ZOONOMIA; 
OR> 
THE L A W S 
OF 
ORGANIC LIFE. 
IN THREE PARTS. 
By ERASMUS DARWIN, M.D.F.R.S. 
AUTHOR OF THE BOTANIC GARDEN, PHYTOLOGIA, &C. 
Principid caelum, ac terras, campofque liquentes, 
Lucentemque globum lunae, titaniaque aftra, 
Spiritus intus alit, totamque infufa per artus 
Mens agitat molem, et magno fe corpore mifcet. 
Virg. /En. 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. 
COMPLETE IN TWO VOtC ME^.1 
Vol. II. 
Second American, from the third London Edition, /orredied by the Author. 
Printed at Bofton, by d. Carlisle, 
For THOMAS and ANDREWS. 
Md at their Bookftore, No. 45, Newbury Street? by I. Thomas, Worcefter; and 
hv Thomas & Thomas, Walpole, N. H.-Sold alfo by T. & J. Swords, 
New York ; Whiting, Leavenworth Whiting, Albany 5 
O. Penniman & Co. Troy ; and Thomas, An- 
drews Butliir, Baltimore. 
Ffr. 1803. Z O O N O M I A; 
OR, 
THE LAWS OF ORGANIC LIFE. 
PART II. 
CONTAINING 
A CATALOGUE OF DISEASES, 
DISTRIBUTED INTO 
NATURAL CLASSES, 
ACCORDING TO THEIR PROXIMATE GAUSES, 
WITH THEIR SUBSEQUENT 
ORDERS, GENERA, AND SPECIES, 
AND WITH THEIR 
METHODS OF CURE. 
Ha:c, ut potero, cxpikabo; nec tamen, quafi Pythius Apollo, certaut fint et fixa, 
qux dixero ; fed ut Homunculus unus e niultis probabiliora conjectura fequens. 
Cic. Tusc. Dxsp. I. I. 9. PREFACE. 
All difeafes originate in the exuberance, deficiency, 
or retrograde adion, of the faculties of the fenforium, 
as their proximate caufe ; and confift in the difordered 
motions of the fibres of the body, as the proximate ef- 
fect of the exertions of thofe difordered faculties. 
The fenforium poflefles four diftind powers, or facul- 
ties, which are occafionally exerted, and produce all the 
motions 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 con- 
fequence of fenfation, which is excited by pleafure or 
pain ; in confequence of volition, which is excited by de- 
fire or averfion ; and in confequence of aflbciation, 
which is excited by other fibrous motions. We are 
hence fupplied with four natural clafles of difeafes de- 
rived from their proximate caufes ; which we fhall term 
thofe of irritation, thofe of fenfation, thofe of volition, 
and thofe of aflbciation. 
- lu VI 
PREFACE. 
In the fubfequent claflification of difeafes I have not 
adhered to the methods of any of thofe who have pre- 
ceded me ; the principal of whom are the great names 
of Sauvages and Cullen; but have neverthelefs availed 
myfelf, as much as I could, of their definitions and dif. 
tinftions. 
The eflential charafteriftic of a difeafe confifts in its 
proximate caufe, as is well obferved by doftor Cullen, 
in his Nofologia Methodica, T. ii, Prolegom. p, xxix. 
Similitude quidem morborum in fimilitudine caufe 
eoruni proximo, qualiftunque fit, revera confiftit.' I 
have taken the proximate caufe for the claflic character. 
The charafters of the orders are taken from the excefs, 
or deficiency, or retrograde aftion, or other properties, 
of the proximate caufe. The genus is generally derived 
from the proximate effeft. And the fpecies generally 
from the locality of the difeafe in the fyftem. 
Many fpecies in this fyftem are termed genera in the 
fyftems of other writers; and the fpecies of thofe wri- 
ters, are, in confequence, here termed varieties. Thus, 
in Dr. Cullen's Nofologia, the variola or fmall-pox is 
termed a genus, and the diftinft and confluent kinds are 
termed fpecies. But as the infeftion from the diftinft 
kind frequently produces the confluent kind, and that of 
the confluent kind frequently produces the diftinft; it 
would feem more analogous to .botanical arrangement, 
which thefe nofologifts profefs to imitate, to call the dif- 
tinft and confluent fmall-pox varieties than fpecies. 
Becaufe the fpecies of plants in Botanical fyftems prop- 
agate PREFACE. 
VII 
agate others fimilar to themfelves; which does not tuli* 
fbrmly occur in fuch vegetable productions as are term* 
cd varieties. 
In fome other genera of nofologifts the fpecies have 
no analogy to each other, either in refpeCt to their prox- 
imate caufe, or to their proximate effeCt, though they may 
be fomewhat fimilar in lefs eflential properties; thus 
the thin and faline difcharge from the noftrils on going 
into the cold air of a frofty morning, which is owing to* 
the deficient action of the abforbent veflels of the nof- 
trils, is one fpecies; and the vifcid mucus difcharged 
from the fecerning veflels of the fame membrane, when 
inflamed, is another fpecies of the fame genus, Catarrhus* 
Which bear no analogy either in refpect to their imme- 
diate caufe, or to their immediate effect. 
The ufes of the method here offered to the public, of 
claflmg difeafes according to their proximate caufes, are, 
firft, more diftinCtjy to underftand their nature by com- 
paring their eflential properties. Secondly, to facilitate 
the knowledge of the methods of cure ; flnce in natural 
claflification of difeafes the fpecies of each genus, and in- 
deed the genera of each order, a few perhaps excepted^ 
require the fame general medical treatment. And laftly, 
to difcover the nature and the name of any dileafe previ- 
oufly unknown to the phyfician ; which I am perfuaded 
will be more readily and more certainly done by this 
natural fyftem, than by the artificial claflifications alrea- 
dy publifhed* 
fhe VIII 
PREFACE. 
The common names of difeafes are not well adapted 
to any kind of claffification, and lead of all to this, from 
their proximate caufes. Some of their names in com- 
mon language are taken from the remote caufe, as 
worms, (tone of the bladder others from the remote 
effed, as diarrhoea, falivation, hydrocephalus; others 
from fome accidental fymptom of the difeafe, as tooth- 
ach, head-ach, heart-burn ; in which the pain is only a 
concomitant circumftance of the excefs or deficiency of 
fibrous actions, and not the caufe of them. Others 
again are taken from the deformity occafioned in confe- 
quence of the unnatural fibrous motions, which confti- 
tute difeafes, as tumours, eruptions, extenuations; all 
thefe therefore improperly give names to difeafes ; and 
fome difficulty is thus occafioned to the reader in en- 
deavouring to difcover to what clafs fuch diforders 
belong. 
Another difficulty attending the names of difeafes is, 
that one name frequently includes more than one difeafe, 
either exifting at the fame time or in fucceffion. Thus 
the pain of the bowels from worms is caufed by the in- 
creafed a&ion of the membrane from the flimulus of 
thofe animals; but the convulfions, which fometimes fuc- 
ceed thefe pains in children, are caufed by the confequent 
volition, and belong to another clafs. 
To difcover under what clafs any difeafe fliouldb'e ar- 
ranged, we mull firft inveftigate the proximate caufe; 
thus the pain of the tooth-ach is not the caufe of any 
difeafed motions, but the effeQ; the tooth-ach there- 
fore PREFACE. 
IX 
fore does not belong to the clafs of Senfation. As the 
pain is caufed by increafed or decreafcd action of the 
membranes of the tooth, and thefe a&ions are owing to 
the increafe or decreafe of irritation, the difeafe is to be 
placed in the clafs of Irritation. 
To difcover 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 concom- 
itant heat or coldnefs of the part. In 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, compared with the oppofite cheek. 
Hence odontalgia is found to belong to the order of de- 
creafed irritation. The genus and fpecies mull be found 
by infpefting 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 increafed a&ion or diftention of the velfels of the 
uterus, in confequence of the ftimulus of the fetus; and 
is therefore caufed by increafed irritation ; but the ac- 
tions of the abdominal mufcles in its exclufion are cauf- 
ed by the pain, and belong to the clafs of increafed fen- 
fation. See Clafs II. 1. 1. 12. Hence the difficulty of 
determining, under what clafs of difeafes parturition 
fhould be arranged, confifts in there being two kinds of 
difeafed a&ions comprehended under one word ; which 
have each their different proximate caufe. 
Vol. II. b In X 
PREFACE. 
In Sect. XXXIX. 8. 4. and in Clafs II. 1. 1. r. we 
have endeavoured to give names to four links of animal 
caufation, which conveniently apply to the clalfification 
of difeafes ; thus in common nictitation, or winking with 
the eyes without our attention to it, the increafed irrita- 
tion is the proximate caufe ; the Itimulus of the air on 
the dry cornea is the remote caufe ; the clofing of the 
eyelid is the proximate effect; and the diffufion of tears 
over the eyeball is the remote effect. In fome cafes two 
more links of caufation may be introduced ; one of 
them may be termed the preremote caufe ; as the warmth 
or motion of the atmofphere, 'which caufes greater 
exhalation from the cornea. And the other the poll-re- 
mote effect; as the renewed pellucidity of the cornea ; 
and thus fix links of caufation may be expreffed in 
words. 
But if amid thefe remote links of animal caufation any 
of the four powers or faculties of the fenforium be intro- 
duced, the reafoning is not juft according to the method 
here propofed ; for thefe powers of the fenforium are 
always the proximate caufes of the contraCiions of an- 
imal fibres: and therefore 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 circumltance 
which has much impeded the inveftigation of the caufes, 
and cures of difeafes. 
Thus the term fever, is generally given to a collection 
of morbid fymptoms; which are indeed fo many dillinCt 
difeafes. PREFACE. 
XI 
difeafes, that fometimes appear together, and fometimes 
feparately ; hence it has no determinate meaning, except 
it fignifies fimply a quick pulfe, which continues for 
fome hours; in which fenfe it is here ufed. 
In naming difeafes I have endeavoured to avoid the 
affedation of making new compound Greek words, 
where others equally expreffive could be procured : as 
a fhort periphrafis is eafier to be underftood, and lefs 
burdenfome to the memory. 
In the Methodus Medendi, which is marked by M. M. 
at the end of many of the fpecies of difeafes, the 
words incitantia, forbentia, torpentia, &c. refer to the 
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 preceding 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 Nofologiae 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 errors will be difcovered, many additional fpe- 
cies will require to be inferted ; and others to be tranf- 
planted or erafed. If he could expend another forty 
years in the pradice of medicine, he makes no doubt, but 
that XII 
PREFACE. 
that he could bring this work nearer perfection, and 
thence render it more worthy the attention of philoso- 
phers." -As it is, he is induced to hope, that fome ad- 
vantages will be derived from it to the fcience of medi- 
cine, and confequent utility to the public, and leaves the 
completion of his plan to the induftry of future genera- 
tions. 
Derby, Jan. i, 1796. 
ZOONOMIA; Z O O N O M I A. 
PART II. 
CLASSES OF DISEASES. 
I. DISEASES OF IRRITATION. 
II. DISEASES OF SENSATION. 
III. DISEASES OF VOLITION. 
IV. DISEASES OF ASSOCIATION. 
The Orders and Genera of the Firfl Clafs of Difenfes, 
CLASS I. 
DISEASES OF IRRITATION.. 
ORDO I. 
Increafed Irritation. 
GENERA. 
i. With increafed actions of the. finguiferous fyftem. 
2. With increafed actions of the fecerning fyftem. 
3. With increafed actions of the abforbent fyltern. 
4. With increafed actions of other cavities and membranes, 
5. With increafed actions of the organs of fenfe. 
ORDO IT. 
Decreafed Irritation. 9 
GENERA. 
1. With decreafed actions of the finguiferous fyftem. 
2. With decreafed actions of the fecerning fyftem. 
3. With decreafed actions of the abforbent fyftem. 
Vol. II. E 4. With 2 
DISEASES 
Class I. 1. 2. 
4. With decreafed a&ions of other cavities and membranes. 
5. With decreafed actions 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 Orders, Oenera, and Species, of the Firfl Clafs of Dif- 
eafes. 
■ 
CLASS r. 
DISEASES OF IRRITATION. 
ORDO I. 
Increafed Irritation. 
GENUS I. 
With increafed A Elions of the Sanguiferous Syfem. $ 
SPECIES. 
I. Febris irritativa. 
2. Ebrietas. 
3. ELemorrhugia arterioEa. 
4. ED moptoe arteriofa. 
5. Hamorrhagia narium. 
Irritative fever. 
Drunkennefs. I 
Arterial Haemorrhage. 
Spitting of arterial blood. 
Bleeding from the nofe. 
GENUS II. 
With^ncreajed AElions of the Secerning Syfem. 
SPECIES. 
i. CalorfArdis. 
2. Rubor febrids. 
3. Sudor Call du s. 
Sudorf brills. 
a labore. 
ab ignc. 
a medicamentis. 
4. Urina ulterior color ata. 
Febrile heat. • p. 
Febrile rednefs. 
Warm fweat. 
Sweat in fevers. 
from exercife. 
from fire. 
from medicines. 
Copious coloured urine.' 
Diarrhoea Class I. 1.3. 
OF IRRITATION. 
3 
.. 5. Dirrheta callda. 
febrilis. 
•- crapulofa. 
k ■■■ infantum. 
6. Salivatio calida. 
Catarrhus calidus. 
8. Expefloratio calida. 
9. Exfudatio pone aures. 
10. Gonorrhoea calida. 
11. Fluor albus calidus. 
12. Hamorrhois alba. 
13. Serum e vefcatorio. 
14. Perfpiratio fcetida. 
15. Crines novi. 
Warm diarrhoea. 
Diarrhoea from fever. 
' from indigeftion. 
•-- of infants. 
Warm falivation. 
- .. - catarrh. 
• expectoration. 
Difcharge behind the ears. 
Warm gonorrhoea. 
fluor albus. 
White piles. 
Difcharge from a blifter. 
Fetid perfpiration. 
New hairs. 
GENUS III. 
With increafed Actions of the Abforbent S\fem. 
SPECIES. 
I. Lingua ar Ida. 
2. Fauces arida. 
3. Nares aridi. 
4. Expecloratio folida. 
$. Confipatio alvi. 
6. Cutis arida. 
7. Urina parcior colorata. 
8. Calculus felleus et icterus. 
9. ■ rents. 
io. vefcit. 
11. arthriticus. 
12. Rheumatifmus chronicus. 
13. Cicatrix vulnerum. 
14. Cornea obffcatio. 
Dry tongue. 
Dry throat. 
Dry noitrils. 
Solid expectoration. 
Coltivencfs. 
Dry (kin. 
Diminifhed. coloured urine. 
Gall-ftone and jaundice. 
Stone of the kidney. 
Stone of the bladder. 
Gout-ftone. 
Chronic rheumatifm. 
Flealing of ulcers. 
Scar on the cornea. 
GENUS IV. 
With increafed Actions of other Cavities and Membranes. 
SPECIES. 
I. Niclitatio irritativa. 
2. Tieglutitio irritativa. 
3. Rejplrat io et tuffs. 
4. Exclufo bills. 1 
5. Dentitio. 
6. Priapfmus. 
7. Diftenjio mammularum. 
Irritative nictitation. 
Irritative deglutition. 
Refpiration and cough. 
Exclufion of the bile. 
Toothing. # 
Priapifm. 
Diftention of the nipples. 
8. Defcenfu) 4 
DISEASES 
Class I. 1. 
S. D.fcenfus uteri. 
9. Prd$Jus ani. 
io. Lumbricus. 
11. Tania. 
12. Afcarides. 
13. Dratunculus. 
14. Morpiones. 
15. Pediculi. 
Defcent of the uterus. 
Defcent of the rectum. 
Round worm. 
Tape-worm. 
Thread-worms. 
Guinea-worm. 
Crab-lice. 
Lice. 
GENUS V. 
With increafed Actions of the Organs of Senfe. 
SPECIES. 
Acuter fight. 
• hearing. 
. fmell. 
■ tafte. 
• touch. 
•- fenfe of heat. 
fenfe of extension, 
Tickling, 
o 
Itching. 
Smarting. 
Surprife. * 
I. Vifus acrior. 
2. Auditus acrior. 
3. OlfaEius acrior. 
4. Gif us acrior. 
if. laid us acrior. 
6. Senfus caloris acrior. 
7. exteifonts acrior. 
8. Titillatio. 
9. Pruritus. 
io. Dolor urens. 
11. Confernatio. 
ORDO II. 
Decreafed Irritation, 
GENUS I. 
With decreafed Actions of the Sanguiferous Sydem. 
SPECIES. 
I. Febris inirritativa. 
2.' Parfs inirritative. 
3. Sommis interrupt us. 
4. Syncope. 
5. Hamorrh'agia venofa. 
6. Hamorrhois cruenta. 
. Hamorrhagia renum. 
8. hepatis. 
9. Ham optoe venofa. 
io. Palpitatio cordis. 
I I. Menorrhagia. 
12. Dyfmenorrhagia. 
13. I.ochia nimia. | 
14. Abort io [penianea. 
Inirritative fever. 
debility. 
Interrupted Heep. 
Fainting. 
Venous haemorrhage. 
Bleeding piles. 
. from the kidneys. 
Bleeding from the liver. 
Spitting of venous blood. 
Palpitation of the heart. 
Exuberant menfiruation. 
Deficient menftruation. 
Too great lochia. 
Spontaneous abortion. 
15. Scorbutus. Class I. 2. 2. 
OF IRRITATION. 
5 
15. Scorbutus. 
16. Vibices. 
I 7. Petechia. 
18. Aneurifma. 
19. Varix. 
Scurvy. 
Extravafations of blood. 
Purple fpots. 
Aneurifm. 
Swelling of veins. 
GENUS II. * ; 
With decreafed Actions oj the Secerning Syfenn 
SPECIES. 
I, Frigus febrile. 
chronicutn. 
2. Pallorfugitivus. 
permanent. 
3. Pus parcius. • 
4. Mucus parcior. 
5. Urina parcior pallida. 
6. Torpor hepaticus. 
7. Torpor pancreatis. 
8. Torpor rents. 
9. PunAce mucofe 'uultus. 
10. Macula cutisfulva. 
11. Canities. 
12. Callus. 
13. Cataract a. 
14. Innutritio offiwn. 
15. Rachitis. 
16. Spina1 diftortio. 
I 7. Claudicatio coxaria. 
18. Spina protuberant. 
19. Spina bifida. 
20. DefeEus palati. 
Coldnefs in fevers. 
permanent. 
Palenefs fugitive. 
permanent. 
Diminifhed pus. 
Diminifhed 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 fkin. 
Grey hairs. 
Callus. 
CataraCt. 
Innutrition of the bones. 
Rickets. 
Diltortion of the fpine. 
Lamenefs of the hip. 
Protuberant fpine. 
Divided fpine. 
DefeCt of the palate. 
GENUS III. 
With decreafid Actions of the Abforbent Sflem. 
SPECIES. 
I. Mucusfauciamfrigidus. 
2. Sudor ft igidus. 
3. Catarrhusfrigidus. 
4. Expecioratio frigida. 
5. Urina uberior pallida. 
6. Diarrhoeafrigida. 
7. Fluor albus frigidus. 
3. Gonorrhoea frigida. 
Cold mucus from the throat. 
fweat. jk 
■ catarrh. 
expectoration. 
Copious pale urine. 
Cold diarrhoea. 
Fluor albus. 
gonorrhoea. 
9. Hepat is 6 
DISEASES 
Class I. 2.4. 
9. He pat is tumor. 
I o. Chlorofis. 
11. Hydrocele. 
12. Hydrocephalus internus. 
13. Afcites. 
14. Hydrothorax. 
15. Hydrops ovarii. 
16. Atiafarca pulmonum. 
17. Obeftas. 
18. Splenis tumor. 
19. Genu tumor albus. 
20. Bronchocele. 
21. Scrofula. 
22. Scirrhus. 
23. recti. 
24. urMorse. 
25. oefopbagi. 
LaHeorum inirrifabilitas. 
27. Lymphaticorum inirritabilti 
tas. 
Swelling of the liver. 
Green ficknefs. 
Dropfy of the vagina tefbis. 
• of the brain. 
of the belly. 
■ of the cheft. 
• of the ovary. 
of the lungs. 
Corpulency. 
Swelling of the fpleen. 
White Iwelling of the knee. 
Swelled throat. 
King's evil. 
Scirrhus. 
of the return.' 
■ of the urethra. 
■ of the throat. 
Inirritability of the latleals. 
Inirritability of the lymphatics. 
GENUS IV. 
With decreafed Actions of other Cavities and Membranes, 
SPECIES. 
I. Sitis calida. 
fn&da' 
2. Efuries. 
3. Natfeafcca. 
4. AEgritudo ventriculi., 
5. Cardialgia. 
6. Arthritis ventriculi. 
7. Colic a flat ulent a. 
8.1 Colica faturnina. 
9. Tympanitis. 
io. Hypochondriafis. 
11. Cephalaa idiopathica. 
12. Hcmicrania idiopathica. 
13. Odontalgia. 
Otalgia. 
14. Pleurodyne chronica. 
15. Sciatica frigida. 
16. Lumbagofrigida. 
I 7. Hyf.eralgia frigida. 
18. Proctalgiafrigida. & 
Thirft warm, 
cold. 
Hunger. 
Dry nauiea. 
Sicknefs of ftomach. 
Heart-burn. 
Gout of the flomach. 
Flatulent colic. 
Colic from lead. 
Tympany.. 
Hypochondriacifm. 
Idiopathic head-ach. 
Idiopathic hemicrania. 
Tooth-ach. 
Ear-ach. 
Chronical pain of the fide. 
Cold fciatica. 
lumbago. 
pain of the uterus. 
pain of the re&um. 
19. V^ica Class I. 3. r. 
OF IRRITATION. 
7 
7 
19. Vefic# fellex inirritabilitas 
et iElerus. 
Inirritability of the gall-bladder 
and jaundice. 
GENUS V. 
With decreafed Actions of the Organs of Senfe. 
SPECIES. 
* I. Stultitia inirritabilis. 
2. Vifus imminutus. 
3. Mufca volitantes. 
4. Strabifmus. 
5. Amaurofs. 
6. Auditus imminutus. 
I 7. OfaEtus imminutus. 
8. Gujlus imminutus. 
9. Tactus imminutus. 
Jo. Stupor. 
Folly from irritability. 
Impaired vifion. 
Dark moving fpecks. 
Squinting. 
Palfy of the optic nerve. 
Impaired hearing. 
fmell. 
tafte. 
touch. 
Stupor. 
ORDO III. 
Retrograde Irritative Motions. 
GENUS I. 
Of the Alimentary Canal. 
I. Ruminatio. 
2. Radius. 
3- Apef/ia.* 
4. Vomit us. ' 
5. Cholera. 
6. Ileus. 1 
7. Globus hyjlericus. 
Z. Vomendi conamen inane. 
9. Borborigmus. 
IO. Hyferia. 
11. Hydrophobia. M 
SPECIES. 
Chewing the cud. 
Eructation. 
Indigeftion, water-qualm. 
Vomiting. 
Cholera. 
Iliac paflion. 
Hyfteric ftrangulation. 
Vain efforts to vomit. I 
Gurgling of the bowels. 
Hyfteric difeafe. 
Dread of water. , 
GENUS II. 
Of the Abforbent S^fem. 
SPECIES. 
J. Catarrhus lymphaticus. 
2. Salivatio lymphatica. 
3. Naufea humida. ■ 
4. Diarrhoea lymphatica. 
S' Diarrhoea chylifera. 
Lymphatic catarrh, \ 
Lymphatic falivation. . 
Moift naufea. 
Lymphatic flux. 
Flux of chyle. 
6. Diabetes. 8 
DISEASES, &c. 
Class I. 3. 3- 
(y. Diabetes. 
Sudor lymphaticus. 
8. Sudor afhmaticus. 
y. Tranfatiopuris. 
To. lahtis. 
11. urince. 
Diabetes. 
Lymphatic fweat. 
Afthmatic fweat. 
Tranflation of matter. 
of mills. 
of urine. 
GENUS III. 
Of the Sanguiferous Syfem. 
I. Capillarium tnotus retrogref. 
2. Palpitatio cordis. 
3. Anbelatio fpafmodica. 
SPECIES. 
Retrograde motion of the ca- 
pillaries. 
Palpitation of the heart. 
Spafmodic panting. Class I. i. I. 
DISEASES, &c. 
9 
CLASS I. 
DISEASES OF IRRITATION. 
ORDO I. 
Increafed Irritation. 
GENUS I. 
With increafed aliions of the Sanguiferous S^fem. 
THE irritability of the whole, or of part, of our fyftem is per- 
petually changing ; thefe viciffitudes of irritability and of inir- 
ritability are believed to depend on the accumulation or exhauf- 
tion of the fenforial power, as their proximate caufe ; and on the 
difference of the prefent flimulus, and of that which we had 
previoufly been accuftomed to, as their remote caufc. Thus a 
fmaller degree of heat produces pain and inflammation in our 
hands, after they have been for a time immerfed in fnow^ 
which is owing to the accumulation of fenforial power in the 
moving fibres of the cutaneous veflels during their previous qni- 
efccncc, when they were benumbed with cold. And we fed 
ourfelves cold in the ufual temperature of the atmofphere on 
coming out of a warm room ; which is owing to the exhaudion 
of fenforial power in the moving fibres of the vcffels of the fkin 
by their previous increafed activity, into which they were exci- 
ted by unufual heat. 
Hence the cold fits of fever are the occafion of the fuccee^ing 
hot cnes ; and the hot fits contribute to occafion in their turn 
the fucceeding cold ones. And though the increafe of flimulus, 
as of heat; exercife, or diflention, will produce an increafed ac- 
tion of the flimulated fibres; in the fame manner as it is pro- 
duced by the increafed irritability which was occafioned bv a 
previous defeat of flimulus ; yet as rhe excefTes of irritation from 
the flimulus of external things are more eafiiy avoided than the 
deficiencies of it; the difeafes of this country, except thole which 
are the confequences of drunkennefs, or of immoderate exercife, 
more frequently begin with torpor than with orgafm ; that is, 
with inactivity of fome parts, or of the whole of the fyftem, and 
confequent coldnefs, than with increafed activity, and confe- 
quent heat. 
If the hot fit be the confequence cf the cold one, it may be 
afked if they are proportionate to each other : it is ptabable that 
Vol. II. C * the 10 
DISEASES 
Class I. i. r. r. 
they are, where no part is deftroyed by the cold fit, as in morti- 
fication or death. But we have no meafure to diftinguifh this, 
except the time of their duration ; whereas the extent of the 
torpor over a greater or lefs part of the fyftem, which occafions 
the cold fit; or of the exertion which occafions the hot one ; as 
well as the degree of fuch torpor or exertion, are perhaps more 
material than the time of their duration. Bolides this, fome 
mufcles are lefs liable to accumulate fenforial power during their 
torpor, than others, as the locomotive mufcles compared with 
the capillary arteries ; on all which accounts a long cold fit may 
often be followed by a fhort hot one. 
As the torpor, with which a* fit of fever commences, is fome- 
timcs owing to defeft of ftimulus, as in going into the cold- 
bath ; and fometimes to a previous exhauftion of the fenforial 
power by the action of fome violent ftimulus, as after coming 
out of a hot room into cold air ; a longer time muft elapfe, be- 
fore there can be a fufiicient 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 coldparoxyfm commences, when the torpor of a part be- 
comes fo great, and its motions in confequence fb flow or feeble, 
as not to excite the fenforial power of aflbciation ; which in 
health contributes to move the reft of the fyftem, which is cate- 
nated with it. And the hot fit commences by the accumulation of 
the fenforial power of irritation of the part firft affected, either 
fo as to counteract its deficient ftimulus, or its previous wafte of 
fenforial power j and it becomes general by the accumulation of 
the fenforial power of aflbciation ; which is excited by the reno- 
vated aClions of the part firft affected ; or becomes fo great as to 
overbalance the deficient excitement of it. On all thefe accounts 
the hot fit cannot be fuppofed to bear any proportion to the cold 
one in length of time, though the latter may be the confequence 
of the former. See Suppl. I. 16. 8. 
SPECIES. 
i. Febris irriiativa. Irritative fever. This is the fynocha of 
feme writers, it is attended with ftrong pulfe without inflama- 
tion ; and in this circumftance differs from the febris inirritativa 
ofClafsI. 2. i. i. which is attended with weak pulfe without 
inflammation. The increafed frequency of the pulfation of the 
heart and arteries conftitutes fever ; during the cold -fit thefe 
pulfations are always weak, as the energy of action is then de- 
creafed throughout the whole fyftem ; and therefore the gener- 
al Class I. 1. 1. 2. 
OF IRRITATION. 
11 
al arterial ftrength cannot be determined by the touch, till the 
cold part of the paroxyfm ceafes. This determination is fome- 
times attended with difficulty ; as ftrong and weak are only com- 
parative ae grees of the greater or lefs refiftance of the pulfation 
of the artery to the compreffion of the finger. But the greater 
or lefs frequency of the pulfations affords a collateral evidence 
in thofe cafes, where the degree of ftrength is not very diftin- 
guiffiable, which may affift our judgment concerning it. Since 
a moderately llrong pulfe, when the patient is in a recumbent 
pofture, and not hurried in mind, feldom exceeds 120 ftrokesin 
a minute.; whereas a weak one often exceeds 130 in a recum- 
bent pofture, and 150 in an ereCl one, in thofe fevers, which 
are termed nervous or putrid. See SeCl. XII. 1. 4. 
The increafcd frequency of the pulfatien of the heart and ar- 
teries, as it is occafioned either by excefs or defeCt of ftimulus, or 
of fenforial powrer, exifts both in the cold and hot fits of fever; 
but when the cold fit ceafes, and the pulfe becomes llrong and 
full as well as quick, in confequen.ee of the increafed irritability 
of the heart and arteries, it conftitutes the irritative fever, or fy- 
nocha. It is attended with confiderable heat during the parox- 
yfm, and generally terminates in a quarter of a lunation, without 
any difturbance of the faculties of the mind. See Clafs IV. 1. 1.8. 
M. M. VenefeCtion. Emetics. Cathartics. Cool the patient 
in the hot fit, and warm him in the cold one. Reft. Torpentia. 
2. Ebrietas. Drunkennefs. By the ftimulus of wine or opi- 
um the whole arterial fyftem, as well as every other part of the 
moving fyftem, is excited into increafed action. All thefe fe- 
cretions, and with them the production of fenforial power itfelf 
tn the brain, feem to be for a time increafed, with an additional 
quantity of heat, and of pleafurable fenfation. See SeCl. XXL 
on this fubjeCt. This explains, why at the commencement of 
the warm paroxyfm of fome fevers the patient is in greater fpir- 
its, or vivacity; becaufe, as in drunkennefs, the irritative motions 
are all increafed, and a greater production of fenfation is the con- 
fequence, which, when in a certain degree, is pleafurable, as in 
the diurnal fever of weak people. SeCt. XXXVI. 3. 1. 
3. Hamorrhagia arteriofa. Arterial haemorrhage. Bleeding 
with a quick, ftrong, 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 
punCture of a leech, will continue to bleed pertinacioufly. 
M. M. VenefeCtion. Cathartic with calomel. Divide the 
wounded artery. Bind fponge on the punCture. If coffee or 
charcoal, internally ? If air, with lefs oxvgen ? 
4. Hamoptoe arteriofa. Spitting of arterial blood Blood fpit 
up 12 
DISEASES 
Class I. i. i. 
up from the lungs is florid, becaufe it has juft been expofed to the 
influence of the air in its paflage through the extremities of .the 
pulmonary artery; it is frothy, from the admixture of air with it 
in the bronchia. The patients frequently vomit at the fame time 
from the difagreeable titillation of blood aboutthe fauces ; and are 
thence liable to "believe, that the blood is ejected from the ftomach. 
Sometimes an hsenioptoe for feveral fucceffive days returns in 
gouty perfcns without danger, and feems to fupply the place of 
the gouty paroxyfms. Is not the liver always difeafed previous 
to the hxmoptoe, as in feveral other haemorrhages ? See Clals 
I. 2. I. Q. 
M. M. Venefeftion, 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 haemorrhage, 
which it may effedt, as ficknefs decreafes the circulation, as is 
very evident in the great ficknefs fometimes produced by too large 
a dole of digitalis purpurea. 
Dr. Rulh fays, a table-fpoonful or two of common fait is fuc- 
cefsful in haemoptoe ; this may be owing to its ftimulating the 
abforbent fyftems, both the lymphatic, and the venous. Should 
the patient refpire air with lefs oxygen ? or be made fick by 
whirling round in a chair fufpended by a rope ? One immer- 
fion in cold water, or a fudden fprinkling all over with cold 
water, would probably flop a pulmonary hemorrhage. See 
Sed. XXVII. 1. 
3. Hamorrhagia narium. Ep 'iftaxis. Bleeding at the nofe in 
elderly fubjects moft frequently attends thofe, whofe livers are 
enlarged or inflamed by the too frequent ule of fermented liquors. 
In boys it occurs perhaps limply from redundancy of blood; 
and in young girls fometimes precedes the approach of the cata- 
menia ; and then it fnews a difpofition contrary to chlorofis; 
which arifes from a deficiency of red blood. 
M. M. It is flopped by plunging the head into cold water, 
with powdered fait haftily diflblved in it; or fometimes by lint 
ftrewed over with wheat flower put up the noftrils ; or by a folu- 
tion of fteel in brandy applied to the veflel by means of lint. The 
cure in other refpedls as in haemoptoe ; when the bleeding recurs 
at certain periods, after venefedlion, and evacuation by calomel, 
and a blifter, the bark and fteel mull be given, as in intermittent 
fevers. See Section XXVII. I. 
The tincture of digitalis given in proper quantities, as 30 
drops from a two-ounce phial every fix hours for two or three or 
four dofes, is probably an efficacious medicine. See Dr. Ferri- 
ar's Treatife on Digitalis. He flopped active hemorrhages by 
the exhibition of digitalis. 
° ORDO. Class I. 1.2. 1. 
OF IRRITATION. 
13 
ORDO I. 
Increafed Irritation. 
GENUS IL 
With increafed Adrions of the Secerning Syfem. 
These are always attended with increafe of partial or of gen- 
eral heat; for the fecr.eted fluids are not Amply feparated from 
the blood, but are new combinations; as they did not previoufly 
exift as fuch in the blood veflels. But all new combinations give 
out heat chemically ; hence the origin of animal h§at, which 
is always increafed in proportion to the fecretion of the part 
affected, or to the general quantity of the fecretions. Neverthe- 
lefs there is reafon to believe, that as we have a fenfe purpofely 
to diftinguilh the prefence of greater or lefs quantities of heat, 
as mentioned in Sect. XIV. 6. fo we may have certain minute 
glands for the fecretion of this fluid, as the brain is believed to 
fecrete the fenforial power, which would more eafily account for 
the inftantapeoup production of the blufh of ihame, and of an- 
ger. This fubject deferves further inveftigation. 
SPECIES. 
I. Calor febrills. The heat in fevers arifes from the increafe 
of fome fecretion, cither of the natural fluids, as in irrita- 
tive fevers ; or of new fluids, as in infectious fevers; or of new 
veflels, as in inflammatory fevers. The pain of heat is a confe- 
quenc.e of the increafed extenfion or contraction of the fibres 
expofed to fo great a ftimulus. See Clafs I. 1.5. 6. 
2. Ruborfebrilis. Febrile rednefs. When the cold fit of fe- 
ver terminates, and the pulfations of the heart and arteries be- 
come ftrong as well as quick from the increafe of their irritabili- 
ty after their late quiefcence, the blood is impelled forwards in- 
to the fine extremities of the arteries, and the anaftamofing ca- 
pillaries, quicker than the extremities of the veins can abforb 
and return it to the heart. Hence the pulfe at the wrift becomes 
full, as well as quick and ftrong, and the fkin glows with arte- 
rial 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 veflels part with the blood, as -foon as it is 
received, and the (kin in confequencc becomes paler ; it is alfo 
probable. 14 
DISEASES 
Class I. i. 2. 3. 
probable, that in more advanced life fome of the finer branches 
of the arteries coalefce, and become impervious, and thus add to 
the opacity of the (kin. 
3. Sudor calidus. Warm fweat may be divided into four va- 
rieties, according to its remote caufes. Firft, the perfpirable 
matter is fecreted in as great quantity during the hot fit of fever, 
as towards the end of it, when the fweat is feen upon the fkin. 
But during the hot fit the cutaneous abforbents a£i alfo with in- 
creafed energy, and the exhalation is likewise increafed by the 
greater heat of the fkin ; and hence it does not appear in drops 
on the furface, but is in part re-abforbed, and in part diflipated 
in the atmofphere. But as the mouths of the cutaneous abforb- 
ents are expofed to the cool air or bedclothes ; whilft thofe of 
the capillary glands, which fecrete the perfpirable matter, are ex- 
pofed to the warmth of the circulating blood ; the former, as 
foon as the fever-fit begins to decline, lofe their increafed adtion 
firft, and hence the abiorption of the fweat is diminifhed, whilft 
the increafed fecretion of it continues for fome hours afterwards, 
■which occafions it to ftand in drops upon the fkin. 
As the fkin becomes cooler, the evaporation of the perfpira- 
ble matter becomes lefs, as well as the abforption of it. And 
hence the diflipation of aqueous fluid from the body, and the 
confequent thirft, are perhaps greater during the hot fit, than 
during the fubfequent fweat. For the fweats do not occur, ac- 
cording to Dr. Alexander's experiments, till the fkin is cooled 
from 112 to 108 degrees of heat; that is, till the paroxyfm be- 
gins 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 
ccnfequence of the decline of the hot fit, commencing with the 
decreafed aftion of the abforbent fyftem, and the decreafed evap- 
oration from the fkin. And from hence it may be concluded, 
that a fever-fit is not in general an effort of nature to reftore 
health, as Sydenham confidered it, but a neceflary confequence 
of the previous torpor; and that the caufes of fevers would be 
lefs detrimental, if the fever itfelf could be prevented from exift- 
ing ; as appears in the cgo! treatment of the fmall-pox. 
It muft be noted that the profufe fweats on the fkm are more 
frequent at the decline of fever-fits than the copious urine, or 
loofe ftools, which are mentioned below ; as the cutaneous ab- 
forbents, being expofed to the cool air, lofe their increafed ac- 
tion fooner than the urinary or inteftina] abforbents; which 
open into the warm cavities of the bladder and inteffines ; but 
which are neverthelefs often affected by their fympathy with the 
cutaneous abforbents. Hence few fevers terminate without a 
moifture ClassI. 1. 2. 3. 
OF IRRITATION. 
15 
moifture of the (kin ; whence arcfe the fatal practice of 
forcing fweats by the external warmth of air or bed-clothes in 
fevers ; for external warmth increafes the action of the cutane- 
ous capillaries more than that of the other fecerning veflels ; be- 
caufe the latter are habituated to 98 degrees of heat, the inter- 
nal warmth of the body ; whereas the cutaneous capillaries be- 
ing nearer the furface are habitually kept cooler by the contact 
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 oxygene by frequent refpiration, 
but is loaded with animal effluvia as well as with moiliure, till 
it can receive no more ; and in confequence, while the cutane- 
ous fecretion Hands upon the fkin in drops for want of exhala- 
tion, the lungs are expofed to an infalubrious atmofphere. 
I do not deny, that fweating may be fo managed as to be 
ferviceable in preventing the return of the cold paroxyifm of fe- 
vers ; like the warm bath, or any other permanent ilimulus, as 
wine, or opium, or the bark. For this purpofe it fhould be con- 
tinued till paft the time of the expelled cold fit, fupported by 
moderate dofes of wine-whey, with fpirit of hartlhorn, and mod- 
erate degrees of warmth. Its falutary effed, when thus man- 
aged, was probably one caufe of its having been fo much attend- 
ed to ; and the fetid fmell, which when profufe is liable to ac- 
company it, gave occafion to the belief, that the fuppofed mate- 
rial caufe of the difeafe was thus eliminated from the circulation'. 
When too great external heat is applied, the fyftem is weak- 
ened by excefs of aCtion, 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 ex- 
hauft the fenforial power by promoting increafe of fibrous action, 
may alfo increafe the production or fecretion of it in the brain, 
yet experience teaches us that the exhauftion far out-balances 
the increafed production, as is evinced by the general debility, 
which fucceeds intoxication. 
In refpeCt to the fetor attending copious continued fweats, it 
is owing to the animalized part of this fluid being kept in that 
degree of warmth, which moft favours putrefaction, and not fuf- 
fered to exhale into the atmofphere. Broth, or other animal 
mucus, kept in fimilar circumftances, 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. 
Ihe eafe, which the patient experiences during fweating, if 
it be not produced by much external heat, is fimilar to that of 
the warm bath; which by its ftimulus applied to the cutaneous 
veflels., 16 
DISEASES 
Class I. r. 2. 3/ 
veflels, which are generally cooler than the interna! parts of the 
fyflem, excites them into greater action ; and pleafurable fenfa- 
tion is the confequence of thefe increafcd actions of the veflels' 
of the fkin. From confidering all thefe circumftances, it ap- 
pears that it is not the evacuation by fweats, but the continued 
flimulus, which caufes and fupports thofe fweats, which is fer- 
viceable 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 increafing in- 
flammation, or by exhaufting the fenforial power. See Clafs I. 
I. 2. 14. 
Secondly) The fweats produced by exercife or labour are of 
the warm kind ; as they originate from the increafed action of 
the capillaries of the fkin, owing to their being more powerfully 
itimulated by the greater velocity of the blood, and by a greater 
quantity of it pafling through them in a given time For the 
blood during violent exercife is carried forwards by the action 
of the mufcles fafter in the arteries, than it can be taken up by 
the veins ; as appears by the rednefs of the fkin. And from 
the confequent fweats, it is evinced, that the fecretory veflels of 
the fkin during exercife pour out the perfpirablc matter fafter, 
than the mouths of the abforbent veflels can drinkit up. Which 
mouths are not expofed to the increafed mufcular adtion, or to 
the flimulus of the increafed velocity and quantity of the blood, 
but to the cool air. 
Thirdly) the increafed fecretion of perfpirable matter occafion- 
ed by the flimulus of exteral heat belongs likewife to this place ; 
as it is caufed by the increafed motions of the capillary veflels ; 
which thus feparate from the blood more perfpirable matter, 
than the mouths of their correfpondent abforbent veflels can take 
up ) though thefe alfo are flimulated by external heat into more 
energetic adlion. If the air be ftationary, as in a fmall room, 
or bed with clofed curtains, the fweat ftands in drops on the fkin 
for want of a quicker exhalation proportioned to the quicker fe- 
cretion. 
A fourth variety of warm perfpiration is that occafioned by 
flimulating drugs, of which opium and alcohol are the moft 
powerful; and next to thefe the fpices, volatile alkali, and neu- 
tral faits, efpecially fea-falt; that much of the aqueous part of 
the blood is diflipated by the ufe of thefe drugs, is evinced by the 
great thirft, which occurs a few hours after the ufe of them. See 
Art. III. 2. 1. 
We may from hence underfland, that the increafe of this 
fecretion of perfpirable matter by artificial means, muft be fol- 
lowed by debility and emaciation. When this is done by taking 
much Class I. 1. 2. 3. 
OF IRRITATION. 
17 
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 
fcrofula, or inirritability of the lymphatic glands, feems alfo to be 
occafionaliy induced by an excefs in eating fait added to food of 
bad nouriflhment. See Clafs I. 2. 3. 21. If an excefs of per- 
fpiration is induced by warm or ftimulant clothing, as by wear- 
ing flannel in contafl with the Ikin in the fummer months, a per- 
petual ftbricula 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, as it is called ; and in grown people, either an eryfipc- 
las, or a miliary eruption, attended with fever. See Clafs IL 
J- 3-. 
Shirts made of cotton or calico ftimulate the Ikin too much 
by the points of the fibres, though lefs than flannel ; whence 
cotton handkerchiefs make the note fore by frequent ufe. The 
fibres of cotton are, 1 fuppofe, ten times fhorter than thofe of 
flax, and the number of points in confequence twenty times the 
number ; and though the manufacturers finge their calicoes on a 
red-hot iron cylinder, yet I have more than once feen an eryfip- 
elas induced or increaied by the ftimulus of calico, as well as of 
flannel; and have during the laft fummer prevailed on two, who 
were confined to their beds by fevers, and three, who were in a 
Hate of great debility, to difencumber themfelves of the flan- 
nel Ihirts, which they had worn for fome time ; all of them be- 
came immediately and confiderably relieved ; and found no in- 
convenience afterwards by difeontinuing an unneceflary Itimulus, 
which had nothing to recommend it to thofe patients but the 
frivolous fafhion of the day. 
