate connections ; which I fliall enu- merate under the following heads. A. Affociate motions diftinguifhed from catenations. B. • Affociate motions of three kinds. C. Affociations affected by external influences. D. Affociations affected by other fenforial motions. E. Affociations catenated v. it:: fenfation. F. Direct, and reverfe fympathy. G. Affociations affected four ways. H. Origin of affociations. I. Of the action of vomiting. II. Tertian aflbciatio;^. K.Ai: Qtk 4* DISEASES [Class IV. i. r. A. Affociate Motions diflinguifhedfrom Catenations. Affociate motions properly mean only thofe, which are caufed by the fenforial power of aflbciation. Whence it appears, that thofe fibrous motions, which conftitute the introductory link of an affociate train of motions, are excluded from this definition, as not being themfelves caufed by the fenforial power of aflbciation, but by irritation, or fenfation, or voli* tion. I fliall give for example the flufliing of the face after dinner; the capillary veffels of the face increafe their actions in confequence of their catenation, not their aflbciation, with thofe of the ftomach ; which latter are caufed to act with greater energy by the irritation excited by the ftimulus of food. Thefe ca- pillaries of the face are aflbciated with each other re- ciprocally, as being all of them excited by the fen- forial power of aflbciation ; but they are only cate- nated with thofe of the ftomach, which are not in this cafe affociate motions but irritative ones. The com- mon ufe of the word aflbciation for almoft every kind of connection has rendered this fubject difficult; from which inaccuracy I fear fome parts of this work are not exempt. B. Affociate Motions of three Kinds. Thofe trains or tribes of affociate motions, whofe, introductory link confifts of an irritative motion, are termed irritative affociations; as when the mufcles of the eyelids clofe the eye in common nictitation. Thofe, whofe introductory link confifts of a fenfitive metion, Class IV. i. i.J OF ASSOCIATION. $ motion, are termed fenfitive affociations; as when the pectoral and intercoftal mufcles act in fneezing. And laftly, thofe, whofe introductory link confifts of a voluntary motion, are termed voluntary affociations; as when the mufcles of the lower limbs act in concert with thofe of the arm in fencing. C. Affociations qffecled by external Influences. Circles of affociate motions, as well as trains anc! tribes of them, are liable to be affected by external influences, which confift of ethereal fluids, and which, by penetrating the fyftem, act upon it perhaps rather as a caufa fine qua. non of its' movements, than directly as a ftimulus; except when they are accumulated ia unufual quantity. We have a fenfe adapted td the perception of the excefs or defect of one of thefe fluids; I mean that of elementary heat; in which all things are imraerfed. See Clafs IV. 1. 4. 1. But there are others of them, which as we have no power to evade their influence, fo> we have no fenfe to perceive it; thefe are the fbkr, and lunar, and terreftrial gravi- tation, in whkh alfb all things are immerfedj the electric aura, which pervades us, and is perpetually varying, See Clafs IV. 1. 4. 5; the magnetic fluid, Clafs IV. r. 4. 6; and laftly, the great life-preferver oxygen gas, and- the aqueous vapour of the atmofphere, fee Clafs IV. 1.4.6. and 7. and 2. Of thefe external influences thofe of heat, and of gravity,, have diurnal periods of increafe and de- ceafej. befides their greater periods of monthly or aiTiual 46 DISEASES [Class IV. i. r. ' a~r::?.!'variation. The manner in which they act by periodical increments on the fyftem, till fome effect is produced,' is fpoken of in Seel. XXXII. 3. and 6. D. Alloc:ailms ajfccled by other Senforial Motions. Circles and trains of affociate motions are alfo liable fo be affected by their catenations with Other fenforial '• powers, as of irritation, or fenfation, or volition ; which other fenforial powers either thus Amply form fome of the iinks of the catenation, or add to. the.ener- gy of the affociated motions. Thus when vomiting is caufed by the ftimulus of a ftone 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 fkin increafe their action from the influence of external heat, they are excited both by the ftimulus of unufual heat, as well as by the ftimulus of the blood, and by their accuf- ■ lomed afbeiation with the actions of the heart and ? rteries. And laftly, in the blullv of anger thefen- torial power of volition is added to that of aflbciation, and irritation, to excite the capillaries of the face with increafed action. See Clafs IV. 2. 3/ 5. . E. AJfoclaiions catenated with Scnfation. Pa'.n frequently accompanies affociate trains or cir- cles of motion without its being a caufe, or a link, of them, but limply an attendant fymptom ; though it frequently gives name to the difeafe, as head-ach. TUui in the cramp of the calves of the legs in diar- rhoea, Class IV. i. i.] OF ASSOCIATION. . .47 rhcea, the increafed fenforial |>ower of afTociation is the proximate caufe; the preceding increafed action of the bowels is the remote caufe; and the proximate effect is the violent contractions of the mufculi gaftroc- nemii; but the pain of thefe mufcles is only an atten- dant fymptom, or a remote effect. See Sect. XVIII. 15. Other fenfitive affociations are mentioned in Clafs IV. 1. 2. and IV. 1. 2. 15. Thus, if the flufliing of the face above mentioned after dinner be called a difeafe, the immediate or proximate caufe is the increafed power of aflbciation the remote caufe is the increafed irritative motions of the ftomach in confequence of the. ftimulus of food and wine. The difeafe or proximate effect confifts in the increafed actions of the cutaneous veffels of the face ; and the fenfation of heat, the exiftence of heat, and the red colour, are attendants or fymptoms, or remote effects, of the increafed actions of thefe cuta- neous veffels. F. Direcl aud reverfe Sympathy* The increafed actions of the primary part of the trains of affociated motions are fometimes fucceeded by increafed actions of the fecondary part of the train; and fometimes by decreafed actions of it. So like- wile the decreafed actions of the primary part of a train of affociate motions are fometimes fucceeded by decreafed actions of the fecondary part, and fometimes bv increafed actions of it. The former of thefe fixa- tions is called direct fvmpathy, and the latter reverfe fympathy. 4« DISEASES tCtAss IV. i. t. fympathy. In general I believe, where the primary part of the train of affociated motions is everted more than natural, it produces direct 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 lefe than natural, it produces direct fympathy in weak people, and reverfe fympathy in ftrong ones, as on being expofed for a certain length of time on horfc- hack in a cold day gives indigeftion and confequent heart-burn to weak people, and ftrengthens the digef- tion, and induces confequent hunger, in ftrong ones. &* Sect. XXXV. t. This may perhaps be more eafily underftood, by confidering ftrength and weaknefs, when applied to animal bodies, as confuting in the quantity of fenforial power rending ill the contracting fibres, and the quan- tity of ftimulus applied* as fhewn in Sect. XII. 2. 1. Now when defective ftimulus, within certain limits, is partially applied to parts fubject to perpetual motion, the expenditure of fenforial power is for a while leffened, but not its general production in the brain, nor its derivation into the weakly-ftimulated part. Hence in ftrong people^ or fuch whofe fibres abound with fenforial power, if the firft tribe of an affociate train of motions be deprived m part of its accuftomed ftimulus, its action becomes diminished; and the fen- forial power becomes accumulated, and by its fuper- abundance, or overflowing as it Were, increafes the action of the fecond tribe of the afiociate actions by 1 reverfe Class IV. x. i.] OF ASSOCIATION. 49 reverfe fympathy. As expofing the warm fkin for a moderate time to cold air increafes the action of the ftomach, and thus ftrengthens the power of digeftion. On the reverfe, when additional ftimulus within certain limits is partially applied to parts, which are deficient in refpect to the natural quantity of fenforial power, the expenditure of fenforial power is increafed, but in a lefs degree than the increafed production of it in the brain, or its increafed derivation into tha ftrongly-ftimulated organ. Hence in weak people, or fuch whofe fibres are deficient of fenforial power, if the firft tribe of an affociate train of motions be fub- iected for a while to greater ftimulus than ufual, a greater production of fenforial power, or a greater derivation of it into the ftimulated parts occurs ; which by its excefs, or overflowing as it were, increafes the actions of the fecond tribe of the affociate motions by direct fympathy. Thus when vomiting occurs with cold extremities, a blifter on the back in a few hours oceafions univerfal warmth of the fkin, and flops 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 fkin, oc- eafions univerfal warmth of it, and checks or cures the diarrhoea. In fome affociate trains of action neverthelefs re* verfe fympathies more frequently occur than direct ones, and in others direct ones more frequently than reverfe ones. Thus in continued fever with debility there appears to be a reverfe fympathy between the Vol. II. D capillary jo DISEASES [Class IV. i. t. capillary veflch of the ftomach and thofe of the fki» ; becaufe there exifts a total averfion to folid food, and conftant heat on the furface of the body. Yet thefe two fyftems of veffels are at other times actuated by direct fympathy, as when palenefs attends ficknefs, or cold feet induces indigeftion. This fubject requires to be further inveftigated, as it probably depends not only on the prefent or previous plus or minus of the fenforial power of aflbciation, but alfo on the intro- duction of other kinds of fenforial power, as in Clafs IV. i. i. D; or the increafed production of it in the brain, or the greater mobility of one part of a train of actions than another. Thus when much food or wine is taken into the ftomach, if there be no fuperfluity of fenforial power in the fyftem, that is, none to be fpared from the con- tinual actions of it, a palenefs and chillnefs fucceeds for a time; becaufe now the expenditure of it by the increafed actions 'of the ftomach is greater than the prefent production of it. In a little time however the ftimulus of the food and wine increafes the production of fenforial power in the brain, and this produces a fuperfluity of it in the fyftem ; in confequence of which the fkin now becomes warm and florid, which was at firft cold and pale ; and thus the reverfe fympathy is fhortly converted into a direft one ; which is pro- bably owing to the introduction of a fecond fenforial power, that of pleafurable fenfation. On the contrary, when an emetic drug produces fn-kaefs, the fkin is at firft pale for a time by direct fympathy Class IV. i. i.] OF ASSOCIATION. 51 fympathy with the capillaries of the ftomach ; but in a few minutes, by the accumulation of fenforial power in the ftomach during its lefs active ftate in ficknefs, the capillaries of the fkin, which are affociated with thofe of the ftomach, aft with greater energy by re- verfe fympathy, and a florid colour returns. Where the quantity of action is diminifhed in the firft part of a train of motions, whether by previous diminution of fenfor'al power, or prefent diminution of ftimulus, the fecond part of the train becomes torpid by direct fympathy. And when the quantity of action of the firft part becomes increafed by the accumulation of fenforial power during its previ6us torpor, or by in- creafe of ftimulus, the actions of the fecond part of it likewife become increafed by direct fympathy. In moderate hunger the fkin is pale, as before din- ner, and in moderate ficknefs, as no great accumu- lation of fenforial power has commenced ; but in vio- lent hunger, and in greater torpor of the ftomach, as from contagious matter, the accumulation of fenforial power becomes fo great as to affect the arterial and capillary fyftem, and fever is produced in both cafes. In contagious fevers with arterial debilities com- mencing with torpor of the ftomach, why is the action of the heart weakened, and that of the capillaries in- creafed ? 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 aflbciation between the mufcular fibres of the ftomach and thofe of the heart have bem uniformly affociated by direct D 2 fympathy; rz DISEASES [Class IV. 1.1. fympathy; and the capillaries of the ftomach and thofe of the fkin have been more frequently affociated by reverfe fympathy r" Where the actions of the ftomach have been pre- vioufly c*:haufted by long ftimulus, as on the day after intoxication, little or no accumulation of fenforial power occurs, during the torpor of the organ, beyond what is required to replace the deficiency of it, and hence fever feldom follows intoxication. Aid a repe- tition of the ftimulus fometimes becomes neceflary even to induce its natural action, as in dram-drinkers. Where there has been no previous cxhauftion of fenforial power, and the primary link of affociate motions is violently actuated by the fenforial power of fenfation, the fecondary link is alfo violently ac- tuated by direct fympathy, as in inflammatory fevers- Where however the fenforial power of the fyftem is lefs than natural, the fecondary link of affociated motions becomes torpid by reverfe fympathy, as in she inoculated fmall-pox during- the eruption- on the face the feet are frequently cold. G. Ajfcciatwns affected four Ways. Hence affociated trains or circles of motions may be ai^ectsd four different ways. i. By the greater or leb; energy of action of the firft fick wkh winch they are catenated, and from which they uke i:\tir names; as irritative, fenfitive, or voluntary affociations. 