The inconvenience, which weak conftitutions experience from 
wearing flannel ihirts, arifes from this circumftance ; that the ex- 
tremities of their limbs are more liable to become Cold, than the 
furiace of the cheft and abdomen, and that hence they fhould in 
preference wdar warmer flockings, (hoes, and locks, or gloves. 
By flimulating the warmer parts of the Ikin into too ftrong and 
ufelefs exertion, as by the hard points of a flannel fnirt at ah fea- 
fons, and by its confining the warmth of the ikin too much in 
the fummer months, a part of the fcnforial power becomes un- 
neceflarily expended ; and in weak conftitutions, where there is 
none to fpare, fome other parts of the fyftem muft aft with left 
energy ; and thus I believe the extremities of feeble people be- 
come colder by the ufe of a flannel fhirt; in ftronger people, and 
perhaps in warmer climates, this increaied coldacfs of the ex- 
Vol. IL I) treinities 18 
DISEASES 
Class t. I. 2. 
tremities may not be perceptible; as ftronger perfons can better 
bear fome increafed exertion, and the confequent unneceflary lofs 
of fome fenforial power; and in warmer climates the extremi- 
ties may not be fo liable to become cold. 
Analogous to this I remember to have feen an inoculated child 
about fix years old, whofe bofom and face, at the beginning of the 
eruptive fever, were of a fiery red colour, and exceedingly hot to 
the touch; and whofe feet were at the fame time pale, and cold 
to the touch. When on expofing the bofom and face to colder 
air with the feet only Rightly covered, the colour of the former in 
a few minutes became nearly natural, with little excefs of tangi- 
ble heat, and at the fame time the feet became as warm as natural. 
Whence I conclude, that all unneceflary increafe of ftimuli, as 
of warm clothing, wine, and opium, is more injurious to fee- 
ble conftitutions than to robuft ones ; and that fuch ftimuli alone 
are falutary to weak perfons, as increafe thofe actions of the fyf- 
tem, which are immediately neceflary to life and health, as the 
clafs of medicines termed forbentia, as peruvian bark, and other 
bitters, and very fmall quantities of fteel, as thefe feem to increafe 
the activity of the abforbent fyftem, both of the lymphatic and 
venous ones, and thus fupply more nutrition, with all its falutary 
confequences- And that the ufe of thefe forbentia, as well as of 
the occafional ufe of warmer clothing, wine, and opium, fhould 
be difcontinued, as foon as the fyftem can acquire the natural 
habit of acting with fufficient energy without them. See Article 
II. 2. 2. I. of the Materia Medica. 
The increafe of perfpiration by heat either of clothes, or of fire, 
contributes much to emaciate the body ; as is well known to jock- 
eys, who, when they are a ftone or two too heavy for riding, 
find the quickeft way to leflen their weight is by fweating them- 
felves between blankets in a warm room ; but this likewife is a 
practice by no means to be recommended, as it weakens the fyf- 
tem by the excefs of fo general a ftimulus, brings on a premature 
old age, and fhortens the fpan of life; as may be further deduced 
from the quick maturity, and fhortnefs of the lives, of the inhab- 
itants of Hindoftan, and other tropical climates. 
When the heat of the body in weak patients in fevers is increaf- 
ed by the ftimulus 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 Ikin, and confequent expenditure of fenforial pow- 
er ; 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 Class I. 1. 2. 4. 
OF IRRITATION. 
19 
in feme parts of the Eaft, does not expend nearly fo much fen- 
forial power, as when the warmth is produced by the locomo- 
tion of the whole weight of the body by mufcular action, as in 
walking, or running, or fwimming. Whence the warmth of a 
fire is to be preferred to flannel fhirts for weak people, and the 
agitation of a horfe to exercife on foot. And I fuppofe thofe, 
who are unfortunately loll in fnow, who are on foot, are liable 
to perifli fooner by being exhaufted by their mufcular exertions ; 
and might 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. \ 
M. Buflbn made a curious experiment to Ihew this circum- 
ftance. He took a numerous brood of the butterflies of filk- 
worms, fome hundreds of which left their eggs on the fame day 
and hour; thefe he divided into two parcels; andplacing one par- 
cel in the fouth window, 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 obferva- 
tions it appears, that the wearing of flannel clothing next the Ikin, 
which is now fo much in faftiion, however ufeful it may be in 
the winter to thofe, who have cold extremities, bad digeftions, or 
habitual coughs, muft greatly debilitate them,if worn in the warm 
months, producing fevers, eruptions, and premature old age. 
See Sed. XXXVII. S. Clafs I. i. 2. 14. Art. III. 2. 1. 
4. Urina uberior colorata. Copious coloured urine. To- 
wards the end of fever-fits a large quantity of high coloured 
urine is voided, the kidneys continuing to aa ftrongly, after the 
increafed aaion of the abforbents of the bladder is fomewhat 
diminifhed. If the abforbents continue alfo to aa ftrongly, the 
urine is higher coloured, and fo loaded as to depofit, when cool, 
an earthy fediment, erroneoufly thought to be the material caufe 
of the difeafe; but is Amply owing to the fecretion of the kidneys 
being great from their increafed aaion; and the thinner parts 
of it being abforbed by the increafed aaion of the lymphatics, 
which are fpread very thick on the neck of the bladder; for the 
urine, as well as perhaps all the other fecreted fluids, is produced 
from the kidneys in a very dilute ftate ; as appears in thofe, 
who from the ftimulus of a ftone, 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 ab- 
forption to the animal ceconomy is evinced from the urinary blad- 
ders of fifh, which would otherwife be unneceflary. High col- 
oured urine in large quantity (hews only, that the fecreting vef- 
fcls 20 
DISEASES 
Class I. i. 2. 
fels of the kidneys, and the abforbents of the bladder, have afted 
with greater energy. When there is much earthy fediment, it 
fhews, that the abforbents have acSted proportionally ftronger, 
and have confequently left the urine in a lefs dilute ftate. In 
this urine the tranfparent fediment or cloud is mucous; the 
opaque fediment is probably coagulable lymph from the blood 
changed by an animal or chemical procefs. The floating fcum 
is oil. The angular concretions to the fides of the pot, lormed 
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. Diarrhoea, calida. Warm diarrhoea. This fpecies may 
be divided 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 etroneoufly called critical, like the copious 
urine, and the fweats ; whereas it arifes from the increafed action 
of thofe fecerning organs, which pour their fluids into the intef- 
tinal canal (as the liver, pancreas, and mucous glands,) contin- 
uing longer than the increafed aRion of the inteftinal abforbents. 
In this diarrhoea there is no appearance of curdled chyle in the 
{tools, as occurs in cholera. I. 3. 1. 5. 
The diarrhoea crapulofa^ or diarrhoea from infligeftion, occurs 
when too great a quantity of food or liquid has been taken ; 
which not being completely digefted, ftimulates the inteftines 
like any other extraneous acrid material ; and thus produces an 
increafe of the fecretions into them of mucus, pancreatic juice, 
and bile. When the contents of the bowels are Rill more ftim- 
ulant, as when draflic purges, or very putrefcent diet, have been 
taken, a cholera is induced. See Sedl. XXIX. 4. 
The diarrhoea infantum^ or diarrhoea of infants, is generally 
owing to too great acidity in their bowels. Milk is found 
curdled in the ftomachs of all animals, old as well as young, and 
even of carnivorous ones, as of hawks. (Spallanzani.) And 
it is the gaftric juice of the calf, which is employed to curdle 
milk in the procefs of making cheefe. Milk is the natural food 
for children, and muft curdle in their ftomachs previous to di- 
geftion ; and as this curdling of the milk deftroys a part of the 
acid juices of the ftomach, there is no reafon for difcontinuing 
the ufe of it, though it is occafionally ejected in a curdled ftate. 
A child of a week old, which had been taken from the breaft of 
its dying mother, and had by feme uncommon error been fuf- 
fered to take no food but water-gruel, became fick 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. Class I. 1. 2. 6. 
OT IRRITATION. 
21 
children, have this natural food of milk prepared for them, the 
analogy is fo ftrong in favour of its falubrity, that a perfou 
Should have powerful teftimony indeed of its difagreeing before 
he advifes the difcontinuance of the ufe of it to young children, 
in health, and much more fo in fickncis. The farmers lofe many 
of their calves, which are brought up by gruel, or gruel and 
old milk ; and among the poor children of Derby, who are 
thus fed, hundreds are ftarved into the fcrofula, and either perilh, 
or live in a Rate of wretched debility. 
When young children are brought up without a breaft, they 
fhould for the firft two months have no food but new milk ; 
fince the addition of any kind of bread or flour is liable to fer- 
ment, and produce too much acidity ; as appears by the confe- 
quent diarrhoea with green dejections and gripes ; the colour is 
owing to a mixture of acid with the natural quantity of bile, and 
the pain to its ftimulus. And they fhould 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 cir- 
cumftance is of great importance to the health ofthofe children, 
who are reared by the fpoon, fince if too much food is given 
them, indigeftion,and gripes, and diarrhoea, are the confequencc; 
and if too little, they become emaciated ; and of this exact 
quantity their own palates judge the belt. 
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 coagulates it. Chalk about four grains every fix hours, 
with one drop of fpirit of hartfhorn, and half a drop of lauda- 
num. But a bliiler about the fize of a (hilling is of the greateft 
fervice by reftoring the power of digeftion. See Article III. 2. 
1. in the Materia Medica. 
6. Salivatio calida. Warm falivation. Increafed fecretion of 
faliva. This may be effected either by ftimulating the mouth 
of the gland by mercury taken internally; or by ftimulating the 
excretory dudl of the gland by pyrethrum, or tobacco; or Am- 
ply by the movement of the mufcles, which lie over the gland, as 
in mafticating any taftelefs fubftance, as a lock of wool, or 
maftic. 
In about the middle of nervous fevers a great {pitting of fali- 
va fometimes 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 acciden- 
tal circumftance, perhaps not unfimilar to the hyfteric ptyalifms 
mentioned in Clafs I. 3. 2. 2. See Scd. XXIV. 
M. M. Cool 22 
DISEASES 
Class I. 1.2. 7. 
M. M. Cool air, diluents, warm bath, evacuations. 
7. Catarrhus calidus. Warm catarrh. Confifts in an in- 
creafed fecretion of mucus from the noftrils without inflamma- 
tion. This difeafe, which is called a cold in the head, is fre- 
quently produced by cold air afting for fome time on the mem- 
branes, which line the noftrils, as it pafles to the lungs in refpi- 
ration. Whence a torpor of the aftion of the mucous glands 
is firft introduced, as in Clafs I. 2. 3. 3. and an orgafm or in- 
creafed ^ftion 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 exu- 
berant fecretion of mucus in the noftrils. 
At other.times it arifes from reverfe fympathy with fome ex- 
tenfive parts of the fkin, which have been expofed too long to 
cold, as of the head, or feet. In confequence of the torpor of 
thefe cutaneous capillaries thofe of the mucous membrane of the 
noftrils aft with greater energy by reverfe fympathy; and thence 
fecrete more mucus from the blood. At the fame time the ab- 
forbents, afting alfo with greater energy by their reverfe fym- 
pathy with thofe of fome diftant part of the fkin, abforb the 
thinner parts of the mucus more haftily ; whence the mucus i$ 
both thicker and in greater quantity. Other curious circumftan- 
ces attend this difeafe j the membrane becomes at times fo thick- 
ened by its increafed aftion in fecreting the mucus, that the pa- 
tient cannot breathe through his noftrils. In this fituation if he 
warms his whole fkin fuddenly by fire or bed-clothes, or by 
drinking warm tea, the increafed aftion of the membrane ceafes 
by its reverfe fympathy with the fkin ; or by the retraftion of 
the fenforial power to other parts of the fyftem ; and the patient 
can breathe again through the noftrils. The fame fometimes oc- 
curs for a time on going into the cold air by the deduftion of 
heat from the mucous membrane, and its confequent inactivity 
or torpor. Similar to this when the face and breaft have been 
very hot and red, previous to the eruption of the fmall-pox by 
inoculation, and chat even when expofed to cool air, I have ob- 
ferved the feet have been cold ; till on covering them with warm 
flannel, as the feet have become warm, the face has cooled. See 
Seft. XXXV. 1.3. Clafs II. 1. 3.5. IV. 2.2. 10. IV. 1. 1. $. 
M. M. Evacuations, abftinence, oil externally on the nofe, 
warm diluent fluids, warm fhoes, warm night-cap. 
8. ExpeEtoralio calida. Warm expeftoration confifts of the 
increafed fecretion of mucus from the membrane, which lines 
the brouchije, or air-cells of the lungs, without inflammation. 
This increafed mucus is ejefted by the aftion of coughing, and 
is Class I. 1. 2. 9. 
OF IRRITATION. 
23 
is called a cold, and refembles the catarrh of the preceding arti- 
cle ; with which it is frequently combined. 
M. M. Inhaling the fteath of warm water, evacuations, warm 
bath, afterwards opium, forbentia. 
9. Exfudatio pone aures. A difcharge behind the ears. This 
chiefly affects 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 j if a morbid action has continued 
a confiderable time, it fhould not be flopped too fuddenly ; fince 
in that cafe feme other morbid action is liable to fucceed in its 
ftead. Thus children are believed to have had colics, or even 
convulfions, confequent to the too fudden healing of thefe mor- 
bid effufions behind their ears. The rationale of this is to be ex- 
plained from a medical fact, which I have frequently obferved ; 
and that is, that a blifler 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 blifter produces 
fenfation in the veffels of the fkin ; with this additional fenfori- 
al power thefe veffels aft more flrongly j and with thefe the vef- 
fels of the internal membranes of the ftomach and bowels aft 
with greater energy from their direct fympathy with them. 
Now the acrid difcharge behind the ears of children produces 
fenfation on that part of the Ikin, and fo far afts as a fmall blif- 
ter. When this is fuddenly flopped, a debility of the digeftive 
power of the ftomach fuccceds from the want of this accuftom- 
ed ftimulus, with flatulency, green ftools, gripes, and fometimes 
confequent convulfions. See Clafs II. 1. 5. 6. and II. 1. 4. 6. 
M. M. If the matter be abforbed, and produce fwelling of the 
lymphatics of the neck, it fhould be cured as foon as poffible by 
dufting the part with white lead, ceruffa, in very fine powder ; 
and to prevent any ill confequence an iflue fhould be kept for 
about a month in the arm $ or a purgative medicine fhould be 
taken every other day for three or four times, which ihould con- 
fift 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 part. The tinea, or 
fcald head, and a leprous eruption, which often appears behind 
the ears, are different difeafes. 
10. Gonorrhea calida. Warm gleet. Increafed difcharge of 
mucus from the urethra or proftrate gland without venereal de- 
fire, or venereal infection. See Clafs I. 2. 3. 8. 
M. M Cantharides, balfams, rhubarb, blifter on perinasum, 
cold 24 
DISEASES 
ClassI. 1. 2. if. 
cold bath, injections of metallic faits, flannel fhirt, change of 
the form of the accuftomed chair or faddle of the patient. 
ii. Fluor albus calidus. Warm fluor albus. Increafed fecre- 
tion of mucus in the vagina or uterus without venereal defire or 
venereal infedion. It is diftinguiflied from the fluor albus frig- 
idus by the increafed fenfe of warmth in the part, and by the 
greater opacity or fpiflitude of the material difcharged ; as the 
thinner parts are re-abforbed by the increafed action of the ab- 
forbents, along with the faline part, whence no fmarting or ex- 
coriation attends it. 
M. M. Mucilage, as ifinglafs, hartfhorn jelly, gum arabic. 
Ten grains of rhubarb every night. Calico or flannel fhift, opi- 
um, balfams. See ClafsI. 2. 3. 7. 
12. H&morrhois alba. White piles. An increafed difcharge 
of mucus from the rectum frequently miftaken for matter ; is 
laid to continue a few weeks, and recur like the bleeding piles ; 
2nd to obey lunar influence. See Clafs 1. 2. 1. 6. 
M. KI. Abftinence from vinous fpirit. Balfam of copaiva. 
Spice fwallowed in large fragments, as ten or fifteen black pep- 
per-corns cut in half, and taken after dinner and fupper. Ware's 
pafte, confifting of black pepper and the powdered root of He- 
lenium Enula. 
13. Serum e vejicatorio. Difcharge from a blifter. The ex- 
cretory duds of glands terminate in membranes, and are endu- 
ed with great irritability, and many of them with fenfibility ; the 
latter perhaps in confequence of their facility of being excitable 
into great adion ; infiances of this are the terminations of the 
gall-dud in the duodenum, and of the falivary and lachrymal 
glands in the mouth and eye ; which produce a greater fecre- 
tion of their adapted fluids, when the ends of their excretory 
duds are ftimulated. 
The external fkin confifts of the excretory duds of the capil- 
laries, with the mouths of the abforbents ; when thefe are ftim- 
ulated by the application of cantharides, or by a flice of the frefli 
root of bryonia alba bound on it, the capillary glands pour an 
increafed quantity of fluid upon the ficin by their increafed ac- 
tion ; and the abforbent veflels imbibe a greater quantity of the 
more fluid and faline part of it; whence a thick mucous or fe- 
rous fluid is depofited between the ficin and cuticle. 
14. Per fairatiofaetida. Fetid perfpiration. The ufes of the 
perfpirable matter are to keep the Ikin foft and pliant, for the 
purpofes of its eafier flexibility during the adivity of our limbs in 
locomotion, and for the prefervation of the accuracy of the fenfe 
of touch, which is diffufed under the whole furface of it to 
guard us againft the injuries of external bodies 5 in the fame 
manner Class I. 1. 2. 14. 
OF IRRITATION. 
25 
manner as the fecretion of tears is defigned to preferve the cor- 
nea of the eye moift, and in confequence transparent ; yet has 
this cutaneous mucus been believed by many to be an excre- 
ment ; and I know not how many fanciful theories have been 
built on its fuppofed obftrudion. Such as the origin of catarrhs, 
coughs, inflammations, eryfipelas, and herpes. 
To all thcfe it may be fufficient to anfwer, that the ancient 
Grecians oiled themfelves all over ; that fome nations have 
painted themfelves all over, as the Pi£ts 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 hogs, according to the tyranny of a 
filthy and wafteful falhion, and all this without inconvenience. 
To this muft be added the ftridT 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. 
The quantity of perfpirable matter being greater than that of 
the excrementitious matters voided by (tool and urine, has been 
ufed as an argument in favour of its being an excrement; the force 
of which I do not fee : but can readily underhand, that there 
muft of neceflity be a great exhalation of a fluid which is diftu- 
fed over the whole external furface of the warm Ikin, and per- 
haps w'armer lungs, for the purpofe of keeping them moift and 
pliant, and which is perpetually renewed as it evaporates ; but, 
if it be conceived to be an excrement, there feems to have been 
no neceflity for its quantity being fo great. 
The evaporation of this great quantity of fluid, fecreted on the 
furface of the Ikin and lungs, muft carry oft' much heat from 
the body ; and as both this fecretion and confequent evaporation 
will be in proportion to the aftivity of the cutaneous vefibls, and 
the heat occafioned by their increafed fecretion, it would feem, 
that this evaporation of perfpirable matter is the caufe which 
preferves the animal body at the uniform degree of heat of 98 ; 
in the fame manner as the evaporation of boiling water preferves 
it at 212 degrees of Farenheit's fcale. 
The peculiar ufe of the perfpirable matter in preferring the 
membranes moift, which line the air-pipes of the lungs, appears 
from the curious difcovery of Dr. Prieftley, that the oxygen of 
the atmofphcre will pafs through moift animal membranes, but 
not through dry ones, fo that if the membranes of the trachea 
were to become dry, the animal muft as immediately perith as 
if he was to breath azotic gas alone. See Sect. XXVIII. 2. of 
the preceding volume. 
Vol. II. F In 26 
DISEASES 
Class I. i. z. 14^ 
In fume conftitutions the perfpirable matter of the lungs ac- 
quires a difagreeable odour ; in others the axilla, and in others 
the feet, emit difguftful effluvia ; like the fecretions of thofc 
glands, which have been called odoriferse ; as thofc, which con- 
tain the caftor in the beaver, and thofe within the recStum of 
dogs, the mucus of which has been fuppofed to guard them 
againft the great coftivenefs, which they are liable to in hot 
tummers ; and which has been thought to occafion canine mad- 
nefs, but which, like their white excrement, is more probably 
owing to the deficient fecreticn of bile. Whether thefe odorif- 
erous particles attend the perfpirable matter in confequence of 
the increafed action of the capillary glands, and properly be 
called excrementitious ; that is, whether any thing is elimina- 
ted, which could be hurtful if retained ; or whether they may 
only contain fome of the eflential oil of the animal; like the 
fmell, which adheres to one's hand on itroking the hides of 
iome 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. 
Add to this, that fome parts of the fkin are liable to more 
prefufe perfpiration than other parts without pofleffing any fetid 
it ent, as the fkin of the face, on any more violent exercife. This 
teems to have been obferved very early in the hillory of man- 
kind, as it was faid, that our firft parents fhould earn their bread 
by the Iweat of their brow. Why this circumftance does not 
attend other animals is a curious inquiry. Mankind foon learn- 
ed to cover their bodies, except their faces, with clothes ; when 
the face, by being more frequently expofed to greater variations 
of heat and cold, acquired greater irritability, or fenfibility, or 
aflbeiability, and thus has become more excitable into greater ac- 
tion by the llimulus of exercife, or by that of food, or by the va- 
liolus infection, than other parts of the fkin, as fpoken of in 
Clafs IV. i. 2. 12; which alfo appears by its fympathy with 
difeafesof the liver or ftomach by fenfitive aflociations, as in the 
gutta rofea. From all thefe analogous fabls the profule fweat, 
which exudes from the face on exercife, does not appear to be 
an excrementitious fluid, but fimply the confequence of more 
violent action of the cutaneous or perfpirative glands. 
M. M. Wafh the parts twice a day with foap and water; 
with lime water ; cover the feet with oiled fiik focks, which 
mull be walked night and morning. Cover them with charcoal 
recently made red hot, and beaten into line powder and fitted, 
as toon a; cold, and Lent well corked in a bottle, to be walked 
off Class I. 1. 2. 15. 
OF IRRITATION. 
27 
off and 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 increafingone evacuation to decre.afe an- 
other. Cool drefs, diluting liquids ? 
15. Crines novi. New hairs. The black points on the face': 
of fome people confift of mucus, which is become vifcid, and 
which adheres in the excretory duffs of the glands of the ikin ; 
as defcribed in Clafs I. 2. 2. 9. and which may be prefled out 
by the fingers, and refembles little worms. Similar to this 
would feem the fabrication of filk and of cobweb, by the tdk- 
worm and fpider ; which is a fecreted matter prefled through 
holes, which are the excretory duffs of glands. And it is prob- 
able, that the produffion of hair on many parts of the body, and 
at different periods of life, may be effected by a fimilar procefs j 
and more efpecially as every hair may be confidered as a (lender 
flexible horn, and is an appendage of the (kin. See Seff. 
XXXIX. 3. 2. Now as there is a fenfitive fympathy between 
the glands, which fecrete the femen, and the throat, as appears 
in the mumps ; fee Hydrophobia, Clafs IV. 1. 2. 7. and Paroti- 
tis, Clafs IV. 1. 2. 19. the growth of the beard at puberty feems 
to be caufed by the greater affion of the cutaneous glands about 
the chin and pubes in confequence of their fympathy with thofe 
of the teifes. But this does not occur to the female fex at their 
time of puberty, becaufe the fenfitive fympathy in them feems to 
exift between the fubmaxillary glands, and the peftoral ones ; 
which fecrete the milk, and afford pleafure both by that fecre- 
tion, and by the ereffion of the mammulae, or nipples j and 
by delivering the milk into the mouth of the child ; this fen- 
fitive fympathy of the pe£toral 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 difagreea- 
ble, they may be thus readily removed without pain or any ilj 
confequence. Warm the ends of a pair of nippers or forceps, 
and flick on them a little refin, or burgundy pitch ; by 
thefe means each fingle hair may be taken fail hold of ; and 
if it be then plucked off flowly, it gives pain ; but if plucked 
off fuddenly, it gives no pain at all ; becaufe the vis inertiae 
of the part of the (kin, to which it adheres, is not overcome ; 
and it is not in confequence feparated from the cellular mem- 
brane under it. Some of the hairs may return, which are 
thus plucked off, or others may be induced to grow near them; 
but in a little time they may be thus fafely deftroyed ; which 
is much to be preferred to the methods faid to be ufed in Turkey 28 
DISEASES 
Class I. 1. 2. 15. 
to eradicate hair ; fuch as a mixture o£ orpiment and quick 
lime ; 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 {having ; or to become white, if the roots 
of it have been much inflamed by the caufticity of the applica- 
tion- See Cla& I. 2. 2. 11. on grey hairs. 
ORDO Class I. 1. 3. r. 
OF IRRITATION. 
29 
ORDO I. 
Increafed Irritation. 
GENUS III. 
With increafed Actions of the Abforfrent Syfem. 
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 fyftern ; nor are the glands 
of the abforbent veflels fo numerous or fo extenfive as thofe of 
the fecerning ones. Yet that fome heat is produced by the in- 
creafed action of the abforbents appears from the greater gener- 
al warmth of the Ikin and extremities of feeble patients after the 
exhibition of the peruvian bark, and other medicines of the arti- 
cle Sorbentia. 
SPECIES. 
i. Lingua arida. Dry tongue occurs in thofe fevers, where 
the expired air is warmer than natural; and happens to all thofe, 
who deep with their mouths open ; the currents of air in refpi- 
ration increafing the evaporation. There is alfo a drynefs in 
the mouth from the increafed action of the abforbent veflels, 
when a floe or a crab-apple is mafticated ; and after the perfpi- 
ration has been much increafed by eating fait or fpice, or after 
other copious fecretions j as after drunkennefs, cathartics, or 
fever fits, the mucus of the mouth becomes vifcid, and in final! 
quantity, from the increafed abforption, adhering to the tongue 
like a white flough. In the diabetes, where the thirfl: is very 
great, this flough adheres more pertinaCioufly, and becomes black 
or brown, being coloured after a few days by our aliment or 
drink. The infpiflated 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 
adheres long to the papillae of the tongue, the faliva, which it 
contains in its interftices, like a fponge, is liable to become pu- 
trid, and to acquire a bitter tafte, like other putrid animal fub- 
ftances; which is generally miftaken for an indication of the 
prefence of bile. 
M. M. Warm fubacid liquids. See Clafs I. 2. 5. 8. 
J. Fauces arid*. Dry throat. The expuition of a frothy 
mucus 30 
DISEASES 
Class I. 1. 3. 3. 
mucus with great and perpetual hawking occurs in hydrophobia, 
and is very diftreffing to the patient ; which may be owing to 
the increafed irritability or fenfibility of the upper part of the 
cefophagus, which will not permit any fluid to reft on it. 
It affetts fome people after intoxication, when the lungs re- 
main flightly inflamed, and by the greater heat of the air in ex- 
piration the mucus becomes too haftily evaporated, and is expec- 
torated with difficulty 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 neceflitated to take 
a fpoonful of water, as foon as he awoke ; otherwise a little blood 
always followed the forcible expuition of the indurated mucus 
from his fauces. See Clafs II. 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. Ora 
pot of water fufpended over the bed, with a piece of lift, or 
woollen cloth, depending from it, and held in the mouth ; w'hich 
will a£t like a fyphon, and flowly fupply moifture, or barley wa- 
ter fhould be frequently fyringed into the mouth of the patient. 
3. Nares aridi. Dry noftrils with the mucus hardening up- 
on their internal furface, fo as to cover them with a kind of 
fkinor fcale, owing to the increafed atftion of the abforbents of 
this membrane ; or to the too great drynefs of the air, which 
paffes into the lungs; or too great heat of it in its expiration. 
When air is fo dry as to lofe its tranfparency ; as when a trem- 
ulous motion of it can be feen over corn-fields in a hot fummer's 
day; or when a dry mift, or want of tranfparency of the air, is 
vifible in very hot weather ; the fenfe of fmell is at the fame 
time imperfect from the drynefs of the membrane, beneath which 
it is fpread. 
4. ExpeHoratio folida. Solid expectoration. The mucus 
of the lungs 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 TranfaCt. of the College, Lon- 
don. There is a rattling or wheezing of the breath, but it i$ 
not at firft attended with inflammation. 
The Cynanche trachealis, or Croup, of Dr. Cullen, or Angina 
polypofa of Michaelis, if they differ from the peripneumony of in- 
fants, feem to belong to this genus. When the difficulty of ref- 
piration is great, venefe£lion is immediately neceffary, and then 
an emetic, and a blifter. And the child fhould be kept nearly 
upright in bed as much as may be. See Tonfillitis, Clafs II. 1, 
3. 3. and II. 1. 2. 4. 
M. M. Diluents, emetics, offence of antimony, foetid gums, 
onions. Class I. 1. 3. 5. 
OF IRRITATION. 
31 
onions, warm bath for half an hour every day for a month. In- 
haling the fleam of water, with or without volatile alkali. Soap. 
5. Cenjlipatio dlvi. Coftivenefs from increafed action of the 
inteflinal abforbents. The feces are hardened in lumps called 
fcybala ; which are fometimes obliged to be extracted from the 
redum with a kind of marrow fpoon. This is faid to have hap- 
pened from the patient having taken much ruft of iron. The 
mucus is alfo hardened fo as to line the inteftines, and to come 
away in fkins, rolled up as they pafs along, fo as to refembie 
worms, for which they are frequently miftaken ; and fometimes 
it is evacuated in ftill larger pieces, fo as to counterfeit the form 
of the inteftines, and has been miftaken for a portion of them. 
Balls of this kind, nearly as heavy as marble, and confiderably 
hard, from two inches to five in diameter, are frequently found in 
the bowels of hcrfes. 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 arida. Dry fkin. 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 
on the hairy fcalp, the fkin becomes covered with hardened mu- 
cus ; 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 fkin be- 
neath refinous or oily plafters, or which is feen to adhere to fuch 
plafters, is owing to their preventing the exhalation of the per- 
fpirable matter, and not to their increafmg the production of it, 
as fome have idly imagined. 
M. M. Warm bathing, oil externally, oil-fkin gloves, refin- 
ous plafters. Wax. 
7. Urina parca colorata. Diminifhcd urine, which is high coj- 
oured, and depofits an earthy fediment, when cold, is owing to 
the great adiou of the urinary abforbents. See Clafs I. 1. 2. 
4. In fome dropfies the cutaneous abforbents are paralytic, as 
well as thofe opening into the cellular membrane 5 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 ad ion. 
Hence the urine is in very fmall quantity, and of deep colour, 
with copious fediment; and the kidneys are erroneouily blamed 
for not doing their office ; ftimulant diuretic medicines are giv- 
en in vain ; and very frequently the unhappy patient is reftrain- 
•d from quenching his thirft, and dies a martyr to falfe theory. 
M. M. Diluent 32 
DISEASES 
Class I. 1.3. 8* 
M. M. Diluent liquids, and warm bathing, are the natural 
cure of this fymptom ; but it generally attends thofe dropfies, 
which are feldom curable ; as they are owing to a paralyfis both 
of the cutaneous and cellular lymphatics. 
8. Calculus felleus. Gall-ftone. From the too hafty abforp- 
tion of the thinner parts of the bile, the remainder is left too 
vifcid, and cryftallizes into lumps; which, if too large to pafs, 
obftrudl the dutSlus 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 bilc-dudl with 
difficulty by changing its form; and thus gives thofe pains, 
which have been called fpafms of the flomach ; and yet thefe 
vifcid lumps of bile may afterwards diffiolve, and not be vilible 
among the feces. 
In two inllances 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 in- 
flammable like bad wax, when put into the flame 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 lettuce, 
cabbage, muftard, and crefles. When in violent pain, four 
ounces of oil of olives, or of almonds, fhould be fwallowed ; 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, 
firll on one fide, and then on the other. Electric fhocks through 
the gall-duct. Factitious Seltzer water made by diflblving one 
dram of fal foda in a pint of water ; to half a pint of which made 
luke-warm add ten drops of marine acid ; to be drunk as foon 
as mixed, twice a day for fome months. Opium mull be ufed 
to quiet the pain, if the oil does not fucceed, as two grains, and 
another grain in half an hour if neceflary. 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 (tone is attended with 
retraftion of the tefticle in men, and numbnefs on the infide of 
the thigh in women. It is diftinguifhed from the lumbago or 
fciatica, as thefe latter are feldom attended with vomiting, and 
have pain on the outfide of the thigh, fometimes quite down to 
the ancle or heel. See Herpes and Nephritis. 
Where the abforption of the thinner parts of the fecretion 
takes place too haftily in the kidneys, the hardened mucus, and 
confequent calculous concretions, fometimes totally flop up the 
tubuli uriniferi, and no urine is fecreted. Of this many die, 
who have drunk much vinous fpirit, and fome of them recover 
by voiding a quantity of white mucus, like chalk and water ; and 
others Class I. 1. 3. 9. 
OF IRRITATION. 
33 
others by voiding a great quantity of fund, or fmall calculi. This 
hardened mucus frequently becomes the nucleus of a (tone in the 
bladder. The faits of the urine, called microcofmic fait, arc of- 
ten rniftaken for gravel, but are diftinguifhable both by their an- 
gles of cryftallization, their adhefion to the fides or bottom of 
the pot, and by their not being formed till the urine cools. Where- 
as the particles of gravel are generally without angles, and always 
drop to the bottom of the veffel, immediately as the vzater is 
voided. 
Though the proximate caufc of the formation of the calculoqs 
concretions of the kidneys, and of chalk-ftones in the gout, and 
of the infoluble concretions of coagulable lymph, which are found 
on membranes, which have been inflamed in peripneumony, or 
rheumatifm, confifts in the two great action of the abforbent 
veflels of thofe parts ; yet the remote caufe in thefe cafes is 
probably owing to the inflammation of the membranes which 
at that time are believed to fecrete a material more liable to co- 
agulate or concrete, than they would otherwife produce by in- 
creafed adtion alone without the produftion of new veflels,which 
conftitutes inflammation. As defined in 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 proceffes. Gall -ftones, ftones 
found in the inteftines of horfes, fcurf of the fkin in leprofy, 
ftones of the kidneys and bladder, the callus from the inflamed 
periofteum, which unites broken bones, the calcareous cement, 
which repairs the injured (hells of fnails, the calcareous cruft on 
the eggs of birds, the annually renewed (hells of crabs, are all in- 
ftances of productions from mucous membranes, afterwards in- 
durated by abforption of their thinner parts. 
All thefe concretions contain phofphoric acid, mucus, and 
calcareous earth in different proportions ; and are probably fo 
far analogous in refpeCt to their component parts as well as their 
mode of formation. Some calcareous earth has been difeovered 
after putrefaction in the coagulable lymph of animals. Fordyce's 
Elements of Practice. A little calcareous earth was detected 
by Scheele or Bergman in the calculus of the bladder with much 
phofphoric acid, and a great quantity of phofphoric acid is (hewn 
to exift in oyfter-fhells by their becoming luminous on expofing 
them a while to the fun's light after calcination ; as in the ex- 
periments of Wilfon. Botanic Garden, P. i. Canto i. 1. 182, 
note. The exchange of which phofphoric acid for carbonic acid, 
or fixed air, converts (hells into lime-ftone, producing mountains 
of marble, or calcareous ftrata. 
Now as the hard lumps of calcareous matter, termed crabs' 
Vol. IL F eyes, 34 
DISEASES 
Class I. 1. 3. 9. 
eyes, which are found in the ftomachs of thofe animals previous 
to the annual 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 dif- 
folved by the gaftric juice of fiflt of prey, as of crabs, or pike ; or 
of voracious young birds, as young rooks or hawks, or even of 
calves ? Could not thefe experiments be tried by collecting the 
gaftric juice by putting bits of fponge down the throats of young 
crows, and retracting them by a ftring in the manner of Spal- 
lanzani ? or putting pieces of calculus down the throat of a liv- 
ing crow, or pike, and obferving if they become digefted ? and 
laftly, could not gaftric juice, if it fhould appear to be a folvcnt, 
be injected and borne in the bladder without injury by means of 
catheters of claftic refin, or caoutchouc ? 
M. M. Diluents. Cool drefs. Frequent change of pofture. 
Frequent horizontal reft in the day. Bathe the loins every morn- 
ing with a fponge and cold water. Aerated alkaline water in- 
ternally. Abftinence from all fermented or fpirituous liquors. 
Whatever increafes perfpiration injures thefe patients, as it dif- 
fipates 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 abftinence from fermented or 
fpirituous liquors ; by drinking much aqueous fluids ; as toaft 
and water, tea, milk and water, lemonade ; and laftly by thin 
clothing, and fleeping on a hardifh 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 kidneys by increafing abforption, when they are 
inflamed ; in the fame manner as is done by fermented or fpir- 
ituous liquor. See Clafs I. 3. 2. 11. 
When the kidneys are fo obftructcd with gravel, that no urine 
pafles into the biadder ; which is known by the external appear- 
ance of the lower part of the abdomen, which, when the bladder 
is full, feems as if contracted by a cord between the navel and 
the bladder ; and by the tenfion on the region of the bladder 
diflinguifhableby the touch ; or by the introduction of the ca- 
theter j the following methods of cure are frequently fuccefsful. 
Vcnefection to fix or eight ounces, ten grains of calomel, and 
an infufion of fenna with faits and oil, every three hours, till 
ftools aie procured. Then an emetic. After the patient has 
been thus evacuated, a blifter on the loins fhould be ufed ; and 
from ten to twenty electric fhocks fhould be pafled through the 
kidneys, as large as can be cafily borne, once or twice a day. 
Along with this method the warm bath fhould be uled for an 
Lour once or twice a day. After repeated evacuations a clyfter, 
confifting Class I. i. 3. io. 
OF IRRITATION. 
35 
confifting of two drams of turpentine diflblyed by yolk of egg, 
and fixty drops of tinflure of opium, fhould be uled at night, 
and repeated, with cathartic medicines interpofed, every night, 
or alternate nights. Aerated folution of alkali ihould 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 (tone flicks in the ureter with inceffant vomiting ten grams 
of calomel mull be given in fmall pills as above ; and fome hours 
afterwards infufion of fenna and faits and oil, if it can be made 
to Hay on the ftomach. And after the purge has operated four 
or five times, an opiate is to be given, if the pain continues, con- 
fiding of two grains of opium. If tins does not fuccee^, ten or 
twenty electric fhocks through the kidney fhould be tried, and 
the purgative repeated, and afterwards the opiate. The patient 
fhould be frequently put into the warm bath for an hour at a 
time. Eighty or a hundred drops of laudanum given in a glyf- 
ter, with two drams of turpentine, are to be preferred to the 
two grains given by the ftomach as above, when the pain and 
vomiting are very urgent. 
io. Calculus veftca. Stone of the bladder. The nucleus, or 
kernel, of thefe concretions is always formed in the kidnev, as 
above defcribed; and pafTrng down the ureter into the bladder, 
is there perpetually increafed by the mucus and faits fecreted 
from the arterial fyftem, or by the mucus of the bladder, difpo- 
fed in concentric ftrata. The ftones found in the bowels of 
horfes are alfo formed on a nucleus, and confift of concentric 
fpheres ; as appears in fawing them through the middle. But 
as thefe are formed by the indurated mucus of the 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 leaf! of 
their component parts ; when a patient, who labours under this 
affliefting difeafe, voids any fmall bits of gravel ; thefe fhould be 
kept in warm folutions of cauftic alkali, or of mild alkali well 
aerated : and if.they diffolve in thefe folutions, it would afford 
greater nopes, that that which remains in the bladder, might be 
affected by thefe medicines taken by the ftomach, or injected 
into the bladder. 
To prevent the increafe of a ftone in the bladder much diluent 
drink ihould 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 faits 
from being precipitated from the urine, and by keeping the mu- 
cus 36 
DISEASES 
Class I. 1. 3. io. 
cus fufpended in it; but will alfo diminifh the ftone already 
formed, by foftening, and walking away its furface. To thi$ 
mult be added cool drefs, and cool bed-clothes, as directed above 
in the calculus renis. 
When the (tone is pufhed againft or into the neck of the blad- 
der, great pain is produced ; this may fometimes be relieved by 
the introduction of a bougie to pulh the ftone back into the fun- 
dus of the bladder. Sometimes by change of pofture, or by an 
opiate either taken into the ftomach, or by a clyiter. 
A dram of lai loda, or of fait of tartar, diflblved in a pint of wa, 
ter, and well faturated with carbonic acid (fixed air), by means 
of Dr. Nooth's glafs apparatus, and drunk every day, or twice a 
day, is the moft efficacious internal medicine yet difcovered, 
which can be eafilytaken without any general injury to the con- 
ftitution. An aerated alkaline water of this kind is fold under 
the name of factitious Seltzer water, by J. Schweppe, at No. 8, 
King's-ftreet, Holborn, London; which I am told is better pre- 
pared than can be eafily done in the ufual glafs-veflels, probably 
by employing a greater preflure in wooden ones. 
A curious account is given in a letter to Sir John Sinclair from 
Colonel Martin ; who aflerts, that, after ufing bougies and in- 
jections into the bladder, the paffage of the urethra became lefs 
fcnfible to pain, and he was enabled to introduce fmall files (I 
fuppofe, with their backs fmooth) ; and that by thefe he gradu- 
ally filed away the ftone, as it lay in the neck of the bladder. 
When the ftone did not properly prefent itfelf, he introduced 
warm water by injection into the bladder, and thus, by again en- 
deavouring to difeharge it, brought forward the ftone to the neck 
of it. He ufed the file three times in twenty-four hours from 
April till October. Medical Journal, No. IL p. 121. If this 
procefs fhould be again attempted, perhaps the file might be intro- 
duced through a flexible canula, with a metallic hood at the in- 
ternal end of the canula to cover the back of the file, fo as to 
prevent the friction of it againft the urethra, or neck of the blad- 
der. If the urethra, by frequent trials, fhould become fo infen- 
fible as to admit eafily the frequent introduction of a metallic 
canula, might not two fine fteel wires properly tempered be join- 
ed at one end by a hinge, and thus introduced through the can- 
ula into the bladder ; and when protruded beyond the extremity 
of the canula, they might open by their elafticity fo as to receive 
the ftone, and confine it againft the end of the canula, by re- 
tracting them ? The proper direction of the wire-fprings, fo as 
to open when they are pufhed through the canula, muft be pre- 
vioufly given them. If this could be managed, a fmall file or 
borer might at the fame time be introduced through the canula, 
the Class I. 1. 3. 11. 
OF IRRITATION. 
37 
the handles of which might confift of joints to permit them to 
bend in ail directions, and thus the hone might be broken to 
pieces by a few trials ; or if it was a foft or fragile ftone, tiie re- 
traction of rhe wire-bow might divide it at every trial, till it be- 
came almoft reduced to powder. A little mechanical ingenuity 
might be neceflary in the conftruftion and ufe of this machine- 
ry ; but I believe it not to be impracticable, fince I read the above 
account of Colonel Martin, though 1 had often before thought 
of it with defpair of its fuccefsfui application. 
Lithotomy is the laft refource. Will the gaftric juice of ani- 
mals diflblve calculi? Will fermenting vegetable juices, as 
fweet-wort, or fugar and water in the act of fermentation with 
yeafl, diflolve any kind of animal concretions ? 
11. Calculus artbriticus. Gout-ftones are formed on infla- 
med membranes, like thole of the kidneys above defcribed, by the 
too hafty abforption of the thinner and faline parts of the mucus. 
Similar concretions have been produced in the lungs, and even 
in the pericardium ; 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, 
frequently applied in their early ftate,. might render them fo li- 
quid as to permit their re-abforption ; which the ftimulus of the 
ether might at the fame time e ncourage. 
12. Rbeumatijmus cbronicus. Chronic rheumatifm. After the 
acute rheumatifm fome infpiffated mucus, or material fimilar to 
chalk-ftones of the gout, which was fecreted on the inflamed 
membrane, is probably left, owing to the too hafty abforption of 
the thinner and faline part of it; and by lying on the fafeia, which 
covers fome of the mufcles, pains them, when they move and rub 
againft it, like any extraneous material. 
The pain of the ihoulder, which attends inflammations of the 
upper membrane of the liver, and the pains of the arms, which 
attend afthma dolorificum, or dropfy of the pericardium, are dif- 
tinguifhed from the chronic rheumatifm, as in the latter the pain 
only occurs on moving the affected mufcles. 
M. M. Warm bath, cold bath, bandage of emplaftrum de 
minio put on tight, fo as to comprefs the part. Cover the part 
with flannel. With oiled filk. Rub it with common oil fre- 
quently. With ether. A blifter. A warmer climate. Ven- 
efetftion. A grain of calomel and a grain of opium for ten fuc- 
celfive nights. The Peruvian bark. 