2. By being excited by two or more ftalbnai powers at the fame tane, a* by irritaroii and ^'Tbcluion, as in the Cx.ass IV. i. i.] OF ASSOCIATION. c- the inftance of the application of the ftimulus of in- creafed 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 aflbciation into action ; as the pain at the neck of the gall-blad- der occafioned by a gall-ftone is transferred to the other end of that canal, and becomes a link of cate- nation between the action-of the' two extremities 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 conftituting necef- fary parts of the fyftem, rather than ftimuli to excite it into action. H. The Origin of Affociations. Some trains or circles of affociate motions muft have been formed before our nativity, as-thofe of the heart, arteries, and capillaries ; others have been affociated, *s occafion required them, as the mufcles of the dia- phragm and abdomen in vomiting ; and others by perpetual habit, as thofe of the ftomach with the heart and arteries directly, as in weak pulfe during ficknefs ; wlt:i the capillaries directly, as in the fiuflied fkin after dinner ; and laftly, whh the cellular abforbents reverfeiy, as in the increafed abforption in anafarca during ficknefs ; and with the irritati/c motions of the organs of fenfe reverfeiy, as in vertigo, or fea-ficknefs. Some of thefe affociations fliall be here fhortly de- fcribed to fa:i!itate the investigation of others. D 3 Firft, t 54 DISEASES [Class IV. i. i. Firft, .other congeries of glands occupy but a par- ticular part of the fyftem, or conftitute a particular Qrgan, as the liver, or kidneys; but thofe glands, which fecrete the mucus, and perfpirabie matter, which 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 cat^ity of the body ; and the perfpirabie matter, which foftens and lubricates the whole furface of the flan, and the more extenfive furface of the air-veffels, which compofe the lungs. Thefe are fupplied with blood by the perpetual action of the heart and arteries, and have therefore their motions affociated with the former, and with each other, by fympathy, which is fometimes direct, and fometimes reverfe. One branch of this aflbciation, the capillaries of the fkin, 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 direct fympathy to act in concert with the former, as in going into the cold bath. And it is probable the capillaries of the internal membranes are like wife directly affected by-their fympathy with thofe of the i!:in, as appears from the defect of fecretion in ulcers during the cold fits of agues. The motions of this extenfive fyftem of capillaries, thus afibci.ued by direct fympathy, are alfo alfociated with thofe of the heart and arteries, fometimes by re- verfe and fometimes by direct fympathy ; and thus CQiiftitutc ample fever. The cold paroxyfm of which CQufifts Class IV. i, L.J OF ASSOCIATION. 55, confifts in their torpor, and the hot one in their ar- gafm, or increafed activity. I. Of the Aclion of Vomiting. The manner, in which the ftomach and the dia- phragm and abdominal mufcles acquire their affociate action in vomiting, requires fome attention. It is not probable, that this action of vomiting occurs be- fore nativity; as the uniform application of the nutri- tive liquor amnii to the mouth of the foetus, and the uniform expenditure of its nourifliment, would not feem to give occafion to too great temporary repletion of the ftomach ; and would preclude the deglutiticn of any improper material. After nativity the ftomach of the child may be occafionally too much diftended with milk ; as previous hunger may induce it to over- gorge itfelf; and by repeated efforts the act of vomit- ing is learned, as a means of getting free from a difagreeable fenfation. 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 difagree- able material out of the mouth again. When the ftomach is difagreeably ftimulated by the diftention or acrimony of the aliment, a fimilar effort lo regurgitate it muft occur; and by repeated trials the action of the diaphragm and abdominal mufcles by fqueczing the ftomach affifts its retrograde exertion to di'^orge its contents. In the fame manner when a piece of gravel is puflied into the urethra, or a piece P 4 of 5S DISEASES [Clasp IV. i. i. of indurated bile into the neck of the gall-bladder, after they have been in vain preffed forward by the ufual motions of thofe ducts, 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 inftantancous rejection from the ftomach occafioned by fome naufeous drug, or from fome naufeous idea; and laftly, from the voluntary power, which fome people have been faid to have acquired, of emptying their ftomachs, much in the fame manner as ruminating animals bring up the grafs from their firft ftomach. There are nevertheless many modes by which thefe inverted motions of the ftomach and ccfophagus arc induced, and which it is of confequence to diftinguifli from each other. The firft is the mode above de- fcribed, where an effort is made to diflodge fomething, which ftimulates the ftomach •into difagreeable fenfa- tion ; and which is returned by repeated exertions ; as when- a naufeous drug is taken into the mouth, or a bit of fand falls into the eye, or a drop of water into the wind-pipe. In this the periftaltic motions of the ftomach are firft flopped, and then reverted by pain- ful fenfation ; and the abdominal mufcles and dia- phragm by repeated efforts become affociated with them. Now as lefs fenforial power is expended on the retro- grade actions of the ftomach, and of the lymphatics, which open their mouths on its furface, than by their natural motionj, an accumulation of femorial power Class- IV. i. i.] OF ASSOCIATION. 57 in the fibres of the ftomach follows the exhibition of an emetic, and on that account an emetic will fome- times ftop a fpontaneous vomiting which was owing to fenforial deficiency. See Sect. XXXV. i. 3. and Art. V. 2. 