13. Cicatrix vulnerum. The fear after wounds. In the heal- 
ing of qlcers the matter is firft thickened by increafing the 
abforption 38 
DISEASES 
Class I. 1. 3. 14. 
abforption in them ; and then leflened, till all the matter is ab- 
forbed, which is brought by the arteries, inftead of being depo- 
fed in the ulcer. 
M. M. This is promoted by bandage, by the forbentia exter- 
nally, as powder of bark, white lead ; folution of fugar of lead. 
And by the forbentia internally after evacuations. See Sedt. 
XXXIII. 3. 2. 
In thofe ulcers, which are made by the contact of external 
fire, the violent action of the fibres, which occafions the pain, is 
liable to continue, after the external heat is withdrawn. This 
fhould 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 com- 
mences in feveral places at the fame time ; which probably con- 
tributes to the unevennefs of large fears. 
14. Cornea olfufeatio. Opacity of the cornea. There are 
few people, who have pafled the middle of life, who have not at 
fome time fuffered fome flight fcratches or injuries of the cornea, 
which by not healing with a perfectly finooth furface, occafion 
fome refractions of light, which maybe 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 im- 
perfe&ions of the cornea will appear like lines or blotches on the 
furface of the fluid, with a lefs white appearance than that fur- 
face. Thofe blemifhes of the eye are diftinguifhed from the 
mufeae volitantes defcribed in Clafs I. 2. 5. 3. by their being in- 
variably feen at any time, when you look for them. 
Ulcers may frequently be feen on the cornea after ophthalmy, 
like little pits or indentations beneath the furface of it j in this 
cafe no external application fhould be ufed, left the fear fhould 
be left uneven ; but the cure fhould 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 
neceflary. 
After ulcers of the cornea, which have been large, the ine- 
qualities and opacity of the cicatrix obfeure the fight: in this cafe, 
could not a fmall piece of the cornea be cut out by a kind of 
trephine about the fize of 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 introduced through the 
opaque cornea to hold it up, and prefs it againft the cutting edge 
of Class I. i. 3. 14. 
OF IRRITATION. 
39 
of the hollow wire or cylinder ; if the fear fhould heal without 
lofmg its tranfparency, many blind people might be made to fee 
tolerably well by this flight and not painful operation. An ex- 
periment I wifh ftrongly to recommend to fome ingenious fur- 
geon or oculifl. 
Or it may be attempted by prefltng one end of a fmall canula 
on the centre of the cornea, and pafling down it a bit of luna 
cornea, fixed in the end of a fmaller canula, and thus introdu- 
ced : the eye may be held fteady by pafling a thread by means 
of a fmall curved needle through a part of the tunica adjun&i- 
va, which may be held by an afliftant, or by prefling on it the 
end of the canula as above, which might have a flat circular rim 
round its extremity for that purpofe. 
ORDO 40 
DISEASES 
Class I. x. 4. 1. 
ORDO I. 
Increased Irritation. 
GENUS IV. 
With increafed Actions of other Cavities and Membranes. 
SPECIES. 
I. Nitfitatio irritative!. Winking of the eyes is performed 
every minute without oUr attention, for the purpofe of cleaning 
and moiftening the eye-ball ; as further fpoken of in Clafs II. i. 
1. 8. When the cornea becomes too dry; it becomes at the fame 
time lefs tranfparent ; which is owing to the pores of it being 
then too large, fo that the particles of light are refracted by the 
edges of each pore, inftead of palling through it ; in the fame 
manner as light is refradled by palling near the edge of a knife. 
When thefe pores are filled with water, the cornea becomes 
again tranfparent. This want of tranfparency of the cornea is 
vifible fometimes in dying people, owing to their inirritability, 
and confequent negleft of nictitation. 
The increafe of tranfparency by filling the pores with fluid is 
feen by foaking white paper in oil; which from an opaque body 
becomes very tranfparent, and accounts for a curious atmofpher- 
ic phenomenon ; when there exifts a dry milt in a morning fo as 
to render diftant objects iefs diftinft, it is a fign of a dry day ; 
when diftant objects 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 moifturc, the pores of the 
dry air are fo large, that the rays of light are refracted by their 
edges inftead of palling through them. But when as much moif- 
ture is added as can be perfectly diffolved, the air becomes tranf- 
parent ; and opaque again, when a part of this moifture collects 
into fmall fpherules previous to its precipitation. This alfo ac- 
counts for the want of tranfparency of the air, which is feen in 
tremulous motions over corn-fields on hot fummer-days, or over 
brick-kilns, after the flame is extinguifhed, while the furnace 
ftill remains hot. 
2. Deglutitio irritativa. The deglutition of our faliva is per- 
formed frequently without our attention, and is then an irritative 
aftion in confequence of the ftimulus of it in the mouth. Or 
perhaps Class I. 1. 4. 3. 
OF IRRITATION. 
41 
perhaps fometimes for the purpoie of diffufing a part of it over 
the dry membranes of the fauces and pharynx; in the fame 
manner as tears are diffufed over the cornea of the eye by the 
act of nictitation to clean or moiften it. 
3. Ref piratic et Tuffis irritative. In the a£ts of refpiration 
and of coughing there is an increafed motion of the air-cells of 
the lungs owing to fome ftimulating caufe, as defcribed above 
in Clafs I. 1. 2. 8. and I. 1. 3. 4. and which are frequently per- 
formed without our attention or confcioufnefs, and are then ir- 
ritative actions ; and thus differ from thofe defcribed in Clafs II. 
1. 1. 2. and 5. To thefe increafed actions of the air-cells are 
fuperadded thofe of the intercoftal mufcles and diaphragm by 
irritative afibciation. When any unnatural ftimulus afts fo vi- 
olently on the organs of refpiration as to induce pain, the fenfo- 
rial power of fenfation becomes added to that of irritation, and 
inflammation of the membranes of them is a general confequence. 
'4. Exchfu bilis. The exclufion of the bile from the gall-blad- 
der, and its derivation into the duodenum, is an irritative action 
in confequence of the ftimulus of the aliment on the extremity 
of the biliary duff, which terminates in the inteftine. The in- 
creafed fecretion of tears is occafioned in a fimilar manner by 
any ftimulating material in the eyes ; which affects the excretory 
ducts of the lachrymal glands. A pain of the external membrane 
of the eye fometimes attends any unufual ftimulus of it, then the 
fenforial power of fenfation becomes added to that of irritation, 
and a fuperficial inflammation is induced. 
5. Ueniitio. Toothing. The pain of toothing often begins 
tnuch earlier than is fufpected ; and is liable to produce convul- 
fions 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 fupplying another means of relieving 
the pain of dentition by irritative exertion ; and a confequent 
temporary exhauftion of fenforial power. See Clafs I. 1. 2. 5. 
Seft. XXXV. 2. 1. 
The convulfions from toothing generally commence long be- 
fore the appearance of the teeth ; but as the two middle incii- 
ors of the lower jaw generally appear fit ft, and then thofe of 
the upper, it is advifable to lance the gums over thefe longitudi- 
nally in refpeit to the jaw-bones, and quite down to the periof- 
teum, and through it. 
As the convulfions attendingthe commencement of toothing arc 
not only dangerous to life in their greateft degree, but are liable to 
induce ftupor or infenfibility by their continuance even in a lei's 
degree, the moft efficacious means fhould be ufed to cure them. 
Vol. II. G M. M. Lance 42 
DISEASES 
Class I. 1. 4. 0. 
M. M. Lance the gum of the expelled teeth quite through 
the periofteum longitudinally. VenefefHon by the lancet or by 
two or three leeches. One grain of calomel as a purge. Tinc- 
ture of jalap, five or fix drops in water every three hours till it 
purges, to be repeated daily. After evacuations a fmall blitter 
on the back or behind the ears. And laftly, two or three drops 
of laudanum according to the age of the child. Warm bath. 
See Clafs III. i. i. 5. and 6. 
6. Priapifmus chronicus. I have feen two cafes, where an 
erection of the penis, as hard as horn, continued two or three 
weeks without any venereal defires, but not without fome pain ; 
the eafieft attitude of the patients was lying upon their backs 
with their knees up. At length the corpus cavernofum urethrae 
became foft, and in another day or two the whole fubfxled. In 
one of them a bougie was introduced, hoping to remove fome 
bit o,f gravel from the caput gallinaginis, camphor, warm bathing, 
opium, lime-water, cold afperfion, bleeding 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 fuddenly a few 
months after his recovery from this complaint. Was it a paral- 
yfis of the terminations of tire veins, which abforb the blood 
from the tumid penis ? or from the fbimulus of indurated femen 
in the feminal veflels ? In the latter cafe fome venereal defires 
fhould have attended. Clafs III. 1. 2. 16. 
The priapifmus, which occurs to vigorous people in a morn- 
ing before they awake, has been called the fignum falutis, or 
banner of health, and is occafioned by the increafe of our irri- 
tability or fenfibility during deep, as explained in Seft. XVIII. 15, 
7. Di/lentio mammularum. The diftention of the nipples of 
la€fefcent women is at firft owing to the ftimulus of the milk. 
See Sedi. XIV. 8. and Seft. XVI. 5. See Clafs II. 1. 7. ic. 
8. Defcenfus uteri. This is a very frequent complaint after 
bad labours, the fundus uteri becomes inverted and defeends 
like the prolapfus ani. 
M. M. All the ufual perfaries are very inconvenient and m- 
cflchlua!. A piece of foft fponge about two inches diameter in- 
troduced into the vagina gives great eafe to'thefe patients, and 
Supports the uterus , it fhould have a firing put through it to 
retrafl it by. 
There are alfo peffarres now made of elallic gum, which are 
faid to be cafily worn, and to be convenient, from their having 
a perforation in their centre. 
9. Prclapfus ani. The lower part of the rcdlum becomes in- 
verted, and defeends after every flool chiefly in children ; and 
thus Simulates the fphincter ani like any other extraneous body. 
M. M. It Class I. 1. 4. 10. 
OF IRRITATION. 
43 
M. M. It fliould be dufted over with very fine powder of 
gum faadarach, and then replaced. Aftringent fomentations ; 
as an infufion of oakbark, or a flight Solution of alum. Hori- 
zontal reft frequently in the day. 
io. Lufnbricus. Round worm. The round worm is fuf- 
peCted in children when the belly is tumid, and the countenance 
bloated and pale, with fwelling of the upper lip. The genera- 
tion of thefe worms is promoted by the too dilute Rate of the 
bile, as is evident in the fluke-worm found in the biliary duds 
and fubftance of the liver in (heep ; and in water-rats, in the 
livers of which laft animals they were lately detected in large 
numbers by Dr. Capelle. TranfaCtions of the college at Phila- 
delphia, 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 con- 
comitant circumftances attending the general inactivity of the 
abforbent fyltem ; which is therefore to be efteemed the remote 
caufe of the generation of worms. 
The fimplicity of the ftruCture pf worms probably enables 
them to exift in more various temperatures of heat; and their 
being endued with life prevents them from being deftroyed by 
digeftion in the ftomach, probably in the fame manner as the 
powers of life prevent the fermentation and putrefaction of the 
llomach itfelf. Hence I conclude, that worms are originally 
taken into our alimentary canal from without; as I believe fim- 
ilar worms 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 te come 
away in fevers, whether of the heCtic or putrid kind, could they 
be removed by purulent mattey, or rotten egg, or putrid flelh, 
fince in thofe fevers from the enfeebled aClion of the inteftiiw 
the faeces become highly putrid. , 
The Iharp fpiculce or hairs, which are found on the pods of 
cowhage, itruolobium filiqua hirfuta, have been recommended 
iri worm-cafes, and laid to deftroy them by mechanical punCture; 
the late Mr. Power of Polefworth, aflured me, he had had great 
fuccefs with this medicine and gave about fix or eight grains in 
a bolus three or four times on one day, with a brilk cathartic 
on the next day. Some have recommended chopped hair or 
briftles for this purpofe. There are numerous Iharp fpicudae in 
the fruit of the wild rofe, which might be worth trying it this 
difeafa, 44 
DISEASES 
Class I. 1.4. r 1. 
difeafe, and the hairs on full grown hairy caterpillars, if the ani- 
mal be laid on the hand, efpecially between the fingers, are liable 
to flick in the fkin, and to produce flight inflammation and itch- 
ing, and might alfo be worth trying in worm-cafes. But it is 
aflerted in M. Vaillant's Travels in Africa, that when thefe in- 
fects feed on poifonous plants, they become themfelves fo venom- 
ous, that the natives collect a juice from them, with which 
when putrid they fmear their war weapons to poifon them. 
ii. 'Tania. Tape-worm confills of a chain of animals ex- 
tending from the flomach to the anus. See Seft. 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 re- 
taining life. Two of them, which were voided by a pointer 
dog in confequence of violent purgatives, each of which were 
fcveral feet in length, had boiling water poured on them in a 
bafin ; which feemed not much to inconvenience them. When 
the water was cool, they were taken out and put into gin or 
whifkey of the ftrongeft kind, in which their life and activity 
continued unimpaired ; and they were at length killed by adding 
to the fpirit a quantity of corrofive fublimate. Medic. Comment, 
for 1791, p. 370. 
The tape-worm is cured by an amalgama of tin and quickfilver, 
fuch as is ufed on the back of looking-glafles ; an ounce fhould 
be taken every two hours, till a pound is taken ; and then a brilk 
cathartic of Glauber's fait two ounces, and common fait one 
ounce, diiTolved in two wine pints of water, half a pint to be taken 
every hour till it purges. The worm extends from the flomach 
to the anus, and the amalgama tears it from the inteftine by me- 
chanical prefiure, acting upon it the whole way. Electric fhocks 
through the duodenum greatly aflift the operation. Large dofes 
of tin in powder. Iron filings in large dofes. The powder of 
fernroot feems to be of no ufe, as recommended by M. Nouffli- 
er. This worm, as well as the lumbricus or round-worm, is 
fometimes brought up by vomiting ; when either of thefe worms 
is in the ftomach it gives a tickling fenfation about the fauces, 
which parts fympathize with the cardia ventriculi. See Annals 
of Medicine, 1797. Give an emetic oftartarized antimony, or 
of vitriol of zinc. 
12. Afcarides. Threadworms. Thefe worms are faid to be more 
frequent in fome parts of this kingdom than in others, as near 
the fens of Lincolnfhire. Do they efcape from the body and be- 
come flies, like the bott-worm in horfes ? Do they crawl from 
one child to another in the fame bed ? Are they acquired from 
flies or worms, which are feen in putrid neceflary houfes, as 
thefe Class I. 1. 4. 12. 
OF IRRITATION. 
45 
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 deftroycd ; or can this 
happen from the eggs or parts of them remaining ? 
Afcarides appear to be of two kinds, the common fmall one 
like a thread ; which has a very fharp bead, as appears in the mi- 
crofcope ; and which is fo tender, that the cold air foon renders 
it motionjefs ; and a larger kind above an inch long, and nearly 
as thick as a yery fmall crow-quill, and which is very hard in re- 
fpeCl 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. Afcarides are faid to be weakened by twenty grains 
of cinnabar and live of rhubarb taken every night, but not to be 
cured by this procefs. As thefe worms are found only in the 
reCtum, variety of clyfters have been recommended. A clyfter 
confifting of one eighth or one fourth of an ounce of fuccotrine 
aloes in powder boiled in a pint of milk or of gruel, till it is dif- 
folved, and injected once a week for many wreeks, I believe has 
fometimes efiefted a cure. I was informed of a cafe, where fo- 
lutions of mercurial ointment were ufed as a clyfter every night 
for a month without fuccefs. Clyfters of Harrowgate water are 
recommended, either of the natural, or of the factitious, as de- 
fcribed below, which might have a greater proportion of liver 
of fulphur in it. As the cold air foon deftroys them, after they 
are voided, could clyfters of 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 inch long, or two fuch pieces, 
fmeared with mercurial ointment, and introduced into the anus 
at night, or twice a day, be effectual by compreffing their nidus, 
as well as by the poifon of the mercury ? 
The clyfters ffiould be large in quantity, that they may pafs 
high in the reClum, as two drams of tobacco boiled a minute in 
a pint of water. Or perhaps what might be ftill more effica- 
cious and lefs inconvenient, the fmoke of tobacco injeCted by 
a proper apparatus every night, or alternate nights, for fix or 
eight weeks. This was long fince recommended, I think, by 
Mr. Turner of Liverpool ; and the reafon it has not fucceeded, 
I believe to have been owing to the imperfections of the joints 
of the common apparatus for injeCling the fmoke of tobacco, fo 
that it did not pais into the inteftine, though it was fuppofed to 
do fo, as I once obferved. The fmoke fhould be received from 
the apparatus into a large bladder ; and it may then be certainly in- 
jefted like the common clyfter with fufficient force 5 otherwife 
oiled 46 
DISEASES 
Class I. r. 4. 13. 
oiled leathers fhould be nicely put round the joints of the ma- 
chine ; and a wet cloth round the injeCting pipe to prevent the 
return of the fmoke by the fides of it. Clyfters of carbonated 
hydrogen gas, or of other factitious airs, might be tried j or of 
the hairs of filiqua hirfuta. 
Harrowgate water taken into die ftomach, fo as to induce fix 
orfeven flools every morning, for four or fix weeks, is perhaps 
the molt efficacious method in common ufe. A factitious Har- 
rowgate water may be made probably of greater efficacy than 
the natural, by dlffolving one ounce of marine fait, (called bay 
fait) and half an ounce of magnefia Glauber's fait, (called Epfom 
fait, or bitter purging fait) in 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 fulphuris into half a pint of water. See Clafs 
IV. I. 2. 9. 
13. Dracunculus. A thin worm brought from the coafl of 
Guinea. It is found in the interftices of the mufcles, and is 
many yards long ; it makes a fmall ulcer ; which is cured by 
extracting an inch of the worm a day, and wrapping the extract- 
ed 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. Aforpiones. Crab-lice. The excrement of this animal 
flains the linen, and appears like dilute^ blood. 
M. M. Spirit of wine. Mercurial ointment, {having the part. 
Oil deflroys other infeCts, if they be quite covered with it, as the 
ticks on dogs, and would probably therefore deftroy thefe. Its 
manner of operation is by flopping up or filling their fpiracula, 
or breathing pores; a few drops of oil poured on a wafp, fo as 
to cover it, deftroy it in a few feconds. 
15. Pediculi. Lice. There is faid to be a difeafe, in which 
thefe animals are propagated in indeftruCtible numbers, fo as to 
deftroy the patient. 
M. M. Cleanlinefs, mercurial ointment, flavis acriain powder, 
or the tinClure of it in fpirit of wine. Spirit of wine alone. ? 
Lath of oil ? 
ORDO Class !, i. 5. t. 
OF IRRITATION. 
47 
ORDO I. 
Increafed Irritation. 
GENUS V. 
With increafed Actions of the Organs of Senfe. 
SPECIES, 
I. Vifus acrior. Acuter fight. There have been inftances of 
people, who could fee better in the gloom of the evening, than 
in the (Ironger light of the day ; like owls, and bats, and many 
quadrupeds, and flying infers. When the eye is inflamed, great 
light becomes eminently painful, owing to the increafed irrita- 
tive morions of die retina, and the confequent increafed fenfa- 
tion. Thus when the eye is dazzled with fudden liglrt, the paid 
is not owing to the motion of the iris ; for it is the contrailion 
of the iris, which relieves the pain from fudden light; but to the 
too violent contrailions of the moving fibres^ which constitute 
the extremities of the optic nerve. 
2. Auditus acrior. The irritative ideas of hearing are fo in- 
creafed in energy as to excite our attention. This happens in 
fome difeafes of the epileptic kind, and in fome fevers. Hence 
the whifpering of the currents of air in a room, the refpiration 
of the company, and noifes before unperceived, become trouble- 
some ; and founds louder than ufaal, or unexpeited, produce 
ftarting, and convulfions. 
M. M. Put oil of almonds into the ears. Stop the meatus 
auditorius with cotton wool. Set the feet of the patient's bed 
on cufliions, or fuipend it by cords from the ceiling. 
3. (J fact us acrior. The irritative ideas of fmell from the in- 
creafed atSlion of the olfa<flive nerve excite our attention. Hence 
common odours are difagreeable ; and are perceived from vari- 
ety of objedls, which were before thought inodorous. Thefe 
are commonly believed to be hallucinations of the fenfe. 
M. M. SnufF(larch up the noftrils. 
4. Gufus acrior. The irritative ideas of tade, as of our own 
faliva, and even of the atmofpheric air, excite our attention; and 
common taftes are difagreeably (trong. 
M. M. Water. Mucilage. Vegetable acids. Scrape the 
tongue clean. Rub it with a fage-leaf and vinegar. 
5. Tact us acrior. The irritative ideas of the nerves of touch 
excite 48 
DISEASES 
Class I. 1.5. 6. 
excite our attention : hence our own preffure on the parts, we 
reft upon, becomes uneafy with univeifal forenefs. 
M. M. Soft feather-bed. Combed wool put under the pa- 
tients, which rolls under them, as they turn, and thus prevents 
their friftion againft the fheets. Drawers of foft leather. Plaf- 
ters of cerate with calamy. 
6. Senfus caloris acrior. Acuter fenfe of heat occurs in fome 
difeafes, and that even when the perceptible heat does not appear 
greater than natural to the hand of another perfon. See Clafs 
I. r. 2. See Soft. XIV. 8. All the above increafed actions of 
our organs of fenfe feparately or jointly accompany fome fevers, 
and fome epileptic difeafes ; the patients complaining of rhe per- 
ception of the leaft light, noifes in their ears, bad fmells in the 
room, and bad taftes in their mouths, with forenefs, numbnefs, 
and other uneafy feels, and with difagreeable fenfations of gen- 
eral or partial heat. 
7. Senfus extenjionis acrior. Acuter fenfe of extenfion. The 
fenfe of extenfion was fpoken of in Se<ft. XIV. 7. and XXXII. 
4. The defend of diftention in the arterial fyftem is accompani- 
ed with faintnefs ; and its excefs with fenfations of fulnefs, or 
weight, or prefture. This however refers only to the vafcular 
mufcles, which are diftended by their appropriated fluids; but 
the longitudinal mufcles are alfo affefted by different quantities 
of extenfion, and become violently painful 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 generally to defeat 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 ftages of this extenfion of 
the fibres ; which have acquired names according to the degree 
or kind of fenfation produced by the extenfion of them ; thefe 
are 1. titillation or tickling ; 2. itching ; and the 3. fmarting, 
as defcribed below. See Se<ft. XIV. 9. 
8. Titillatio. Tickling is a pleafurable pain of the fenfe of 
extenfion above mentioned, and therefore excites laughter ; as 
defcribed in Se<ft. XXXIV. 1. 4. The tickling of the noftrils, 
which precedes the efforts of fneezing, is owing to the increafed 
irritation occafioned by external ftimulus ; and is attended with 
a pleafurable fenfation in confequence of the increafed adtion of 
the part. When this action is exerted in a greater degree, the 
fenfation becomes painful, and the convulfion of fneezing en- 
fues ; as the pain in tickling the foies of the feet of children is 
relieved by laughter. 
A Class I. 1. 5. 9. 
OF IRRITATION. 
49 
A lady after a bruife on her nofe by a fall was affedtcd with 
inceflant freezing, and relieved by fruffing ftarch up her noltrils. 
Perpetual freezings in the mealies, and in catarrhs from cold, 
are owing to the flimulus of the faline part of the mucous effu- 
fion on the membrane of the noftrils. See Clafs II. i. i. 2. 
Pruritus. Itching feems to be a greater degree of titilla- 
tion, and to be owing to the flimulus 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 drunk much vinous fpirit. It 
occurs alfo, when inflammations arc declining, as in the healing 
of blifters, or in the cure of ophthalmia, as the action of the vef- 
fels is yet fo great as to produce fenfation ; which, like the titil- 
lations thatoccafion laughter, is perpetually changing from pleaf- 
ure to pain. 
When the natural efforts of fcratching do not relieve the pain 
of itching, it fometimes increafes fo as to induce convulfions and 
madnefs, A.s in the furor uterinus, and fatyriafis, and in the 
fphindter ani and fcrotum. See Clafs II. 1. 4. 14. IV. 2. 2. 6. 
M. M. Warm bath. Fomentation. • Alcohol externally. 
Poultice. Oiled Hlk. Mercurial ointments on fmall furfaces at 
once. See Clafs II. 1. 4. 12. Solutions of lead on fmall fur- 
faces at once. 
10. Dolor urens. Smarting follows the edge of a knife in ma- 
king a wound, and feems to b^ owing to the detention of a part 
of a fibre, till it breaks. A fmarting of the 'lkin is liable to af- 
feeft the fears left by herpes or fringles; and the callous parts of 
the bottoms of the feet ; and around the bales of corns on the 
tees; and frequently extends after fciatica along the outlide of 
the thigh, and of the leg, and part of the foot. All thefe may 
be owing to the flimulus of extenfion, by blood or fcrum being 
forced into veflels nearly coalefced. 
M. M. EmpTaftrum de minio put like a bandage on the part. 
Warm fomentation. Oil and camphor rubbed on the part. Oil- 
filk covering. A blifter on the part. Ether, or alcohol, fuffer- 
ed to evaporate on the part. 
11. Conjlernatw. Surprife. As our eyes acquaint us at the 
fame time with lefs than half of the objects, which furround us, 
we have learned to confide much in the organ of hearing to wafn 
us of approaching dangers. Hence it happens, that if any found 
flrikes us, which we cannot immediately account for, our fSars 
are inftantly alarmed. Thus i^| great debility of body, the loud 
clapping of a door, or the fall of a fire-fhovel, produces alarm, 
and fometimes even convulfions ; the fame occurs from unex- 
pected fights, and inthe dark from unexpected objects of touch. 
Vol. IL H In 50 
DISEASES 
Class I. 1.5. 11 
In thefe cafes the irritability is lefs than natural, though it is 
erroneoufly fuppofed to be greater ; and the mind is bulled in 
exciting a train of ideas inattentive to external objects ; when 
this train of ideas is diflevered by any unexpected ftimulus, fur- 
prifeis excited ; as explained in Se£h XVII. 3. 7. and XVIII. 
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 Se<St. XIX. 2. 
The proximate caufe of furprife is the increafed irritation in- 
duced by fome violent ftimulus, which diflevers our ufual trains 
of ideas ; but in difeafes of inirritability the frequent ftarting or 
furprife from founds not uncommon, but rather louder than ufu- 
al, as the clapping of a door, Ihews, that the attention of the pa- 
tient to a train of fenfitive ideas was previoufly ftronger than, 
natural, and indicates an incipient delirium ; which is therefore 
worth attending to in febrile difeafes. 
ORDO Class I. 2. 1. 
GF IRRITATION. 
51 
ORDO II. 
Decreafed Irritation. 
GENUS I. 
With decreafed Action of the Sanguiferous Syfem. 
The reader Ihould be here apprized, that the words ftrength 
and debility, when applied to animal motions, may properly ex- 
prefs the quantity of refiftance fuch motions may overcome ; but 
that, when they are applied to mean the fufceptibility or infuf- 
ceptibility of animal fibres to motion, they become metaphorical 
terms ; as in Sect. XII. 2. 1. and would be better expreffed by 
the words aCtivity and inactivity. 
There are three fources of animal inactivity ; firft, the defect 
of the natural quantity of Itimulus on thofe fibres, which have 
been accuftomcd to perpetual itimulus ; as the arterial and fe- 
cerning fyftems. "When their accuitomed Itimulus is for a 
while intermitted, as when fnow is applied to the ikin of the 
hands, an accumulation of fenforial power is produced ; and then 
a degree of itimulus, as of heat, fomewhat greater than that at 
prefent applied, though much lefs than the natural quantity, ex- 
cites the vefl'els of the ikin into violent action. Wemuftob- 
ferve, that a deficiency of itimulus in thofe fibres, which are 
not fubjeCt to perpetual itimulus, as the, locomotive mufcles, 
is not fucceeded by accumulation of fenforial power; thefe 
therefore are more liable to become permanently inactive after 
a diminution of itimulus; as in ftrokes of the palfy, this may- 
be called inactivity from defeCt of itimulus. 
2. A fecond fource of animal inactivity exifts, when the fen- 
forial power in any part of the fyftem has been previouily ex- 
haufted by violent ftimuli ; as the eyes after long expofure to 
great light ; or the itomach, to repeated fpirituous potation j 
this may be termed inactivity from exhauition of fenforial pow- 
er. .See SeCt. XII. 2. 1. 
■ 3. But there is a third fource of inactivity owing to the defi- 
cient production of fenforial power in the brain ; and hence 
Itimuli ftronger than natural are required to produce the accuf- 
tomed motions of the arterial fyftem ; in this cafe there is no 
accumulation of fenforial power produced ; as in the inactivity 
owing to defeCt of Itimulus ; nor any previous exhauftion of it, 
as in the inactivity owing to excefs of ftimulus. 
This third kind of inactivity caufes many of the difeafes of 
this genus; which are therefore in general to be remedied by 
fuclj 52 
DISEASES 
Class I. 2. 1. r. 
finch medicines as promote a greater production of fenforial pow- 
er in the brain ; as the incitantia, confining of wine, beer and 
opium, in fmall repeated quantities ; and fecondly of fuch as 
limply ftimulate the arterial and glandular fyftem into their nat- 
ural aCtions ; as fmall repeated blifters, fpices and eflential oils. 
And laftly the forbentia, which contribute to fupply the more 
permanent ftrength of the fyftem, by promoting the abforption 
of nourifliment from the ftomach and inteftines; and of the fu- 
perfluous fluid, which attends the fecretions. 
SPECIES. 
I. Febris inirritativa- 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 production of fenforial pow- 
er 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 
pufhed on with lefs energy, as well as in lefs quantity, and thence 
its ftimulus on their (ides is diminiflied in a duplicate ratio. In 
compreflions of the brain, as in apoplexy, the pulfe becomes 
flower and fuller j for in that difeafe, as in natural fleep, the irri- 
tative motions of the heart and arteries are not diminiflied, voli- 
tion alone is fufpended or deftroyed. 
. If the abforption of the terminations of the veins is not equal- 
ly impaired with the force of the heart and arteries, the blood is 
taken up by the veins the inftant 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 be- 
comes empty, as well as weak and quick ; the veins of the Ikin 
are fuller than the arteries of it ; and its appearance becomes 
pale, bluifh, and fhrunk. See Clafs II. 1.3. 1. 
When this pulfe perfifts many hours, it conftitutes the febris 
inirritativa, or typhus, or nervous fever, of fome writers j it is 
attended with little heat, the urine is generally of a natural col- 
our, though in lefs quantity ; with great proftration of ftrength, 
and much difturbance of the faculties of the mind. Its imme- 
diate caufe feems to be a deficient fecrction of the fenforial pow- 
er from the inaCtion of the brain ; hence almoft the whole of 
the fenforial power is expended in the performance of the mo- 
tions neceflary to life, and little of it can be fpared for the volun- 
tary actions of the locomotive mufcles, or organs of fenfe, fee 
pilafs I. 2. 5. 3. Its more remote caufe may be from a naraly- 
4 ' ' " Class I. 2.1. 2. 
OF IRRITATION. 
53 
Cs 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 kidneys, when the urine continues pale and in final) 
Quantity. Does the revivefcence of thefe affedied parts, or their 
torpor, recurring at intervals, form the paroxyfms of thefe fevers ? 
and their permanent revivefcence eftabiifh the cure ? See Clafg 
IV. 2. i. 19. 
The inirritative fever differs from the puerperal and from the 
hedtic fever, by the permanent inactivity of the ftomacb, which 
in this difeafe admits of up folid nutriment. See Ciafs II, 1. 6, 
16. and Suppl. I. 12. 
M. M. Wine and opium in fmall quantities repeated every 
three hours alternately ; fmall repeated blitters ; warm but frelh 
air; forbentia ; nutrieatia ; transfufion of blood. Small electric 
fhocks palled through the brain in all directions. Oxygene air ? 
2. Pa< efts inirritativa. Inirritative debility. A defective ac- 
tion of the irritative motions without increafe of the frequency 
of the pulfe. It continues three or four weeks like a fever, and 
then either terminates in health, or the patient finks into one kind 
of apoplexy, and periflies. Many fymptoms, which attend inirrita- 
tive fevers, accompany this difeafe, as cold hands and feet at pe- 
riodic times, feurf on the tongue, want of appetite, muddy 
urine, with pains of the head, and fometimes vertigo, and vom- 
iting. 
This difeafe differs from the inirritative fever by the pulfe 
pot 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 debility, which may be occafioned by the 
want of nourilhment. The vertigo is a fymptom of inirritabil- 
ity, as (hewn in Ciafs IV. 1. 2. 6. the muddy mine is owing to 
jncreafed abforption from the bladder in confcquence of the di- 
jninifhed cutaneous and cellular abforption, as in anafarca, ex- 
plained in Sedt. XXIX. 5. 1. and is therefore a confcquence of 
the inirritability of that part of the fyflem ; the foul tongue is 
owing to an increafed abforption of the thinner part of the mu- 
cus in confcquence of the general deficiency of fluid, which 
fhould be abforbed by the fkin and ftomach. The ficknefs is ow- 
ing to decreafed adtion of the ftomach, which is probably the 
primary difeafe, and is connedled with the vertigo. 
M. M. An emetic. Calomel, grains iv. once or twice. Then 
a blifter. Peruvian bark. Valerian. Columbo. Steel. Opi- 
um and wine in fmall quantities, repeated alternately every three 
hours. Small eledlric percuffions through the ftomach. 
3. Scnwus inter nipt us. Interrupted ileep. In fome fevers, 
where the inirritability is very great, when the patient falls afleep, 
the 54 
DISEASES' 
Class I. 2. 1. 4. 
the pulfe 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 debil- 
ity there is reafon to believe, that fome voluntary power during 
our waking hours is employed to aid the irritative ftimuli 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 with to view an objeft by a fmali light; in 
fleep volition is fufpended, and the deficient irritation alone is 
not fufficient to carry on the pulmonary circulation. This ex- 
planation feems the molt probable one, becaufe in cafes of apo- 
plexy 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 fmali dofes, as three drops of lauda- 
num. A perfon fhould watch the patient, and awaken him fre- 
quently ; or he fhould meafure the time between flumber and 
flumber by a flop-watch, and awaken the patient a little before he 
would otherwife awake ; or he fhould keep his finger on the 
pulfe, and fhould forcibly awaken him, as foon as it becomes ir- 
regular, before the diforder of the circulation becomes fo great 
as to difturb him. See Clafs 1. 2. 1. 9. and Sedt. XXVII. 2. 
4. Syncope. Fainting confills in the decreafed action of the 
arterial fyftem •, which is fometimes occafioned by defe«St of the 
flimulus of diftcntion, as after venefeflion, 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 fenfo- 
rial power is exerted on thefe interefting ideas, and becomes ex- 
haufted. Thus during great furprife or fear the heart flops for 
a time, and then proceeds with throbbing and agitation; and 
fometimes the vital motions become fo deranged, as never to re- 
cover their natural fucceflive action ; as when children have been 
frightened into convulfions. See Sett. XII. 7. 1. 
Mifs , a young lady of Stafford, in travelling in a chaife 
wasfo affe&ed by feeing the fall of a horfe and poftillion, in go- 
ing 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 fucceflive con- 
vulfions and fiupor. 
5. Hamorrhagia venofa. A bleeding from the capillaries ari- 
fing from defeat of venous abforption, as in fome of thofe fevers 
commonly termed putrid. When the blood flagnates in the cel- 
lular membrane, it produces petechise from this torpor er paraly- 
fis of the abforbent mouths of the veins. It mull be obferved, 
that thofe people who have dileafed livers, are more liable to this 
kind of hemorrhages, as well as to the hapmorrhagia arteriofa ; 
, ' ' • the Glass I. 2. i. 6. 
OF IRRITATION. 
55 
the former, becaufe patients with difeafed livers are more fubjeft 
to paralytic complaints in general, as to hemiplegia, and to drop- 
fy, which is a paralyfis of the lymphatics ; and the latter is 
probably owing to the delay of the circulation in the vena por- 
ta by the torpor of this hepatic veflel, when the liver is not 
much enlarged ; and to its preflure on the vena cava, when it is 
much enlarged. 
I have feen two elderly men, and one middle aged woman, all 
of whom had drunk too much fermented or fpirituous liquors, 
and had been for fome months gradually linking, were feized 
with a ceafelefs haemorrhage from their mouths, and from every 
part of the Ikin, where they happened to fcratch themfelves, 
which continued fome days till they died. See Sect. XXVII. 2. 
M. M. Vitriolic acid, opium, fteel, bark. Sponge bound 
on the part. Steel difTolved in fpirit of wine externally. Flour. 
6. Hamorrhois cruenta. In the bleeding piles the capillary 
veflels of the reftum become diftended and painful from the de- 
left of the venous abforption of the part, and at length burft ; 
or the mucous glands are fo dilated as to give a palTage to the 
blood ; it is faid to obferve lunar periods. 
M. M. Venefeftion, poultices, cathartics, fpice, cold bath, 
and forbentia. External compreffion by applying lint, fponge, 
or cotton. Internal compreflion by applying a bit of candle 
fmeared with mercurial ointment. Strangulate the tumid piles 
with a filk firing. Cut them off". See Seft. XXVII. 2. 
Mrs. had for twelve or fifteen years, at intervals of a 
year or lefs, a bleeding from the reftum without pain ; which 
however flopped fpontaneoufly after fhe became weakened, or 
by the ufe of injeftions of brandy and water. Lately the bleed- 
ing continued above two months, in the quantity of many ounces 
a day, till fhe became pale and feeble to an alarming degree. 
Injeftions of folutions of lead, of bark and fait of fteel, and of 
turpentine, with fome internal aftringents, 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 efleft 
the two firft times on account of the imperfeftion of the machine; 
on the third time it produced great ficknefs, and vertigo, and nearly 
a fainting fit ; from which time the blood entirely flopped. 
Was this owing to a fungous excrefcence in the reftum ; or to 
a blood-veflel being burft from the difficulty of the blood palling 
through the vena porta from fome hepatic obftruftion, and 
which had continued to bleed fo long ? Was it flopped at laft 
by the tainting fit ? or by the ftimulus of the tobacco ? 
7. Hamorrhagia renum. Haemorrhage from the kidneys, when 
attended with no pain, is owing to defect of venous abforption in 
the 56 
DISEASES 
ClassI. 2. 1. 8- 
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 difeule than ths former. See Sett. 
XXVII. I. 
M. M. i. Venefeflion in fmail quantity, calomeb bark, fteel, 
an opiate ; cold immeruon up to the navel, the upper part of 
the body being kept clothed. Neville-Holt water. 2. A'cali- 
zed water aerated. Much diluent liquids. Cool drefs. Cool 
bed-room. 
Cow's are much fubiecl to bloody urine, called foul water by 
the farmers j in this difeale about lixty grains of opium with or 
Without as much ruft of iron, given twice a day, in a ball mixed 
with flour and water, or diflblved in warm water, or warm ale, 
are, I believe, an efficacious remedy, to which however Ihould be 
added about two quarts of barley or oats twice a day, and a cover 
at night, if the weather be Cold. 
8. Hamorrhagid hepatis. Hemorrhage from the liver. It 
fometimes happens in thofe, who have the gutta rofea, or para- 
lytic afleflions owing to difeafed livers induced by the potation 
of fermented liquors, that a great difcharge of black vifcid blood 
occafionally comes away by ftool, 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 mult remain fome time in the intellines from 
its black colour, when it pafles downwards, and probably comes 
from the bile-du€ts, and is often a fatal fymptom. When it is 
evacuated by vomiting it is lefs dangerous, becaufe it (hews great- 
er remaining irritability of the inteftinal canal, and is fometimes 
falutary to thofe who have difeafed livers. 
Two elderly men, who had loft their appetite for animal food, 
which is always a dangerous fymptom, when it occurs to thofe 
who have drank too much fermented liquor,' obferved, that they 
parted with black ftools. One of them alfo had the mucus of 
his noftrils occafionally ftained with blood. The black ftools 
appeared evidently to confift of the coagulum of blood, fome- 
times without other feces. After a few weeks, they both funk 
under this difcharge, which I-fuppofed to proceed from the liv- 
er, as it never appeared florid in any part of it. See Seclion 
XXVII. 2. 
M. M. An emetic. Rhubarb, fteel, wine, bark, opium. 
9. Hamoptoe venofa. Venous hsemoptoe frequently attends 
the beginning of the hereditary confumptions of dark-eyed peo- 
ple 5 and in others, whofe lungs have too little irritability. Theie 
fittings of blood are generally in very fmall quantity, as a tea- 
> x fpoonful; Class I. 2. 1. 10. 
OF IRRITATION. 
57 
fpoonful ; and return at firft periodically, as about once a 
month ; and are lefs dangerous in the female than in the male 
fex ; as in the former they are often relieved by the natural pe- 
riods of the menfes. Many of thefe patients are attacked with 
this pulmonary hemorrhage in their firft fleep ; becaufe in fee- 
ble people the power of volition is neceffary, befides that of irri- 
tation, to carry on refpiration perfectly ; but, as volition is fuf- 
pended during fleep, a part of the blood is delayed in the vef- 
fels of the lungs, and in confequence effufed, and the patient 
awakes from the disagreeable fenfation. See Clafs I. 2. I. 3. 
II. 1.6.6. III. 2. 1. 10, and Sed. XXVII. 2. 
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. Iffues. Leeches 
applied once a fortnight or month to the hemorrhoidal veins to 
produce a new habit. Emetics after each period of haemoptoe, 
to promote expectoration, 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 
cathai^ic once a fortnight. 
10. Palpitatio cordis. The palpitation of the heart frequently 
attends the haemoptoe above mentioned ; and confifts in an in- 
effectual exertion of the heart to pufh forwards its contents in 
due time, and with due force. The remote caufe is frequently 
fome impediment to the general circulation j as the torpor of 
the capillaries in cold paroxyfms of fever, or great adhefions of 
the lungs. At other times it arifes from the debility of the aftion 
of the heart owing to the deficient fenforial power of irritation 
Or of affociation, 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 contraCtion ; 
and on that account contracts more frequently, as defcribed in 
Sect. XXXII. 2. 2. Another kind of palpitation may fometimes 
arife from the retrograde motions of the heart, as in fear. See 
Clafs I. 3. 1. 2. and IV. 3. 1.6. 
11. Menorrhagia. Continued flow of the catamenia. The 
monthly effufion of blood from the uterus or vagina is owing to 
a torpor of the veins of thofe membranes in confequence of the 
defeCt of venereal ftimulus ; and in this refpect refembies the 
mucus difeharged in the periodical venereal orgafm of the female 
quadrupeds, which are fecluded from the males. The menor- 
rhagia, or continued flow of this difeharge, is owing to a con- 
tinued defeCt of the venous abforption of the membranes of the 
uterus or vagina. See Clafs IV. 2. 4. 7. p 
M. M. VenefeClion in fmall quantity. A cathartic. Then 
Vol. II I opium 58 
DISEASES 
Class I. 2. 1. 12. 
opium, a grain every night. Steel. Bark. A blifter. Topi- 
cal afperfion with cold water, or cold vinegar. 
One caufe of exceffive menftruation, which fometimes recurs 
monthly, and continues for a fortnight at each period, and is 
fucceeded by fluor albus during the intervals, I have fufpefted to 
arife, like the bleeding piles, from enlargement of the liver, which 
is liable to occur about the age of forty to thofe who have drank 
much ftrong fmall beer, or wine ; or to thofe who have unfor- 
tunately been long accuftomed to the ufe of tight ftays, or other 
bandages round their bowels. In thefe fituations 6 or 8 grains of 
rhubarb fhould be taken every night for months, or even years. 
Calomel, 4 or 6 grains Ihould be taken as a cathartic one a month. 
A flannel drefs on the legs, thighs, and lower body may be ufe- 
ful in the cold feafon, but injurious in the warmer months. 
Weak acid of vitriol ten drops, two or three times a day ; Reel 
in very fmall quantity ; and a very loofc drefs round the body j 
are recommended. 
12. Dyfmenorrhagia. A difficulty of menftruation attended 
with pain. In this complaint the torpor of the uterine veflels, 
■which precedes menftruation, is by fympathy accompanied with 
a torpor of the lumbar membranes, and confequent pain ; and 
frequently with cold extremities, and general debility. The 
fmall quantity and difficulty of the difcharge is owing to arterial 
inactivity, as in chlorofis. Whence it happens, that chalybeate 
medicines are of efficacy both to flop or prevent too great men- 
ftruation, and to promote or increafe deficient menftruation ; 
as the former is owing to inirritability of the veins, and the lat- 
ter of the arteries of the uterus. See Article IV. 2. 6. in the Ma- 
teria Medica. 