1. As bitters and metallic falts, exhibited in fmall dofes, ftimulate the ftomach into greater action, as appears by their increafmg the power of digeftion, and yet become emetic, when given in larger dofes ; one might fufpedt, that they became emetic by inducing debility, and confequent retrograde actions of the ftomach, by their previoufly exhaufting the fenforial power by their great ftimulus ; which might be effected in a moment without producing pain, and in confequence without our perceiving it. But on the contrary, there does not in general appear on the exhibition of emetics to be any previous exhauftion of fenforial power ; be- caufe there is evidently an accumulation of it during the ficknefs, as appears from the digeftion being ftron- ger afterwards; and from the increafed action of the cellular and cutaneous abforbents during its operation. See Art. V. 2. 1. Another mode, by which vomiting is induced, h owing to debility or deficiency of fenforial power, from the previous exhauftion of it; as on the day after intoxication, or which occurs in people enfeebled with the gout, and in dropfy, and in fome fevers with debility. In thefe, when the vomiting ceafes, there is no appearance of accumulation of fenforial pow- er, as the digeftion ftill remains weak and imperfect. Another 5* DISEASES [Class IV. i. x. Another mode by which ficknefs or vomiting is induced, is by defect 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 fick after taking food without thefe additional ftimuli. Other means of inducing ficknefs by vertigo, or by naufeous ideas, will be mentioned below. We fliall only add, that the motions of the mufcu- lar fibres of the ftomach are affociated with thofe of the heart and arteries by direct fympathy, as appears by the weaknefs of the pulfe during the exhibition of an emetic ; and that the abforbents of the ftomach are affociated with the cellular and cutaneous abfor- bents by reverfe fympathy, as is fhewn by the great abforption of the mucus of the cells in anafarca during ficknefs ; at the fame time that the abforbents of the ftomach invert their actions, 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 debility, either by its aflbciation 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 contagi- ous miafmata are fwallowed with the faliva, and where fever is produced by fea-ficknefs, which I once faw. Neverthelefs a diforder of the ftomach does not ahvayi. induce fever, as in that cafe it fhould conftantly attend indigeftion, and -xergito, and fta-ficknefs; but is Class IV. i. i.] OF ASSOCIATION. 59 is itfelf frequently induced by aflbciation with the difordered movements of other parts of the fyftem, as when it arifes from gravel in the ureter, or from a percuflion on the head. The connexion of the motions of the ftomach with irritative ideas, or motions of the urgans of fenfe, in vertigo, is fhewn in Sect. XX. and thus it appears, that many circles of aflbciation are either directly or reverfely affociated, or catenated, with this vifcus; which will much contribute to unfold fome of the fymptoms of fever. K. Tertian Affociations. The third link of affociate trains of motion is fome- times actuated by reverfe fympathy with the fecond, link, and that by reverfe fympathy with the firft link ; fo that the firft and third link may act by direct fym- pathy, and the intermediate one by reverfe fympathy. Of this inftances are given in the fyngultus nephriti- cus, Clafs IV. 1. 1.7. and IV. 2. 1. At other time* the tertian or quartan links of affociate motions are actuated by direct fympathy ; and that fometimes for- wards and fometimes backwards in refpeet to the ufu;.l order of thofe trains of affociate motions, as in Clafs IV. 1. 2. 1. SPECIES. 1. Rubor vidtih pranforum. Flufliing of the face after dinner is explained in Sect. XXXV. 1. In the beginning of intoxication the whole fkin becomes florid £rpm the aflbciation c; tae actions of the cutaneous arteries 6s DISEASES [Class IV. i. i. arteries with thofe of the ftomach, becaufe vinous fpirit excites the fibres of the ftomach into more violent action than the ftimulus of common food; and the cutaneous capillaries of the face, from their more fre- quent expofure to the viciflitudes of cold and heat, poflefs more mobility or irritability than thofe of other parts of the fkin, as further explained in Sect. XXXIII. 2. 10. Vinegar is liable to produce this flufhing 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 effect. In every kind of blufh the arterial blood is propelled into the capillaries fafter than the venous abforption can carry it forwards into the veins, in this refpect refembling the tenfio phalli. Can the beginning vinous or acetous fermentation of the aliment in weak ftomachs contribute to this effect ? or is it to be afcribed to the greater power of affocia- lion between the arteries of the face and the fibres of the ftomach in fome people than in others ? M. M. Eat and drink lefs 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 be loofe. Ufe no fermented li- quors, or vinegar, or fpice. 2. Sudor Jlragulis immcrforum. Sweat from being covered in bed. In the commencement of an epidemic fever, in which the perpetual efforts to vomit wras a uiftrefling fymptom, Dr. Sydenham difcovercd, that if Class IV. r. i.} OF ASSOCIATION. Ci if the patient's head was for a fhort time covered over with the bed clothes, warmth was produced, and a fweat broke cut upon the fkin, and the tendency to vomit ceafed. In this curious fact two trains of affo- ciated motions are excited into increafed action. Firft, the veffels of the lungs are known to have their mo- tion affociated with thofe of the fkin by the difficulty of breathing on going into the cold bath, as defcribed in Se£t. XXXII. 3. 2. Hence, when the veffels of the lungs become excited into ftronger action, by the bad air under the bed clothes, warmed and adulte- rated by frequent breathing, thofe of the external fkin foon become excited by their aflbciation into more energetic action, and generate more heat along with a greater fecretion of perfpirabie matter. Se- condly, the fympathy between the ftomach and /kin is evident in variety of circumftances ; thus the cold air of frofty days applied to the fkin for a fhort time increafes the action of the ftomach by reverfe fympa- thy, but decreafes it if continued too long by direct fympathy ; fo in the circumftanee above mentioned the action of the ftomach is increafed by direct fym- pathy with that of the fkin; and the tendency to vomit, which was owing to its diminifhed aftion, ceafes. 3. Ceffatio agritudinis cute excitatd. The cure of ficknefs by ftimulating the fkin. This is explained in the preceding article; and further noticed in IV. 2. 2. 4. and in IV. 1. 1. f. Similar DISEASES [Class IV. i. t. ' Similar to thefe is the effect of a blifter on the hack in relieving ficknefs, indigeftion, and heart-burn ; and, on the contrary, by thefe fynp terns being fre- quently induced bv coldnefs of the extremities. The blifter ftimulates the cutaneous veffels into greater ac- tion ; whence warmth and pain are produced at the fame time, and the fibres of the ftomach are excited into greater action by their aflbciation with thofe of the fkin. It does not appear, that the concomitant pain of the blifter caufes the increafed energy of the ftomach, becaufe the motions of it are not greater than natural ; though it is fometimes difficult to determine, whether the primary part of fome affo- ciated trains be connected with irritative or fenfitive motions. In the fame manner a flannel fhirt, to one who has rot been in the habit of wearing one, ftimulates the ikin by its points, and thus flops vomiting in fome cafes; and is particularly efficacious in checking fome clironical diarrhoeas, which are not attended with _ fever; for the abforbents of the ikin are thus ftimu- kited into greater action, with which thofe of the interlines confent by direct fympathy. This effect cannot be afcribed to the warmth alone of the flannel fhirt, as being a covering of loofe texture, and confining air in its pores, like a fponge, which air iv kuov/n to be a bad conductor of heat, fince in that cafe its ufe fhould be equally efficacious, if it were worn over a linen fhirt; and an increafed warmth of the room of the patient would be equally ferviceable. 4. Digcftie Class IV. i. n] OF ASSOCIATION. C3 4. Digcflio aucla frigore cutaneo. Digeftion increafed by coldnefs of the fkin. Every one has experienced the increafe of his appetite after walking in the cool air in frofty days ; for there is at this time not only a faving of fenforial power by the lefs exertion of the cutaneous veffels; but, as thefe confent with thofe of the ftomach and bowels, this faving of fenforial power is transferred by reverfe fympathy from the cutaneous capillaries and abforbents to thofe of the ftomach and inteftines. Hence weak people fhould ufe the cold air of winter as a cold bath ; that is, they fhould ftay in it but a fhort time at once, but fhould immerfe themfelves in it many times a day. 5, Catarrhus a frigore cutaneo. Catarrh from cold fkin. This has been already explained in Clafs I. 1. 1. 7. and is further defcribed in Sect. XXXV. 1. 3. In this difeafe the veffels of the membrane, which lines the noftrils, are excited into greater action ; when thofe of the fkin, with which they arc affociated, are excited into lefs action 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 cutane- ous veffels, and not with the pain of them, becaufe no inflammation follows. 6. Abforpilo cdlularis aucla vomit u. In the act of vomiting the irritative motions of the ftomach arc inverted, 64 DISEASES [Class IV. i. u inverted, and of the abforbents, which open their mouths into it; while the cutaneous, cellular, and pulmonary abforbents are induced, by reverfe fympa- thy with them, to act with greater energy. This is feen in cafes of anafarca, when long ficknefs and vo- miting are caufed by fquills, or antimonial falts, or moft of all by the decoction of digitalis purpurea, foxglove ; and Mr. J. Hunter mentions a cafe, in which a large bubo, wThich was juft ready to break, was abforbed in a few days by ficknefs at fea. Trea- tife on the blood, p. 501, which is thus accounted for ; lefs fenforial power is expended during ficknefs by the decreafed action of the fibres of the ftomach., and of its abforbents; as fhewn in Sect. XXXV. 1. 3. whence an accumulation of it is produced, and there is in confequence a greater quantity of fenforial power for the exertion of thofe motions, which are affociated with the abforbents of the ftomach by reverfe fympathy. The reverfe fympathy between the lacteal and lym- phatic branches of the abforbent fyftem have been produced by the one branch being lefs excited to act, v. hen the other fupplies fufficient fluid or nutriment to the fanguiferous veffels. Thus when the ftomach is full, and 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 fkin raoift, from the defect of abforption on thofe furfaces. 7. Syngultus nephriticus. When a ftone irritates the ureter, and that even without its being attended 1 with Class IV. i. i/) OF ASSOCIATION. 6c with pain or fever, fometimes a chronical hicc6ij|h occurs, and continues for days and weeks, inftead of ficknefs or vomiting; which are the common fymp- toms. In this cafe the motions of the ftomach are decreafed by their fympathy with thofe of the ure- ter, 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 aflbciation with the ftomach by a fecond reverfe fympathy. This hiccough may neverthelefs admit of another explana- tion, and be fuppofed to be a convulfive exertion of the diaphragm to relieve the difagreeable fenfation of the ftomach in confequence of its difordered irri- tative affociations; and in that cafe it would belong to Clafs III. i. i. See Clafs IV. 2. 1. for another example of tertiary aflbciation. M. M. Venefection. Emetic. Calomel. Cathar- tic, opium, oil of cinnamon from two to ten drops* Aerated alkaline water. Peruvian bark. 8. Febris irritativa. Irritative fever, defcribed in Clafs I. 1. 1. 1. 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 affociated with the arterial fyftem, as to throw it into diforder, when they are flightly deranged ; but when any great congeries of conglo- merate glands, which may be confidered as the ex- tremities of the arterial fyftem, are affected with tor- por, the whole arterial fyftem and the heart fympa* Vol. II. E thize 65 DISEASES [Class IV. i. a-. fchize with the torpid glands, and act with lefs energy; wWh conftitutes the cold fit of fever; which is therefore at firft a decreafed action of the affociate organ ; but as this decreafe of a£tion is only a tem- porary 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. ORDO I. Increafed Affociate Motions. GENUS II. Catenated with Senftive Motions. The primary links of the affociated actions of this genus are either produced or attended by painful or •pleafurable fenfation. The fecondary links of the firft ten fpecies are attended with increafed motions without inflammation, thofe of the remainder arc at- tended with inflammation. All inflammations, which do not arife in the part which was previoufly torpid, belong to this genus; as the gout, rheumatifm, eryfi- pelas. It is probable many other inflammations may, by future obfervation, require to be tranfplanted into this clafs. The circles of fenfitive affociate motions confift chiefly of the excretory ducts of the capillaries and of the Class IV. i. 2.] OF ASSOCIATION. 