M. M. Opium, fteel, pediluvium. Warm bath. 
13. Lochia niinia. Too great difcharge alter delivery. In that 
unnatural practice of fome hafty accoucheurs of introducing the 
hand into the uterus immediately after the delivery of the child, 
and forcibly bringing away the placenta, it frequently happens, 
that a part of it is left behind ; and the uterus, not having pow- 
er to exclude fo fmall a portion of it, is prevented from com- 
plete contraction, and a great haemorrhage enfues. In this cir- 
cumftar.ee a bandage with a thick comprefs on the lower part of 
the belly, by apprelimg the fidcs of the uterus on 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 vefieh 
In other cafes the lochia continues too long, or in too great 
quantity, owing to the deficiency of venous abforption. 
M. M. An enema. An opiate. A blifter. Slight calybe- 
ates. Peruvian bark. Cloths dipped in cold vinegar and applied 
externally. Class I. 2. 1. 14. 
OF IRRITATION. 
59 
externally. Bandages on the limbs to keep more blood in them 
for a time have been recommended. 
14. Abortio Spontanea. Some delicate ladies are perpetually 
liable to Spontaneous abortion, before the third, or after the fev- 
enth, 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 induce them to rife haftily up in bed; and 
have hence fufpedled, that this was a tendency to a kind of afth- 
ma, owing to a deficient absorption of blood in the extremities 
of the pulmonary or bronchial veins ; and have concluded from 
thence, that there was generally a deficiency of venous absorp- 
tion ; and that this was the occafion of their frequent abortion. 
Which is further countenanced, where a great Sanguinary dis- 
charge precedes or follows the exclufion of the fetus. 
MiScarriages are fometimes induced by what is termed a re- 
troverfion of the uterus, in which the fundus uteri is retroverted 
and prefled down between the rectum and the vagina. This 
can only occur in the firft or Second month of geftation, and is 
generally preceded by a difficulty of making water, and a conse- 
quent tumour of the bladder ; a violent pain about the perimeum 
of reeftum is thus caufed, and a mifearriage is liable to follow. 
Draw off the urine with a catheter; inject an enema with Sixty 
drops of tindiure of opium, if it can be done. If it recurs fre- 
quently after the mifearriage, a wax candle, or a peffary, made 
by rolling fome emplaftrum de minio Spread on linen, may be 
introduced into the recStum, and worn as a compreSs to pre- 
vent the return for a few days, till the parts recover their ftrength. 
See London Medical Observations, Vol. IV. p. 38S. and Dr. 
Hunter's Tables of the Gravid Uterus. 
M. M. Opium, bark, chalybeates in Small quantity. Change 
to a warmer climate. I have directed with SucceSs 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. By thefe means being exactly and regularly per- 
iifted in, a new habit became eftablifhed, and the ufual mifcar- 
riages were prevented. 
Mifcarriages more frequently happen from eruptive fevers, and 
from rheumatic ones, than from other inflammatory difeafes. I 
faw a moft violent pleurify and hepatitis cured by repeated vene- 
feftion about a week or ten days before parturition ; yet another 
lady whom I attended, mifearried at the end of the chicken pox, 
with which her children were at the fame time affefted. Mifcarri- 
ages towards the termination of the fmall-pox are very frequent, 
yet there have been a few inftances of children, who have been 
bor? 60 
DISEASES 
ClassI. 2. 1. rj. 
born with the eruption on them. The blood in the (mail pox will 
not inoculate that difeafe, if taken before the commencement of 
thefecondary fever ; as (hewn in SeCt. XXXIII. 2. 10. becaufc 
the contagious matter is not yet formed, but after it has been 
oxygenated through the cuticle in the puftules, it becomes con- 
tagious ; and if it be then abforbed, as in the fecondary fever, 
the blood of the mother may become contagious, and infeCt the 
child. The fame mode of reasoning is applicable to the chicken 
fox. See ClafsIV. 3. 1. 7. 
15. Scorbutus. Sea-fcurvy is caufed by fait diet, the perpet- 
ual Itimulus of which debilitates the venous and abforbent fyf- 
tems ; and may alfo be promoted by the fea-air, which is known 
to be fo injurious to mo.ft vegetables, which grow near the coafts, 
and has been perhaps incautioufly recommended to confumptivc 
patients. See Clafs II. 1. 6. 7. Hence the blood is imperfect- 
ly taken up by the veins from the capillaries, whence brown 
and black fpots appear upon the fkin without fever. The limbs 
become livid and edematous, and laftly ulcers are produced from 
deficient abforption. See S^Ct. XXXIII. 3. 2. and Clafs II. 1. 
4. 13. For an account of the fcurvy of the lungs, fee SeCt. 
XXVII. 2. 
M. M. Frefii animal and vegetable food. Infufion of malt. 
New beer. Sugar. Wine. Steel. Bark. Sorbentia. Opium ? 
16. Vibices. Extravafations of blood become black from their 
being fecluded from the air. The extravafation of blood in 
bruifes, cr in fome fevers, or after death in fome patients, ef- 
pecially in the parts which were expofed to preflure, is owing 
to the fine terminations of the veins having been mechanically 
comprefled fo as to prevent their abforbing the blood from the 
capillaries, or to their inactivity from difeafe. The blood when 
extravafated undergoes a chemical change before it is fufficient- 
ly fluid to be taken up by the lymphatic abforbents, and in that 
procefs changes its colour to green and then yellow. 
17. Petechia. Purple fpots. Thefe attend fevers with great 
venous inirritability, and are probably formed by the inability 
of a Angle termination of a vein, whence the correfponding 
capillary becomes ruptured, and effufes the blood into the cellu- 
lar membrane round the inert termyaation of the vein. This is 
generally efteemed a fign of the putrid llate of the blood, or that 
ftate contrary to the inflammatory one. As it attends fome in- 
flammatory 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 Amply announces the in- 
activity of the terminations of fome veins ; and is thence indeed 
a bad fymptom in fevers, as a mark of approaching inactivity of 
the Class I. 2. 1. 18. 
OF IRRITATION. 
61 
the whole fanguiferous fyftem, 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 
the veins, whence the blood is accumulated in them, and fome- 
timesburfts them. See Hspmorrhagia venofa, and Suppl. t. 2. 7. 
In fome cafes of fever attended with petechias, Dr. Hall, of 
Colchefter, directed the body to be wafhed with cold vinegar and 
water twice a day, with great advantage. The petechiae became 
daily lefs numerous and lefs livid, the puife flower and ftrong- 
er, with lefs delirium, and more fleep. He has treated twenty 
cafes in this manner, and not loft one. Medical Review, Vol. 
III. p. 8. 
In thefe cafes not only the application of external cold feems 
to have been of fervice, by preventing the unneceflary expendi- 
ture of animal power ; but as the ftimulus of vinegar renders 
the lips pale, when applied externally, and in confequence ftim- 
ulates the terminations of the veins into greater ailion 5 it feems 
alfo to have contributed to remove the Petechiae. 
18. Aneurifma. Aneurifm is probably owing to the want of 
due irritability of a part of the coat of an artery. As living 
mufclesare known to refift diruption more than dead ones, ac- 
cording to the experiments (I think) of Dr. Langrifh, it follows 
that when a part of the coat of an artery ceafes to contract by 
the ftimulus of the blood, that it will foon become diftended by 
the force of it, till it widens into a fack, and at laft becomes 
ruptured. 
M. M. Venefe6tion repeatedly in fmall quantities. Reft. 
Diluent, mild nutriment. Daily evacuation by a pill confifting 
of rhubarb eight grains, and foap four grains. 
It is pofiible alfo, that an aneurifm may be produced by the 
refiftance to the circulation, and the force of the heart being 
greater than the fides of the arteries can counterbalance. 
Mr. Gimbernat is laid to have cured fome cafes of aneurifm 
in the popliteal artery by comprefling it by means of an adapted 
machine, confifting of a fteel ring above and below the knee, 
which are joined by a plate, beneath which is placed a proper 
curhion, which can be prefled on the diftended part of the arte- 
ry more or lefs by of means a fcrew. The other method of cure 
is by a double ligature above the aneurifm, as firft pra&ifed by 
Mr. J. Hunter. 
19. Varix. The varix of veins occurs frequently in the legs 
of women, pcflibly fometimes from tight garters, and has for its 
proximate caufe the inirritability of the coat of the vein ; whence 
becomes diftended, till it burfts, by the power with which the 
blood 62 
DISEASES 
Class I. 2. 1. 19. 
blood is thrown into it by the abforbent mouths, which take it 
up from the capillary arteries. 
M. M. Tie the vena faphena below the joint of the knee, and 
the blood will then circulate by the internal veins; and that flop- 
ped in the veins beneath the ligature will be abforbed. 
The piles may be termed varixes, and may be deftroyed by 
<pxcifion or ligature. See Haemorrhois. ► 
ORDO Class I. 2. 2. i« 
OF IRRITATION. 
63 
ORDO IL 
Decreafed Irritation. 
GENUS II. 
Decreafed Action of the Secerning Syjlem. 
These are always attended with decreafe of partial, or of gen- 
eral heat 5 for as the heat of animal bodies is the confequence 
of their various fecretions, and is perpetually paffing away into 
the ambient air, or other bodies in contact with them ; when 
thefe fecretions become diminifhed, orceafe, the heat of the part 
or of the whole is foon diminifhed, or ceafes along with them. 
SPECIES. 
i. Frigus febrile. Febrile coldnefs. There is reafon to be- 
lieve, that the beginning of many fever-fits originates in the qui- 
efcence 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 
heat, 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 occafion to error in Mar- 
tyn'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 
preceding activity of the fyftem, as by long continued external 
heat, or violent exercife, a fudden expofure to much cold produ- 
ces a torpor both greater in degree and over a greater portion of 
the fyftem, by fubtratiing their accuftomed ftimulus from parts 
already much deprived of their irritability. Dr. Franklin in a 
letter to M. Duberge, the French tranilator of his works, men- 
tions an inftance of four young men, who bathed in a cold 
fpring after a day's harveft work ; of whom two died on the 
Ipot, a third on the next morning, and the other furvived with 
difficulty. Hence it would appear, that thofe, who have to trav- 
el in intenfely cold weather, will fooner perhh, who have pre- 
vioufly 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. 1. 17. 
Frigus chronicum. Permanent coldnefs. Coldnefs of the ex- 
tremities, 64 
DISEzXSES 
Class I. 2. 2. 2. 
tremities, without fever, with dry pale (kin, is a fymptom of 
general debility, owing to the decreafed action of the arterial 
fyftem, and of the capillary veffels ; whence the perfpirable 
matter is fecreted in lefs quantity, and in confequence the (kin 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 Ikin, is 
owing to the deficient exertion of the fubcutaneous veffels, and 
probably to the accumulation of fenforial power in the extremi- 
ties of their nerves. See Sett. XII. 5. 3. XIV. 6. XXXII. 3. 
and Clafs I. 2. 4. 1. 
M. M. A blifter. Incitantia, nutrientia, forbentia. Exer- 
cife. Clothes. Fire. Joy. Anger. 
2. Pallor fugitivus. The fugitive palenefs, which accompa- 
nies the coldnefs of the extremities, is owing to a lefs quantity 
of blood palling 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 junc- 
tion with the capillary arteries, and a bluifh tinge is mixed with 
the palenefs ; as is fecn in the loofe Ikin under the eye-lids, and 
is always a mark of temporary debility. See Clafs II. 1. 4. 4. 
Where the palenefs 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 of- 
ten miftaken for a fuperabundance of bile. 
A permanent palenefs of the Ikin 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 Sect. XXVII. 1. and another from the retrograde 
motions of the capillaries and fine extremities of the arteries. 
See Clafs II. 3. 1. 1. 
M. M. A blifter, nutrientia, incitantia, exercife, oxygene gas. 
3. Pus parcius. Diminifhed pus. Drynefs of ulcers. In 
the cold fits of fever all the fecretions are diminifhed, whether 
natural or artificial, as their quantity depends on the actions of 
the glands or capillaries, which then Ihare in the univerfal inac- 
tion of the fyftem. Hence the drynefs of iffues and blifters in 
great debility, and before the approach of death, is owing to de- 
ficient fecretion, and not to increafed abforption. 
M. M. Opium, wine in very fmill quantities, Peruvian bark. 
4. Mucus parcior. Diminifiied mucus. Drynefs of the 
mouth Class I. 2. 2. 5. 
OF IRRITATION. 
65 
mouth and noftrils. This alfo occurs in the cold fits of intermit- 
tents. In thefe cafes I have alfo found the tongue cold to the 
touch of the finger, 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 ef- 
teemed a good fymptom, when the noftrils and tongue become 
moift after having been previouily dry; as it thews an increafed 
action of the mucous glands of thofe membranes, which were be- 
fore torpid. And the contrary to this is the facies Hippocratica, 
or countenance fo well defcribed by Hippocrates, which is pale, 
cold, and Ihrunk; all which are owing to the ina&ivity oi the 
fecerning vefl'els,the palenefs from there being lefs red blood palf- 
ing through the capillaries, the coldnefs of the fkin from there 
being lefs fecretion of perfpirable matter, and the Ihrunk appear- 
ance from there being lefs mucus fecreted into the ce^s of the 
cellular membrane. See Clafs IV. 2. 4. 11. 
M. M. Blitters. Incitantia. 
5. Urina parcior pallida. Paucity of pale urine, as in the cold 
fits of intermittents ; it appears in fome nervous fevers through- 
out the whole difeafe, and feems to proceed from a palfy of the 
kidneys 5 which probably was the caufe of the fever, as the fever 
fometimes ceafes, when that fymptom is removed : hence the 
Itraw-coloured urine in this fever is fo far falutary, as it thews 
the unimpaired action of the kidneys. 
M. M. Balfams, eflential oil, afparagus, rhubarb, a blifter. 
Cantharides internally. 
6. Torpor hepaticus. Paucity of bile from a partial inaction 
of the liver ; hence the bombycinous colour of the tkin, grey 
ftools, urine not yellow, indigeftion, debility, followed by tym- 
pany, dropfy, and death. 
This paralyfisor inirritability of the liver often deftroys thofe. 
who have been long habituated to much fermented liquor, and 
have fuddenly omitted the ufe of it. It alfo deftroys plumbers 
and houfe-painters, and in them feems a fubftitute for the colica 
faturnina. See Sect. XXX. 
M. M. Aloe and calomel, then the bark, and chalybeates. 
Mercurial ointment rubbed on the region of the liver. Rhubarb, 
three or four grains, with opium half a grain to a grain twice a 
day. Equitation, warm bath for half an hour every day. 
7. Torpor pancreatis. Torpor of the pancreas. I law what 
I conjectured to be a tumour of the pancreas with indigeftion, 
and which terminated 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 fmoked it all the 
afternoon. As the fecretion from the pancreas refembles faliva 
Vol. II. K in 66 
DISEASES 
Class I. 2. 2. 8. 
in its general appearance, and probably in its office of affifting di- 
geftion, by preventing tbe fermentation of the aliment; as would 
appear by the experiments of Pringle and Maebride ; there is rea- 
fon to fufpeft, that a fympathy may exift between the falivary 
and pancreatie glands ; and that the perpetual ftimulus of the 
former by tobacco might in procefs of time injure the latter. 
See Tobacco, Article III. 2. 2. 
8. Torpor renis. Inirritability or paralyfis of the kidneys is 
probably frequently miftaken for gravel in them. Several, who 
have lived rather intemperately in refpe6t to fermented or fpir- 
ituous liquors, become fuddenly feized about the age of fixty, or 
later, with a total ftoppage of urine j though they have previ- 
oufly had no fymptoms of gravel. In thefe cafes there is no 
water in the bladder; as is known by the introduction of the 
catheter, of which thofe made of elaftic gum are faid to be pref- 
erable to metallic ones ; or it may generally be known by the 
Ihape of the abdomen, either by the eye or hand. Bougies and 
catheters of elaftic gum are fold at No. 37, Red Lion-ftrect, 
Holborn, London. 
M. M. Electric Ihocks, warm bath. Emetics. See calcu- 
lus 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. 
9. Punfla mucofe vultus. Mucous fpots on the face. Thefe 
are owing to the ina£tivity of the excretory dufts of the mucous 
glands ; the thinner part of this fecretion exhales, and the re- 
mainder becomes infpiffated, and lodges in the duct ; the ex- 
tremity of which becomes black by expofure to the air. 
M. M. They may be prefled out by the finger-nails. Warm 
water. Ether frequently applied. Blifter on the part ? 
10. Macula cutis fulva. 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 younger people, who have red hair, feem to be a fim- 
ilar production, and feem all to be caufed by the coalefcence of 
the minute arteries or capillaries of the part. In a fear alter a. 
wound the integument is only opaque •, but in thefe blotches, 
which are called morphew and freckles, the Imall vefl'els feem 
to have become inactive with fome of the ferum of the blood ftag- 
nating in them, from whence their colour. See Clafs III. 1. 2. 12. 
M. M. Warm bathing. A blifter on the part ? 
11. Canities. Grey hair. In the injection of the vefl'els of 
animals for the purpofes of anatomical preparations, the colour 
of the injected fluid will not pafsinto many very minute vefl'els ; 
which. Class I. 2. 2. 11. 
OF IRRITATION. 
67 
which neverthelefs uncoloured water, or fpirits, or quickfilver, 
will permeate. The fame occurs in the filtration of fome col- 
oured fluids through paper, or very fine fund, where the colour- 
ing matter is not perfectly difl'olved, but only difiufed 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 dimi- 
nution, or greater tenuity, of the glandular veflels, which fecrete 
the mucus, which hardens into hair ; and that the fame differ- 
ence of the tenuity of the fecerning veflels may poflibly make the 
difference of colour of the filk from different (ilk-worms, which 
is of all (hades from yellow to white. 
But as the fecreted fluids are not the confequen<r'e of mechan- 
ical filtration, but of animal feledlion ; we muft look out for 
another caufe, which muft be found in the decreafing activity of 
the glands, as we advance in life ; and which affects many of 
our other fecretions as well as that o( 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 blif- 
ters; and frequently on the human fubject by external injuries 
on the head ; and fometimes by fevers. And as the grey col- 
our of hair confifts in its want of tranfparency, like water con- 
verted into fnow; there is reafon to fuppofe, that a defect of fe- 
creted moifture (imply may be the caufe of this kind of opacity, 
as explained in Cataradta, Clafs I. 2. 2. 13. 
M. M. Whatever prevents the inirritability and infenfibility 
of the fyftem, that is, whatever prevents the approach of old age, 
will fo far counteract the production of grey hairs, which is a 
fymptom of it. For this purpofe in people, who are not corpu- 
lent, and perhaps in thofe who are fo,.the warm bath twice or 
thrice a week is particularly ferviceable. See Sedt. XXXIX. 5. 
i. on the colours of animals, and Clafs I. 1. 2. 15. 
As mechanical injury from a percuflion, or a wound, or a cauf- 
tic, is liable to occafion the hair of the part to become grey; fo 
I fufpedt the comprefiion of parts againft each other of fome an- 
imals in the womb is liable to render the hair of thofe parts of 
a lighter colour ; as feems often to occur in b1ack cats and dogs. 
A (mail terrier bitch now (lands by me, which is black on all 
thofe parts, which were external, when (lie 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 conftantly preffed 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 
iij 68 
DISEASES 
Class I. 2. 2. 1 r. 
in confab with the fore part of the neck and breaft; the tail is 
applied clofe againft the divifion of the thighs behind ; the infide 
of the binder thighs are prefled plofe co the fides of the belly, all 
thefe parts have white hairs. 
The fore-legs in the uterus lie on each fide of the face ; fa 
that the feet cover part of the temples, and comprefs the prom- 
inent part of the upper eye-brows, but are fo placed as to defend, 
the eye-balls from preiTure ; it is curious to obferve, that the 
hair of the fides of the face, and of the prominent upper eye- 
brows, are tawny, and of the infide of the feet and legs, which 
covered them ; for as this pofture admitted of more change in thp 
latter weeks of geftation, the colour of thefe parts is not fo far 
removed from black, as of thofe parts, where the contact or 
compreflion was more uniform. 
I have lately alfo irifpected a male cat; who is quite black all 
over,except thofe parts which appear to have been folded together 
in the uterus ; all which are perfectly white. In both thefe ani- 
mals the parts comprefled together are fo diftinftly defined by 
their colour, that the difleience of the curvature and fituation 
of them in the uterus may be nicely difeerned ; the hinder feet 
of the cat lay in the arm-pits of the fore-legs, and are white ; 
her fore-legs eroded over the hinder thighs, and left on them a 
white mark ; but the fore-feet, at lead, the hind part of them, 
lay under the tail; whence the fore-feet are tipped with white. 
Where the foetus is lefs tender, I fuppofe, this compreflion in 
the uterus does not afreet it ; as dogs and cats are perpetually 
jeen, which are totally black. 
Where this uterine compreflion of parts has not been fo great 
as to render the hair white in other animals, it frequently hap- 
pens, that the extremities of the body are white, as the feet, 
and nofe, 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 inftance by compreflion, and in the laft by the debility of 
the circulation in them. See Clafs I. 1.2. 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 up- 
per part of which, where it extends on the hairy fcalp, has thick 
purled hair, like the other part of his head, but quite w hite. By 
thefe marks I fuppofed him to be the fame black, who is defers 
bed, when only two years old, in the 1 ranfadtions of the Ameri- 
can p.ASsI. 2. 2. 12. 
OF IRRITATION. 
69 
can Philofophical Society, Vol IL page 292, where a female one 
is likewise defcribed with nearly fimilar marks. 
The joining of the frontal bones, and the bregma, having been 
later than that of the other futures of the cranium, probably 
gave caufe to the whitenefs of the hair on thefe parts by delaying 
or impeding its growth. 
12. Callus. The callous (kin on the hands and feet of laborious 
people is owing to the extreme veffels coalelcing from the per- 
petual preflure they are expofed to. 
As we advance in life, the finer arteries lofe their power of 
action, and their fides grow together; hence the palenefs of the 
(kins of elderly people, and the lofs of that bloom, which is ow- 
ing to the numerous fine arteries, and the tranfparency of the 
/kin, that enclofes them. 
M. M. Warm bath. Paring the thick fkin with a knife. 
Smoothing it with a pumice ftone. Coyer the part with oiled 
filk to prevent the evaporation of the perfpirable matter, and 
thus to keep it moift. 
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 feiflars the cornea of a calf's 
eye, and holding it in the palm of one's hand, fo as to gain a prop- 
er light, the artery, which fupplies nutriment to the cryftalline 
humour, is eafily and beautifully feen ; as it rifes from the cen- 
tre of the optic nerve through the vitreous humour to the cryf- 
ialline. 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 ; a$ 
is fhewn 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 looking at the middle one, 
withone eye, and retreating till you lofe fight of one of the exter- 
nal papers. Now as the animal grows older, the artery becomes lefs 
vifible, and perhaps carries only a tranfparent fluid, and at length in 
feme fubjecls I fuppofe ceafes to be pervious ; then it follows,that 
the cryftalline lens, lofing fome fluid, and gaining none, becomes 
dry, and in confequence opaque; for the fame reafon, that wet or 
piled paper is more tranfparent than when it is dry,as explained in 
Clafs I. 1.4. 1. 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 milkv opacity. The fame analogy may be ufed to explain 
the whitenefs of the hair of old people, which lofes its pellucidity 
along with its moift-ure. See Clafs I. 2. 2. 11. 
M. M. Small ele&ric (hocks through the eye. A quarter of 
a 70 
DISEASES 
Class I. 2. 2. 13.' 
a grain of corrofive fublimate of mercury diflblved in brandy, or 
taken in a pill, twice a day for fix weeks. Couching by depref- 
fion, or by extraction. The former of thefe operations is much to 
be preferred to the latter, though the latter is at this time fo 
falhionable, that a furgeon is almoft compelled to ufe it, left he 
ihould not be thought an expert operator. For deprefting the 
cataraCt is attended with no pain, no danger, no confinement, 
and may be as readily repeated, if the cryftalline fhould rife again 
to the centre of the eye. The extraction of the catarad is at- 
tended with confiderable pain, with long confinement, generally 
with fever, always with inflammation, and frequently with irre- 
parable injury to the iris, and confequent danger to the whole 
eye. Yet has this operation of extraction been trumpeted into 
univerfal fafliion for no other reafon but becaufe it is difficult to 
perform, and therefore keeps the bufinefs in the hands of a few 
empirics, who receive 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 operation, and in fpite of my earneft exhortation to the con- 
trary, was prevailed upon to have it extracted rather than deprelT- 
ed. 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 4 nearly, if not totally, 
without contraCtion, and thus greatly impedes the little vifion, 
which he poflefles. Whereas I faw fome patients couched by 
depreflion many years ago by a then celebrated empiric, Cheva- 
lier Taylor, who were not confined above a day or two, that the 
eve might gradually be accuftomed to light, and who faw as well 
as by extraCtion, perhaps better, without cither pain, or inflam- 
mation, or any hazard oflofing the eye. 
As the inflammation of the iris is probably owing to forcing 
the cryftalline through the aperture of it in the operation of ex- 
tracting it, could it not be done more fafely by making the open- 
ing behind the iris and ciliary procefs into the vitreous humour ? 
but the operation would ftill be more painful, more dangerous, 
and not more ufeful than that by deprefling it. 
If extraCtion of the cryftalline be ufed, Dr. Rcimarus of Ham- 
burgh ^vifes to drop into the eye previous to the operation, 
fome extraCi of belladonna diflblved in water, which he has found 
to produce a temporary paralyfis of the retina, and thence a total 
inaCtion of the iris, fo that it remains perfectly expanded, and 
is thence lefs liable to be injured by the operation, and the eye 
perhaps lefs liable to inflammation. Might not this be of advan- 
tage in fome ophthalmies ? 
14. Innutritio Class I. 2. 2. 14. 
OF IRRITATION. 
71 
14. Innutritio offium. Innutrition of the bones. Not only 
the blood effufed in vibices and petechire, or from bruifes, as well 
as the blood and new veflels in inflamed parts, are reabforbed by 
the increafed action of the lymphatics ; but the harder materials, 
which conftitute the fangs of the fir it fet of teeth, and the ends 
of exfoliating bones, and fometirnes the matter of chalk-ftones 
m the gout, the coagulable lymph, which is depofited on the 
lungs, or on the mufcles after inflammation of thofe parts, and 
which frequently produces difficulty of breathing, and the pains 
of chronic rheumatifm, and laflly the earthy part of the living 
bones arediflblved and abforbed by the increafed actions of this 
fyftem of veflels. See Soft. XXXIII. 3. 1. 
The earthy part of bones in this difeafe of the nutrition of 
them feems to fuffer a folution, and reabiorption ; while the 
fecerning veflels do not fupply a fuiheient quantity of calcareous 
earthand phofphoric acid, which conftitute the fubftance of bones. 
As calcareous earth abounds every where, is the want of phof- 
phoric acid the remote caufe ? One caufe of this malady is 
given in the Philofophic Tranfatfions, where the patient had 
been accuftomed to drink large quantities of vinegar. Two cafes 
are defcribed by Mr. Gouch. In one cafe, which I faw, a con- 
fiderable quantity of calcareous earth, and afterwards of bone- 
alhes, and of decoftion of madder, and alfo of fublimate of 
mercury, were given without effeff. All the bones became foft, 
many of them broke, and the patient feemed to die from the 
want of being able to diftend her cheft owing to the foftnefs of 
the ribs. 
M. M. Salt of urine, called fal microcofmicum, phofphorated 
foda. Calcined hartfhorn. Bone-afhes. Hard or petrifying 
water, as that of Matlock, or fuch as is found in ail limeftone 
or marly countries. The calcareous earth in thefe waters might 
poflibly be carried to the bones, as madder is known to colour 
them. Warm bath. Volatile or fixed alkali 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 thanufual, whioh I fuppofe is owing to the foft- 
nefs of the ends of the ribs adjoining to the fternum ; on which 
account they do not perfectly diftend the cheft, when they are 
railed by the peftoral and intercoftal mufcles with greater force 
than ufual. After this the fpine becomes curved both bv the 
foftnefs of its vertebrae, and for the purpofe 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 
deficiency of oxygene in their blood, and in confequence a defi- 
ciency 72 
DISEASES 
Class L 2. 2- 14. 
ciency of phofphdric acid ; which is probably produced by ox- 
ygene in the act of refpiration. 
Mr. Bonhome, in the Chemical Annals, Auguft, 1793, fup- 
pofes the rickets to arife from the prevalence of vegetable or 
acetous acid, which is known to fofien bones oat of the body. 
Mr. Dettaen feems to have efpoufed a fimilar opinion, and both 
of them in confequence give alkalies and teftacea. If this the- 
ory was juft, the foft bones of fuch patients fhould fhew evident 
marks of fuch acidity after death; which I believe has not been 
obferved. Nor is it analogous to other animal faffs, that nu- 
tritious fluids fecreted by the fineft veftels of the body fhould be 
lb little animalized, as to retain acetous or vegetable acidity. 
'Fhe fuccefs attending the following cafe in fo fliort a time as 
a fortnight I alcribed principally to the ufe of the warm bath ; 
in which 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 leaft exercife, with oc- 
cafional violent dry cough, for a year or more, with dry lips, 
little appetite either for food or drink, and dry fkin, with cold 
extremities. She has at times been occafionally worfe, and been 
relieved in fome degree by the bark. She began to bend for- 
wards, and to lift up her fhoulders. The former feemed 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 veiTels, and by fupplying more moifture to the blood might 
probably tend to carry further the materials, which form calca- 
reous or bony particles, or to convey them in more dilute folu- 
tion. She took twice a day twenty grains of extract of bark, 
twenty grains of foda phofphorata, and ten grains of chalk, and 
ten of calcined hartfhorn mixed into a powder with ten drops 
of laudanum ; with fleth food both to dinner and fupper ; and 
port wine and water irrftead of the fmall beer fhe had been ac- 
cuftomed to; fhe lay on a fofa frequently in a day, and occafion- 
ally ufed a neck-fwing. 
There is no fituation, where the foftnefs of the bones and 
confequent deformity of them is fo frequently attended with 
calamitous confequences, as when it affects the bones of the 
pelvis, fo as to contract the form of it; whence many unfortu- 
nate women have loft their infants, or perifhed themfelves. In 
this miferable fituation of the pregnant uterus, fome have deftroy- 
ed the child, others have undergone the Cefarean operation, 
and Class I. 2. 2. 15. 
OF IRRITATION. 
73 
and have thence generally perilhed themfe'ves. But Dr. Den- 
man has ingenioufly introduced a new practice, which has laved, 
in fuch cafes, both the mother and child ; which is by promo- 
ting a premature delivery between the feventh and eighth months, 
before the child has acquired its full growth, which has been at- 
tended with fuccefs. See Denman's Midwifery, and Medical 
Journal, Vol. III. No. 11. 
In one inftance, nature feems to have had a fimilar expedient, 
and perhaps to overcome a fimilar difficulty, in the premature 
birth of the progeny of the kanguroo ; whofe young are exclu- 
ded from the uterus in a very early ftate of their growth, and re- 
ceived into an exterior bag ; which is furnifhed with teats, to 
which they long adhere by their mouths, till they are ready for 
a fecond birth. 
15. Rachitis. Rickets. The head is large, protuberant chief- 
ly on the forepart. The fmaller joints are fwelled ; the ribs de- 
.prefled ; the belly tumid, with other parts emaciated. This dif- 
eafe from the innutrition or foftnefs of the bones arofe about two 
centuries ago; feems to have been half a century in an increaf- 
ing or fpreading ftate ; continued about half a century at its 
height, or greateft diffufion ; and is now nearly vanifhed : which 
gives reafon to hope, that the fmall-pox, mealies, and venereal 
difeafe, which are all of modern production, and have already 
become milder, may in procefs of time vanifh from the earth, 
and perhaps be fucceeded by new ones ! See the preceding 
Species. 
16. Spina dijlortio. Diftortion of the fpine is another difeafe 
originating from the innutrition or foftnefs of the bones. I once 
faw a child about fix years old with palpitation of heart, and 
quicknefs of relpiration, which began to have a curvature of the 
fpine ; I then doubted, whether the palpitation and quick refpi- 
ration were the caufe or confequence of the curvature of the 
fpine ; fufpeCling either that nature had bent the fpine outwards 
to give room to the enlarged heart; or that the malformation of 
the cheft had comprefled 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 begun to be diftorted, with 
very great difficulty and quicknefs of refpiration, and alarming 
palpitation of the heart, I convinced myfelf, that the palpitation 
and difficult refpiration were the effeCt of the change of the cav- 
ity 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 direCling her to lie down much in the day, and to 
take the bark, the diftortion became lefs, and the palpitation and 
Vol. II. L quick 74 
DISEASES 
Class I. 2. 2. 16. 
quick refpiration became lefs at the fame time. After this ob- 
fervation a neck-fwing was direfted, and fhe took the bark, 
madder, and bone-afhes ; and {he continues to amend both in 
her fhape and health. 
Delicate young ladies are very liable to become awry at many 
boarding-fchools. This is occasioned principally by their being 
obliged too long to preferve an ereft attitude, by fitting on forms 
many hours together. To prevent this, the fchool-feats fhould 
have either backs, on which they may occafionally reft them- 
felves ; or defks before them, on which they may occafionally lean. 
This is a thing of greater confequence than may appear to thofe, 
■who have not attended to it. 
• When theleaft tendency to become awry is obferved,they fhould 
be advifcd 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 higher in a morning than at night; as is well 
known to thofe who inlift very young men for foldiers. This 
is owing to the cartilages between the bones of the back becom- 
ing compreffed by the weight of the head and fhoulders on them 
during the day. It is the fame preffure which produces curva- 
tures and diftortions of the fpine in growing children, where 
the bones are fofter than ufual; and which may thus be relieved 
by an horizontal pofture for an hour in the middle of the day, 
or by being frequently allowed to lean on a chair, or to play on 
the ground on a carpet. 
Young ladies fliould alfo be direfted, where two fleep in a 
bed, to change every night, or every week, their fidqs of the bed ; 
which will prevent their tendency to deep always on the fame 
fide ; which is not only liable to produce crookcdnefs, but alfo 
to occafion difeafes by the internal parts being fo long kept in 
uniform contact as to grow together. For the fame reafon they 
fliould 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 fhape of young ladies is 
from the preffure of ftays, or other tight bandages, which at the 
fame time caufe other difeafes by changing the form or fituation 
of the internal 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 molt painful, and thus occafions a curvature of the fpine. 
To counteract this effeft, fuch ftays as have feweft hard parts, 
and Class I. 2. 2. 16. 
OF IRRITATION. 
75 
and efpecially fuch as can be daily or weekly turned, are pref- 
erable to others. 
Where frequent lying down on a fofa in the day-time, an< 
Twinging frequently for a fhort time by the hands or head, with 
loofe drefs, do not relieve a beginning diftortion of the back ; re- 
courfe may be had to a chair with fluffed moveable arms for the 
purpofe of fufpending the weight of the body by cufhions under 
the arm-pits, like refling on crutches, or like the leading-flrings 
of infants. From the top of the back of the fame chair a curv. 
cd fteel bar may alfo project to fufpend the body occafionaliy, 
or in part by the head, like the fwing above mentioned- The 
ufe of this chair is more efficacious in flraightening the fpine, 
than fimply lying down horizontally ; as it not only takes off the 
preffure of the head and ffioulders from the fpine, but at the 
fame time the inferior parts of the body contribute to draw the 
fpine flraight by their weight ; or laftly, recourfe may be had 
to a fpinal machine firfl defcribed in the Memoires of the acad-r 
emy of furgery in Paris, Vol. III. p. 600, by M. Le Vacher, and 
fince made by Mr. Jones, at No. 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 improve- 
ment by joints in the bar at the back of it, to permit the body to 
bend forwards without diminifhing the extenfion of the fpine. 
The objections of this machine of M. Vacher, which is made 
by Mr. Jones, are firfl, 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, riling up behind each ear, 
with webs faflened to it, which pafs under the chin and occiput. 
But this is not an improvement,but a deterioration of M. Vacher's 
machine, as it prevents the head from turning with facility to either 
fide. Another objection is, that its being worn, when the muf- 
cles of the back are in action, it is rather calculated to prevent 
the curvature of the fpine from becoming greater, than to extend 
the fpine, and diminilh its curvature. 
For this latter pqrpofe I have made a fteel bow, which re- 
ceives the head longitudinally from the forehead to the occiput; 
having a fork furnilhed with a web to fuftain the chin, and an- 
other 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 web? 
line> 76 
DISEASES 
Class I. 2. 2. Kx 
lined with fur for the hands to take hold of occafionally, and al- 
fo to go under the arms. By thefe means I fhould hope great 
advantage from gradually extending the fpine during the inac- 
tivity of the mufcles of the back ; and that it maybe done with- 
out difturbing the fleep of the patient, and if this fhould hap- 
pen, the bow is made to open by a joint at the fummit of it, fo as 
to be inflantlv difengaged from the neck by the hand of the 
wearer. This bow I have now uled with advantage on one pa- 
tient, and it may be had from Mr. Harrifon, whitefmith, Bridge- 
gate, Derby. 
It is alfo poflible that a flight comprefs on the prominent part 
of a curved fpine might be applied with advantage both in fleep 
and in waking hours, if it could be nicely held on the part by a 
weak and very flexible fpring, with a proper counter-preflure on 
forne diftant part ; but this would require more art than could 
be managed, except by thofe who have very accurate mechanical 
ideas, and mult differ with every kind of curvature. Thus if 
the prominent part of the curve of the fpine be on one fide, a 
fluffed cufhion fixed to the centre of a long thin fteel fpring 
fhould be applied on the prominence ; one end of this long 
fpring fhould be bent by a ftrap joined to a waiftcoat on the op- 
polite fhoulder, and the other end of it by a ftrap joined to draw- 
ers on the oppofite hip ; the degree of preflure to be adjufted 
by the tightnefs of thefe ftraps. If the prominent part of a 
curved fpine be exactly behind, the ends of the long fpring 
fhould extend from the loweft bone of the neck to the os cocci- 
gis, and fhoiild have its two ends attached to the top of a waifU 
coat, and to the waiftband of a pair of drawers. 
It will be from hence eafily perceived, that all other methods 
of confining or direfting the growth of young people fhould be 
ufed with great fkill; fuch as back boards, or bandages, or flocks 
for the feet; and that their application Ihould not be continued 
too long at a time, left worfe confequences Ihould enfue, than 
the deformity they were defigned to remove. To this may be 
added, that the ItifF ereft attitude taught by forne modern danc- 
ing mailers does not contribute to the grace of perfon, but rather 
militates again ft it ; as is well feen in one of the prints in Ho- 
garth's Analyfis of Beauty 5 and is exemplified by the eafy grace 
of forne of the ancient ftatues, as of the Venus de Medicis, and 
the Antinous, and in the works of feme modern artills, as in a 
beautiful print of Hebe feeding an Eagle, painted by Hamilton, 
and engraved by Eginton, and many of the figures of Angelica 
Kauffman. 
Where the bone of one of the vertebrae of the back has been 
fwelled cn both fides of it, fo as to become protuberant, iflues 
* • ne^ Class I. 2. 2. 17. 
OF IRRITATION. 
77 
near the fwelled part have been found of great fervice, as men- 
tioned in Species 18 of this Genus. This has induced me to 
propofe in curvatures of the fpine, to put an iflue on the outfide 
of the curve, where it could be certainly afcertained, as the bones 
on the convex fide of the curve mult be enlarged ; in one cafe I 
thought this of fervice, and recommend the further trial of it. 
In rhe tendency to curvature of the fpine, whatever ftrength- 
ens the general conftitution is of fervice ; as the ufe of the cold 
bath in the fummer months. This however requires fome re- 
ftri&ion both in refpeT to the degree of coldnefs of the bath, 
the time of continuing in it, and the feafon of the year. Com- 
mon fprings, which are of forty-eight degrees of heat, are too 
cold for tender conftitutions, whether of children or adults, and 
frequently do them great and irreparable injury. 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 fliould be but a minute or two, 
or not fo long as to occafion a trembling of the limbs from cold. 
In refpeft to the feafon of the year, delicate children ihould 
certainly only bathe in the fummer months ; as the going fre- 
quently into the cold air in winter will anfwer all the purpofes 
of the cold bath. 
17. Claudicatio coxaria. Lamenefs of the hip. A nodding 
of the thigh-bone is laid to be produced in feeble children by the 
foftnefs of the neck or upper part of that bone beneath the car- 
tilage ; which is naturally bent, and in this difeafe bends more 
downwards, or nods, by the preflure 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, bv in- 
flammation or enlargement of the cartilages or ligaments of the 
joint, fo that it refts on fome part of the edge of the acetabu- 
lum, which in time becomes filled up. When the legs are 
ftraight, as in (landing erect, there is no verticillary motion in. 
the knee-joint ; all the motion then in turning out the toes fur- 
ther than nature defigned, mult be obtained by flraining in fome 
degree this head of the thigh-bone, or the acetabulum, or cavi- 
ty, in which it moves. This has induced me to believe, that this 
misfortune of the nodding of the head of the bone, or partial 
diflocation of it, by which one leg becomes ihorter than the other, 
is fometimes occafioned by making very young children hand in 
what are called ftocks ; that is with their heels together, and 
their toes quite out. Whence the focket of the thigh-bone be- 
comes inflamed and painful, or the neck of the bone is bent 
downward and outwards. 
In 78 
DISEASES 
ClassI. 2. 2. if. 
In this cafe there is no expectation of recovering the ftraight- 
nefs of the end of the bone; but thefe patients are liable to 
another misfortune, that is, to acquire afterwards a diftor- 
tion of the fpine ; for as one leg is fhorter than the other, they 
fink on that fide, and in confequence bend the upper part of 
their bodies, as their fhoulders, the contrary way, to balance 
themfelves ; and then again the neck is bent back again towards 
the lame fide, to preferve the head perpendicular; and thus the 
figure becomes quite diftorted like the letter S, owing original- 
ly to the deficiency of the length of one Jimb. The only way 
to prevent this curvature of the fpine is for the child to wear a 
high-healed fhoe or patten on the lame foot, fo as to fupport that 
fide on the fame level with the pther, and thus tQ prevent a 
greater deformity. 
I have this day feen a young lady about twelve, who does not 
limp or waddle in walking; but neverthelefs, when fhe itands 
er fits, flie finks down towards her right fide, and turns out that 
toe more than the other. Hence, both as fhe fits and ftands, 
Ihe bends her body to the right; whence her head would hang 
a little over her right fhouider ; but to replace this perpendicu- 
larly, fhe lifts up her left fhouider and contracts the mufcles on 
that fide of the neck $ which are therefore become thicker and 
ftronger by their continued action ; but there is not yet any very 
perceptible diftortion of the fpine. 
As her right toe is turned outward rather more than natural, 
this thews the difeafe to 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 rotation of the tibia and fibula of the leg round 
each other. Hence if children are fet in ftocks with their heels 
touching each other as they fit, and are then made to rife up, 
till they (land ereCt, the focket or head of the thigh-bone becomes 
injured, efpecially in thofe children, whofe bones are foft ; and 
a fhortnefs 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 confequcnt rifing of one fhouider, and a curvature of the 
fpine are produced from fo diftant a caufe. 
M. M. An elaflic cufhion made of curled hair fhould be pla- 
ced under the affected hip, whenever fhe fits ; or fhould be fit- 
ted to the part by means of drawers, fo that fhe cannot avoid 
fitting on it. A neck-fwing, and lying down in the day, fhould 
be occafionally ufed to prevent or remove any curvature of the 
fpine. The reft as in Species 13 and 15 of this genus. 
18. Spina protuberant. Protuberant fpine. One of the bones 
of Class I. 2. 2. 19. 
OF IRRITATION. 
79 
of the fpine fwells, and rifes above the reft. This is not an un- 
common difcafe, and belongs to the innutriton of the bones, as 
the bone muft become foft before it fwells ; which foftnefs is 
owing to defect of the fecretion of phofphorated calcareous earth. 
The (welling of the bone comprefles a part of the brain, called 
the fpinal marrow, within the cavity of the back-bones ; and in 
confequence the lower limbs become paralytic, attended fome- 
times with difficulty of emptying the bladder and reCtum. 
M. M. Iflues put on each (ide of the prominent bone are of 
great effect, I fuppofe, by their ftimulus ; which excites into 
aCtion more of the fenforial powers of irritation and fenfation, 
and thus gives greater aCtivity to the vafcular fyftem in their 
vicinityr The methods recommended in diftortion of the fpine 
are alfo to be attended to. 
19. Spina bifida. Divided fpine, called alfo Hydrorachitis, as 
well as the Hydrocephalus externus, is probably owing in part 
to a defeCt of offification of the fpine and cranium ; and the col- 
lection of fluid beneath them may originate from the general de- 
bility of the fyftem ; which affects both the fecerning, and ab- 
forbent veflels. 
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 affected, and the patient falls afleep. I 
fuppofe the fame muft happen on compreffing the hydrocephalus 
externus ? See Sect. XVIII. 20. 
20. Offts palati def eft us. A defeCt of the bone of the palate, 
which frequently accompanies a divifion of the upper lip, oc- 
curs before nativity ; and is owing to the deficient a&ion of the 
fecerning fyftem, from whence the extremities are not comple- 
ted. From a (imilar 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 SeCt. XXXIX. 4. 4. 
The operation for the hare-lip is defcribed by many furgical 
writers; but there is a perfon in London, who makes very ingeni- 
ous artificial palates; which prevent that defeCt of fpeech, which 
attends this malformation. This factitious palate confifts of a 
thin plate of filver of the (hape 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 pa(s through them ; on the back of it is then fewed a piece of 
fponge •, which when expanded with moifture is nearly as large 
as the filver plate. This fponge is flipped through the divifion 
•f the bone of the palate, fo as to lie above it, while the filver 
plate 80 
DISEASES 
Class I. 2. 2. 2«. 
plate covers the aperture beneath, and is fufpended by the ex- 
panding fponge. This is removed every night and wafhed, and 
returned into its place in the morning ; on this account it is con- 
venient 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 know the name, or place of refidencc, of the maker. 
ORDO Class I. 2. 3. r. 
OF IRRITATION. 
81 
ORDO II. 
Decreafed Irritation. 
GENUS III. 
With decreafed Action of the Abforbent Syfem. 
Some decreafe of heat attends fhefe 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 
action as the fecerning fyftem of glands, as explained in Clafe 
I. 1. 3. 
SPECIES. 
1. Mucus ftucium frigidus. Cold mucus from the throat* 
Much mucus, of rather a faline tafte, and lefs infpiflated than 
ufual, is evacuated from the fauces by hawking, owing to the 
deficient abforption 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 tobacco ; which by frequently ftimulating the 
fauces have at length rendered the abforbent veflels lefs excita- 
ble 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. 
2. Sudorfrigidus. The cold dampnefs of the hands of fome 
people is caufed by the deficient abforption of perfpirable matter j 
the clammy or vifeid feel of it is owing to the mucous part being 
left upon the (kin. The coldnefs is produced both by the de- 
creafed action of the abforbent fyftem, 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 quan- 
tity of volatile alkali in water. 
3. Cptarrhus frigidus. The thin difeharge 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 felect the fluid they fecrete ; whereas the abiorbent 
Vol. II. M veflels 82 
DISEASES 
Class I. 2» j. 4, 
veflels of the noftrils drink up their fluids, namely the thin and 
faline part of the mucus, after it has been cooled by the atmof- 
phere. Hence the abforbents ceafing to a£t, and the fecerning 
veflels continuing fome time longer to pour out the mucus, a 
copious thin difcharge is produced, which trickles down the 
noftrils in cold weather. This difcharge is fo acrid as to inflame 
the upper lip; which is owing to the neutral faits, with which 
it abounds, not being reabfcrbed ; fo the tears in the fiftula lach- 
rymalis inflame the cheek. See Clafs I. i. 2. 7. 
4. ExpeHoratio frigida. Cold expectoration. Where the 
pulmonary abforption is deficient, an habitual cough is produced, 
and a frequent expectoration of thin faline mucus; as is often 
feen in old enfeebled people. Though the ftimulusof the faline 
fluid, which attends all fecretions, is not fuflicient to excite the 
languid abforbent veflels to imbibe it; yet this faline part, to- 
gether with the increafcd 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 
Angle grain of opium, or any other ftimulant drug, as a wine 
poflet with fpirit of hartfliorn, will cure this cold cough, and the 
cold catarrh of the preceding article, like a charm, by ftimula- 
ting the torpid mouths of the abforbents into aClion. Which 
has given rife 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 gram of opium night and morning promotes 
the abforption of the more fluid and faline parts, and in confe- 
quence thickens the mucus, and abates its acrimony. Warm 
diluent drink, wine-whey,, with volatile alkali. 
5. Urina ubericr pallida. On being expofed naked to cold, 
air, or fprinklcd 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 qui- 
efcent by the diminution of external heat; but the kidneys con- 
tinue to fecrete the urine, and as no part of it is abforbed, it be- 
comes copious and pale. This happens from a fimilar caufe ii> 
cold fits of agues; and in lefs degree to many debilitated confti- 
tutions, whole extremities are generally cold and pale. The 
great quantity of limpid water in hyfteric cafes, and in diabetes^ 
belongs to Clafs I. 3. 1. 10. I. 3. 2. 6. 
M. M. Tin&ure of cantharides, opium, alum, forbentia. 
Flannel fhirt in cold weather. Animal food. Beer. Wine. 
Ln&ion. Exercife. Fire. 
6. Diarrhea frigida. Liquid ftools are produced by expofing 
the •Class I. 2. 3. 7. 
OF IRRITATION. 
83 
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 in- 
teftinal abforption being fo impaired, that the aliment is faid to 
come away undiminifhed in quantity, and almolt unchanged by 
the powers of digeftion, and is then called lienter^-. 
The mucus of the reftum fometimes comes away like pellu- 
cid hartfhorn 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 
fomc old people. 
M. M. Opium, campechy wood, armenian bole. Bliller. 
Flannel {hirt in cold weather. Clyfters with opium. Friction 
on the bowels morning and night. Equitation twice a day. 
7. Fluor albus fri^idus. Cold fluor albus. In weak conftitu- 
tions, where this difcharge is pellucid and thin, it mull proceed 
from want of abforption of the mucous membrane of the vagina, 
or uterus, and not from an increafed fecretion. This I fufpedl 
to be the moft frequent kind of fluor albus ; the former one de- 
fcribed at Clafs I. .f. 2. n. attends menftruation, or is a dif- 
charge inftead of k, and thus refembles the venereal orgafm of 
female quadrupeds. The -difcharge in the cold kind being more 
faline, is liable to excoriate rhe part, and thus produce imarting; 
in making water ; in its great degree it is difficult to cure. 
M. M. Increafe the evacuation by (tool and by perfpiration, 
by taking rhubarb every night, about fix or ten grains with one 
grain of opium for feme months. Flannel fhirt in winter. Balfam 
copaiva. Gum kino, bitters, chalybeates, fritlion over the whole 
Ikin with flannel morning and night. Partial cold bath, by 
fprinkling the loins and thighs, or fponging them with cold 
water. Mucilage as ifinglafs boiled in milk ; blanc mange, 
hartfhorn jelly, are recommended by fome. Tindlure of can- 
tharides 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 comprefiion in the manner of a ban- 
dage. A folution of metallic faits, as white vitriol, fixty grains 
to a pint; or an infufion of oak-bark may be injected into the 
vagina. Cold bath. 
8. Gonorrhoea frigida. Cold gleet. Where the gleet is thin 
and pellucid, it muft arife from the want of abforption of the 
membranes of the urethra, rather than from an increafed fecre- 
tion from them. This I fuppofe to be a more common difeafe 
than that mentioned at Clafs 1. 1. 2. 10. 
M. M. Metallja 84 
DISEASES 
Class I. 2. 3. 9. 
M. M. Metallic injections, partial cold bath, internal method 
as in the fluor albus above defcribed. Balfam of copaiva. Tinc- 
ture of cantharides. Introduce a few inches into the urethra a 
bougie fmeared with balfam of copaiva. See Horne on urethra, 
p. 105. 
9. Hepatis tynw. The liver becomes enlarged from 'defecT 
of the abforption of mucus from its cells, as in anafarca, efpeci- 
ally in feeble children ; at the fame time lefs bile is fecreted 
from the torpid circulation in the vena porta;. And as the ab- 
forbents, which refurne the thinner parts of the bile from the 
gall-bladder and hepatic ducts, are alfo torpid or quiefcent, the 
bile is more dilute, as well as in lefs quantity. From the ob» 
Itruciion of the paflage of the blood through the comprefled ve- 
ni porta thele patients have tumid bellies, and pale bloated coun- 
tenances ; their palenefe is probably owing to the deficiency of 
the quantity of red globules in the blood in confequence of ths 
inert Rate of the bile. 
Thefe fymptoms in children are generally attended with worms, 
the dilute bile and the weak digeRion not deRroying them. In 
flieep I have feen fluke-worms in the gall-dudds themfelves among 
the dilute bile ; which gall-dutfls they eat through, and then 
produce ulcers, and the heHic fever, called the rot. See Clafs 
I. 1.4. 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 dellroyed by the 
returning acrimony and quantity of the bile. AbliReron th^ 
region of the liver. Sorbentia, as worm-feed, fantonicum. Co» 
Jumbo. Bark. 
The nitrous acid has been firongly recommended by Mr. Scot 
in tumours of the liver, which frequently occur in the eaR, where 
this gentleman refides ; he gives two drachms of Rrong nitrous 
acid mixed with two pounds of water, to be drunk daily at in-* 
tervals. See Syphilis, Clafs II. 1. 5. 2. 
10. Chlorojis. When the defect of the due a<Stion of bofh the 
abforbent and fecerning yeflels of the liver a Re Cfs women, and is 
attended with obfiruttion of the catamenia, it is called chlorofis; 
and is cured by the exhibition of Reel, which restores by its fpe- 
cific Rimulus the abforbent power of the liver ; and the men- 
ftruation, which was obfiru^ded in confequence of debility, 
recurs. 
IndigeRion, owing to torpor of the Romach, 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 in- 
aftion of the abforbents, which are diftributed on the neck of 
the Class I. 2. 3. 11. 
OF IRRITATION. 
85 
the bladder, during deep. The fwelling of the ankles, which, 
frequently attends chlorofis, is another effect of deficient action 
of the abforbent fyftem ; and the pale countenance is occafioncd 
by the deficient quantity of red globules of blood, caufed by the 
deficient quantity or acrimony of the bile, and confequent weak- 
nefs of the circulation. The pulfe is fo quick in feme cafes of 
chlorofis, that, when attended with an accidental cough, it may 
be miilaken for pulrponary confumption. This quick pulfe is 
owing to the debility of the heart from the want of ftimulus oc- 
cafioncd by the deficiency of the quantity, and acrimony of the 
blood. 
M. M. Steel. Bitters. Conftant moderate exercife. Fric- 
tion with flannel all over the body and limbs night and morn- 
ing. Rhubarb 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. 
it. Hydrocele. Dropfy of the vagina teftis. Dropfies have 
been divided into the eneyfted and the diffufed, meaning thole of 
the cellular membrane, the cells of which communicate with each 
other like a fponge, and thofe of any other cavity of the body., 
The collections of mucous fluids in the various cells and cavities 
of the body arife from the torpor of the abforbent veflels of thofe. 
parts. It is probable, that in dropfies attended with great thirft 
rhe cutaneous abforbents become paralytic firft ; and then from 
the great thirft, which is thus occafioncd by the want of atmof- 
pheric moifture, the abforption of the fat enfues; as in fevers 
attended with great thirft, the fat is quickly taken up. See Obe- 
fitas I. 2. 3. 16. Some have believed, that the cellular and adi- 
pofe membranes are different ones ; as no fat is ever depofited 
in the eyelids or fcrotum, both which places are very liable to 
be diftended with the mucilaginous fluid of the anafarca,and with 
air in limphyfema. Sometimes a gradual abforption of the ac- 
cumulated fluid takes place, and the thinner parts being taken 
up, there remains a more vifeid fluid, or almoft a folid in the 
part, as in fome fwelled legs, which cannot eafily be indented by 
the preflure of the finger, and are called fcorbutic. Sometimes 
the paralyfis of the abforbents is completely 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 fluctuation, and a de- 
gree of pellucidity, when a candle is held behind it; it is the 
molt Ample ineyfted dropfy, as it is not in general complicated 
with other difeafes, as afeites with feirrhous liver, and hydro- 
cepha! us 86 
DISEASES 
Class I. 2. 3.12/ 
cephahis internus, with general debility. The cure of this dif- 
eafe is effefted by different ways ; it confifts in difcharging the 
water by an external aperture ; and by fo far inflaming the cyft 
and tellicle, that they afterwards grow together, and thus pre- 
vent in future any fecretion or effufion 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, and is more certainly manageable by tapping, or difcharg- 
ing 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 min- 
utes till the neceflary degree of ftimulus is produced, and then to 
withdraw it; as recommended by Mr. Earle. See alfo Medical 
Commentaries by Dr. Duncan for 1793. 
12. Hydrocephalus internus, 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, ac- 
cording to the opinion of Dr. Gilchrilt, in the Scots Medical 
Eflays. 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 parox- 
yfms of quick impulfe, and in that refpedt correfponds with oth? 
er fevers with inirritability. 
The hydrocephalus internus is diftinguifhed from apoplexy by 
its being attended with fever, and from nervous fever by the 
paroxyfms being very irregular, with perfect intermiflions many 
times in a day. In nervous fever the pain of the head generally 
affe&s the middle of the forehead ; in hydrocephalus internus it 
is generally on one fide of the head. One of the earlieft crite- 
rions is the patient being uneafy on raifing his head from the pil- 
low, and wifhing to lie down again immediately; which I fup- 
pofe is owing to the prelTure of the water on the larger trunks 
of the blood-veflels entering the cavity being more intolerable 
than on the fmaller ones; for if the larger trunks are comprelT- 
ed, it mult inconvenience the branches alfo ; but if fome of the 
fmall branches are compreiled only, the trunks are not fo imme- 
diately incommoded. 
Blitters on the head, and mercurial ointment externally, with 
calomel internally, are principally recommended in this fatal dif- 
eafe. When the patient cannot bear to be raifed up in bed with- 
out great uneafinefs, it is a bad fymptom. So I believe is deaf- 
neis, which is commonly miltaken for ftupor. 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 dila- 
ted. Class I. 2. 3. 12. 
OF IRRITATION. 
87 
ted, it is generally fatal. As by ftimulating one branch of 
lymphatics into inverted motion, another branch is liable to ab- 
forb its fluid more haltily ; fuppofe llrong errhines, as com- 
mon tobacco fnuff to children, or one grain of turpeth mineral, 
(hydrargyrus vitriolatus), mixed with ten or fifteen grains of fu- 
gar, were gradually blown up the noftrils ? See Clafs I. 3. 2. 1. 
I have tried common fnuff upon two children in this difeafe 
one could not be made to fneeze, and the other was too near death 
to receive advantage. When the mercurial preparations have 
produced falivation, I believe they may have been of fervice, but 
I doubt their good effect 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 Sedt. 
XXIX. 5. 
As all the above remedies generally fail of fuccefs, I think 
frequent, almolt hourly, Ihocks of electricity from very fmall 
charges might be pafled through the head in all directions with 
probability of good event ; as by Volta's rods of zinc and filver 
defcribed in Clafs I. 2. 5. 5. A folution of hydrargyrus muria- 
tus, corrofive fublimate of mercury in rectified fpiritof wine, 
three grains to an ounce, is faid to produce inftantaneous and 
violent falivation ; as defcribed in Clafs II. 1. 5. 1. on Gonor- 
rhoea. Could a fmall quantity of this violent ftimulus be 
ufed according to the age of the child with probable good ef- 
feCt ? Could the trephine be ufed with fafety or advantage 
■where the affected fide can be diftinguifhed ? See Strabiftnus, 
Clafs I. 2. 5. 4. When one eye is affected, does the difeafe ex- 
ift in the ventricle of that fide ? 
The following extract from a letter of Dr. Beddoes on hydro- 
cephalus interims, is well worthy to be attended to. 
" Mailer 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 after- 
wards. He had complained of violently acute pain in his head, 
Shrieked frequently, ground his teeth hard, could not bear to 
have his head raifed from the pillow, and was torpid or 
deaf. His tongue was white, pulfe 110 in the evening and full. 
As yet the pupil of the eye was irritable, and he had no ftrabif- 
mus. He had been bled with leeches about the head, and blitter- 
ed. Idiredled mercurial inundlion,and calomel from 3 to 6 grains 
to be taken at firft every fix, and afterwards every three hours. 
This plan produced no fenfible effett, and the patient died on 
the 18th day after the feizure. He had convulfion-fits two days, 
preceding his death, and the well-known fymptoms of hydro- 
cephalus internus all made their appearance. From what I had 
« feen 88 
DISEASES 
Class I. 2.3. 
feen and read of this difeafe, I believed it to belong to inflamma-* 
tions, and at an earlier period I ihould be tempted to bleed as 
largely as for pneumonia. The fluid found after death in the ven- 
tricles of the brain I impute to debility of the abforbents indu- 
ced by inflammation. My reafons are briefly theie : i. The 
auutenefs of the pain. 2. The Hate of the pulfe. In the above 
cafe for the firft 9 or 10 days it did not exceed 110, and was 
full and ftrong. 3. To find out whether any febrile alternations 
took place, Mailer L.'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 difeafe, but the patients were too young, or 
too far advanced, to inform me, whether they had chilinefs fuc- 
ceeded by heat at its onfet. 4. The diforders to which the 
young are more peculiarly liable afford a prefumption, that hy- 
drocephalus internus is an inflammatory difeafe ; and this is 
confirmed by the regularity of the period, within which it fin- 
ishes its courfe. And laftly, does not happen more frequently 
than is fufpedted from external injury ? 
" I have juft 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 doClrine may be found in cer- 
tain modern publications, but it is delivered in that vague and 
diffufe ftyle, which I trull your example will banilh from medi-* 
cal literature." 
To this idea of Dr. Beddoes may be added, that the hydrocele 
generally fucceeds an injury, and confequent inflammation of 
the bag, which contains it. And that other droplies, which 
principally attend inebriates, are confequent to too great action 
of the mucous membranes by the Him ulus 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 ferioully attended to. 
This idea of inflammation preceding hydrocephalus was men- 
tioned by Dr. Quin, and afterwards in a pamphlet of Dr. Pat- 
erfon, of Dublin. 
13. Afcites. The dropfy of the cavity of the abdomen is 
known by a tenfe fwelling of the belly ; which does not found 
on being ftruck like the tympany ; and in which a fluctuation 
can be readily perceived by applying one hand expanded on one 
fide, and linking the tumour on the other. 
Effufions of water into large cavities, as into that of the abdo- 
men or thorax, or into the ventricles of the brain or pericardi- 
um, are more dilhcult to be re-abforbed, than the eft'ufion of 
fluids into the cellular membrane j becaufe one part of this ex- 
tenfive Class L 2. 3. 14. 
OF IRRITATION. 
89 
tenfive fponge-like fyftem of cells, which connects all the folid 
parts of the body, may have its power of abforption impaired, 
at the fame time that fame other part of it may ftili retain that 
power, or perhaps poffefs it in an increafed degree ; and as all 
thefe cells communicate with each other, the fluid, which abounds 
in one part of it, can be transferred to another, and thus be re- 
abforbed into the circulation. 
In the afeites, cream of tartar has fometimes been attended 
with fuccefs; a dram or two drams are given every hour in a 
morning till it operates, and this 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 fnc- 
cefsful method of performing this operation, by making a punc- 
ture with a lancet in the fear of the navel} and leaving it to dif- 
charge itfelf gradually for feveral days, without introducing a 
eanula, which he thinks injurious, both on account of the too 
fudden emilhon of the fluid, and the danger of wounding or ftim- 
ulating the vifeera. This operation I have twice known per- 
formed 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 fuc- 
cefs. Firft, becaufe the patients are generally much debilitated, 
molt frequently by fpirituous potation, and have generally a dif- 
eale of the liver, or of other vifeera. And fecondly, beraufe 
the quantity of inflammation, neceflary to prevent future fecretiort 
of mucus into the cavity of the abdomen, by uniting the perito- 
neum with the inteftines or mefentery, as happens in the cure 
of the hydrocele, would I fuppofe generally deftroy the patient* 
either immediately, or by the confequence of fuch adhefions. 
This however is not the cafe in refpeft to the dropfy of the 
ovarium, or in the hydrocele. 
14. Hydrops thoracis. The dropfy of the cheft commences 
with lofs of flefh, cold extremities, pale countenance, high col- 
oured urine in fmall quantity, and general debility, like many 
other dropfies. The patient next complains of numbnefs in the 
arms, efpecially when elevated, with pain and difficulty of fwal- 
lowing, and an abfolute impoffibility of lying down for a few* 
minutes, or with fudden ftarting from fleep, with great difficulty 
of breathing and palpitation of his heart. It is often confound- 
ed with anafarca pulmonum, which fee. 
The numbnefs of the arms is probably owing more frequent- 
ly to the increafed action of the peCtoral mufcles in refpiration. 
Vol. II. N whence 90 
DISEASES 
Class I. 2. 3. 14* 
■whence they are lefs at liberty to perform other offices, than to 
the connexion of nerves mentioned in Se£t. XXIX. 5. 2. The 
difficulty of fwallowing is owing to the compreffion of the 
cefophagus by the lymph in the chefl; and the impoffibility of 
breathing in a horizontal pofture originates from this, that if any 
parts of the lungs muft be rendered ufelefs, the inability of the 
extremities of them muft be lefs inconvenient to refpiration ; 
fmce if the upper parts or larger trunks of the air-veffels ihould 
be rendered ufelefs by the compreffion of the accumulated lymph, 
the air could not gain admitance to the other parts, and the ani- 
mal muft 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 aftedted than the other, the patient leans 
moft that way, and has more numbnefs in that arm. 
The hydrops thoracis is diftinguifhed from the anafarca pul- 
monum, as the patient in the former cannot lie down half a min- 
ute ; in the latter the difficulty of breathing, which occafions 
him to rife up, comes on more gradually; as the tranfition of 
the lymph in the cellular membrane 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 con- 
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 abforption in them. Thefe exacerbations of difficult 
breathing are attended with cold extremities, cold breath, cold 
tongue, upright pofture with the mouth open, and a defire of 
cold air, and a quick, weak, intermittent pulfe, and contracted 
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 mufclesof refpiration induced by the pain of the 
dyfpncea. As in Clafs III. 1. 1. 9. 
M. M. A grain of dried fquill, and a quarter of a grain of 
blue vitriol every hour for fix or eight hours, unlefs it vomit or 
purge. A grain of opium. Bliiters. Calomel three grains 
everv third day, w ith infufion of fenna. Bark. Chalybeates. 
Puntture in the fide. 
Can the fluctuation in the cheft be heard by applying the ear 
to the Iide, as Hippocrates afferts ? Can it be felt by the hand or 
by the patient before the difeafe is too great to admit of cure by 
the Class I. 2. 3. 15. 
OF IRRITATION. 
91 
the paracentefls ? Does this dropfy of the cheft often come on af- 
ter peripneumony ? Is it ever cured by making the patient fick 
bytinfture of digitalis ? Could it be cured, if on one fide only, 
by the operation of pumSture between the ribs, and afterwards 
by inflaming the cavity by the admiffion of air for a time, like 
the cure of the hydrocele', the pleura afterwards adhering whol- 
ly to that lobe of the lungs, fo as to prevent any futpre effuGoa 
of mucus ? 
I fufpecb the anafarca of the lungs, as well as the hydrops 
thoracis, to be moll frequently difeafes of thofe membranes on- 
ly, and nor to depend on the general paralyfis of the abforbent 
fyftem ; and that they are then not accompanied with fwelled 
kgs, till the patient becomes univerfally weak ; and that they 
have for their caufe a rheumatic or gouty peripneumony or pleu- 
rify ; that is, that the lungs or pleura have been inflamed from 
their fympathy with fame other vifeus, and have depofited much 
coagulable lymph on the furface of their inflamed membranes, 
which could not readily become abforbed, and has thus caufed 
the dropfy of the cavity of the cheft, like the coagulable lymph 
©r chalky matter left after the gout and rheumatifm in other 
parts ; or that the cellular membrane of the lungs becomes fill- 
ed with a fluid from the prefent inaction of their abforbent vef- 
fels, which had previoufly been excited too violently ; and that 
the anafarca g£ the lungs is thus produced like the anafarca 
which, frequently in weak conftitutions, exifts after the gout in 
tire feet and knees, and after rheumatic inflammations of the 
joints. See Peripneumonia, Qlafs II. 1.2. 4. whence it appears, 
why the hydrops thoracis and anafarca pulmonum fo generally 
occur in gouty conftitutions. 
15. Hydrops ovarii. Dropfy of the ovary is another eneyfted 
dropfy, which feldom admits of cure. It is diftinguilhed from 
afeites by tire tumour and pain, efpecially at the beginning, ocr 
cupying cne fide, and the fludluation being lefs diftindlly per- 
ceptible. When it happens to young fubjedls it is lefs liable to 
be miftaken for afeites. Jr affects women of aft ages, either 
married or virgins ; and is produced by cold, fear, hunger, bad 
food, and other debilitating caufes. I faw an elegant young la- 
dy, who was fhortly to have been married to a fenfible man, with 
great profpedl of happinefs ; 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 gradually 
afflicted 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 recoiled! feeing, 
who was about fc venteen, and being .of the very inferior clafs 
of 92 
DISEASES 
Ct ASS I. 2. 3. 
of people, feemed to have been much weakened by the hardfhip 
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 neighbors, 
and the perfecution of parifh officers. 
The following is abftradted from a letter of my friend Mr. 
Power, furgeon, at Bofworth in Leicefterftiire, on examining the 
body of an elderly lady who died of this difeafe, March 29, 
j 793. " On opening the abdomen I found a large cyft attach- 
ed to the left ovarium by an elaftic neck as thick as the little fin- 
ger, and fo callous as not to admit of being feparated by fciflars 
without confiderable difficulty. The fubftance of the cyft had 
an appearance much refgmbling the gravid uterus near the full 
period of geftation, and was as thick. It had no attachment to 
the peritoneum, or any of the vifcera, except bv the hard callous 
neck I have mentioned ; fo that the blood muff 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, 
without any greater tenacity. It has fallen to my lot to have 
opened two other patients, whofe deaths were occasioned by en- 
cyftcd dropfy of the ovarium. In one of thefe the ovarium was 
much enlarged with eight or ten cyfts on its furface, but there 
was no adhefion formed by any of the cyfts to any other part j 
nor had the ovarium formed any adhefion with the peritoneum, 
though in a very difeafed ftate. In the other the difeafe was 
more firn pie, being only one cyft, 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 fhall be 
induced, notwithftanding 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 I can with precifion fay, that the ovarium is the feat of 
the difeafe, and the patient in other refpcdls tolerably healthy ; 
as the cavity of the abdomen is often opened in other cafes 
without bad confequences." 
An argument, which might further countenance the opera- 
tion thus propofed by Mr. Power, might be taken from the dif- 
eafe frequently atfedling young perfons ; from its being gener- 
ally in thefe fubjedls local and primary; and not like the afeites, 
produced or accompanied with other difeafed vifcera; and laft. 
ly, as it is performed in adult quadrupeds, as old fows, with 
gaiety, though by awkward operators. 
160 dnajarca puhnonum. The dropfy of the cellular mem- 
bl4UC Class I. 2. 3. 
OF IRRITATION. 
93 
brane of the lungs is ufually connected with that of the Other 
parts of the fyftem. As the cells of the whole cellular mem- 
brane communicate with each other, the mucilaginous fluid, 
which remains in any part of it for want of due abforption, finks 
down to the moft depending cells j hence the legs fwell,though, 
the caufe of the difeafe, the deficiency of abforption, may be in 
other parts of the fyftem. The lungs however 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 ref- 
piration accompanied with fwelled legs, and with a very irregu- 
lar pulfe. This 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 paflage of the blood through 
the lungs ; becaufe I found on difleftion, in one inftance, that 
the moft irregular pulfe, which I ever attended to, was owing to 
very extenfive adhefion of the lungs ; infomuch that one lobe in- 
tirely adhered to the pleura; and 1'econdly, 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 
producing either in any perceptible degree, by affecting the lym- 
phatics of the ftomach, fo as either to invert their motion, or to 
weaken them, increafes by reverfe fympathy the action, and con- 
fequent abforbent power of thefe lymphatics, which open into 
the cellular membrane. But as thefe medicines feldom fucceed 
in producing an abforption of thofe fluids, which ftagnate in 
the larger cavities of the body, as in the abdomen, or cheft, and 
do generally fucceed in this difficulty of breathing with irregu- 
lar pulfe above defcribed, I conclude that it is not owing to an 
effufion of lymph into the pericardium, but Amply to an anafar- 
ca of the lungs. 
M. M. Digitalis. See Art. V. 2. 1. 2. and IV. 2. 3. 7. 
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 pre- 
ferred to the fpirit and water, which thefe patients have general- 
ly been accuftomcd to. 
1 have feen two cafes, which were efteemed to be hydrotho- 
rax, but which I believed to be anafarca pulmonum, though they 
were attended with irregular pulfe ; for I do not underftand, 
■why an irregularity of pulfe ffiould be occafioned by water in 
the pericardium any more than by water in the lungs, or by 
anj 94 
DISEASES 
Class I. 2. 3. 17. 
any other obftruclion to the circulation. See Clafs IV. 2. 1. 18. 
Pulfus intermittens, and Palpitatio cordis. 
In both thefe cafes the patients could not fleep above one min- 
ute at a time ; which I afcribed to the debility of the aflion of 
the heart compared with the refiftance to the circulation, and 
that fome voluntary exertion became neceffiry to carry on the 
circulation, which doesnot exill in fleep. See Clafs I. 2. 1. 3. 
Somnus interruptus. 
Thefe two cafes of patients about fixty years of age are here 
mentioned from a curious circumftance, that both the patients 
became in fome degree infane after being relieved by the tinc- 
ture of digitalis taken to the quantity of thirty drops three or four 
times a day for two or three days ; and remained in a flight de- 
gree of infanity for fome months, and then as this increafe of 
voluntary exertion ceafed, they again became afflicted with the 
anafarca pulmonum, and fwelling of the legs, and this repeat- 
edly for two or three years. I have before feen a common an- 
afarca repeatedly cured by infanity for a year or two, and two 
fevers I have feen attended with great debility cured by the ac- 
cefs of infanity, which was called delirium by the attendants j 
and I lately witnefled the prefent cure of what was believed to 
be confumption by the accefs of infanity. All which were 
probably effected by the increafed energy of fome parts of the 
fyftem owing to the addition of volition to the fenforial powers 
of irritation or affbeiation. 
The ufual caufe of anafarca is from a difeafed liver, and hence 
it moft frequently attends thofe, who have drunk much ferment- 
ed or fpirituous liquors ; but I fufpett that there is another 
caufe of anafarca, which originates from the brain ; and which 
is more certainly fatal than that, which originates from a difeaf- 
ed liver. Thefe patients, where the anafarca originates from, or 
commences in, the brain, have not other fymptoms of difeafed 
liver ; have lefs difficulty of breathing at the beginning $ and 
hold themfelves more upright in their chair, and in walking. In 
this kind of dropfy I fufpecl the digitalis has lefs or no effect ; 
as it particularly increafes the abforption from the lungs. 
17. Obejitas. Corpulency may be called anafarca or dropfy 
of fat, fince it mult be owing to an analogous caufe; that is, to 
the deficient abforption of fat compared to the quantity fecreted 
into the cells which contain it. See Clafs IL 1. 1. 4. 
The method of getting free from too much fat without any 
injury to the conftitution, confifts, firft, in putting on a proper 
bandage on the belly, fo that it can be tightened or relaxed with 
cafe, as a tightifh under waiflcoat, with a double row of buttons. 
This is to comprefs the bowels and increafe their abforption ; 
and Class I. 2. 3. 18. 
OF IRRITATION, 
95 
and it thus removes one principal caufe of corpulency, which is 
the looienefs of the (kin. Secondly, he fhould omit one entire 
meal, as fupper ; by this long abftinence from food the abforb- 
ent fyftcm will act on the mucus and fat with greater energy. 
Thirdly, he fhould drink as little as he can with eaie to his fen- 
fations ; (nice, if the abforbents of the ftomach and bowels fup- 
ply the blood with much, or pet haps too much, aqueous fluid, 
the abforbents of the cellular membrane will act with lefs ener- 
gy. Fourthly, he ftiould ufe much fait or faked meat, which 
will increafe the perfpiration and make him thirfty ; and if he 
bears this thirft, the abforption of his fat will be greatly increaf- 
ed, as appears in fevers and dropfies with thirft; this I believe to 
be more efficacious than foap. Fifthly, he may ufe aerated al- 
kaline water for his drink, wffiich may be fuppofed to render the 
fat more fluid,-or he may take foap in large quantities, which 
will be decompofed in the ftomach. Sixthly, fhort reft, and 
conftant exercife. 
Vinegar has been faid to reduce corpulency, but as it con- 
tains much vinous fpirit, it may injure the general health with- 
out previoufly inducing leannefs. Perhaps cryftals of tartar" 
might fucceed better ufed daily in water at meals. 
The moft efficacious method of reducing the quantity of the 
fat I fufpedt may be by the ufe of the tinfture of digitalis in 
fmall quantity, as twenty or thirty drops twice a day, as direct- 
ed in Article IV. 2. 3. 7. As the effeCt of this medicine, when 
given in greater quantity, as in forty drops twice or thrice a day 
in hydrothorax or general anafarca,evidently confifts in weaken- 
ing the natural actions of the ftomach, perhaps by previoufly 
ftimulating that vifcus too violently ; in confequence the heart 
and arteries aft lefs powerfully from their fympathy with the 
ftomach ; and the capillary veflels, and abforbents, act more 
powerfully in confequence of the lefs expenditure of fenforial 
power by the inert aftion of the heart and arteries ; and will 
consequently abforb the accumulated fat from the cellular mem- 
brane, as explained in Supplement I. 12. 10. 
18. Splenis tumor. Swellings of the fpleen, or in its vicinity, 
are frequently preceived by the hand in intermittents, which are 
called Ague-cakes, and feem owing to a deficiency of abforption 
in the affefted part. 
Mr. Y , a young man about twenty-five years of age, 
who lived intemperately, was feized with an obftinate intermit- 
tent, which had become a continued fever with ftrongpulfe, at- 
tended with daily remiffion. A large hard tumour on the left 
fide, on the region of the fpleen, but extending much more 
downward, was fo diftinddy preceptibie, that one feemed to get 
one's 96 
DISEASES 
Class I. 2. 3. ip# 
ene's fingers under the edge of it, much like the feel of the brawn 
or fhield on a boar's (boulder. He was repeatedly bled, and 
purged with calomel, had an emetic, and a blitter on the part, 
without diminidiing the tumour ; 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 to- 
wards the end of his life he fuffcred much from ulcers on his 
legs, and died about fixty, of general debility ; like many others 
who live intemperately in refpect to the ingurgitation of fer- 
mented 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 endangering his life, there is reafon to believe it was 
(imply occafioned by deficient abforption, and not by more en- 
ergetic adlion of the veffels which conftitute the fpleen. See 
ClafsII. i. 2. 13. 
M. M. Vencfedlion. Emetic, cathartic with calomel; then 
forbentia, chalybeates, Peruvian bark. 
19. Genu tumor albu/. White fwelling of the knee, isowing 
to deficient abforption of the lymphatics of the membranes in- 
cluding the joint, or capfular ligaments, and fometimes perhaps 
of the gland which fecretes the fynovia; and the ends of the bones 
are probably affected in confequence. 
1 law an inftance, where a cauftic had been applied by an 
empyric on a large white fwelling of the knee, and was told, that 
a fluid had been difeharged from the joint, which became an- 
chylofed, 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 ex- 
ternally are recommended. Bark, animal charcoal, as burnt 
fponge, opium in fmall dofes. Fritftion with the hand. Four 
or fix leeches applied on or beneath the knee alternately with the 
blifters, and a cupping glafs put over the wounds made by the 
leeches are much recommended. 
20. Broncbocelc. Swelled throat. An enlargement of the 
thyroid glands, faid to be frequent in mountainous countries, 
where river water is drunk, which has its fource 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 fubject to this difeafe, but whether 
more fo than other populous towns, I can not determine ; certain 
it C/ ASS I. 2. 3. 21. 
OF IRRITATION. 
97 
it is, that they chiefly drink the water of the Derwent, which 
arifes in a mountainous country, and is very frequently blacken- 
ed as it pafles through the morafles near its fource ; and is gen- 
erally of a darker colour, and attended with a whiter foam, than 
the Trent, into which it falls ; the greater quantity and white- 
nefs of its froth I fuppofe may be owing to the vifcidity com- 
municated to it by the colouring matter. The lower parts bf 
the town of Derby might be eafily fupplied with fpring water 
from St. Alkmond's well ; or the whole of it from the abun- 
dant fprings near Bowbridge : the water from which might be 
conveyed to the town in hollow bricks, or clay-pipes, at no very 
great expence, and might be received into frequent refervoirs 
with pumps to them ; or laid into the houfes. 
M. M. Twenty grains of burnt fponge with ten of nitre made 
with mucilage into lozenges, and permitted to diflblve flowly un- 
der the tongue twice a day, is aflerted to cure in a few months ; 
perhaps other animal charcoal, as candle-fnufls, might do the 
fame. 
I have directed in the early ftate of this difeafe a mixture of 
common fait and water to be held in the mouth, particularly 
under the tongue, for a few minutes, four or fix times a day for 
many weeks, which has fometimes fucceeded, the fait and water 
is then fpit out again, or in part fwallowed. Externally vinegar 
of fquills has been applied, or a mercurial plaftcr, or fomentations 
of acetated ammoniac ; or ether. Some empyrics have applied 
cauftics on the bronchocele, and fometimes, I have been told, 
with fuccefs ; which (hould certainly be ufed where there is 
danger of fuflbeation 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 hedtic fever fupervened with colliquative 
fweats ; but I do not know the final event of either of them. 
De Haen affirms the cure of branchocele to be effected by 
flowers of zinc, calcined egg-fhells, and fcarlet-cloth burnt to- 
gether in a clofe crucible, which was tried with fuccefs, as he 
affured me, by a late lamented phyfician, my friend, Dr. Small 
of Birmingham ; who to the cultivation of modern fciences add- 
ed the integrity of ancient manners ; who in clearnefs of head, 
and benevolence of heart, had few equals, perhaps no fuperiors. 
2i. Scrofula. King's evil is known by tumours of the lym- 
phatic glands, particularly of the neck. The upper lip, and di- 
vifion of the noftrils are fwelled, with a florid countenance, a 
fmooth ikin, and a tumid abdomen. Cullen. The abforbed flu- 
ids in their courfe to the veins in the fcrofula are arrefted in the 
lymphatic or conglobate glands ; which fwell, and after a great 
length of time, inflame and fuppurate. Materials of a peculiar 
Vol. II. O kind, 98 
DISEASES 
Class I. 2.. 3* 21* 
kind, as the variolous and venereal matter, when absorbed in a 
wound, produce this torpor, and confequent inflammation of 
thofe lymphatic glands, where they firft arrive, as in the axilla 
and groin. There is reafon to fufpedl, that the tonfils frequent- 
ly become inflamed, and fuppurate from the matter abforbed 
from carious teeth ; and I faw a young lady, who had both the 
axillary glands fwelled, and which fuppurated ; which was believ- 
ed to have been caufed by her wearing a pair of new green gloves 
for one day, when fhe had perfpired much, and was much ex- 
haulled and fatigued by walking 5 the gloves were probably dyed 
in a folution of verditer. 
Thefe indolent tumours of the lymphatic glands, which con- 
ftitute the fcrofula, originate from the inirritability of thofe 
glands; which therefore fooner fall into torpor after having 
been ftimulated too violently by fome poifonous material; as 
the mufclcs of enfeebled people fooner become fatigued, and 
ceafe to a€l, when exerted, than thofe of ftronger ones. On the 
fame account thefe fcrofulous glands are much longer in acquir- 
ing increafe of motion, after having been ftimulated into inac- 
tivity, and either remain years in a Rate of indolence, or fup- 
purate with difficulty, and fometimes only partially. 
The difference between fcrofulous tumours, and thofe before 
defcribed, confifts in this j that in thofe either glands of differ- 
ent kinds were difeafed, or the mouths only of the lymphatic 
glands were become torpid ; whereas in fcrofula the conglobate 
glands themfelves become tumid, and generally fuppurate after 
a great length of time, when they acquire new fenfibility. 
See Seft. XXXIX. 4. 5. 
Thefe indolent tumours may be brought to fuppurate fome- 
times by paffing elearic ffiocks through them every day for two 
or three weeks, as I have witneffed. It is probable, that the al- 
ternate application of fnow or iced water to them, till they be- 
come painfully cold, and then of warm flannel or warm water, 
frequently repeated, might reftore their irritability by accumula- 
tion of fenfonal power; and thence either facilitate their difper- 
fion,or occafion them to fuppurate. See Clafs II. r. 4. 13. 
This difeafe is very frequent amongft the children of the poor in 
large towns, who are in general ill fed, ill lodged, and ill clothed ; 
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. 1. 2. 5. Scrofulous ulcers are 
difficult to heal, which is owing to the deficiency of abforption 
on their pale and flabby furfaces, and to the general inirritability 
of the fyltem. See Clafs L 1. 3. 13. 
M. M. Plentiful Class I. 2. 3. 22. 
OF IRRITATION. 
99 
M. M. Plentiful diet of flcfli meat and vegetables with fmall 
beer. Opium, from a quarter of a grain to half a grain twice 
a day. Sorbentia. Tincture of digitalis, thirty drops twice a 
<lay. Externally fea-bathing, or bathing in fait and water, one 
pound to three gallons, made warm. The application of Peru- 
vian bark in fine powder, feven parts, and white lead (cerufla), 
in fine powder one part, mixed together and applied on the ul- 
cers in dry powder, by means of lint and a bandage, to be renew- 
ed every day. Or very fine powder of calamy alone, lapis ca- 
laminaris. If powder of manganefe ? See Clefs II. i. 4. 13. 
22. Scirrhus. After the abforbent veins of a gland ceafc to 
perform their office, if the fecerning arteries of it continue to 
act fome time longer, the fluids are pufhed forwards, and Hag- 
nate in the receptacles or capillary veflels of the gland ; and the 
thinner part of them only being refumed by the abforbent fyfiem 
.of the gland, a hard tumour gradually fucceeds ; which contin- 
ues like a lifelefs mafs, till from fome accidental violence it gains 
fenfibility, and produces cancer, or fuppurares. Of this kind 
are the feirrhus glands of the breafts, of the lungs, of the mefen- 
tery, and the fcrofulous tumours about the neck and the bron- 
chocele. 
Another feat of feirrhus is in the membranous parts of the 
fyfiem, as of the return inteRinum, the urethra, the gula or 
throat; and of this kind is the veruca or wart, and the clavus pe- 
dum, or corns on the toes. A wen fometimes arifes on the back 
of the neck, and -fometimes between the (houlders; and by dif- 
tending the tendinous fafeia produces great and perpetual pain. 
M. M. Mercurial ointment. Cover the part with oiled filk. 
Extirpation. Electric (hocks through the tumour, /in iflue 
into the fubftance of the wen. Opium. Ether externally. 
23. Scirrhus reChi intejiini. Scirrhus of the rectum. A 
feirrhus frequently affects a canal, and by contracting its diam- 
eter becomes a painful and deplorable difeafe. The canals thus 
obHructed are the reCtum, the urethra, the throat, the gall-duCls, 
and probably the excretory ducts of the lymphatics, and of oth- 
er glands. 
The feirrhus of the reCtum is known by the patient having 
pain in the part, and being only able to part with liquid feces, 
and by the introduction of the finger ; the fwelled part of the 
telline is fometimes protruded downwards, and hangs like a 
valve, fmooth and hard to the touch, with an aperture in the 
centre of it. See a paper on this fubject by J. Sherwin. Me- 
moirs of a London Medical Society, Vol. II.' p. 9. 
M. M. To take but little folid food. Aperient medicines. 
Introduce 100 
DISEASES 
Class I. 2. 3. 24. 
Introduce 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 contracted 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 thick- 
nefs 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 ufed to comprefs bleeding internal piles. See 
Clafs I. 2. i. 6. Rub mercurial ointment on the fphinder ani 
every night for a fortnight. 
May not thisdifeafe be cured by lunar cauftic applied on the 
end of a peflary or bougie, in the fame manner as ufed by J. 
Hunter, and fince by Mr. E. Home, in ftri&ures of the urethra j 
■when, on introducing the finger, a kind of membranous valve can 
be diftinguiffied rather than an extenfive feirrhus or induration. 
See the next article, 
24. Scirrhus urethra. Scirrhus of the urethra. The paflage 
becomes contracted by the thickened membrane, and the urine is 
forced through with great difficulty, and is thence liable to dif- 
iend the canal behind the ftricture ; till at length an aperture is 
made, and the urine forces its way into the cellular membrane, 
making large finufes. This fituation fometimes continues many 
ynonths, or even years, and fo much matter is evacuated after 
making water, or at the fame time, by the action of the mufcles 
in the vicinity of the finufes, that it has been miftaken for an in- 
creafed fecretion from the bladder, and has been erroneoully 
termed a catarrh of the bladder. See a paper by Dr. R. W. 