6? the mouths of the abforbent veffels, which conftitute the membranes; and which have been induced into action at the fame time; or they confift of the ter- minations of canals; or of parts which are endued with greater fenfibility than thofe which form the firft link of the affociation. An inftance of the firft of thofe is the fympathy between the membranes of the alveolar proceffes of the jaws, and the membranes above or beneath the mufcles about the temples in hemicrania. An inftance of the fecond is in the fym- pathy between the excretory duct of the lacrymal gland, and the nafal duct of the lacrymal fac. And, an inftance of the third is the fympathy between th£ membranes of the liver, and the fkin of the face in the gutta rofea of inebriates. SPECIES. 1. Lacrymarum fluxus fympatheticus. A flow of tears from grief or joy. When the termination of the dudt of the lacrymal fac in the noftrils becomes affected cither by painful or pleafurable fenfations, in confe- quence 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 Sect. XVI. 8. 2. In this cafe there exifts a chain of affociated actions, 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 ftimulates the E 2 puncta- 68 DISEASES [Class IV. 1. z. puncta lacrymalia into greater aftion ; and the fluid thus abforbed ftimulates the lacrymal fac, and its nafal du& in the nofe into greater action. In a contrary direction of this chain of affociation the prefent in- creafe of action is induced. Firft, the nafal duct of the lacrymal fac is excited into increafed action by fome pleafnrable or painful idea, as defcribed in Sect. XVI. 8. 2. 2d. The puncta lacrymalia or other ex- tremity of the lacrymal fac fympathizes with it (as the two ends of all other canals fympathize with each Other). 3d. With thefe increafed motions of the puncta lacrymalia thofe of the excretory duct of the lacrymal gland are affociated from their having fo per- petually acted together. And, laftly, with the in- creafed actions of the excretory duct of this gland are affociated thofe of the other end of it by their fre- quently acting together; in the fame manner as the extremities of other canal's are affociated; 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 ferrfations, when great, excite the faculty of volition; and the perfon conti- nues voluntarily to caH up or perform thofe ideas, which occafion the painful fenfation; that is, the afflicted perfon becomes fo far infane or melancholy ; but tears are produced by the fenforial faculty of affo- ciation, and ftiew that the pain is fo far relieved as not to excite the exceffive power of volition, or infa- iu\y, and are therefore a fign of the abatement of the painful Class IV. i. 2.] OF ASSOCIATION. €9 painful ftate of grief, rather than a caufe of that abatement. See Clafs III. 1. 2. 10. 2. Sternutatio a lumine* Some perfons fneeze from looking up at the light fky in a morning after coming out of a dark bed-room. The olfactory nerves are brought into too great action by their fympathy with the optic nerves, or by their refpedtive fympathies with fome intervening parts, as probably with the two extremities of the lacrymal fac; that is, with the puncta lacrymalia and the nafal duct. See Clafs II. 1. 1. 3. 3. Dolor dentiumflridore. Tooth-edge from grating founds, and from the touch of certain fubftances, and even from imagination alone, is defcribed and ex- plained in Sect, XVI. 10. The increafed actions of the alveolar veffels or membranes are affociated with the ideas, or fenfual motions of the auditory nerves in the firft cafe ; and of thofe of the fenfe of touch, in the fecond cafe ; and by imagination, or ideas eserted of painful fenfation alone, in the laft, 4. Rifus fardonicus, A difagreeable fmjle attends inflammations of the diaphragm arifing from the aflb- ciations of the reiterated exertions of that mufcle with thofe of the lips and cheeks in laughing. See Dia- phragmitis, Clafc II. 1. 2, 6, 5. Saliva fluxus cibo vifo. The flow of faliva into the mouths of hungry animals at the fight or fmell of E 3 food DISEASES [[Class IV. i. 2. food is feen in dogs ftanding round a dinner-table. The increafed actions of the falivary glands have been ufually produced by the ftimulus of agreeable food on their excretory ducts during the maftication of it; and with this increafed action of their excretory ducts the other terminations of thofe glands in the capillary arteries haire been excited into increafed action 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 mo- tions becomes affociated with thofe vifual or olfactory ideas, or with the pleafure, which produces or attends them, 6. Tenfio mammularum vifo puerido. The nipples of lactefcent women are liable to become turgid at the fight of their young offspring. The nipple has gene- rally been rendered turgid by the titillation of the lips or gums of the child in giving fuck ; the vifible idea of the child has thus frequently accompanied this pleafurable fenfation 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 affociated with thofe in- creafed arterial actions, which fwell the cells of the mammula, and extend its tubes; which is very fimilar to the tenfio phalli vlfa muliere nuda etiam in infomnio. 7. Tenfo penis in hydrophobia. An erection of the penis occurs in the hydrophobia, and is a troublefomc fymptoni, Class IV. i. 2.] OF ASSOCIATION. 71 fymptom, as obferved by Ccelius Aurelianus, Fother- gill, 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 very liable to affect the throat with ulcers. Violent coughs, with forenefs or rawnefs about the fauces arc often attended with erection of the penis ; which is alfo faid to happen to male animals, that are hanged ; which laft circumftance has generally been afcribed to the obftruction 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 the Mediterranean, which commences at puberty ; a ftring is wrapped twice round the thinneft part of the neck, the ends of it are then put one into each corner of the mouth ; and if, when thus held in the teeth, it paffes readily over the head, the fubject is taxable. It is difficult to point out by what circumftance the feniltive motions of the penis and of the throat and nofe become affociated ; I can only obferve, that thefe E 4 parts 72 DISEASES [Class IV. i. «. parts are fubjected to greater pleafurable fenfations than any other parts of the body; one being defigned to preferve 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 affociation of their fenfitive motion by their being emi- nently fenfible to pleafure. See Clafs I. 3. 