Darwin in the Medical Memoirs. 
M. M. Diftend the part gradually bv catgut bougies, which 
by their compreffion will at the fame time diminifh the thicknefs 
of the membrane, or by bougies of elaftic gum, or of horn boil- 
ed foft. The patient fhould gain the habit of making water 
dlowly, which is a matter of the utmoft confequence, as it pre- 
vents the diftention and confequent rupture, of that part of the 
urethra, which is between the ftritlure and the neck of the blad- 
der. 
When there occurs an external ulcer in the perinteum, and 
the urine is in part difeharged that way, the difeafe cannot be 
miftaken. Oiherwife, from the quantity of matter, it is gener- 
ally fuppofed to come from the bladder, or proftate gland ; and 
the urine, which efcapes from the ruptured urethra, mines its 
way amongft the mufcles and membranes, and the patient dies 
tabid, owing to the want of an external orifice to difeharge the 
matter. See Clafs II. 1. 4. 11. 
Mr. Home ClassI. 2. 3. 25. 
OF IRRITATION. 
101 
Mr. Home has publifhed a very ingenious and ufeful work,en- 
titled, a Didertation on Strictures of the Urethra, in which he has 
recorded many cafes fuccefsfully treated by lunar cauftic, infert- 
ed in the end of a bougie, and applied to the contracted part of 
the urethra, fo as to deftroy the ftriCture. 
From the form of the cavity of the urethra, taken by injecting 
wax into it, there appears naturally to exiit a kind of valve im- 
mediately behind the bulb of the urethra, which when the penis 
is ereCt, (huts up the orifice, and prevents the regurgitation of 
the femen into the bladder during the aCtion of the accelerator 
mufcles in the aCt of its expulfion ; and this natural conftriction 
or valve appears generally to be the firft feat of ftriCture. 
Above the bulb, about two or three inches from the orifice 
of the glans, the cavity of the urethra appears alfo lefl'ened ; and 
in fome cafes the orifice of the very extremity appears lefs than 
other parts of the canal ; thefe parts are therefore more contract- 
ed during the emiffio feminis, and add to its velocity at its exit ; 
and are thence more liable to feirrhofity or ftriCture. And by 
fome obfervations, Mr. Home has fhewn, that a fympathy exifts 
between the ftriCtures of thefe parts ; and that the more for- 
ward ftriCtures are frequently produced in confequence of that 
behind the bulb ; and finds it neceflary to deftroy them all, by 
frequent application of the cauftic. 
By the ufe of which, (which was firft propofed by Wifeman, 
firft applied by John Hunter, and fo greatly improved by Mr. 
Home) the lives of great numbers are rendered happy, who oth- 
erwife gradually perifh by a molt painful and hopelefs malady. 
25. Scirrhus oefophagi. A feirrhus of the throat contracts the 
paffage fo as to render the fwallowing of folids impracticable, and 
of liquids difficult. It affeCts patients of all ages, but is probably 
moft frequently produced by fwallowing hard angular fubftan- 
ces, when people have loft their teeth ; by which this membrane 
is over-diftended, or torn, or otherwife injured. 
M. M. Put milk into a bladder tied to a canula or catheter; 
introduce it paft the ftriCture, and prefs it into the ftomach. 
Diftend the ftriCture gradually by a fponge-tent faftened to the 
end of whalebone, or by a plug of wax, or a fpermaceti candle, 
about two inches long; which might be introduced, and left 
there with a firing only fixed to it to hang out of the mouth, to 
keep it in its place, and to retract it by occafionajly ; for which 
purpofe the firing muft be put through a catheter or hollow pro- 
bang, when it is to be retraCted. Or laftly, introduce a gut 
fixed to a pipe ; and then diftend it by blowing wind into it. 
The fwallowing a bullet with a firing put through it, to retract 
it ou the exhibition of on emetic, has alfo been propofed. Ex- 
ternally, 102 
DISEASES 
Class I. 2. 3. 25, 
ternally, mercurial ointment has been much recommended. 
Poultice. Oiled filk. Clyilers of broth. Warm bath of broth. 
Transfufion of blood into a vein three or four ounces a day ? 
See Clafs III. i. i. 15. 
I directed 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 ftricture in her throat; af- 
ter a few days, her fpirits funk, and fhe refufed to ufe it further, 
and died. Above thirty years ago, I propofed to an old gentle- 
man, whofe throat was entirely impervious, to fupply him with 
a few ounces of blood daily from an afs, or from the human an- 
imal, who is Hill more patient and tractable, in the following 
manner : To fix a filver pipe about an inch long to each extrem- 
ity 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 ; and when the gut was quite 
full, and the blood running through the other filver end, to in- 
troduce that end into the vein of the patient upwards towards 
the heart, fo as to admit no air along with the blood. And 
lartly, to fupport the gut and filver ends on a water-plate, fill- 
ed with water of ninety-eight degrees of heat, and to meafure 
how many ounces of blood was introduced by palling the finger, 
fo as to comprefs the gut, from the receiving-pipe to the deliv- 
ering-pipe ; and thence to determine how many gut-fulls were 
given from the healthy perfon to the patient. Mr. con- 
iidered a day on this propofal, and then another day, and at 
length 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 wilhed rather to pro- 
ceed to the end of that journey, which he was now fo near, and 
which he mud at all events focn go, than return for fo fliort a 
time." He lived but a few days afterwards, and feemed quite 
carelefs and eafy about the matter. See Suppl. I. 14. 4. 
A difficulty of fwallowing food, and a rejection foon after, of 
the whole or a part of it, may be often owing probably to a fort 
of valve made by a part of the membrane which lines the oefoph- 
agus ; and may thus refemble ftrictures of the urethra; which 
Jail are fo frequently cured by the nice application of lunar cauf- 
tic, as defcribed by Mr. Everard Home, in his Treatife on Stric- 
tures of the Urethra. Suppofe a thick bougie, made of linen 
fpread with adhefive plafter, and rolled up, was armed at the 
end with a bit of lunar cauftic, with which the llricture of the 
oefophagus could be touched repeatedly, till an unarmed bougie 
could be palled readily into the ftomach ? Could fuch a valve be 
burft. Class I. 2. 3. 26. 
OF IRRITATION. 
103 
burft, or inverted, by pouring a pound or two of crude mercury 
into the oefophagus ? 
26. LaPleorum inirritabilitas. Inirritability of the lafteals is 
defcribed in Sect. XXVIII. under tire name of paralyfis of the 
latlcals ; but as the word paralyfis has generally been applied to 
the difobedience of the mufcles to the power of volition, the 
name is here changed to inirritability of the la&eals, as more 
chara<Sleriftic of the difeafe. 
27. Lympbaticorum inirritabilitas. The inirritability of the 
cellular and cutaneous lymphatics is defcribed in Se£t. XXIX. 
1. and in Clafs I. 2. 3. The inirritability of the cutaneous 
lymphatics generally accompanies anafarca, and is the caufe of 
the great thirft in that malady. At the fame time, the cellular 
lymphatics a£t with greater energy, owing to the greater de- 
rivation of fenforial power to them, in confequence of the lefs 
expenditure of it by the cutaneous ones; and hence they abforl* 
the fat, and mucus, and alfo the thinner parts of the urine^ 
Whence the great emaciation of the body, the muddy fediment^ 
and the fmall quantity of water in this kind of dropfy. 
ORDQ 104 
DISEASES 
Class I. 2. 4. 
ORDO II. 
Decreafcd Irritation. 
GENUS IV. 
frith decreafed Actions of other Cavities and Membrants. 
Many of the difeafes of this genus are attended with pain^ 
and with cold extremities, both which ceafe on the exhibition 
of wine or opium ; which (hews, that they originate from de- 
ficient action of the affefted organ. Thefe pains ate called ner- 
vous or fpafmodic, are not attended with fever, but are fre- 
quently fueceeded by convulfions and madnefs ; both which be- 
long to the clafs of volition. Some of them return at periods, 
and when thefe can be afcertained, a much lefs quantity of opi- 
um will prevent them, than is neceffary to cure them, when they 
are begun ; as the veflels are then torpid and inirritable from 
the want of fenforial power, till by their inaction it becomes 
again accumulated. 
Our organs of fenfe, properly fo called, are not liable to pain 
from the abfcnce of their appropriated ftiinuli, as from darknefs 
or fdence ; but the other fenfes, which may be more properly 
called appetites, as thofe by which we perceive heat, hunger, 
third:, lull, want of frelh air, are affected with pain from the de- 
feat or abfence of their accultomed ftimuli, as well as with pleaf- 
ure by the pofleflion of them ; it is probable that fome of our 
glands, the fenfe or appetite of which requires or receives fome- 
thing from the circulating blood, as the pancreas, liver, teftes, 
proftate gland, may be affected with aching or pain, when they 
cannot acquire their appropriated fluid. 
Wherever this defeat of ftimulus occurs, a torpor or inaction 
of the organ enfues, as in the capillaries of the Ikin, when expo- 
fed to cold ; and in the glands, which fecretc the gaftric juice, 
when we are hungry. This torpor however, and concomitant 
pain, which are at firft owing to defeat of ftimulus, are after- 
wards induced by other aflbciations or catenations, and confti- 
tute the beginning of ague-fits. 
It muft be further obferved, that in the difeafes of pain with- 
out fever, the pain is frequently not felt in the part where the 
caufe of the difeafe refides ; but is induced by fympathy with a 
diftant part, the irritability or fenfibility of which 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 Class I. 2. 4. 1. 
07 IRRITATION. 
105 
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- 
duct, which enters the duodenum immediately under the pit of 
the fiomach ; 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 ge- 
nus are confequences of the inactivity of the organ ; and, as they 
do not occafion other difeafes, fhould be clafled according to 
their proximate caufe, which is, defective irritation ; there are 
neverthelefs other pains from defeft of ftimulus, which produce 
convulfions, and belong to Clafs III. 1. I. ; and others, which 
produce pains of fome diftant part by aflbciation, and belong to 
Clafs IV. 2.2. 
SPECIES. 
I. Sitis. Thirft. The fenfes of third and of hunger feem 
to have this connexion, that the former is fituated at the upper 
end, and the latter at the lower end of the fame canal. One 
about the pharinx, where the oefophagus opens into the mouth, 
and the other about the cardia ventriculi, where it opens into the 
ftomach. The extremities of other canals have been fhewn to 
poflefs correfpondent fenfibilities, or irritabilities, as the two ends 
of the urethra, and of the common gall-duct. 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 fyftem ; it then wants its proper ftimulus. 
In the fame manner a want of the ftimulus of more folid mate- 
rials at the other end of the canal, which terminates in the liom- 
ach, produces hunger ; as mentioned in Sett. XIV. 8. The 
proximate caufes of both of them therefore conhlt in deficient 
irritation, when they are confidered as pains ; becaufe thefe pains 
are in confequence of the inactivity of the organ, according to 
the fifth law of animal caufation. Sedt. IV. 5. But when they 
are confidered as defires, namely, of liquid or folid aliment, 
their proximate caufe confifts in the pain of them, according to 
the fixth law of animal caufation. So the profcimate caufe of 
the pain of coldnefs is the inactivity of the organ, and perhaps 
the confequent accumulation of fenforial power in it; but the 
pain itfelf or tlie confequent volition, is the proximate caufe of the 
Vol. II. P fhuddermg 106 
DISEASES 
Class I. 2. 4. 2v 
Juddering and gnafhing the teeth in cold fits of intermittent fe- 
vers. See Clafs I. 2. 2. i. 
Thirft may be divided into two varieties, alluding to the re- 
mote 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 increafcd 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 unaccuf- 
tomed to falted meat, is of this kind ; the increafed affion of the 
cutaneous veflels diflipates fo much of our fluids by infenfible 
perforation, as to require above two quarts of water to reftore 
the fluidity of the blood, and to wafh the fait out of the fyilem. 
See Art. III. 2. 1. 
M. M. Coldwater. Vegetable acids. Warm bath. 
The remote caufe of fitis frigida, or cold thirft, is owing to 
the inadlion of the cutaneous, pulmonary, urinary, and cellular 
abforbents ; whence 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 thirft exifts in dropfies, and in the cold fits of inter- 
mittents. The defire of fluids, like that of folids, is liable to ac- 
quire periods, and may therefore readily become difeafed by in- 
dulgence in liquids grateful to the palate. 
Of difeafed thirft, the moft common is either owing to defeat 
of the action of the numerous abforbent veflels on the neck of 
rhe bladder, in which the patient makes much paleifh water; or 
to the defective abforption of the ficin and lungs, in which the 
patient makes but little water, and that high-coloured, and with 
fediment. In both the tongue and lips arc liable to become very 
dry. The former in its greateft degree attends diabetes, and the 
latter anafarca. 
M. M. Warm water, warm wine, warm bath. Opium. 
Cold bath. Iced water. Lemonade. Cyder. 
2. E/uries. Hunger has been fancilully afcribed to the fides 
of the itomach rubbing againft 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 feme time; but, on the contrary, coldnefs 
not heat is attendant on hunger ; which evinces, that like thirft 
it is owing to the inaffivity of the membrane, which ft the feat 
of it; while the abundant nerves about the cardia ventriculi, 
and Class I. 2. 4. 3. 
OF IRRITATION. 
107 
and the pain of hunger being felt in that part, gives great reafon 
to conclude, that it is there fituated. 
The fenfe of hunger as well as of thirft, is liable to acquire 
habits in refpeCt to the times of its returning painfulnefs, as well 
as in refpedt to the quantity required to fatiate its appetency, 
and hence may become difeafed by indulgence, as well as by 
want of its appropriate ftimulus. Thole who have been accuf- 
tomed to diftend their llomach by large quantities of animal and 
vegetable food, and much potation, find a want of didention, 
when the llomach is empty, which occafions faintnefs, and is 
miftaken for hunger, but which does not appear to be the fame 
fenfation. I was well informed, that a woman near Litchfield, 
who eat much animal and vegetable food for a wager, affirmed, 
that fince diflending her llomach fo much, (he had never felt 
herfelf fatisfied with food ; and had in general taken twice as 
much at a meal, as Cne had been accuftomed to, before ihe eat 
fo much for a wager. 
3. Naufea fcca. Dry naufea. Con fills in a quiefcence or 
torpor of the mucous or falivary glands, and precedes their in- 
verted motions, defcribed in naufea humida, Clafs I. 3. 2. 3. 
In the fame manner as ficknefs of the llomach is a quiefcence 
of that organ preceding the action of vomiting, as explained in 
SeCl. XXXV. 1. 3. This is fometimes induced by difagreeable 
drugs held in the mouth, at other times by difguftfu] ideas, and 
at other times by the ailbciation of thefe actions with tlrcffe of 
the llomach ; 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. Talleful food. A blifter. Warm bath. 
4. JEgritudo ventriculi. Sioknefs of llomach is produced by 
the quiefcence or inactivity of that organ, as is explained in 
Sedt. XXXV. 1.3. It confifts in the flate between the ufual 
periftaltic motions of that organ, in the digeftion of our aliment 
and the retrograde motions of it in vomiting ; for it is evident, 
that the direct motions of it from the cardia to the pylorus mult 
flop, before thofe in a contrary direction can commence. This 
ficknefs, like the naufea above defcribed, is fometimes produced 
by difguftful ideas, as when nafty objects are feen, and nafty 
llories related, as well as by the exhaullion of the fenforial pow- 
er by the ftimulus of fome emetic drugs, and by the defect of 
the production of it, as in enfeebled drunkards. 
Sicknefs may likewife confift in the retrograde motions of the 
lymphatics of the llomach, which regurgitate into it 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 fen* 
. fations- 108 
DISEASES 
Class I. 2. 4. 5. 
fations, though they have acquired but one name; as one of them 
attends hunger, and the other repletion ; though either of them 
may poffibly be induced by afTociation with naufeous ideas. 
M. M. A blifter on the back. An emetic. Opium. Crude 
mercury. Covering the head in bed. See Sect. XXV. i.6. Ciafs 
IV. I. i. 2. and 3. 
5. Cardialgia. Heartburn originates from the inactivity of 
the ftomach, whence the aliment, inflead of being fubdued by 
digeftion, and converted into chyle, runs into fermentation, pro-, 
ducing acetous acid. Sometimes the gaftric juice itfelf becomes 
io acid as to give pain to the upper orifice of the ftomach ; thefe 
acid contents of the ftomach, on falling on a marble hearth, 
have been fcen to produce an effervefcence on it. The pain of 
heat at the upper end of the gullet, when any air is brought up 
from the fermenting contents of the ftomach, is to be alcribed 
to the fympathy between thefe two extremities of the oefophagus 
rather than to the pungency of the carbonic gas, or fixed air j 
as the fenfation in fwallowing that kind of air in water is of * 
different kind. See Ciafs I. 3. 1. 3. and IV. 2. 2. 5. 
M. M. This difeafe arifmg from indigeftion is often very per- 
tinacious, and affliding ; and attended with emaciation of the 
body from want of fufficient chyle. As the faliva fwallowed 
along with our food prevents its fermentation, as appears by the 
experiments of Pringle and Macbride, fome find confiderable re- 
lief by chewing parched wheat, or maftic, or a lock of wool, fre- 
quently in a day, when the pain occurs, and by fwallowing the 
faliva thus effufed ; a temporary relief is often obtained from an- 
tiacids, or aerated alkaline water, Seltzer water, calcareous earths, 
alkaline faits made into pills with foap, foap alone, tin, milk, 
bitters. More permanent ufe may be had from fuch drugs as 
check fermentation, as acid of vitriol ; but ftill more permanent 
relief from fuch things as invigorate the digeftion, as a blifter on 
the back ; a due quantity of vinous fpirit and water taken 
regularly. Steel. Temperance. A fleep after dinner. A waift- 
coat made fo tight as flightly to comprefs the bowels and ftom- 
ach. A flannel fhirt in winter, not in fummer. A lefs quan- 
tity of potation of all kinds. Ten black peppcr-corns fwallow- 
ed after dinner. Half a grain of opium twice a day, or a grain. 
The food fhould confift of fuch things as do not eafily ferment, 
as flefh, fhel'-fifh, fea-bifeuit, toafted cheefe. I have feen toaft- 
ed cheefe brought up from the ftomach 24 hours after it had 
been fwallowed, without apparently having undergone any 
chemical change. See Ciafs II. 1. 3. 17. and IV. 1. 2. 13. 
It is probable that violent cardialgia is moft frequently owing 
to increafe of the quantity or acidity of the gaftric juice, rather 
than Class I. 2. 4. 6. 
OF IRRITATION. 
109 
than to the acetous acid produced by fermenting aliment; be- 
caufe in violent apepfy, as in low fevers, and total want of di- 
geftion, no meh violently ftrong or painful acidity occurs. See 
I. 3. 1. 3. See Anorexia Ii. 2. 2. I. And fecondly, becaufe 
in all thefe cafes, which have come under my eye, the difeafe 
was not increafed by vegetable food, or even by acid fruits, when 
•taken in their ufual quantity; and I have uniformly obferved, 
that the food which fuited the palate, and that water alone, or 
fmall wine and water, agreed with thefe patients better than 
ftronger mixtures of fpirit and water, efpecially when they were 
more agreeable to the palate. 
6. Arthritis Ventriculi. Sicknefs of the ftomach in gouty 
cafes is frequently a corifequence 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 ftomach with 
the fenfation of coldnefs, which they have called an ice-bolt, this 
is a primary affeCtion of the ftomach, and deftroys the patient 
in a few hours, owing to the torpor or inaction of that vifeus fo 
important to life. 
This primary gout of the ftomach, as it is a torpor of that 
vifeus, is attended with fenfation of coldnefs, and with real de- 
fcCt of heat in that part, and may thence be diftinguilhed from 
the pain occafioned by the paflage of a gall-ftone into the duod- 
enum, as well as by the weak pulfe, and cold extremities ; to 
which muft be added, that it afleCts thofe only, who have been 
long aflli&ed with the gout, and much debilitated by its numer- 
ous attacks. 
M. M. Opium. Vinous fpirit. Volatile alkali. Spice. 
Warmth applied externally to the ftomach by hot cloths or fo- 
mentation. 
7. (Alien jlatulenta. The flatulent colic arifes from the too 
great diftention of the bowel by air, and consequent pain. The 
caufe of this difeafe is the inactivity or want of' fufficiently pow- 
erful contraCtion 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 diftinguilhed, firft, from the pain occafioned by tire paf- 
fage of a gall-ftone, as that is felt at the pit of the ftomach, and 
this nearer the navel. Secondly, it is diftinguilhed from the 
colica faturnina, or colic from lead, as that arifmg from tLe tor- 
por of the liver, or of fome other vifeus, is attended with greater 
coldnefs, and with an aching pain ; whereas the flatulent colic 
being owing to diftention of the mufcles of the bowel, the pain 
is more acute, and the coldnefs lefs. Thirdly, it is diftinguilh- 
ed from inflammation of the bowels, or ileus, as perpetual vom- 
iting 110 
DISEASES 
Class I. 2. 4. 8. 
iting and fever attend this. Fourthly, it rs diftinguilhed from 
cholera, becaufe that is accompanied with both vomiting and di- 
arrhoea. And laitly, from the colica epileptica, or hyfteric col- 
ic, as that is liable to alternate with convulfion, and fometimes 
with infanity ; and returns by periods. 
M. M. Spirit of wine and warm water, one fpoonful of each. 
Opium one grain. Spice. Volatile alkali. Warm fomenta- 
tion externally. Rhubarb. 
8. Colica jaturnina. Colic from lead. The pain is felt about 
the navel, is rather of an aching than acute kind at firft, which 
increafes after meals, and gradually becomes more permanent 
and more acute. It terminates in paralyfis, frequently of the 
mufcles 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 difeafe is not well afeertain- 
ed ; it probably affects fome part of the liver, as a pale bluilh 
countenance and deficiency of bile fometimes attend or fucceed 
it, with confequent anafarca ; but it feems to be caufed imme- 
diately by a torpor of the inteftine, whether this be a primary or 
fecondary affedtjon, as appears from the conftipation of the 
bowels, which attends it ; and is always produced in confe- 
quence of the great ftimulus of lead previoufly ufed either inter- 
nally for a length of time, or externally on 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 (he was 
fond of cream, licked it from her finger. She was feized with 
the faturnine colic, and femi-paralytic wrifts, and funk from 
general debility. 
A feeble woman about forty years of agc,fprained her ancle, 
and bruifed her leg and thigh ; and applied by ill advice a folu- 
tion of lead over the whole limb, as a fomentation and poultice 
for about a fortnight. She was then feized with the colica fa- 
turnina, loft the ufe of her wrifts, and gradually funk under a 
general debility. 
There are various means by which lead finds its way into the 
fyftem ; in the cyder counties of this country this difeafe has 
been frequently almoft epidemic from the ufe of fome lead about 
their mills, or by the pernicious ufe of it to correct the acidity 
of weak cyder. This difeafe has been fo frequent in fome of the 
wine countries, that in France the punifhment of death is di- 
rected for thofc, who ufe lead to deftroy the acidity of wine. 
There is a bad cuftomin almoft all families and public houfes 
of wafhing out their bottles by putting a handful of (hot corns 
into them, and by (baking them about forcibly, by which the 
lead ClassI. 2. 4. 8. 
OF IRRITATION. 
111 
lead may in part adhere to the fides of the bottle, and become 
diflblved in the acid of the wine or cyder. Milk kept in %ad is 
highly pernicious, as in the inftance above related. Nor fhould 
coppers for brewing be edged at the top of them with lead, which 
is frequently done ; nor fhould flelh-meat be falted in leaden 
cifterns. Another way by which lead is liable to be taken into 
the ilomach is by broth, which is boiled in copper veflels 
tinned within. Now the lining of thefe veflels conltfts, I am 
well informed, of nearly half lead mixed with the tin ; which is 
very foluble in hot greafe. From this eaufe thofe, who live 
much on foups long boiled, as the French, are perpetually fub- 
jcCt to complaints of the itomach and inteftines. When a 
fauce-pan has been new tinned, if the finger be rubbed hard on 
it, it becomes black ; which is owing to the lead, which is mix- 
ed with the tin. Hence the broth for all Tick people fhould be 
boiled but a fhort time, and be immediately put into a china- 
bafon. 
In an ingenious pamphlet lately published by Mr. Clutterbuck, 
feveral cafes are given of the fuccefsful ufe of mercury in the 
conflipation, colic, and paralyfis of the wrifts, produced by lead. 
In feme of thefe patients a drachm of ftrong mercurial ointment 
was rubbed morning and night on the wriils, till the mouth be- 
came fore. In others calomel one grain was given daily with ol. 
ricini ; and in others a quarter of a grain ofhydragyrum muria- 
tum, fublimatc of mercury, was given three times a day with 
great apparent advantage. The author ingeniously afks, if 
fmall doles of feme preparation of lead might not be given inter- 
nally to counteract the ill effects fornetimes believed to rcfult 
from the too long ufe of mercury. On the Poifon of Lead, 
Bodfcy, Loud. See Clafs III. 2. 1. 4. 
The effect of metals in deftroying or preventing the acidity 
of wine or cyder, may be nicely obferved in attending to the 
colour of fyrup of violets ; which, if it ferments, is changed by 
the acid thus produced from blue to red : but if it be kept in a 
tin veflel, this does not occur ; as the acid is attracted by the 
metal producing an oxyde. Other metals are faid by M. Guy- 
ton, to have the fame effect in preferving the colour of fyrup 
of violets. 
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 ou the navel. Warm 
bath. The Itimuius of the opium, by reftoring to the bowel its 
natural irritability in this cafe of painful torpor, aflifts the aCtion 
of the cathartic. A clyfter of the fmoke of tobacco pulhed high 
up 112 
DISEASES 
Class I. 2. 4. 9. 
up and continued, or repeated frequently for an hour or two, or 
longed is faid to remove the pain, and totally to cure the difeafe. 
9. Tympanitis. Tympany confifts in an elaftic tumor of the 
abdomen, which founds on being ftruck. It is generally attend- 
ed 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 exchanged for water, and the tympa- 
ny becomes an afeites. 
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 percuflion on other parts of the 
bowels : but towards the end of fevers and efpecially in the 
puerperal fever, a diftention of the abdomen by air is generally 
a fatal fymptom, though the eafe, and often cheerfulnefs of the 
patient, vainly flatters the attendants. 
M. M. In the former cafe a clyfter-pipe unarmed may be in- 
troduced, and left fome time in the return, to take off the re- 
liftance of the fphincter, and thus difeharge the air, as it is pro- 
duced from the fermenting or putrefying aliment. For this 
purpofe, in a difeafe fomewhat fimilar in horfes, a perforation is 
made into the rectum on one fide of the fphincter ; through 
which fiftula the air, which is produced in fuch great excefs 
from the quantity of vegetable food which they take, when their 
digeftions are impaired, is perpetually evacuated. 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. 
10. Hypochondriacs. The hypochondriac difeafe confifts in 
indigeftion and confequcnt flatulency, with anxiety or want of 
pleafurable fenfation. When the action of the ftomach and 
bowels is impaired, much gas becomes generated by the ferment- 
ing or putrefeent aliment, and to this indigeftion is catenated 
languor, coldnefs of the (kin, and fear. For when the extremi- 
ties are cold for too long a time in fome weak conftitutions, indi- 
geftion is produced by direct fympathy of the Ikin and the ftom- 
ach, with confequcnt heartburn, and flatulency. The fame oc- 
curs, if the fkin be made cold by fear, as in riding over dan- 
gerous roads in winter, and hence converfely fear is produced 
by indigeftion or torpor of the ftomach by affociation. 
This difeafe is confounded with the fear of death, which is 
an infanity, and therefore of a totally different nature. It is al- 
fo confounded with the hyfleric difeafe, which confifts in the 
retrograde Class I. 2. 4. 11. 
OF IRRITATION. 
113 
retrograde, motions of the alimentary canals and oflome parts of 
the abforbent fyftem. 
The hypochondriafis, like chlorofis, is foinetimes attended 
with very quick pulfe ; which the patient feems to bear fo eafi- 
ly in thefe two maladies, that if any accidental cough attends 
them, they may be miftaken for pulmonary confumption ; which 
ft not owing primarily to the debility of the heart, but to its di- 
re<Sl fympathy with the acLlions of the ftomach. 
M. M. Blifter. A phfter of Burgundy pitch on the abdo- 
men. Opium a grain twice a day. Rhubarb fix grains every 
night. Bark. Steel. Spice. Bath-water. Sicfta, or deep 
after dinner. Uniform hours of meals. No liquor itronger 
than fmall beer, or wine and water. Gentle exercife on horfe- 
back in the open air uniformly perfifted in. See Cardialgia, L 
2- 4- 5- 
11. Cephalaa idiopathica. Head-achs, which are attended 
with inflammation, are termed phrenitis, defcribed in Clafs II. 
I. 2. 3. Thofe, whiqh are not attended with inflammation, 
may be divided into fuch as affe€l the whole head, to which the 
word cephalasa is applied, and into fuch as affeft one fide of the 
head only at a time, which is termed hemicrania. The former 
of thefe may be divided into ccphalaea idiopathica, and cephalrea 
fympathetica; and the latter into hemicrania idiopathica, and 
hemicrania fympathetica. Befides thefe there exifts a cephalsa 
fonxiiiofa, a cephalaea fyphilitica, and a cephaltea hydrapica. 
The idiopathic head-ach frequently attends the cold paroxyfm 
of intermittents ; afRiiTs inebriates the day after intoxication ; 
and many people who remain too long in the cold bath. In all 
which cafes there is a general inaction of the whole fyftem, and 
as thefe membranes about the head have been more expofed to 
the variations of heat and cold of the atmofphere, they arc more 
liable to become affected fo far as to produce fenfation, than oth- 
er membranes; which are ufually covered either with clothes, 
or with mufcles, as mentioned in Sedl. XXXIII. 2. 10. 
The promptitude of the membranes about the fcalp to fym- 
pathize with thofe of other parts of the fyftem is fo great, that 
this cephalaea without fever, or quicknefs of pulfe, is more fre- 
quently a fecondary than a primary difeafe, and then belongs to 
Clafs IV. 2. 2. 7. The hemicrania, or partial head-ach, I be- 
lieve to be ahnoft always a difeafe from affbeiation; though it 
is not iinpofiible, but a perfon may take cold on one fide of the 
head only. As fome people by fitting always on the fame fide 
of the fire in winter are liable to render one fide more tender 
than the othyr, and in confequence more fubject to pains, which 
have been erroneoufly termed rheumatic. 
Vol. II. M. M. The 114 
DISEASES 
Class I. 2. 4. 1 & 
M. M. The method of cure confifts in rendering the habit 
more robuft, by gentle conftant excrcife in the open air, flefh 
diet, fmall beer at meals with one glafs of wine, regular hours 
of reft and rifmg, and of meals. The clothing about the head 
ihould be warmer during deep than in the day; becaufe at that 
time people are more liable to take cold ; that is, the membra- 
nous parts of it are more liable to become torpid ; as explained 
in Sect. XVIII. 15. In refpect to medicine, two drams of va- 
lerian root in powder three or four times a day are recommend- 
ed by Fordyce. The bark. Steel in moderate quantities. Ari 
emetic. A blifter. Opium, half a grain twice a day. Decay- 
ed teeth fhould be extracted, particularly fuch as either ache or 
are ufelefs. Cold bath between 60 and 70 degrees of heat. 
Warm bath of 94 or 98 degrees every day for half an hour du- 
ring a month. See Clafs IV. 2. 2. 7. and 8. and IV. 2. 4. 3. 
A folution of arfenic, about the fixteenth part of a grain, is re- 
ported to have great effect in this difeafe. It fhould be taken 
thrice a day, if it produces no griping or ficknefs, for two or 
three weeks. A medicine of this kind is fold under the name 
of taftelefs ague-drops ; but a more certain method of afcer- 
taining the quantity is delivered in the preceding Materia Med- 
ica, Art. IV. 2. 6. 8. Five grains of the powdered leaves of 
Atropa Belladonna are recommended in fome foreign publica- 
tion to be repeated once in two days, and are faid to be fuccefs- 
ful in the dolor faciei, or hemicrania idiopathica. 
Cephalaa [omnioja. Head-ach from fleep. This difeafe has 
not been defcribed,! believe,by any writer, though it affects fome 
invalids for years. After fome hours of fleep the patients arc 
afllidied with diftreffmg dreams, and awake with pain of the 
head, which continues for fome time after they awake ; and fo 
circumftanced furnifhes the diagnoftic fymptom of this fpecies of 
cephalsea. 
The paroxyfms or repetitions of many difeafes are liable ter 
commence in fleep, fome from the increafe of fenfibility during 
fleep, as explained in Secft. XVIII. 5. and 15. of the firft part of 
this work, as thole of fome epilepfies, of fome afthmas, and of 
the gout. Other difeafes are liable to return during fleep from 
the debility of the pulmonary circulation, or of pulmonary ab- 
forption, as in fomnus interruptus, Clafs I. 2. I. 3. and in in- 
cubus, or night-mare, Clafs III. 2. 1. 13. and in haemoptoe 
venofa, Clafs I. 2. 1. 9. and probably in the humoral afthma, 
Clafs II. 1. 1. 8. 
The cephalsea fomniofa I fufpeft to bear the fame analogy to 
the hydrocephalus internus, as I believe the afthma humorale to 
bear to the anafarca pulmonum; and to confrft in this cirqum- 
ftance. Class I. 2. 4. 12. 
OF IRRITATION. 
115 
ftance, that during fleep in the cephalaea fomniofa a temporary 
congeftion of fluid may occur in fome part of the brain, as a 
permanent one occurs in the hydrocephalus internus ; in the 
fame manner as I believe in the afthma humorale a temporary 
congeftion of fluid occurs in fome part within the cheft, and a 
permanent one in the anafarca of the lungs. 
M. M. The patient fhould fleep with his head raifed high 
on many pillows, and wear drawers to prevent his flipping down 
in bed. 2. He fhould fleep on a hardifh bed, or mattrefs, to 
prevent his fleqping too profoundly, or too long together. 3. 
Or he may be wakened, after having flept a certain number of 
hours by an alarum clock. 4. Any carious teeth fhould be ex- 
traded, as the matter from putrid bones, fwallowed with the 
faliva, weakens the fyftem by its effect on the ftomach. 5. 
Twenty drops of faturated tindure of digitalis may be taken 
twice or thrice a day for three or four weeks. 6- Half a grain 
of opium and fix grains of rhubarb fhould be taken every night 
for many weeks or months. 7. Oxygen gas may be refpired 
daily for a time, till its effect can be known. 
12. Hemicrania idiopathica. This difeafe is defcribed by Sau- 
vage, under the name of trifmus dolorificus, or tic douloureux, in 
Clafs IV. ord. 1. gen. 2. fpec. 14. of his elaborate work. But 
the word trifmus is an improper name, as no fixed fpafm like the 
locked jaw exifts in this malady, nor any ftridor dentium, or con- 
vulfion of the mufcles of the face, or trick, attends thefe patients 
in the few cafes which I have witnefled, though this may poffi- 
bly occur occalionally astheconfequence of difagreeable fenfation, 
or to relieve it. I fuppofe the word tic douloureux is a vulgar 
French exprefllon, like megrim in Englilh. 
The cauie of this afflicting difeafe is yet unknown. As it 
does not appear to fympathize with a difeafed tooth, like the he- 
micrania fympathetica, defcribed in Clafs IV. 2. 2. 8. I fuf- 
peCl the caufe to confift in a difeafed ftate of the nerve itfelf, or 
of its covering or theca, and to refemble the fciatica frigida, 
mentioned below; or to refemble fome of thofe pains, which are 
fucceeded or relieved by epileptic convulfions, defcribed in Clafs 
III. 1. 1. 8. and that it thus differs from the hemicrania fym- 
pathetica ; as in this the caufe of the difeafe, and the feat of the 
pain, exift in the fame place. 
One cafe, which occurred to me long ago, of this difeafe, was 
of an elderly gentleman, Mr. W. of Litchfield, who had long 
loft all his teeth ; the pain began chiefly about the cheek-bone, 
and extended fometimes to the ala of the nofe, and to other parts 
of the face on the fame fide ; on examining the gums of the up- 
per jaw, there was no fufpicion of any ftump of a decayed tooth 
remaining 116 
DISEASES 
Class I. 2. 4. 12. 
remaining in the alveolar precedes ; nor was there any reafon to 
fufpeCt any difeafe of the maxillary finus. Whence this did not 
appear to be any kind of fympathetic hemicrania. He was af- 
flicted with it for many years till his death. 
The cafe of Mr. B. a gentleman between 20 and 30 years of 
age, whom I was lately concerned for, in this difeafe, is well 
worthy a minute defcription ; I (hall therefore copy a letter, which 
I wrote on his cafe to Mr. Cruiklbank, and an anfwer I receiv- 
ed fome time after from his partner, Mr. Leigh Thomas, who I 
hope will publifh the fuccefsful method of cure, with adapted 
prints. 
To Mr. Cruik/bank. 
Sir, Derby, Dec. 1798. 
Mr. Bofworth, whofe cafe I wifh to remind you of, confulted 
you fome time ago in London, and I believe that you then told 
him, that his head-ach was owing to a difeafe of the third branch 
of the fifth pair of nerves. He came under my care at Derby a 
few weeks ago, and complained of much pain about the left 
cheek-bone ; I fufpedted the antrum maxillare might be difeafed, 
and as the fecond of the dentes molarcs had then been lately ex- 
tradied, I defired a perforation might be made into the antrum, 
which was done by Mr. Hadley, of this town, and kept open 
for two or three days without advantage. Afterwards, bv fric- 
tion about the head and neck with mercurial unguent, he was 
copioufly falivated for a few days, and had another tooth extradi- 
ed by his own defire, and had laftly an incifion made by Mr. 
Hadley, fo as to divide the artery near the centre of the car next 
the cheek, hoping to divide a branch of the afledled nerve, but 
without fuccefs j and internally, opiates in large quantity were 
given, when the pain was exceedingly violent, the bark alfo was 
ufed for a time in large quantity without effedt. 
On attending, as much as I could, to his fen fations when in 
pain, he feems to exprefs the commencement of the periods of 
pain to exill about the part of the left cheek before the middle 
of the ear ; and then draws his finger from thence to the fore 
part of the lower jaw fometimes, and to the ala of the nofe on 
that fide ; and at other times he draws his finger from the fame 
part of the cheek before the ear upwards to the orbit of the eye, 
and from thence downwards, a little way on the nofe •, and alfo 
he complains of pain under his tongue on the fame fide. The 
pain returns many times in an hour on forne days, and continues 
many minutes, during which he feems to firetch and exert his 
arms, and appears to have a tendency to epileptic actions ; and 
his Class I. 2. 4. 12. 
OF IRRITATION 
117 
his life is thus miferable to himfelf, and uncomfortable for his 
friends to witnefs. 
I write this to you to beg that you will acquaint Mr. Bof- 
worth, whether you think you could divide by incifion the dif- 
eafed nerve ; as he is willing to undergo fuch an operation, if 
you think it practicable, as I believe it to be the only means, 
which promifes to cure him ; and have therefore advifed him 
again to apply to you ; and if you think this can be done with 
effect, he defigns to wait on you in London. 
I am, fir, &c. 
E. Darwin. 
The following anfwer of Mr. Leigh Thomas (hews the difeafe 
to have exifted in every branch of the affected nerve. 
Sir, Leicejhr-fquare, May, 
About the middle of December laft, you did Mr. Cruiklhank 
the favour to write him an account of Mr. Bofworth, a young 
gentleman, fome time under your care at Derby, with a painful 
affection of the nerves of his face. The patient foon after came 
to town in a much worfe ftate, than you defcribed him to be at 
that time; as the pain was extremely acute andalmoft unremit- 
ting, opiates, which he had been in-the habit of taking occafion- 
ally, afforded him now little or no relief, though taken to the 
quantity of fix tea-fpoonfuls of laudanum at a time. After pay- 
ing every attention to the cafe, your fuggeftion of the neceffity 
of dividing the difeafed nerve appeared obvious. 
As the pain was felt more acute in the left ala of the nofe, and 
the upper lip of the fame fide, we were induced to divide the 
fecond branch of the fifth pair of nerves, as it paffes out at the in- 
fraorbital foramen. He was inftantly relieved in the nofe and 
lip ; but towards night the pain from the eye to the crown of 
the head became more acute than ever. Two days after, we 
vrere obliged to cut through the firft branch palling out at the 
fupra-orbital foramen ; this afforded him the like relief with the 
firft. On the fame day the pain attacked, w'ith great violence, 
the lower lip on the left fide, and the chin; this circumftance 
induced the neceffity of dividing the third branch* paffing out at 
the foramen mentale. During the whole period, from the firft 
divifion of the nerves, he had frequent attacks of pain on the 
fide of the tongue ; thefe however difappeared on divifion of the 
laft nerve. 
Mr. Cruikffiank performed the above operations, but being 
particularly engaged at this time with ledlures and other bufi- 
nefs, he now gave up the cafe to my management. The patient 
was evidently bettered by each operation; ft ill the pain was very 
fev^re, 118 
DISEASES 
Class I. 2. 4. 12/ 
fevere, palling from the ear under the zygoma towards the note 
and mouth, and upwards round the orbit. This route proved 
pretty clearly, that the portio dura of the auditory nerve was al- 
fo affefted ; at leaf! the uppermoft branch of the pes anferinus. 
Before I proceeded to divide this, I was willing to try the efFeft of 
arfenic internally, and he took it in fufficient quantity to excite 
naufea and vertigo, but without perceiving any good effect. 
I could now truft only to the knife to alleviate his mifery, as 
the pain routed the orbit was become moft violent; and therefore 
intercepted the nerve by an incifion acrofs the fide of the nofe, 
and alfo made fome fmaller incifions about the ala nafi. To di- 
vide the great branch lying below the zygomatic procefs, I found 
it necefTary to pafs the fcalpel through the mafleter mufcle, till 
it came in contact with the jaw-bone, and then to cut upwards; 
this relieved him as ufual. Then the lower branch was affect- 
ed, and alfo divided : then the middle branch running under the 
parotid gland. In cutting this, the gland was confequently di- 
vided into two equal parts, and healed tolerably well after a co- 
pious difcharge of faliva for feveral days. 
I hoped and expected, that this laft operation would have ter-, 
minated his fufferings and my difficulties; but the pain ftill af- 
fected the lower lip and fide of the nofe, and upon coughing, or 
fwallowing, his mifery was dreadful. This pain could only arife 
from branches from the fecond of the fifth pair paffing into the 
cheek, and lying between the pterygoideus internus mufcle, and 
the upper part of the lower jaw. The fituation of this nerve 
rendered the operation hazardous, but after fome attempts it 
was accomplifhed, and this day he fet out for Leicefterfhire per* 
fectly reftored. 
I am, fir, &c. 
Leig-h Thomas. 
Since I wrote the above, I have feen an equally deplorable and 
inftructive cafe, of hemicrania idiopathica, of an elderly perfon, 
defcribed by Dr. Haighton, under the name of tic douloureux, 
with an equally fuccefsful cure, by dividing the difeafed nerves. 
Medical Records and Refearches. Cox, London. 
Two cafes of tic douloureux are related by a Dr. Watfon, in 
the Recueil periodique de Medecine, Paris, 1798, tom. IV. 
•which are faid to have fubmitted to mercurial fridiions and warm 
bathing. Thefe pains were probably venereal fymptoms, as the 
author fufpects; but would perfuade us again to try the ufe of 
mercury, though it failed in the cafe above related, and efpecially 
as it fometimes fucceeds in the hemicrania fympathetica, as men- 
tioned in Clafs IV. 2. 2. 8. Five grains of the powdered leaf of 
belladonna Class I. 2. 4. 13. 
OF IRRITATION. 
119 
belladonna are faid to have been fuccersful. See Cephalaea idio. 
pathica. 
13. Odontalgia. Tooth-ach. The pain has been erroneoufly 
fuppofed, where there is no inflammation, to be owing to fome 
acrid matter from a carious tooth ftjmulating the membrane of 
the alveolar procefs into violent adtion and confequent pain ; 
but the effeA 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. 
Firil, becaufe the pain precedes the decay of the tooth in re- 
gard to time, and is liable to recur, frequently for years, without 
certainly being fucceeded at laft by a carious tooth, as I have 
repeatedly obferved. 
Secondly, becaufe any ftimulant drug, as pyrethrum, or oil of 
cloves, applied to the tooth, or ether applied externally to the 
cheek, is fo far from increafing the pain, as it would do if the 
pained membrane already adted too llrongly, that it frequently 
gives immediate relief like a charm. 
And thirdly, becaufe the torpor, or deficient action of the 
Kiembrane, which includes the difeafed tooth, occafions the mo- 
tions of the membranes moft connected with it, as thofe of the 
cheek and temples, to aft with lefs than their natural energy ; 
and hence a coldnefs of the cheek is perceived cafily 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 affected fide. 
This coldnefs of the cheek in common tooth-ach evinces, that 
the pain is not then caufed by inflammation ; becaufe in all in- 
flammations fo much heat is produced in the fecretions of new 
veflels and fluids, as to give heat to the parts in the 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 membrane, excited by the ac- 
tivity of the fenforial power of fenfation ; which previoufly exift- 
ed in its paflive ftate in the painful torpid membrane. See 
Odontitis, Clafs II. 1.4. 7. and IV. 2. 2. 8. 
M. M. If the painful tooth be found, venefe&ion. Then a 
cathartic. 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, this {hould be widened within by an inftru- 
ment, and then flopped with leaf-gold, or leaf-lead ; but the tooth 
fhould be extracted, 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 with- 
out giving any additional pain; but this experiment requires 
great 120 
DISEASES 
Class I. 2. 4. ij* 
great caution left any of the folution fliould touch the tongue or 
gums. 
Much cold and much heat are equally injurious to the teeth, 
which are endued with a fine fenfation of this univerfal fluid. 
The beft method of preferving them is by the daily ufe of a brufli, 
which is not very hard, with warm water and fine charcoal du ft. 
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 fliould 
be blown off, and it fliould be immediately reduced to fine pow- 
der in a mortar, and kept clofe flopped in a phial. It takes away 
the bad fmell from decayed teeth, by waffling the mouth with 
this powder diffufed in water, immediately. The putrid fmell 
of decaying ftumps of teeth may be deftroyed for a time by wafli- 
ing the mouth with a weak folution of alum in water. If the 
calcareous cruft upon the teeth adheres very firmly, a fine pow- 
def of pumice-ftone may be ufed occafionally, or a tooth-inftru- 
ment. 
Acid of fea-falt, much diluted, 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 ipots in teeth be cut out ? Does 
the enamel grow again when it has been perforated or abraded ? 
Otalgia. Ear-ach fometimes continues many days without ap- 
parent inflammation, and is then frequently removed by filling 
the ear with laudanum, or with ether ; or even with warm oil, 
or warm water. See Claf.IL 1. 4. 8. This pain of the ear, 
like hemicrania, is frequently ''he confequence of affociation with 
a difeafed tooth ; in that cale the ether fliould be applied to the 
cheek over the fufpected tooth, or a gram of opium and as much 
camphor mixed togetlrcr, and applied to the fufpected tooth. In 
this cafe the otalgia belongs to the fourth clafs of difeafes. 
14. Pleurodyne 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 reftridted to thofe pains which exift only when 
the parts are in motion, and which have been left after inflam- 
mation of them ; as defcribed in Clafs I. 1. 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 weak- 
ened the atlion of the veflels compofing fome membranous part, 
as, like the cold head-ach, it is attended with prefent debility ; 
in one patient, a boy about ten years old, it was attended with 
daily convulfions, and was fuppofed to have originated from 
worms. The difeafe is very frequent, and generally withstands 
Ute ufe of bliiters on the part; but in fome cafes I have known 
I it Class I. 2. 4. 14. 
OF IRRITATION. 
121 
it removed by eleilric (hocks repeated every day for a fortnight 
through the alfefted fide. 
Pains of the fide may be fometimes occafioned by the adhe- 
Con of the lungs to the pleura, after an inflammation of them ; 
or to the adhefion of fome abdominal vifeera to their cavity, or 
to each other; which alfo are more liable to affect ladies from 
the unnatural and ungraceful preflure of tight ftays, or by fitting 
or lying too long in one pofture. But in thefe cafes the pain 
fhould be more of the fmarting, than of the dull kind. 
M. M. Ether. A blifter. A plafter of Burgundy pitch. 
An iflue or feton on the part. Electric (hocks. Friclion on 
the part with^oil and camphor. Loofe drefs. Frequent change 
of pofture both in the day and night, internally, opium, vale- 
rian, bark. 
15. Sciatica frigida. Cold fciatica. The pain along the 
courfe of die fciatic nerve, from- the hip quite down to the top 
of the foot, when it is not attended with fever, is improperly' 
termed either rheumatifm or gout; as it occurs without inflam- 
mation, 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 fafeia which contains them. The theory 
of Cotunnius, who believed it to be a dropfy of the (heath of the 
nerve, which was compreflcd by the accumulated fluid, has not 
been confirmed by diffedlion. The difeafe feems to confift of a 
torpor of this (heath of the nerve, and the pain feems to be in 
Confequence of this torpor. See Oafs II. 1.2. 17. 
M. M. Venefedtion. A cathartic. And then one grain of 
calomel and one of opium every night for ten fucceflive nights. 
And a blifter, at the fame time, a little above the knee-joint on 
the outfide of the thigh, where the fciatic nerve is not fo deep 
fcated. Warm bath. Cold bath. Cover the limb with oiled 
filk, or with a plafter-bandage of emplaftrum de minio. 
16. Lumbago frigida. Cold lumbago. When no fever or 
inflammation attends this pain of the loins, and the pain exifts 
without motion, it belongs to this genus of difeafes, and refem. 
bles the pain of the loins in the cold fit of ague. As thefe mem- 
branes are extenfive, and more eafily fall into quiefcence, either 
by fympathy, or when they are primarily affected, this difeafe 
becomes very affli&ing, and of great pertinacity. See Clafs II. 
1. 2. 17. 
M. M. Venefe&ion. A cathartic. Iflues on the loins, 
Adhefive plafter on the loins. Blifter on the os facrum. Warm 
bath. Cold bath. Remove to a warmer climate in the winter. 
Loofe drefs about die waift. Friction daily with oil and cam- 
phor. 
Vol. II. R 17. Lffisvalgia 122 
DISEASES 
Glass I. 2. 4; 17, 
17. Hferalgia frigida. Cold pain of the uterus preceding or 
accompanying menftruation. It is attended with cold extremi- 
ties, want of appetite, and other marks of general debility. 
M. M. A clyfter of half a pint of gruel, and 30 drops of 
laudanum ; or a grain of opium and fix grains of rhubarb every 
night. To fit over warm water, or go into a warm bath. 
18. Proflalgia frigida. Cold pain at the bottom of the rec- 
tum previous to the tumor of the piles, which fomctimes extends 
by fympathy 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 extremity of the alimentary canal, or to the 
cbftruftion of the blood in its paiTage through the liver, when 
that vifcus is aftefted, and its consequent delay in the veins of 
the return, occafioning tumours of them, and dull fenfations of 
pain. 
M. M. Calomel. A cathartic. Spice. Clyfter, with 30 
drops of laudanum. Sitting over warm water. If chalybeates 
after evacuation ? See Clafs I. 2. 3. 23. and I. 2. r. 6. 
19. Vftca fellete inirritabilitas. The inirritability of the gall- 
bladder probably occafions one kind of icterus, or jaundice ; 
which is owing to whatever obftrufts the paffage of bile into the 
duodenum. The jaundice of aged people, and which attends 
Ibme fevers, is believed to be moft frequently caufed by an irri- 
tative palfy of the gall-bladder ; on which account the bile is 
not prefl'ed from the cyft by its contraction, as in a paralyfis of 
the urinary bladder. 
A thickening of the coats of the common bile-duft by inflam- 
mation or incrcafed aftion of their veflels fo as to prevent tire 
paffage of the bile into the inteftine, in the fame manner as the 
membrane, which lines the noftriis, becomes thickened in ca- 
tarrh fo as to prevent the paffage of air through them, is proba- 
bly another frequent caufe of jaundice, efpecially of children j 
and generally ceafes in about a fortnight, like a common catarrh, 
without the aid of medicine ; which has given rife to the char- 
after, which charms have obtained in fomc countries for curing 
the jaundice of young people. 
The fpilhtude of the bile is another caufe of jaundice, as men- 
tioned in Clafs I. 1. 3. 8. This allo in children is a difeafe of 
little danger, as the gall-duftsare diftenfible, and will the eafier 
admit of the exclufion of gall-ftones ; but becomes a more feri- 
cais difeafe in proportion to the age of the patient, and his habits 
of life in refpeft to fpirituous potation. 
A fourth caufe of jaundice is the comprefiion of the bile-duft 
by the enlargement of an inflamed or feirrhous liver; this attends 
thoft Class I. 2. 4. 20. 
OF IRRITATION. 
123 
thofe who have drunk much fpirituous liquor, and is generally 
fucceeded by dropfy and death. 
M. M. Repeated emetics. Mild cathartics. Warm bath. 
Electricity. Bitters. Then heel, which, when the pain and 
inflammation are removed by evacuations, adts like a charm in 
removing the remainder of the inflammation, and by promoting 
the abforption of the new veflels or fluids; like the application 
of any acrid eye-water at the end of ophthalmia ; and thus the 
thickened coats of the bile-dudl become reduced, or the enlarge- 
ment of the liver leflened, and a free paflage is again opened for 
the bile into the inteftine. Ether with yolk of egg is recom- 
mended, as having a tendency to diflblve infpiffated bile. And 
a decodtion of madder is recommended for the fame purpole 5 
becaufe the bile of animals, whofe food was mixed with madder, 
was found always in a dilute ftate. Aerated alkaline water, or 
Seltzer water. Raw cabbage, and other acrid vegetables, as 
water-crefles, muftard. Horfes are faid to be fubjedt to infpif- 
fated bile, with yellow eyes, in the winter feafon, and to get well 
as foon as they feed on the fpring grafs. 
The larged bile-ftone I have feen was from a lady, uho had. 
■parted with it fome years before, and who had abftained above 
-ten years from all kinds of vegetable diet to prevent, as (he 
fuppofed, a colic of her ftomach, which was probably a pain 
of the biliary dudt; on refuming the ufe of fome vegetable diet, 
Ihe recovered a better ftate of health, and formed no new bilious 
concretions. 
A ftrong aerated alkaline water is fold by J. Schweppe, No. 
■8, King-ftreet, Holborn. See Clafs I. i. 3. 10. 
20. Pelvis renalis inirritabilitas. Inirritability of the pelvis 
of the kidney. When the nucleus of a ftone, whether it be in- 
fpiffated mucus, 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 apportions of indurated animal matter, in the 
fame manner as the ftone of the bladder. This is the general 
caufe of haemorrhage from the kidney ; and of obtufe pain in it 
on exercife ; or of acute pain, when the ftone advances into the 
ureter. See Clafs I. 1. 3. 9. 
ORDO 124 
DISEASES 
Class I. 2. 5. 
ORDO II. 
Decreafed Irritation. 
GENUS V. 
Decreafed Action of the Organs of Serf. 
SPECIES. 
I. Ztultiiia inirritabilitas. Folly from inirritability. Dulneis 
,of perception. When the motions of the fibrous extremities 
of the nerves of fenfe are too weak, to excite fenfation with luf- 
ficient quicknefs and vigour. The irritative ideas are neverthe- 
lefs performed, though perhaps in a feeble manner, as fuch peo- 
ple do not run againil a poft, or walk into a well. There are 
three other kinds of folly; that from deficient fenfation, from 
deficient volition, and from deficient aflbciation, as will be men- 
tioned in their places. In delirium, reverie,and fleep, tire pow- 
erof perception is abolifhed from other caufes,. 
2. Vifus imminntus. Diminifhed vifion. In our approach to 
old age our vifion becomes imperfect, not only from the form of 
the cornea, which becomes lefs convex, and from its decreafed 
tranfparency mentioned in Clafs I. i. 3. 14 ; but alfo from the 
decreafed irritability of the optit 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 albugi- 
nea in thefe fevers is frequently feen during fleep ; which is ow- 
ing to the inirritability of tire retina to light, or to the general 
parefis of mufcular action, and in confeqence to the lefs contrac- 
tion of the fphinfler of the eye, if it may be fo called, at that 
time. 
In fome eyes there is an inaptitude to adapt themfelves to 
the perception of objects at different diffances, which I fuppofc 
may be owing to the inirritability of thofe mufcular fibres, which 
conffitute the ciliary procefs, fo well defcribed and explained by 
Dr. Porterfield, and in thp Scots Medical Eflays, and fa elegant- 
ly feen in a differed eye. It was formerly believed, and has in- 
deed lately been again pretended, that the focus of the cryftal- 
line humour was adapted to objects at different diftances by a 
change of the fhape of the whole eye by the action of the exter- 
nal mufcles, which are inferted into the tunica albuginea, and 
give motion to it in every direction : but in anfwer to this may be 
obferved, Class I. 2. 5. 3. 
OF IRRITATION. 
125 
obferved, that if the common aftions of the mufcles affe&edthe 
focus of the eye, every motion of the eye-ball, when we attend 
to objects at any diftance, muft difturb our vifion. At the fame 
time though it is poffible, that a violent action of all the mufcles 
together, fo as to counter-balance each other, and keep the eye 
motionlefs, as when we look painfully at a very diftant object, 
may in fome degree affc£t the form of it; yet that the contrac- 
tion of the ciliary procefs perpetually adapts the focus of the cryf- 
talline lens to the diftance of the retina is not to be dilputed. 
There have been inftances of fome, who could not diftinguifh 
certain colours; and yet whofe eyes, in other refpe&s, were not 
imperfect. Philof. Tranfadi. Which feems to have been 
owing to the want of irritability, or the inaptitude to aftion, of 
fome clafles of fibres which compofe the retina. Other perma- 
nent defects depend on the difeafed Hate of the external organ. 
Olafs L 1.3. 14.1. 2. 2. 13. IV. 2. 1. 11. 
3. Mufca wlitantes. Dark fpots appearing before the eyes, 
and changing their apparent place with the motions of the eyes, 
are owing to a temporary defect of irritability of thofe parts of 
the retina, which have been lately expofed to more luminous ob- 
jedls than the other parts of it, as explained in Sedt. 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 tli£ 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 fboner exhaufted 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 fitu- 
ation, till fome antagonift mufcles are exerted to retract them ; 
whence, when any one is much exhaufted by exercife, or by want 
of fleep, or in fevers, it is eafier to let the fibres of the retina re- 
main in their laft fituation, after having been ftimulated into 
contraction, than to exert any antagonift 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 power is expended during the day in the perpetual ac- 
tivity 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 cur arms, which are fupplied with nerves of 
about the fame diameters. From hence we may conclude, that 
the light fhould be kept from patients in fevers with debility, to 
prevent the unneceffary exhauftion of the fenforial power. 
And 126 
DISEASES 
Class I. 2. 5. 4. 
And that on the fame account their rooms fhould be kept filent 
as well as dark ; that they fhould be at reft in a horizontal pof- 
ture; and be cooled by a blaft of cool air, or by walhing them 
with cold water, whenever their ficins are warmer than natural. 
4. Strsibijmus. Squinting is generally owing to one eye be- 
ing lefs perfect 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 infects inclofed in it in the frontal finus 
on one fide, turn towards the affected fide; becaufe the vifion 
on that fide, by the preffure of the hydatide, becomes lefs per- 
fect ; and tire difeafe being recent, the animal turns round, ex- 
pecting to get a more diftindl view of objects. 
In the hydrocephalus internus, where both eyes are not be- 
come infenfible, the patient fquints with only one eye, and views 
objects 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 on both tides of the brain ; in fuch circumftances, 
as the patients I believe never recover as they are now treated, 
might it not be advifeable to perforate the cranium over the ven- 
tricule of the affected fide ? which might at leaft give room and 
ftimulus to the affected part of the brain ? 
M. M. If the fquiuting has not been confirmed by long habit, 
and one eye be not much worfe than the other, a piece of 
gauze ftretched on a circle of whale-bone, to cover the beft eve 
in fuch a manner as to reduce the diftin&nefs of vifion of this 
eye to a fimilar degree of imperfection with the other, fhould be 
worn fome hours every day. Or the better eye fhould be total- 
ly darkened by a tin cup covered with black filk for fome hours 
daily, by which means the better eye will be gradually weak- 
ened by the want of ufe, and the worfe eye will be gradually 
flrengthened by ufmg it. Covering an inflamed eye in chil- 
dren for weeks together, is very liable to produce fquinting, for 
the fame reafon. 
5. Amaurojis. Gutta ferena. Is a blindnefs from the inirritabil- 
ity of the optic nerve. It is generally efteemed a palfy of the nerve, 
but fhould rather be deemed the death of it, as paralyfis has gener- 
ally been applied to a deprivation only of voluntary power. This 
is a difeafe of dark eyes only, as the cataract is a difeafe of light 
eyes only. At the commencement of this difeafe, very minute 
electric (hocks fhould be repeatedly paffed through the eyes ; fuch 
as may be produced by putting one edge of a piece of filver the 
fize.of 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 Class I. 2. 5. 6. 
OF IRRITATION. 
127 
and then repeatedly bringing tbeir exterior edges into contact, 
by which means very final! electric fparks become vifible in the 
eyes. 
- Mrs. T had for fome weeks complained of imperfedt 
fight. For the laft fortnight ihe could not in lefs thati a minute 
fpell out a fmgle word in a large print. Her eyes black, and the 
pupils large. Very flight eledtric (hocks, notfparks, were palled 
through the forepart of her forehead twice a day, and the zinc' 
and fdver pencils as mentioned below were ufed many times a 
day. She took valerian and columbo internally, and regained her 
light very perfectly in about three weeks. 
I ufed in the above cafe a more convenient and efficacious 
method of galvanifm by employing two rods, one of them of zinc 
about the fize of a writing pencil, and the other a filver pencil- 
cafe about the fame fize ; and by putting the end of the zinc 
rod in contact with the external corner of one eye, and the end 
of the filver pencil-cafe in contact with the external corner of the 
other eye, and then repeatedly making the other ends touch each: 
other ; fparks will be vifible in the eyes both at the time of con- 
tact and at the time of feparation of the two rods. This experi- 
ment was published by Volta fince the former one by Galvani. 
See Sedf. XIV. 5. of Vol. I. 
A foreign phyfician, profeflbr Arnemann, has lately recom- 
mended the production of vertigo in gutta ferena, as he fays, to 
accumulate more blood in the head. If this fhould be really 
found of advantage the patient might lie on a large mill-ftone, 
which might be fuffered to turn flowly, but a very great velocity 
of the whirling ftone might occafion fleep, apoplexy, and death. 
See Supl. I. 15.7. 
M. M. Minute electric {hocks. 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. Er- 
rhines, fo as to induce violent fneezing twice a day for a week. 
6. Auditus imminutus. Diminished hearing. Deafnefs is a 
frequent fymptom in thofe inflammatory or fenfitive fevers with 
debility, which are generally called putrid ; it attends the general 
ftupor in thofe fevers, and is rather efteemed a falutary fign, as 
during this ftupor there is lefs expenditure of fenforial power. 
In fevers of debility without inflammation, called nervous fe- 
vers, I fufpeft deafnefs to be a bad fymptom, arifing, like the di- 
lated pupil, from a partial paralyfis of the nerve of fenfe. See 
Clafs IV. 2. 1. 15. 
Nervous fevers are fuppofed by Dr. Gilchrift to originate from 
a congeftion of ferum or water in fome part of the brain, as many 
of the fymptoms are fo fimilar to thofe of hydrocephalus inter- 
nus, 128 
DISEASES 
Class I. 2. 5. 6. 
nus, in which a fluid is accumulated in the ventricles of the 
brain ; on this idea the inactivity of the optic or auditory nerves 
in thefe fevers may arife from the comprefiion of the effufed fluid ; 
while the torpor attending putrid fever may depend on the me- 
ninges of the brain being thickened by inflammation, and thus 
comp refling it ; now the new veflels, or the blood, which thick- 
ens inflamed parts, is more frequently re-ablbrbed, than the ef- 
fufed fluid from a cavity j and hence the ftupor in one cafe is 
lefs dangerous than in tire other. 
In inflammatory or fenfitive fevers with debility, deafnefs may 
fometimes arife from a greater fecretion and abforption of the 
ear-wax, which is very limilar to the bile, and is liable to fill the 
meatus auditorius, when it is too vifcid, as bile obftruds the gall- 
duCls. 
M. M. In deafnefs without fever, Dr. Darwin applied a cup- 
ping-glafs on the ear with good efteCt, as defcribed in Phil. 
Tranf. Vol. LXIV. p. 348. Oil, ether, laudanum, dropped into 
the ears. Errhines. Electricity. 
If ether when dropped into the ears be not very pure, it is lia- 
ble bo give pain j it has otherwife the property both of diflblving 
the ear-wax, and of Rimnlating torpid parts into their accuftom- 
ed aCtivity, as is known from its relieving pains from inactivity 
of the pained part, as tooth-ach and head-ach. If unreCtified 
ether be diftilled from the oxyde of manganefe, the oxygen dif- 
engaged from the manganefe isaflerted to convert the fulphurous 
into fulphuric acid, which is then not difpofed to rife in diftilla- 
tion. Journal de Phyfique, April, 1798. And that this is the 
great fecret of procuring pure ether, and it will then give no pain 
on being dropped into the ear. See Art. IE 2. 3. 
Deafnefs is believed fometimes to arife from obftruflion of the 
Euftachian tubes, which communicate from the fauces to the in- 
ternal ear behind the tympanum 5 if this obftrudion be flight, as 
by infpiflated mucus, it has been propoled to injeCt the Eufta- 
chian tubes ; and it is faid, that if the deaf perfon frequently 
has recourfe to the Ample aCiion of fhutting his mouth and of 
clofing his noftrils by pinching them together with his finger and 
thumb, and then forcibly endeavours to prefs the breath through 
his nofe, that air will pafs into the internal ear through the Eu- 
ftachian tubes, condenfing that air which exifts behind the tym- 
panum ; which the patient will himfelf be fenfible of, by a fen- 
fation of found in his ears. And that this has relieved many. 
Where an eruption occurs in the ear, followed by a dry fcale 
or fcab at the bottom of the meatus auditorius, a folution of 
corrofive fublimate of mercury, hydrargyrus muriatus, about one 
grain to an ounce of water, dropped into the ear, frequently has 
been ClassI. 2. 5. 7. 
OF IRRITATION. 
129 
been ufed with advantage by Dr. Darwin of Shrewlbury. See 
Clafs IV. 2. i. 15. 
7. OlfaEtus imminutus. Inactivity of the fenfe of fmelh 
From our habits of trailing to the art of cookery, and not exam- 
ining our food by the fmell as other animals do, our fenfe of 
fmell is lefs perfect than theirs. See Seft. XVI. $. Clafs IV. 2. 
1. 16. 
M. M. Mild errhines. 
8. Gujlus imminutus. Want of tafte is very common in fevers', 
owing frequently to the drynefs or fcurf of the tongue, or exter- 
nal organ of that fenfe, rather than to any injury of the nerves of 
taile. See Clafs I. 1. 3. 1. IV. 2. f. 16. 
M. M. Warm fubacid liquids taken frequently. 
9. TaRus imminutus. IN umbnefs is frequently complained of 
in fevers, and in epilepfy, and the touch is fometimes impaired 
by the drynefs of the cuticle of the fingers. See Clafs IV. 2.1. 16. 
When the fenfe of touch is impaired by the compreflion of the 
nerve, as in fitting long with one thigh eroded over the other, 
the limb appears larger, when we touch it with our hands, 
which is to be afcribed to the indiitinCtnefs of the fenfation of 
touch, and may be explained in the fame manner as the appar- 
ent largenefs of objects feen through a mill. In this lalt cafe 
the minute parts of an object, as fuppofe of a dillant boy, are 
feen lefs diftinCtly, and therefore we inilantly conceive them to 
be further from the eye, and in confequence that the whole fub- 
tends 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 fhould be, judging from vifible 
ciicumhances ; we therefore conceive, that fomething interve- 
ned between the object and the fenfe, for it is felt as if a blank- 
et, 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 ac- 
quired habits of one part of it acting in the vicinity of another 
part of it. Thus if the middle finger be eroded 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 laflly, the fenfe of touch is liable to be deceived 
by preconceived ideas ; which we believe to be excited by exter- 
nal objefls, even when we are awake. It has happened to me 
more than once, and I fuppofe to moil others, to have put my 
hands into an empty bafon, (landing in an obfeure corner of a 
room, to wafh them, which I believed to contain cold water, and 
have inilantly perceived a fenfation of warmth, contrary to that 
which 1 expelled to have felt. 
Vol. II. S In 130 
DISEASES 
Class I. 2. 5. 10. 
In fome paralytic affeflions, and in cold fits of ague, the fen* 
fation of touch has been much impaired, and yet that of heat has 
remained. See Seft. XIV. 6- 
M. M. FriCtion alone, or with camphorated oil, warm bath. 
Ether. Volatile alkali and water. Internally, fpice, fait. In* 
citantia. Secernentia. 
i o. Stupor. The ftupor, which occurs in fevers with debili- 
ty, is generally efteemed 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 produdion of fen- 
forial power, or an accumulation of it in the torpid parts of the 
fyftem, which is not improbable, becaufe fuch a production of 
it continues during Heep, to which ftupor is much allied, there 
is ftill further reafon for believing it to be a favourable fymptom 
in inirritable' fevers; and that much injury it often done by 
blifters and other powerful- ftimuli to remove the ftupor. See 
Sect. XII. 7. 8. and XXXHI. 1.4. 
Dr. Blane, in his Croonian Lecture on mufcular motion, for 
1788, among many other ingenious obfervations and deductions, 
relates a curious experiment on falmon, and other fifli, and which 
he repeated upon eels with fimilar event. 
" If a fifh, immediately upon being taken out of the water, is 
ftunned by a violent blow on the head, or by having the head 
crufhed, the irritability and fweetnefsof the mufcles will be pre- 
ferved much longer, than if it had been allowed to die with the 
organs of fenfe entire. This is fo well known to filhermen, 
that they put it in practice, in order to make them longer fufcep- 
tible of the operation called crimping. A falmon is one of the 
fifti leaft 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 fliew vifible irritability for more than twelve hours 
afterwards. 
Dr. Blane afterwards well remarks, that, " in thofe difordcrs 
in which the exercife of the fenfes is in a great meafure deftroy- 
ed, or fufpended, as in the hydrocephalus, and apopleClic palfy, 
it happens, not uncommonly, that the appetite and degeftion are 
better than in health." Class I. 3. 1. 
OF IRRITATION. 
131 
ORDO III. 
Retrograde Irritative Motions. 
GENUS I. 
Of the Alimentary Canal. 
The retrograde motions of our fyftem originate either from 
defect of ftimulus, or from defeat of irritability. Thus ficknefs 
is often induced by hunger, which is a want of ftimulus ; and 
from ipecacuanha, in which laft cafe it would feem, that the 
ficknefs was induced after the violence of the ftimulus was aba- 
ted, and the confequent torpor had fucceeded. Hence, fpice, 
opium, or food, relieves ficknefs. 
The globus hyftericus, falivation, diabetes, and other inver- 
fions 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, opium, fteel, and flelh diet 5 that is, by 
any additional ftimulus. 
When the longitudinal mufcles are fatigued by long aftion, or 
are habitually weaker than natural, the antagonift mufcles re- 
place the limb by ftretching it in a contrary direction ; and as 
thefe mufcles.,have had their ablions aflbciated in fynchronous 
tribes, their actions ceafe together. But as the hollow mufcles 
propel the fluids, which they contain, by motions aflbciated in 
trains ; when one ring is fatigued from its too great debility, and 
brought into retrograde a&ion ; the next ring, and the next, 
from its aflbciation in train falls into retrograde adtion. Which 
continue fo long as they are excited to a<ft, like the tremors of 
the hands of infirm people, fo long as they endeavour to acl. 
Now as thefe hollow mufcles are perpetually ftimulated, thefe 
retrograde actions do not ceafe as the tremors of the longitudi- 
nal mufcles, which are generally excited only by volition. 
Whence the retrograde motions of hollow mufcles depend on 
two circumftances, in which they differ from the longitudinal 
mufcles, namely, their motions being aflbciated in trains, and 
their being fubjebt to perpetual ftimulus. For further eluci- 
dation of the caufe of this curious fource of difeafes, fee Se6l. 
XXIX. II. 5. 
The fluids difgorged by the retrograde motions of the various 
vafcular mufcles maybe diftinguifhed, 1. From thofe, which 
are produced by fecretion, by their not being attended by increafe 132 
DISEASES 
" Class I. 3. 1. 1. 
of heat, which always accompanies increafed fecretion. 2. They 
may be diftinguifhed from thofe fluids, which are the confc- 
quence of deficient abforption, by their not poflefling the faline 
acrimony, which thofe fluids poflefs ; which inflrunes the ikin or 
other membranes on which they fall; and which have a faline 
tafte to the tongue. 3. They mjy 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 infpiflated by the abftraCtion of their aqeous parts. 4. 
Where chyle, or milk, is found in the feces or urine, or when 
other fluids, as matter, are translated from one part of the fyftem 
to another, they have been the product of retrograde adlion of 
lymphatic or other canals. As explained in Seft. XXIX. 8. 
SPECIES. 
t. Ruminatio. In the rumination of horned cattle the retro- 
grade motions of the cefophagus are vifible to the eye, as they 
bring up the foftened grafs from their firft ftomach. The veg- 
etable aliment in the firft ftomach of cattle, which have filled 
themfclves too full of young clover, is liable to run into ferment- 
ation, and diftend the ftomach, lb as to preclude its exit, and 
frequently to deftroy the animal. To difcharge this air the 
farmers frequently make an opening into the ftomach of the 
animal with fuccefs. 1 was informed, I believe by the late Dr. 
"Whytt of Edinburgh, that of twenty cows in this fituation two 
had died, and that he directed a pint of gin or whiiky, mixed 
with an equal quantity of water, to be given to the other eigh- 
teen ; all of which erufled immenfe quantities of air, and recov- 
ered. 
There are hiftories of ruminating men, and who have taken 
pleafure in the act of chewing their food a lecond time. Phi- 
Jof. Tranfadt. 
2. Rtifltis. Emulation. An inverted motion of the ftomacji 
excluding through its upper valve an elaftic vapour, generated 
by the fermentation of the aliment; which proceeds fo haftily, 
that the digeftive power does not fubdue it. This is fometimes 
acquired by habit,fo that fome people can erudt when they pleafe, 
and as long as they pleafe; and there is gas enough generated 
to lupply them for this purpofe ; for by Dr. Hales'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 eject the fixable air from their ftom- 
a.chs, the fermentation of the aliment proceeds the fafter; for 
flopping the veil'els, which contain new wines, retards their fer- 
mentation. .Class I. 3. 1. 3. 
OF IRRITATION. 
133 
mentation, and opening them again accelerates it; hence where 
the digeftion is impaired, and the itomach fomewhat diftended 
with air, it is better to reftrain than to encourage eructations, 
jexcept the quantity makes it neceffary. When wine is confined 
in bottles, the fermentation ftill proceeds flowly even for years, 
till all the fugar is converted into fpirit; but in the procefs of 
digeftion, the Saccharine part is abforbed in the form of chyle 
by the bibulous mouths of the numerous la&eals, before it has 
time to run into the vinous fermentation. 
3. Apepjia. Indigeftion. Water-qualm. A few mouthfuls 
of the aliment are rejected at a time for fome hours after meals. 
When the aliment has had time to ferment, and become acid, it 
produces cardialgia, or heart-burn. This difeafe is perhaps gen- 
erally left after a flight inflammation of the ftomach, called a fur- 
feit, occafioned by drinking cold liquors, or eating cold vegeta- 
bles, when heated with exercife. This inflammation of the 
ftomach 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 
fkin round the bale of each eruption is lefs inflamed. See Clafs 
II. 1. 4. 6. This difeafe differs from Cardialgia, 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 ftom- 
ach about the upper orifice of it. In the fame manner as hyfte- 
ria differs from hypochondriafis 5 the one confiding in the weak- 
nefs 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 many years, even to old age; 
.Mr. G of Litchfield fuffered under this difeafe from his in- 
fancy ; and, as he grew old, found relief only from repeated dofes 
pf opium. 
M. M. A blifter, rhubarb, a grain of opium twice a day. 
Soap, iron-powder. Tin-powder. 
4. Vomitus. An inverted order of the motions of the ftom- 
ach and cefophagus with their abforbent veffels, by which their 
contents are evacuated. In the aft of vomiting lefs fenforial 
power is employed than in the ufual periftaltic motion of the 
ftomach, as explained in Seft. XXXV. 1. 3. Whence after 
the operation of an emetic the digeftion becomes ftronger by an 
accumulation of fenforial power during its decreafed aflion. 
This decreafed aftion of the ftomach may be either induced by 
want of ftimulus, as in the ficknefs which attends hunger ; or it 
may be induced by temporary want of irritability, as in cold fits 
of feyer; or from habitual want of irritability, as the vomiting 
of 134 
DISEASES 
Class I. 3. 1. 
of enfeebled drunkards. Or laftly, by having been previoufly 
too violently ftimulated by an emetic drug, as by ipecacuanha. 
M. M. A blitter. An emetic. Opium. Warmth of a bed, 
covering the face for a while with the bed-clothes. Crude mer- 
cury. A poultice with opium or theriaca externally. 
5. Cholera. When not only the ftomach, as in the laft arti- 
cle, but alfo the duodenum, and ileum, 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 laaeals become retrograde, and difgorge their 
contents into the upper part of the alimentary canal; and other 
branches of them difgorge their contents into the lower parts of 
it beneath the valve of the colon ; a vomiting and purging com- 
mence 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 poifonous drugs, as in the 
cafe narrated in Se£f. XXV. 13. where other circumftances of 
this difeafe are explained. See Oafs II. 1. 2. 11. 
The cramps of the legs, which are liable to attend cholera, 
are explained in Oafs III. 1. 1. 15. 
6. Ileus. Confifts in the inverted motions of the whole intefti- 
nal canal, from the mouth to the anus ; and of the laaeals and 
abforbents which arife from it. In this pitiable difeafe, through 
the valve of the colon, through the pylorus, the cardia, and the 
pharynx, are ejected, firft, the contents of the ftomach and in- 
teftines, with the excrement and even clyfters themfelves ; then 
the fluid from the laaeals, which is now poured into the intef- 
tines by their retrograde motions, is thrown up by the mouth ; 
and, laftly, every fluid, which is abforbed by the other lymphatic 
branches, from the cellular membrane, the fkin, the bladder, and 
all other cavities of the body ; and which is then poured into 
the ftomach or inteftines by the retrograde motions of the laae- 
als ; all which fupply that amazing quantity of fluid, which is 
in this difeafe continually ejected by vomiting. See Sea. XXV, 
13. for a further explanation of this difeafe. 
M. M. Copious venefeaion. Twenty grains of calomel in 
fmall pills, or one grain of aloe every hour till ftools are procur- 
ed. Blifters. Warm bath. Crude mercury. Clyfter of ice- 
water. Smear the fkin all over with greafe, as mentioned in 
Seft, 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 fervice after venefeaion ? Or the exhibition 
of crude quickfilver two ounces every half^iour, till a pound is 
taken, Class I. 3. 1. 7. 
OF IRRITATION. 
135 
taken, be particularly lerviceable in this circumftance ? Or 
could half a pound, or a pound, of crude mercury be injected as 
a clyfter, the patient being elevated by the knees and thighs fa 
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 alfa 
be of advantage in ftrangulated hernia ? 
Where there exifts an introfufeeption of the inteftine, or in 
obftinate coftivenefs, perhaps a forcing pump, fuch as gardeners 
employ to water their trees, might be ufed with advantage, by 
driving water forcibly up the reflum, as is mentioned by Mr. 
Adair; and was ufed by Dettaen in experiments on dogs, who 
found the valve of the colon did not prevent warm water being 
pulhed along the whole courfe of the alimentary canal by a 
forcing fyringe. This is well worthy trial, as well as the quick- 
filver introduced by the anus in inflammations of the inteltines, 
where no pafiage downwards can be procured. 
Where an introfufeeption of the inteftine exifts, as is bcliev- 
ed frequently to occur in thofe inflammations of the bowels of 
children, which are not owing to fome indigeftible material, as 
to plum ftones or cherry ftones, it is probable that a quantity of 
air alone, or of the fmoke of tobacco, might be injected fo forci- 
bly as to dilate, and in consequence to pafs the valve of the co- 
lon ; and might pulh into its place the ftrangulated duplicature of 
the inteftine. Air might be thus injected from a large brown 
bladder by means of a clyfter-pipe coveted with foft leather 
moiftened with oil or mucilage^ or by means of bellows, or the 
common apparatus for injecting the fmoke of tobacco, or by a. 
fyringe ufed for condenfing air in philofophical experiments. I 
have feen fchool-boys blow air through a grafs-ftem into the bow- 
els of frogs, fo as to prevent their diving, without injuring them. 
Where the difeafc is owing to ftrangulated hernia, the part 
fliould be fprinkled with cold water, or iced water, or fait and 
water recently mixed, or moiftened with ether. In cafes of 
ftrangulated hernia, could a cupundture, or punflure with a ca- 
pillary trocar, be ufed with fafety and advantage to give exit to 
air contained in the ftrangulated bowel ? Or to ftimulate it in- 
to aftion ? It is not uncommon for bafhful men to conceal 
their being afflifted with a fmall hernia, which is the caufe of 
their death; this circumftance fhould therefore always be in- 
quired into. Is the feat or caufe of the ileus always below the 
valve of the colon, and that of the cholera above it ? See Clafs 
II. I. 2. II. 
7. Globus hyjlericus. Hyfteric fuffbeation is the perception 
of a globe rolling round in the abdomen, and afeending to the 
ftomach and throat, and there inducing ftrangulation. It con- 
iifts 136 
Diseases 
Class I. 3. t. & 
lifts of an ineffectual inverfion of the motions of the oefophagus', 
and other parts of the alimentary canal; nothing being rejected 
from the ftomach. 
M. M. TinCture of caftor, tinCi. of opium, of each 15 drops. 
See Hyfteria, Clafs I. 3. 1. 9. 
8. Vomendi conamen inane. An ineffectual effort to vomit. 
It frequently occurs, when the ftomach is empty, and in fome 
cafes continues many hours; but as the lymphatics of the ftom- 
ach are not inverted at the fame time, there is no fupply of mate- 
rials to be ejected; it is fometimes a fymptom of hyfteria, but 
more frequently attends irregular epilepfies or reveries ; which 
however may be diftinguifhed by their violence of exertion, for 
the exertions of hyfteric motions are feeble, as they are caufed 
by debility ; but thofe of epilepfies, as they are ufed to relieve 
pain, are of the moft violent kind ; infomuch that thofe who 
have once feen thefe ineffectual efforts to vomit in fome epilep- 
lies, cain never again miftake them for fymptoms of hyfteria. 
See a cafe in SeCb. XIX. 2. 
M. M. Buffer. Opium. Crude mercury. 
9. Borborigmui. A gurgling of the bowels proceeds from a 
partial invertion of the periltaltic motions of them, by which the 
gas is brought into a fuperior part of the bowel, and bubbles 
through the defcending fluid, like air ruffling into a bottle as the 
water is poured out of it. This is fometimes a diftreffing fymp- 
tom of the debility of the bowels joined with a partial inverfion 
of their motions. I attended a young lady about fixteen, who 
was in other refpeCts feeble, whofe bowels almoft inceflantly 
made a gurgling noife fo loud as to be heard at a confiderable 
diftance, and to attract the notice of all who were near her. As 
this noife never ceafed a minute together for many hours in a day, 
it could not be produced by the uniform defcent of water, and 
afcent of air through it, but there muft have been alternately 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 hap- 
pen in fome of the curvatures of the fmaller inteftines, the air 
in which might be moved backw'ard and forward like the air- 
bubble in a glafs-level. 
M. M. Eflential oil. Ten corns of black pepper fwallowed 
whole after dinner, that its effeCt might be flower and more per- 
manent ; a fmall pipe occafionally introduced into the reCtum 
to facilitate the cfcape of the air. Crude mercury. See Clafs 1. 
2- 4- 
10. Hyjleria. The three laft articles, together with the lym- 
phatic Glass I. 3. 1.10. 
OF IRRITATION. 
137 
phatic diabetes, are the molt common fymptoms of the hyfteric 
difeafe; to which fametimes is added the lymphatic falivation, 
and fits of fyncope, or convulfion, with palpitation of the heart 
(which probably confifts of retrograde motions ot it), and a great 
fear of dying. Which laft circumftance diftinguiihes thefe con- 
vulfions from the epileptic ones with greater certainty than any 
other fingle fymptom. The pale copious urine, cold Ikin, palpi- 
tation, and trembling, are the fymptoms excited by great fear. 
Hence in hyfteric difeafes, when thefe fymptoms occur, the fear, 
which has been ufually aftbciated with them, recurs at the fame 
time, as in hypochondriafis, Clafs I. 2. 4. 10. See Seft. XVI. 
8. 1. 
The convulfions which fometimes attend the hyfteric difeafe, 
are exertions to relieve pain, either of fome torpid, or of fome 
retrograde organ; and in this refpecl they refemble epileptic 
convulfions, except that they are feldom fo violent as entirely to 
produce infenfibility to external ftimuli; for thefe weaker pains 
ceafe before the total exhauftion of fenforial power is produced, 
and the patient finks into imperfect fyncope ; whereas the true 
epileply generally terminates in temporary apoplexy, with per- 
fect infenfibility to external objects. 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 Sedt. XXIX. 4. 5. And 
the lymphatic falivation ariles from the inverted motions of the 
falivary lymphatics. 
Hyfteria is diftinguilhed from hypochondriafis, as in the latter 
there are no retrograde motions of the alimentary canal, but lim- 
ply a debility or inirritability of it, with diftention and flatulency. 
It is diftinguilhed from apepfia and cardialgia by there being noth- 
ing ejected from the ftomach by the retrograde motions of it, 
or of the cefophagus. 
M. M. Opium. Camphor. Afafoetida. Caftor, with fin- 
apilms externally; to which muft be added a clyfter of cold wa- 
ter, or iced w^ter ; which, according to Monf. Pomme, relieves 
thefe hyfteric fymptoms inftantaneoufly like a charm ; which it 
may effect by checking the inverted motions of the inteftinal ca- 
nal by the torpor occafioned by cold ; or one end of the intefti- 
nal canal may become ftrengthened, and regain its periftaltic 
motion by reverfe fympathy, when the other end is rendered 
torpid by ice-water. (Pomme des Affections Vaporeufes, p. 2 c.) 
Thefe remove the prefent fymptoms ; and bark, fteel, excrcife, 
coldilh bath, prevent their returns. See Art. VI. 2. 1. 
Vol. II. T 11. Hydrophobia. 138 
DISEASES 
Class I. 3. r. r r. 
II. Hydrophobia. Dread of water occafioned by the bite of a 
mad-dog, is a violent inverfion of the motions of the cefopha- 
gus on the contain or even approach of water or other fluids. 
The pharynx feems to have acquired the fenfibility of the larynx 
in this difeafe, and is as impatient to reject any fluid which gets 
into it. Is not the cardia ventriculi the feat of this difeafe ? As 
in cardialgia the pain is often felt in the pharynx, when the acid 
material ftimulates the other end of the canal, which terminates 
in the ftomach. As this fatal difeafe refembles tetanus, or lock- 
ed jaw, in its tendency to convulfion from a diftant wound, and 
aflects fome other parts by aflbeiation, it is treated of in Clafs 
III. i. i. 15. and IV. 2. 1.7. 
M. M. I Ihould recommend the trial of one grain and £ half 
of corrofive fublimate of mercury, hydrargyrus muriatus, dif- 
folved in half an ounce of rectified fpirit of wine, to be given 
undiluted, if poflible, as defcribed in Clafs II. 1. 5. 1. and tobs 
repeated according to its operation. 
ORDO Class I. 3. 2. 1. 
OF IRRITATION. 
139 
ORDO III. 
Retrograde Irritative Motions. 
GENUS II. 
Of the Abforbent Sy fem. 
SPECIES. 
I. Catarrhus lymphaticus. Lymphatic catarrh. A periodic- 
al defluxion 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 tome other lymphatic branches in their vicinity. It is dif- 
tinguiflied 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 an intermit- 
tent fever, for weeks and months together, with great freezing 
and very copious difcharge for an hour or twor 
I have feen two of thefe cafes, both of which occurred in deli- 
cate women, and feemed an appendage to other hyfteric fymp- 
toms ; whence I concluded, that the difcharge was occafioned by 
the inverted motions of the lymphatics of the nollrils, like the 
pale urine in hyfteric cafes ; and that they might receive this 
fluid from fome other branches of lymphatic veifels opening into 
the frontal or maxillary cavities in their vicinity. 
Could fuch a difcharge be produced by ftrong errhines, and 
excite an abforption of the congeftion of lymph in the dropfy of 
the brain ? 