1. 11. and III. 1. 1. 15. and Sect. XVI. 5. In the female fex this affociation between the face, throat, nofe, and pubis does not exift ; whence no hair grows on their chins at the time of puberty, nor do their voices change, or their necks thicken. This happens prcbably from there being in them a more exquifite fenfitive fympathy between the pubis and the breafts. Hence their breafts fweil at the time of puberty, and fecrete milk at the time of parturition. And in the parotitis, or mumps, the breafts of women fweil, when the tumor of the parotitis fubfides. Sec Ciafs I. 1. 2. 15. Whence it would appear, that (heir breafts poffefs an intermediate fympathy between the pubis and the throat; as they are the feat of a paffion, which inen do not poffefs, that of fuckling children. 8. Tenefmus cakulofus. The fphincter of the rectum pecomes painful br inflamed from the affociation of its fenfitive motions with thofe of the fphincter of the bladder, when the latter is ftimulated into violent pain pr inflammation by a ftone. t), Polypus Class IV. t. 2.] OF ASSOCIATION. 7; 9. Pohpus narium ex afcaridibus ? The ftimulation of afcarides in the rectum produces by fenfitive fym- pathy an itching of the nofe, as explained in IV. 2. 2. 6 ; and in three children I have feen a polypus in the nofe, who were all affected with afcarides ; to the perpetual ftimulation of which, and the confequent fenfitive affociation, I was led to afcribe the inflamma- tion and thickening of the membrane of the noftrils. 1 o. Grampus furarum in cholera. A cramp of the mufcles of the legs occurs in violent diarrhoea, or cho- lera, and from the ufe of too much acid diet in gouty habits. This feems to fympathize with uneafy fenfa- tion in the bowels. Sep Clafs III. 1. 1. 14. Thi3 affociation is not eafily accounted for, but is analogous in fome degree to the paralyfis of the mufcles of the arms in colica faturnina. It would feem, that the muf- cles 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. 11. Zona ignea nephrilica. Nephritic fhinglcs. The external fkin about the loins and fides of the belly I fuppofe to have greater mobility in refpect to fenfitive affociation, than the external membrane of the kidney; and that their motions are by fome un- known means thus affociated. When the torpor or beginning inflammation of this membrane ceafes, the external ikin becomes inflamed in its ftead, and a kind of 74 DISEASES [Class IV. 1.2. of herpes, called the fliingles,' covers the loins and fides of the belly. See Clafs II. 1. 5. 9. 12. Eruptio variolarum. After the inflammation ©f the inoculated arm has fpread for a quarter of a lunation, it affects the ftomach 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 ikin, the other part of this fenfitive affociation is deprived of its natural fhare, and becomes torpid, or inverts its motions. After this torpor of the ftomach has continued a time, and much fenforial power is thus accumulated ; other parts of the fkin, which are alfo afforiated with it, as that of the face firft, are thrown into partial inflammation; that is, the eruptions of the fmall-pox appear on the face. For that the variolous matter affects the ftomach previous to its eruption on the ikin appears from the ficknefs at the commencement of the fever; and be- caufe, when the morbid motions affect the fkin, thofe of the ftomach ceafe ; as in the gout and eryfipelas, mentioned below. The'confent between the ftomach and the ikin appears in variety of other difeafes ; and as lhey both confift of furfaces, which abforb and fecretc a quantity of moifture, their motions muft frequently be produced together or in fucceffion; which is the foundation of all the fympathies of animal motions, whether of the irritative, fenfitive, or voluntary kinds. %* Now Class IV. i. 2.3 OF ASSOCIATION'. fS Now as the fkin, which covers the face, is expofed to greater variations of heat and cold than any other part of the body ; it probably poffeffes more mobility to fenfitive affociations, not only than the ftonach, but than any other part of the fkin ; and is thence affected at the eruption of the fmall-pox with violent action and confequent inflammation, by the affociation of its motions with thofe of the ftomach, a day before the other parts of the fkin ; and becomes fuller of puf- tules, than any other part of the body. See Clafs II. 1. 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 fub- fide, were governed by fome unknown affociatidns of thofe parts of the fyftem; but thefe fucceilions 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 comparative mobility of thofe parts of the fkin. 13. Gutta rofea flomatica. 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 harveft-time have been afflicted with what has been called a furfeit. The ftomach becomes painful, with indigeftion and flatulency, and after a few days an eruption of the face appears, and con- tinue; 75 DISEASES [Class IV. i. a. flrraes with fome relief, but not with entire relief; as both the pimpled face and indigeftion are liable to continue even to old age. M. M. Venefection. 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 hepatica. The rofy drop of the face of fome drinking people is produced like the gout defcribed below, in confequence of an inflamed liver. In thefe conftitutions the ikin of the face being ex- pofed to greater variation of heat and cold than the membranes of the liver, poffeffes more mobility than thofe hepatic membranes; and hence by whatever means thefe membranes are induced to fympathize, when this fenfitive affociation occurs, the cutaneous veffels of the face run into greater degrees of thofe motions, which conftitute inflammation, than pre- vioufly exifted in the membranes of the liver; and then thofe motions of the liver ceafe. See Clafs II. r. 4. 6. An inflammation of the liver fo frequently attends the great potation of vinous fpirit, there is reafon to fufpect, that this vifcus itfielf becomes inflamed by fenfitive affociation with the ftomach -* or that, when one termination of the bile-duct, which enters the duodenum is ftimulated violently, the other end may become inflamed by fenfitive aflbciation. 15. Podagra* Class IV. i. J.] OF ASSOCIATION. the detriment of thoufands ; and is faid himfelf to have perifhed a martyr to the difeafe, which he knew how to fubdue 1 As example has more forcible effect than Ample sffertion, I fliall now concifely relate my own cafe, and that of one of my moft refnected friends. E. D. was about forty years of age, when he was firft fcized with a fit of the gout. The ball of his right great toe was very painful, and much fwelled and inflamed, which continued five or fix days in fpite of venefection, a briik 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 fnffered two other fits of the gout, in lefs violent degree. He then totally abftained from all fermented liquors, not even tafting fmall-beer, or a drop of any kind of wine; but eat plentifully of flefh-mcat, ard all kinds of vegetables, and fruit, ufing for his drink at meals chiefly water alone, or lemonade, or cream and r water j Class IV. t. 2.] OF ASSOCIATION. 8r 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 occafion- ally, 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 oc* cafioned him to return to his habit of drinking watei% and has now for above twenty years kept in perpetual health, except accidental colds from the changes of the feafons. Before he abftained from fermented or fpirituous liquors, he was frequently fubject to the piles, and to the gravel, neither of which he has fince experienced. In the following cafe the gout was eftablifhed by longer habit and greater violence, and therefore re- quired 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 degree 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 ftrength, he was advifed to drink exactly two wine glaffes, about four ounces, of wine mixed with three or four Vol. II. F times Se DISEASES [Class IV. i. 2. times its quantity of water, v.ith or without lemon and fugar, for hi 5 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 fcru- puloufly continued this regimen for above five years, and has had an annual moderate gouty paroxyfm of a few weeks, inftead of the confinement of fo many months, with great health and good fpirits during the intervals. The following is a more particular account of the hiftory of this cafe ; being part of a letter which Mr. Wilmot wrote on that fubject at my entreaty. " I entered into the army with an excellent con- ftitution at the age of fifteen. The corps I ferved in was diftinguifhed by its regularity, that is, the regu- lar 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 confidered as excefs for men, was certainly too great for a youth of my age. This ftyle of living I continued, when with the regi- ment, till the latter end of the year 1769, when I had tlie misfortune to fleep in a damp bed at Sheffield on a journey to York, but arrived there before I felt the ill effects of it. I was then feized with a violent inflammatory rheumatifm with great inflammation of my eyes, and was attended by Dr. Dealtry ; fo violent was the diforder, that I was bled for it eight times in lefs Class IV. i. 2.] OF ASSOCIATION. S3 lefs than a fortnight; and was tliree months, before I could confider my health perfectly re-eftablifhed. Dr. Dealtry told me, that I fhould be fubject to fimi- lar attacks for many years ; and that he had no doubt, from the tendency he found in my habit to inflam- mation, that, when I was farther advanced in life, I fhould change that complaint for the gout. lie pre- dicted truly ; for the three fucceeding winters I had the fame complaint, but not fo violently ; the fourth winter I efcaped, and imputed my efcape to the con- tinuance of cold bathing during the whole of that winter ; after that I never efcaped it, till I had a re- gular and fevere fit of the gout : after the firft attack of rheumatic fever I was more abftemious in my man- ner of living, though when in company I never fub- jected myfelf to any great reftraint. In the year 1774 I had quitted the army, and being in a more retired fituation, was feldom led into any exccfs ; in 1776 and 1777 I was in the habit of drinking a good deal of wine very frequently, though not conftantly. After that rJeriod till the year 1781, I drank a larger quan- tity of wine regularly, but very feldom 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 how- ever obferve, that at no part of my life was I accuf- tomed to drink.wine in an evening, and very feldom drank any thing more than a fingle half-pint glafs of fome fort of fpirits diluted with much water. Till the year 17 S1 I had always been accuftomed to ufe F 2 very *4 DISEASE 5 [Class IV. i. r. very violent and continued exercife on horfeback ; in the winter months I purfued all field diverfions, and m the fummer months I rode frequent and long journeys; and with this exercife was liable to per- fpire to great excefs ; befides which I was fubject to very profufe night-fweats, and had frequently boils break out all over me, cfpecially in the fpring and autumn; for which I took no medicine, except a little flour of fulphur with cream of 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 I was juft entered into the thirty-fecond year of my age, I had the firft attack of gout; that fit was very fcvere, and of many weeks continuance. 1 now determined upon a more abftemious method of living, in refpect to wine ; and indeed the fociety, in which T had before been accuftomed to live, being confi- derably changed, I had lefs frequent temptations to excefs. From this time I enjoyed the moft perfect good ftate of health till Auguft 1784, when I had my fecond attack of gout. I never perfectly re- covered from this attack through the fucceeding winter, and in March 1785 was advifed to try the Bath waters, and drank them under the direction 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 fhould 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 faint- ing fit one day on the road, after having travelled only Class IV. i. 2.J OF ASSOCIATION. l5 only about fifty miles; in the courfe of the fummer I had two or three more flight attacks of gout of lefs •confequence, till the month of October; when I was .afflicted with it all over me in fuch a manner, as to be without the poffibility of the leaft 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 experienced; though I have fince had feveral equally fevere. In the courfe of this fummer I had a fall with my horfe ; and fooa after it, having difcovercd an enlargement on one «lbow, I concluded I had hurt it at that time ; but in the courfe of this laft attack having a fimilar enlargement on the other elbow, I found my miftake, and that they were collections 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 hruifed, I was under the neceflity of having it lanced, and a large quantity of chalky matter was difcharged from it; and have fince that time frequently had