2. Salivatio lymphatica. Lymphatic falivation. A copious 
expuition of a pellucid infipid fluid, occafioned by the retrograde 
motions of the lymphatics of the mouth. It is fometimes peri- 
odical, and often attends the hyfteric difeafe, and nervous fevers ; 
but is not accompanied with a faline tafte, or with heat of the 
mouth, or naufea. 
3. Naufea humida. Moift naufea confifts 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 retrograde motions of the fauces or pharynx along 
with this naufea, a ficknefs generally precedes the atl of vomit- 
ing ; which may confift of a fimilar difcharge of mucus or chyle 
into- 140 
DISEASES 
Class I. 3. 2. 4. 
into the ftomach by the retrograde motions of the lymphatics or 
la&eals, which open into it. See Oafs I. 2. 4. 3. and I. 2. 4. 4. 
M. M. Subacid liquids. Wine. Opium. A bliftcr. 
4. Diarrhoea lymphatica. Lymphatic diarrhoea. A quantity 
of mucus and lymph are poured into the inteftines by the in- 
verted motions of the inteftinal lymphatics. The feces are lefs 
fetid and more liquid ; and it fometimes portends the commence- 
ment of a diabetes, or dropfy, or their temporary relief. This 
lymphatic diarrhoea fometimes becomes chronical, in which the 
atmofpheric moifture, abforbed by the cutaneous and pulmona- 
ry lymphatics, is poured into the inteftines by the retrograde mo- 
tions of the lafteals. See Section XXIX. 4. 6. where fome 
cafes of this kind are related. 
5. Diarrhoea chylifera, caliaca. Chyliferous diarrhoea. The 
chyle drunk up by the la&eals of the upper inteftines is poured 
into the lower ones by the retrograde motions of their ladleals, 
and appears in the dejections. This circumflance occurs at the 
beginning of diarrhoea crapulofa, where the patient has taken 
and digefted more aliment than the fyftem can conveniently re- 
ceive, and thus eliminates a part of it; as appears when there is 
curdled chyle in fome of the dejections. See SeCt. XXIX. 4. 7. 
It differs from the lymphatic diarrhoea, as the chyliferous diabe- 
tes differs from the aqueous and mucaginous diabetes. 
6. Diabetes. By the retrograde motions of the urinary lym- 
phatics, 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 in- 
toxication, in worm cafes, or in thofe expofed to cold damp air, 
or to great fear, or anxiety, or in the commencement of fome 
dropfies ; or it becomes chronical. 
When the urinary lymphatics invert their motions, and pour 
their refluent contents into the bladder, fome other branch of 
the abforbent fyftem arts with greater energy to fupply this flu- 
id. If it is the inteftinal branch, the chyliferous diabetes is pro- 
duced : if it is tjie cutaneous or pulmonary branch, the aqueous 
diabetes is produced : and if the cellular or cyftic branches, the 
mucaginous diabetes. In the two laft the urine is pellucid, and 
contains no fugar. 
In dropfies the fluid is fometimes abforbed, and poured into 
the bladder by the retrograde 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 previ- 
oufly Class I. 3. 2. 4. 
OF IRRITATION. 
141 
oufly feels a fulnefs about the praecordia, with difficult refpira- 
tion, and fymptoms fimilar to thofe ofhyfteria. Perhaps a pre- 
vious defeat of abforption takes place in fome part of the body in 
thofe hyfteric cafes, which are relieved by a copious difcharge of 
pale urine. See Diabetes explained at large, Section XXIX. 4. 
A difcharge of blood fometimes attends the diabetes, which 
was occafionally a fymptom of that difeafe in Mr. Brindley, the 
great navigable 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 discovered by J. F. 
Meckel. See Section XXVII. 2. 
M. M. Alum. Earth of alum. Cantharides. Calomel. 
Bark. Steel. Refin. Opium. See Seft. XXIX. 4. 
Since the publication of the firft edition of this work, I have 
feen two patients affefted with diabetes, who were both of them 
between fixty and Seventy years old, and had formerly lived rath- 
er freely, though very temperately latterly for many years. The 
water they made had not been accurately meafured or evapora- 
ted ; but one of them obferved that his terrier bitch lapped his 
urine in large quantities,and preferred it much to common water; 
whence he concluded, it mult contain fome nutritious matter. 
They both complained of thirft, and had drunk two or three 
times as much as ufual, during the time they had been affected 
with the diabetes; which was about four months in one, and 
about three in the other. As I elteemed thefe cafes to be ow- 
ing to the patients Swallowing more fluid than could be So hafti- 
ly taken into the circulation, and that therefore a part of it was 
conveyed to the bladder by the retrograde action of the lymphat- 
ics, as in the beginning of intoxication ; I prevailed on them to 
drink no more than their ufual quantity, or lefs ; and both thefe 
mild cafes of diabetes ceafed immediately by this Simple treat- 
ment of them. 
A fimilar event Seems to have exifted in the two cafes of dia- 
betes firlt published by Dr. Rollo; on thofe days the patients 
drank but little, the quantity of urine was not more than natural. 
Both from thefe cafes, and from others related by Dr. Rollo, it 
appears, that when the patient lived on animal food, lefs Saccha- 
rine matter was dete&ed in the urine, and alfo that the quanti- 
ty of the urine abated ; the former of thefe circumftances is read- 
ily accounted for, as vegetable materials are probably more co- 
pioufly convertible into Sugar, either chemically or by the power 
of digeftion, than animal materials ; and the latter feems proba- 
bly owing to the patients drinking lefs in quantity, when they 
were reftrained from beer and milk, and were allowed only broth 
in their ftead. 
In 142 
DISEASES 
Class I. 3. 2. 7. 
In the cafe from Liverpool, publiPaed by Dr. Rollo, the pa- 
tient did not weigh heavier after fitting ten minutes in a bath 
of i to degrees of heat; which (hews that no part of the diabe- 
tic urine was owing to increafed cutaneous abforption, and that 
this difeafe was not the aqueous but the chyliferous diabetes; 
and I fuppofe the patient's weighing heavier or not after ufmg 
a warm bath may depend on the quantity of fluid previoufly 
taken by the mouth ; as the (kin may thence be either in an ab- 
forbent or exhalent ftate, and owing to a greater or lefs degree 
of heat, which may render the quantity of perfpiration in the 
bath greater than the quantity abforbed. See Se£t. XXIX. 4. 5. 
7. Sudor lymphaticus. Profufe fweats from the inverted mo- 
tions of the cutaneous lymphatics, as in fome fainting fits, and 
at the approach of death ; and as perhaps in the fudor anglica- 
nus. See Seel. XXIX. 5. Thefe fweats are glutinous to the 
touch, and without increafed heat of the fkin ; if the part is not 
covered, the fkin becomes cold from the evaporation of the fluid. 
Thefe fweats without heat fometimes occur in the act of vomit- 
ing, as in Sect. XXV. 9. and arc probably the caufe of the cold 
fweaty hands of fome people. As mentioned in Se6t. XXIX. 
4. 9. in the cafe of R. Davis, which he cured by frequent ap- 
plication of lime. Though it is poflible, 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 diabetic patient, and afcribes to the chyle effufed on the 
fkin, muff be afcribed to the retrograde action of the cutaneous 
lymphatics. See Sect. XXIX. 6. 
8. Sudor ajlbmaticus. The cold fweats in this difeafe only 
cover the head, arms, and breaft, and are frequently exceeding- 
ly profufe. Thefe fweats are owing to the inverted motions of 
the cutaneous lymphatics of the upper part of the body, and at 
the fame time the increafed abforption of the pulmonary abfor- 
bents : hence thefe fweats when profufe relieve the prefent fit of 
afthma. There is no other way to account for fweats appear- 
ing 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 fkin by the retrograde movements of the cutaneous lym- 
phatics ; which join thofe of the lungs before they enter into 
the venous circulation. For if they were occafioned, as gener- 
ally fuppofed, by the difficulty of the circulation of the blood 
through the lungs, the whole fkin mult be equally affefted, both 
of the upper and lower parts of the body ; for whatever could 
obftruct the circulation in the upper part of the venous fyftem, 
mu ft Class I. 3. 2. 9. 
OF IRRITATION. 
143 
muft equally obftrud it in the lower part of it. See Sed. XXIX. 
6. In the convulfive afthma thefe fweats do not occur5 hence 
they may be diftinguiffied ; and might be called the hydropic 
afthma, and the epileptic afthma. 
9. Tranjlatio puris. Tranflation of matter from one part of 
the fyftern to another can only be explained from its being ab- 
forbed by one branch of the lymphatic fyftern, and depofited in 
a diftant part by the retrograde motions of another branch ; as 
mentioned Sed. XXIX. 7. 1. It is curious, that thefe tranfla- 
tions of matter are attended generally, I believe, with cold fits 5 
for lefs heat is produced during the retrograde addon of this 
part of the fyftern, as no fecretion in the lymphatic glands of the 
afleded branches can exift at the fame time. Do any ineffec- 
tual 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 obfervcd in two 
inftances, which is difficult to explain, without fuppofing the 
new veffels, or the matter produced on the inflamed liver, to be 
abforbed, and either eliminated by fome retrograde motion, or 
carried to the newly inflamed part ? See Clafs IV. 1. 2. 15. 
10. Tranjlatio JaEtis. Tranflation of milk to the bowels in 
puerperal fevers can only be explained by the milk being abforb- 
ed by the pedoral branch of lymphatics, and carried to the 
bowels by the retrograde motions of the inteftinal lymphatics or 
ladeals. See many inftances of this in Sed. XXIX. 7. 4. 
11. Tranjlatio urina. Tranflation of urine. There is a curi- 
ous cafe related in the Tranfadions of the College of Phyficians 
at Philadelphia, Vol. I. p. 96. of a girl, who labouring under an 
ifehuria vomited her urine for many months; which could not 
be diftinguiihed from that which was at other times drawn off 
by the catheter. After having taken much opium, ilie feems at 
length to have formed gravel, fome of which was frequently 
brought up by vomiting. Dr. Senter afcribes this to the retro- 
grade motions of the lymphatics of the ftomach, and the increaf- 
ed ones of thofe of the bladder, and refers to thofe of Sed. 
XXIX. of this work ; which fedion was firft publiffied in 17805 
and to Macquer's Didionary of Chemiftry, Art. Urine. 
The patient above defcribed fometimes had a difeharge of 
urine by the navel, and at other times by the redum, and fome- 
times by urinous fweats. 
ORDO 144 
DISEASES 
Class I. 3. 3.1. 
ORDO III. 
Retrograde Irritative Motions. 
GENUS III. 
Of the Sanguiferous Syfem. 
SPECIES. 
I. Capillarium motus retrogrefiis. In niicrofcopic experi- 
ments it is ufual to fee globules of blood regurgitate from the ca- 
pillary veffels again and again, before they pafs through them ; 
and not only the mouths of the veins, which arife from thefe ca- 
pillaries, are frequently feen by microfcopes to regurgitate fome 
particles of blood during the ftruggles of the animal; but a re- 
trograde motion of the blood in the veins of thefe animals, from 
the very heart to the extremities of the limbs, is obfervable by 
intervals during the diftrelfes of the dying creature. Haller, 
Elem. Phyf. T. i.p. 216. See Section XXI^. 3. 8. 
2. Palpitatio cordis. May not the ineffectual and weak une- 
qual motions of the heart in hyfteric cafes be afcribed to the re- 
trograde motions of it, which continue for a fliort time, or ter- 
minate in fyncope ? See Clafs IV. 3. 1. 6. 
3. Anhelatiofpafmodica. In fome afthmas may not the difficul- 
ty of refpiration arife from the inverted action of the finer branch- 
es of the bronchia, or of the pulmonary artery or vein, like thofc 
of the capillaries above defcribed in No. 1. of this genus ? 
Th Class II. 1. 1. 
DISEASES, &c. 
145 
The Orders and Genera of the Second Clafs of Difeafes, 
CLASS II. 
Diseases of sensation. 
ORDO I. 
iucreafed Senfation. 
GENERA. 
1. With increafed aCtion of the mufcles. 
2. With the production of new veflels by internal membranes 
or glands with fever. 
3. With the production 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 production of new veflels by external membranes 
or glands without fever. 
6. With fever confequent to the production of new veflels or 
fluids. 
7. With increafed aCtions of the organs of fenfe. 
ORDO II. 
Decreafed Senfation. 
GENERA. 
1. With decreafed actions of the general fyftem. 
2. With decreafed aCtions of particular organs. 
ORDO III. 
Retrograde Senfttive Motions. 
GENERA. 
i. (X the arterial fyftem. 
2. Of the abforbent fyftem. 
3. Of the excretory duCts. 
Vol. II. 
u 
The 146 
DISEASES 
Class II. 1. 1. 
The Orders, Genera, and Species, of the Second Clajs of 
Difeafes. 
CLASS II. 
DISEASES OF SENSATION. 
ORDO I. 
Increafed Senfation. 
GENUS I. 
With increafed A ciion of the mufcles. 
SPECIES. 
I. Defutitio. 
2. Refpiratio. 
3. Sternutatio. 
4. Anhelitus. 
5. Tuffs ebriorum. 
6. Singultus. 
7. Crapula ventriculi. 
8. AJlhma humor ale. 
9. Niclitatio fenfitiva. 
I o. Ofcitatio et pandiculatio. 
11. Tenefmus. 
12. Stranguria. 
13. Parturitio. 
Deglutition. 
Refpiration. 
Sneezing. 
Panting. 
Cough of inebriates. 
Hiccough. 
Indigcftion. 
Humoral afthma. 
Winking from pain. 
Yawning and ftretchingv 
Tenefmus. 
Strangury. 
Parturition. 
GENUS II. 
With the Production of new Vcffels by internal Membranes or 
Glands, •with Fever. 
SPECIES. 
I. FebrisJenJitiva irritata. 
2. Ophthalmia interna. 
3. Phrenitis. 
4. Peripneumonia. 
trachealis. 
5. Pleuritis. 
6. Diaphragmitis. 
7. Carditis. 
8. Peritonitis. 
9. Mefenteritis. 
Senfitive irritated fever. 
Inflammation of the eye. 
of the brain. 
-- of the lungs. 
The croup. 
Inflammation of the pleura. 
of the diaphragm. 
of the heart. 
• of the peritone- 
um. 
of the mefentery. 
io. Gajlritis. Class IT. 1.3. 
OF SENSATION. 
147 
10. Gafiritis. 
11. Enteritis. 
12. Hepatitis. 
13. Splenitis. 
14. Nephritis. 
15. Cyfiitis. 
16. Hyperit is. 
17. Lumbagofenfitiva. 
iB. Ifchias. 
19. Paronychia interna. 
Inflammation of the ftomach. 
- of the bowels. 
of the liver. 
> of the fpleen. 
of the kidney. 
■ of the bladder. 
of the womb. 
- - of the loins. 
of the pelvis. 
beneath the nails. 
GENUS III. 
With the Production of new Veffels by external Membranes or 
Glands.) •with Fever. 
I. Febrisfenfitiva inirritata. 
2. Eryfipelas irritatum. 
inirritatum. 
fenfitivum. 
3. TonfilUtis interna. 
fuperficialls. 
inirritata. 
4. Parotitis fuppurans. 
mutabilis. 
felina. 
5. Catarrhus fenfitivus. 
6. contagiojus. 
- 1 equinus et cani- 
nus. 
Peripneumonia fuperficialls. 
8. Pertuffis. 
9. Variola difcreta. 
-r- confluent. 
inoculata. 
io. Rubeola irritata. 
-- inirritata. 
11. Scarlatina mitis. 
maligna. 
12* e Miliaria fudatoria. 
- irritata. 
- - inirritata. 
13. Pefiis. 
'vaccina. 
14. Pemphigus. 
SPECIES. 
Senfitive inirritated fever. 
Eryfipelas, irritated. 
inirritated. 
fenfitive. 
Angina, internal. 
fuperficial. 
■ inirritated. 
Mumps, fuppurative. 
mutable. 
• of cats. 
Catarrh, inflammatory. 
• contagious. 
among horfes and dogs. 
Superficial peiipneumony. 
Chin-cough. 
Small-pox, diftindh 
• confluent. 
inoculated. 
Meafles, irritated. 
inirritated. 
Scarlet-fever, mild. 
malignant. 
Miliary fever, fudatory. 
irritated. 
inirritated. 
Plague. 
■ of horned cattle. 
Bladdery fever. 
15. Varicell* 148 
DISEASES 
Class II. i. 4. 
15. Varicella. 
16. Urticaria. 
17. Aphtha fenjitiva. 
• irritata. 
inirritata. 1 
18. Dyfenteria. 
19. Gajlritisfuperjicialis. 
20. EnteritisfuperJiciaUs. 
Chicken-pox. 
Nettle-rafli. 
Thrufh, fenfitive. 
irritated. 
inirritated. 
Bloody flux. 
Superficial inflarp. of the ftomr 
ach. 
~ of the bowels. 
GENUS IV. 
With the Production of new Vejfels by internal Membranes ar 
Glands, without Fever. 
SPECIES. 
I. Ophthalmiafuperficialis. 
lymphatica. 
equina. 
2. Pterigion. 
3. Tarfitis palpebrarum. 
4. Hordeolum. 
Paronichia fuperfcialis. 
6. Gutta rofea hepatica. 
flomatica. 
: hereditaria. 
7. Odontitis. 
8. Otitis. 
9. Fiftula lacrymalis. 
io. Fijlula in ano. 
11. Hapatitis chronica. 
12. Scrofula fuppurans. 
13. Scorbutusfuppurans. 
14. Scirrhus fuppurans. 
Carcinoma. 
16. Arthrocele. 
iy. Arthropuofs. 
18. Caries ojfium. 
Ophthalmy, fuperficiaL 
• - lymphatic. 
- of horfes. 
Eye-wing. 
Red eyelids. 
Stye. 
Whitlow. 
Pimpled face, hepatic, 
ftomatic. 
hereditary. 
Inflamed tooth. 
■ ear. 
Fiftula lacrymalis. 
Fiftula in ano. 
Chronical hepatitis. 
Suppurating fcrofula. 
Suppurating fcurvy. 
Suppurating fcirrhus. 
Cancer. 
Swelling of the joints. 
Suppuration of the joints. 
Caries of the bones. 
GENUS V. 
With the Production of new Vejfels by external Membranes or 
Glands, without Fever* 
SPECIES. 
I. Gonorrhoea venerea. 
g. Syphilis. 
Clap. 
Venereal difeafe. 
3. Lepra. Class II. 1. 6. 
OF SENSATION. 
149 
3. Lepra. 
4. Elephantufis. 
5. Frambofa. 
6. Pfora. 
y. Pjora ebriorum. 
8. Herpes. 
9. rLona ignea. 
10. Annulus repens. 
11. Tinea capitis. 
12. Crufa laflea. 
13. Trichoma. 
Leprofy. 
Elephantiafis. 
Frambocfia. 
Itch. 
Itch of drunkards. 
Herpes. 
Shingles. 
Ri ng-worm. 
Scald-head. 
Milk-cruft. 
Plica polonica. 
GENUS VI. 
With Fever confeyuent to the Production of new Vejfels or Fluids* 
I. Febrisfenftiva. 
2. ■■ a pure claufo. 
3. a vomica. 
4. ab empyemate. 
5. -- mefenterica. 
6. a pure aerato. 
rj. a phthif. 
8. fcrfutofa. 
9. - ifcfnadica. 
io. arthropuodica. 
11. a pure contagiofo. 
12. variotofa fecundaria. 
13. carcinomatofa. 
14. venerea. 
15. a fanie contagiofa. 
16. puerpera. 
-- a fphaceto. 
SPECIES. 
Senfitive Fever. 
Fever from concealed matter. 
from vomica. 
from empyema. 
mefenteric. 
from aerated matter. 
from confumption. 
fcrofulous. 
--- from ifchias. 
from joint-evil. 
from contagious matter. 
fecondary of fmall-pox. 
cancerous. 
venereal. 
from contagious fanies. 
puerperal. 
from fphacelus. 
GENUS VII. 
With increafed AH ion of the Organs of ^enfe. 
SPECIES. 
I. Delirium febrile. 
0.. maniacale. 
3. ebrietatis. 
4. Somnium. 
5. Hallucinatio vifus. 
6. tiuditus. 
7. Rubor a catore. 
Delirium of fevers. 
maniacal. 
of drunkennefs 
Dreams. 
Deception of fight. 
of hearing. 
Blulh from heat. 
g. Rubor. 150 
DISEASES 
Class II. 2. rt 
8. Rubor jucunditalis. 
9. Priapifmus amatorius. 
10. Dijlentio mamularum. 
Blufh from joy. 
Amorous priapifm. 
Diftention of the nipples. 
ORDO II. 
Decreafed henfation. 
GENUS I. 
With decreafed Action of the general Sy fern. 
I. Stultitia infenftbilis. 
2. Tadium vita. 
3. Par efts fenfitiva. 
SPECIES. 
Folly from infenfibility, 
Irkfomenefs of life. 
Senfitive debility. 
GENUS II. 
With decreafed Actions of particular Organs. 
SPECIES. 
I. Anorexia. 
2. Adipfia. 
3. Impotentia. 
4. Sterilitas. 
5. Infenfibilitas artuum. 
6. Dyfuria infenftiva. 
7. Accumulatio alvina. 
Want of appetite. 
Want of thirft. 
Impotence. 
Barrennefs. 
Infenfibility of the Jjmbs. 
Infenfibility of the bladder. 
Accumulation of feces. 
ORDO III. 
Retrograde Senftive Motions. 
GENUS I. 
Of Excretory DuEls. 
Motus retrogreffus. 
I. ureterum. 
2. urethra. 
3. duel us coledoci. 
SPECIES. 
Retrograde motion. 
of the ureters. 
of the urethra. 
• of the bilc-dudt. 
CLASS Class-II. 1. r. 
OF SENSATION. 
151 
CLASS II. 
DISEASES OF SENSATION. 
ORDO I. 
Increafed Senfation, , 
GENUS I. 
With Inc re (fed Action of the Mufcles. 
THE actions belonging to this genus are thofe which are im- 
mediately 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 fublequent genera of this 
order, and the latter to the clafs of voluntary motions. 
The criterion between the actions, which are the immediate 
confequence of painful fenlation, and convuliive actions prop- 
erly focalled, confifts in the former having a tendency to dif- 
lodge the ftimulating caufe, which induces the painful fenfation ; 
and the latter being exerted for the purpofe of expending the 
fenforial power, and thus dulling or deftroying the general fen- 
fation of the fyftem. See Clafs III. 1. 
There is a degree of heat produced in the affe£led part by 
thefe fenfitive actions without inflammation, but in much lefs 
quantity than when attended by inflammation ; as in the latter 
there is produtSiion of new vefleis. See Se€l. XXXIII. 2. 3. 
Some of the fpecies of this genus cannot properly be termed 
difeafes in their natural ftate, but become fo by their defeat or 
excefs, and are here inferred to facilitate the explanation of the 
others. 
SPECIES. 
i. Deglutitio. Swallowing our food is immediately caufed 
by the pleaiurable fenfation occalioned by its ftimulus on the 
palate or fauces, and is acquired long before the nativity of the 
animal. Afterwaids the pain of hunger previously produces 
the various voluntary exertions to procure the proper material, 
but the actions of mafticating and of fwallowing it are effected 
by the fenforial power of fenfation ; which appears by their not 
being always controlable by the will, as when children in vain 
attempt to fwaliow paufeous drugs. See Clafs IV. i. 3. v 
The 152 
DISEASES 
Class II. 1. 2. 
The mafticated food ftirhulates the palate, which is an organ of 
fenfe, into fo much aftion, as to produce agreeable fenfation ; 
and the mufcles fubfervient to deglutition are brought into ac- 
tion by the fenfation thus produced. The pleafurable fenfa- 
tion is the proximate caufe ; the action of the fibres of the ex- 
tremities of the nerves of tafte is the remote caufe ; the fenfo- 
rial power of irritation exciting thefe fibres of the nerves of tafte 
into increafed action is the pre-remote caufe ; the action of the 
mufcles of deglutition is the proximate effect; the pufhing the 
food into the ftomach is the remote effect; and the nutrition 
of the body is the poft-remote effect. 
Though the mufclcs fubfervient to deglutition have their ac- 
tions previoufly aflbeiated, fo as to be excited into fynchronous 
tribes or fucceffive trains, either by volition, as when we fwal- 
low a difagreeable drug ; or by fenfttion, as when we fwallow 
agreeable food ; or by irritation, as when we inattentively fwal- 
low our faliva ; yet do all thofe three kinds of deglutition belong 
to the refpcctive claffes of volition, fenfation, and irritation j 
becaufe the firft links of thefe tribes or trains of mufeular action 
are excited by thofe fenforial powers, and the affociated links, 
which accompany or fucceed them, are excited by the combined 
powers either of volition, or of fenfation, or of irritation, along 
with that of aflbeiation. 
2. Refpiraho. Refpiration is immediately caufed by the fen- 
forial 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 aflion of refpiration is 
thus fimilar to that of {wallowing our food to appeafe the pain 
of hunger ; but the lungs being furrounded with air, their prop- 
er pabulum, no interimmediate voluntary exertions are requir- 
ed, 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 in- 
flammable part of the blood generates an acid, probably the 
phofphoric acid ; a portion of carbonic acid is likewife produ- 
ced 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 mufeular actions produ- 
ced by the fenforial faculty of fenfation ; and is an effort to dif- 
lodge, by means of air forcibly impelled through the noftrils, 
fome material; which ftimulates the membrane, which lines 
them, Class II. 1. 1.4. 
OF SENSATION. 
153 
them, into too great action, and might thence injure the fenfe 
of fmell which is diffufed on it. 
In this operation the too great action of the veflels of the 
membrane of the noftrils is the remote caufe; the fenfation 
thence induced is the proximate caufe; and the mufcular ac- 
tions are the proximate effect. 
This action of fneezing frequently precedes common refpira- 
tion in new-born children, but I believe not always ; as like the 
latter u cannot have been previoufly acquired in the uterus. 
It is produced in fome people by fudden light, as by looking 
up at the fky in a morning, when they come cut of a gloomy 
bed-chamber. It then becomes an aflbciate action, and belongs 
to Clafs IV. i. 2. 2. 
M. M. When it is exerted to excels it may be cured by 
fnufhng ftarch up the noftrils. See Clafs I. i. 2. 13. 
4. Anhelitus. Panting. The quick and laborious breathing 
qf running people, who are not accuftomed to violent exercife, 
is occafioned by the too great conflux of blood to the lungs. As 
the fanguiferous fyftem, as well as the abforbent fyftem, is fur- 
nifhed in many parts of its courfe with valves, which in general 
prevent the retrograde movement of their contained fluids ; and 
as all thefe veflels, in fome part of their courfe, lie in contact 
with the mufcles, which are brought into action in running, it 
follows that the blood mult be accelerated by the intermitted 
fwelling of the bellies of the mufcles moving over them. 
The difficulty of breathing, with which very fat people are 
immediately affefted on exercife, is owing to the preffure of the 
accumulated fat on the veins, arteries, and lymphatics ; and 
which, by diftending the ikin, occafions it to act as a tight ban- 
dage on the whole furface of the body. Hence when the muf- 
cles are excited into quicker action, 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 ban- 
dage on a limb, explained in Art. IV. 2. 10. and in SecT. 
XXXIII. 3. 2. Hence the circulation is inftantly quickened to 
a great degree, and the difficulty of breathing is the confequence 
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 reft, are believed toper- 
fpire 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 than many thin people ; and laftly, 
from the perforation of fat people being generally more inodo- 
rous than that of lean ones; but when corpulent people are put 
in motion, the fweat ftands in drops on their fkins, and they 
Vol. II. W "lard 154 
DISEASES 
Class II. 1. 1. 5, 
lard the ground" as they run. The increafe of heat of corpulent 
people on exercife, is another confequence of their more rapid 
circulation, and greater fecretion. See Clafs I. 2. 3. 17. 
Other caufes of difficult or quick refpiration will be treated 
of under Afthma, Pertuffis, Peripneumonia, Tonfillitis. 
5. Tuftis ebriorum. Senfitive cough is an exertion of the 
mufcles ufed in expiration excited into more violent action by 
the fenforial power of fenfation, in confequence of fomething 
which too powerfully ftimulates the lungs. As the faline part 
of the fecreted mucus, when the abforptibnof it is impeded ;or 
the too great vifcidity of it, when the abforption is inefeafed ; 
or the too great quantitiy of the mucus, when the fecretion is 
increafed ; or the inflammation of the membranes of the lungs j 
it is an effort to diflodge any of thefe extraneous materials. 
Of this kind is the cough which attends free-drinkers after a 
debauch ; it confifts of many fhort efforts to cough, with a fre- 
quent expuition of half a tea-fpoonful of frothy mucus, and is 
attended with confiderable thirft. The thirft is occafioned by 
the previous diffipation of the aqueous parts of the blood by fen- 
fible or infenfible perfpiration ; which was produced by the in- 
creafed aCtion of the cutaneous and pulmonary capillaries during 
the ftimulus of the wine. In confequence of this an increafed 
abforption commences to replace this moifture, and the fkin and 
mouth become dry, and the pulmonary mucus becomes infpiffa- 
ted ; which Simulates the bronchia, and is raifed into 'froth by 
the fucceffive currents of air in evacuating it. This production 
of froth is called by fome free-drinkers " fpitting fixpences" af- 
ter a debauch. This fubfequent thirft, dry mouth, and vifeid 
expectoration in fome people fucceeds the flighted: degree of in- 
toxication, of which it may be efteemed a criterion. See Clafs 
IV. 2. 1. 8. 
As coughs are not always attended with pain, the mufcular 
aCtions, which produce them, are fometimes excited by the fen- 
forial faculty of irritation, as in Clafs I. 1. 2. 8. I. 1. 3. 4. 
I. 1. 4. 3. I. 2. 3. 4. Coughs are alfo fometimes convulfive, 
as in Clafs III. 1. 1. 10. and fometimes fympathetic, as in Clafs 
IV. 2. 1. 7. 
M. M. VenefeCtion, when the cough is attended with in- 
flammation. Mucillages. Opium. Torpentia. Blifter. 
6. Singultus. Hiccough is an exertion of the mufcles ufed 
in infpiration excited into more violent action by the fenforial 
power of fenfation, in confequence of fomething which too pow- 
erfully ftimulates the cardia ventriculi, or upper orifice of the 
ftomach. As when folid food is too hastily taken without fuf- 
ficient dilution. And is an effort to diflodge that offcnfive ma- 
terial, Class II. 1. 1. .7. 
OF SENSATION. 
155 
rial, and pu(h it to fome lefs fenfible part of the ftomach, er in- 
to the middle of the contained aliment. 
At the end of fatal fevers it may arife from the acrimony of 
the undigefted aliment, or from a part of the ftomach being al- 
ready dead, and by its weight or coldnefs affecting the furviving 
part with difagreeable fenfation. The pain about the upper 
orifice of the ftomach is the proximate caufe, the too great or 
too little action of the fibres of this part of the ftomach is the re- 
mote caufe, the action of the mufeies ufed in infpiration is the 
proximate effect, and the rcpercuffion of the offending material 
is the remote effect. 
Hiccough is fometimes fympathetic, occafloned by the pain 
of gravel in the kidney or ureter, as in Clafs IV. i. i. 7. and 
is fometimes a fymptom of epilepfy or reverie, as in Sect. XIX. 2. 
M. M. Oil of cinnamon from one drop gradually increafed 
to ten, on fugar, or on chalk. Opium, Blifter. Emetic. 
7. Crapula ventriculi. Indigeltible fubftances in the ftomach. 
This frequently occurs in children, who are reftrained by their 
ill-adtive friends from fruit or other fweet things ; and thus the 
rational mind is taught to fuperintend the fatiety of the fenfation 
of the fenfe of hunger, or of the pleafure of the palate, which 
is contrary to nature, and a much more erroneous guide. Hence 
children are liable to fwailow more plums and cherries than 
their ftomachs can digeft ; and if thefe run haftily into ferment- 
ation, much air, or gas, is generated ; and produces an incon- 
venient diftention of the ftomach, as well as a difagreeable fenfa- 
tion, which generally terminates in ejecting the offending mat- 
ter by vomiting. 
In cows which have eaten too much young clover, the faccha- 
rine and mucilaginous matter, which it contains, runs into fo 
violent fermentation as by diftention to deftroy the animal. 
Whence it has been cuftomary with fome to perforate the Grft 
ftomach, and thus let out the air. Dr. White, of Edinburgh, 
afferted, that he witneffed about twenty beads in this fituation, 
two were dead before the medicine could be adminiftered, but 
to the other eighteen he diretied half a pint of fpirits, called gin 
or whifky, mixed with as much water, to be given; and they 
all parted with much air by eructation, and recovered. An in- 
genious gentleman has lately put a flexible pipe down the efoph- 
agus into the diftended ftomach of thefe animals with certain 
fuccefs, as related in fome late publication. A flexible tube for 
this purpofe might be made of wire wrapped round a ftick about 
half an inch in diameter, and afterwards covered with leather. 
A boy about 8 years old fwallowed a halfpenny, which was 
believed to pafs through him at fchool, fome weeks afterwards, 
* bu 156 
DISEASES 
Class II. 1. 1. 8. 
but he has not recovered his health. I w«qs informed, that an 
idiot had fwallowed a half-crown piece, and directed crude 
quickfilver to be given him in repeated quantities, but never 
heard the event of the cafe. 
A lady in my prefence was eating a cuftard out of a tea-cup, 
and put 3 or 4 pins into her mouth, which were fuppofed to 
have been carelefsly left in the cup, and fwallowed one of them : 
now, though needles have found their way out of the body, and 
other (harp indigeftible materials, yet pins being terminated 
with heads are faid often to have occafioned dangerous and pain- 
ful difeafes, and fometimes death. What then fhould be done ? 
It occurred to me, that as the head of the pin would have fo 
much greater friction than the point, that if it was carried for- 
wards by a ftream of mucilaginous fluid, the head muft go firft ; 
and I therefore immediately directed an emetic, and the pin was 
brought up without any pain, or any ftains of blood in the eject- 
ed fluid. 
8. AJlhma humor ale. The humoral afthma probably con fills 
in a temporary anafarca of the lungs, which may be owing to a 
temporary defedl of lymphatic abforption. Its caufe is never- 
thelefs at prefent very obfeure, fince a temporary deficiency of 
venous abforption, at the extremities of the pulmonary or bron- 
chial veins, might occafion 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 cheft might, by fome addi- 
tional heat during fleep, acquire an aerial form, and thus com- 
prefs the lungs ; and on this circumftance the relief, which thefe 
patients receive from cold air, would be readily accounted for. 
The paroxyfms attack the patient in his firft fleep, when the 
circulation through the lungs in weak people wants the affiftance 
of the voluntary power. Clafs I. 2. 1. 3. And hence the ab- 
forbents 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 unabforbed, and occafions the difficult 
refpiration, which awakes the patient. And the violent exer- 
tions of the mufcles of refpiration, which fucceed, are excited by 
the pain of fuffocation, for the purpofe of puffiing forwards the 
blood through the comprefled capillaries, and to promote the ab- 
forption of the effufed lymph. 
In this the humoral differs from the convulfive afthma, treat- 
ed of in Clafs III. 1. 1. 10. as in that there is probably no ac- 
cumulated 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 diftant part, as in other convulfions, or epilep- 
fy ; and in this refpedl the fits of humoral and convulfive afthma 
effentially Class II. <. 1. 8. 
OF SENSATION. 
157 
eflentially differ from each other, contrary to the opinion ex- 
prefl'ed without fuihcient conuderation in Seel. XVIII. 15. 
The patients in the paroxyfms both of humoral and convulfive 
afthma find relief from cold air, as they generally rife out of 
bed, and open the window, and put out their heads ; for the 
lungs are not fenfible to cold, and the fenfe of fuffocation is fome- 
what relieved by there being more oxygen contained in a given 
quantity of cold frelh 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 exceflive drinker of 
fpirituous potation. And M. Savage aflerts, that this difeafe 
frequently terminates in diabetes; which feems to fhew, 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 I. 3. 2. 8. which would countenance the idea of their be- 
ing occafioned by congeftions of lymph in the lungs. 
The congeftion of lymph in the lungs from the defective ab- 
forption 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 
Sedt. XVIII. 15. For the fame reafon many epileptic fits, and 
paroxyfms of the gout, occur during fleep. , 
In two gouty cafes, complicated with jaundice, and pain, and 
ficknefs, the patients had each of them a fhivering fit, like the 
commencement 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 ceffation of the jaundice, and 
pain about the ftomach, and ficknefs ; and inftead of that the 
gout appeared in their extremities. In thefe cafes I conjecture, 
that there was a metaftafis not only of the difeafed aCtion from 
the membranes of the liver to thofe of the foot; but that fome 
of the new veffels, or new fluids, which were previoufly produ- 
ced in the inflamed liver, were tranflated to the feet during the 
cold fit, by the increafed abforption of the hepatic lymphatics, 
and by the retrograde motions of thofe of the affeCted limbs. 
This I think refembles in fome refpecls a fit of humoral afth- 
ma, where ftronger motions of the abforbent vefl'els of the lungs 
are excited, and retrograde ones of the correfpondent cutaneous 
lymphatics ; whence the violent fweats of the upper parts of the 
body 158 
DISEASES 
Class II. 1. 1. 9. 
body only are produced ; and for a time the patient becomes re- 
lieved by the metaftafis and elimination of the offending material 
by fenfitive exertion. For a further account of this intricate 
fubjeff fee Clafs III. i. r. io. 
KI. M. To relieve the paroxyfm a tea-fpoonful of ether may 
be given mixed with water, with io drops of laudanum, to be 
repeated three or four times. Vcnefedlion. An emetic. A 
blifter. Afterwards 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. Iflues. 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 ; feme well obferved and 
well attefted cafes of which are publiihed by Dr. Beddoes ; as 
this purer air invigorates the circulation, and the whole fyftem 
in confequence, perhaps not only by its llimulus, but by its fup- 
plying the material from which the fenforial power is extracted 
or fabricated. In fpafmodic afthma, on the contrary, Dr. Fer- 
riar has found undoubted benefit from an atmofphere mixed with 
hydrogen. See Seft. XVIII. 15. and Clafs III. 1. 1. 10. 
9. NiElitatio fenjitiva. Winking of the eyes is performed eve-p- 
ry minute, without our attention, for the purpofe of diffufmg 
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 lachrymal points above and below the internal corner of it. 
When this operation is performed without our attention, it is 
caufed by the faculty of irritation, and belongs to Clafs I. 1.4. 
1. but when it is produced by a ftronger ftimulus of any extra- 
neous material in the eye, fo as to caufe pain, the violent and fre- 
quent nictitation is caufed by the faculty of fenfation. 
This difeafe is fometimes produced by the introverfion of the 
edge of the lower eyelid, which bends the points of the hairs of 
the evelafh upon the ball of the eye, which perpetually ftimulate 
it into painful fenfation. This introverfion of the eyelid is gen- 
erally owing to a tumour of the cellular membrane below the 
edge of the eyelid, and though a very troublefome complaint may 
often be cured by the following Ample means. A little common 
plafter fpread on thin linen, about a quarter of an inch long, 
muft be rolled up fo as to be about the fize of a crow-quill ; 
this muft be applied immediately below the eyelaih on the out- 
fide of the eye, and muft be kept on by another plafter over it. 
This will then act as a flight comnreihon on the tumor under 
the eyelaih, and will prevent the hairs from touching the eye- 
ball. In a week or two the com preflion will diminiih the tu- 
mor it lies over, and cure this painful deformity. 
io. Ofcitatio Class II. 1. 1. 10. 
OF SENSATION. 
159 
to Ofcitatio et pandiculatio. Yawning and ftretching of the 
limbs is produced either by a long inactivity of the mufcles now- 
brought into action, as fometimes happens after fleep, or after 
liitening a long time to a dull narrative ; or it is produced by a 
too long continued action of the antagonift mufcles. In the 
former cafe there is an accumulation of fenforial 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 afting violently, 
and a confcquent accumulation in the mufcles, which are antag- 
onifts to them, and which were at reft. 
Thefe involuntary motions are often feen in paralytic 
limbs, which are at the fame time completely difob*dient to the 
will; and are frequently obfervable in very young children ; and 
from thence we may conclude, that thefe motions are learnt be- 
fore nativity ; as puppies are feen to open their mouths before 
the membranes are broken. See Seft. XVI. 2. 
Where thefe motions are obferved in limbs otherwife paralyt- 
ic, it is an indication that eleftric fhocks may be employed with 
advantage, as the excitability of the limb by irritation is not ex- 
tinct, though it be difobedient both to volition and fenfation. 
11. Tenefmus confifts in violent and frequent ineffectual ef- 
forts to difeharge the contents of the reftum, owing to pain of 
the fphinfter. 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 mar- 
row-fpoon, as cathartics and even clyfters will pafs without re- 
moving them. It is fometimes caufed by fyrnpathy with the 
urethra, when there is a ftone at the neck of the bladder. See 
Clafs II. 2. 2. 7. and IV. 1. 2. 8. 
M. M. Fomentation, an enema with mucilage and laudanum. 
The common exclufion of the feces from the reftum is a pro- 
cefs fimilar to this, except that the mufcles of the fphinfter ani, 
and thofe of the abdomen, which aft along with them by the 
combined powers of fenfation and affociation, are in tenefmus 
excited by painful fenfation, and in the latter by a fenfation, 
which may in fome inftances be almoft called pleafurable, as re- 
lieving us from a painful one in the exclufion of the feces. 
12. Stranguria. Strangury conlifts in painful efforts to dif- 
eharge the contents of the urinary bladder. It is generally ow- 
ing to a ftone in the fphinfter of the bladder ; or to the inflam- 
mation of the neck of itoccafioned by cantharides. It is fome- 
rimes caufed by fyrnpathy with the piles ; and then is liable in 
women 160 
DISEASES 
Class II. r. i. 13. 
women to occafion convuIGons, from the violence of the pain 
without inflammation. See Clafs IV. 2. 2. 2. and 3. 
M. M. Fomentation clyfter with oil and laudanum, pulh the 
Hone back with a bougie ; if from cantharides, give half a pint 
of warm water every ten minutes. Mucilage of gum arabic and 
tragacanth. 
The natural evacuation of the urine is a procefs fimilar to this, 
except that the mufcular fibres of the bladder, and the mufcles 
of the abdomen, which aft in concert with them by the combi- 
ned powers of fenfation and of affociation, are, in the former 
cafe of ftrangury, excited into action by painful fenfation ; and 
in the latter by a fenfation, which may almoft be termed pleafur- 
able, as it relieves us from a previous uneafy one. 
The ejedtro feminis is another procefs in fome refpedls fimilar 
to ftrangury, as belonging to the fame fenfible canal of the ure- 
thra, and by exciting into acTion the accelerator}' mufcles; but 
in the ftrangury thefe mufcles are excited into adbion by painful 
fenfation, and in the ejection of the femen by pleafurablc fenfa- 
tion. 
13. Parturhio. Parturition is not a difeafe, it is a natural pro- 
cefs, but is more frequently unfortunate in high life than amongft 
the middle clafs of females ; which may be owing partly to 
fear, with which the priefts of Lucina are liable to infpirc the 
ladies of falhion to induce 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 ; fuch as their greater 
general debility from negledb of energetic exercife, their inexpe- 
rience of the variations of cold and heat, and their fecluhon 
from freflr air. To which muft be added, that great fource of 
the deftruebion of female grace and beauty, as well as of female 
health, the tight ftays and other bandages, with which they are 
generally tortured in their early years by the active folly of their 
friends, which by difplacing many of the vifeera impedes their 
actions, and by comprefling them together produces adhefions of 
one part to another, and aftedts even the form and aperture of 
the bones of the pelvis, through which the nafeent child muft 
be protruded. 
As parturition is a natural, not a morbid procefs, no medicine 
fliould be given, where there is no appearance of difeafe. The 
abfurb cuftom of giving a powerful opiate without indication to 
all women, as foon as they are delivered, is, I make no doubt, 
frequently attended with injurious, and fometimes with fatal 
eonfequcnces. See Clafs II. 1. 2. 16. 
Another thing very injurious to the child, is the tying and 
cutting Class II. 1. 1.13. 
OF SENSATION. 
l6l 
cutting the navel-ftring too foon ; which fhould always be left 
till the child has not only repeatedly breathed, but till all pulfa- 
tion 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 pla- 
centa, which ought to have been in the child ; and at the fame 
time the placenta does not fo naturally collapfe, and withdraw it- 
felf from the fides of the uterus, and is not therefore removed with, 
fo much fafety and certainty. The folly of giving rue or rhu- 
barb to new-born children, and the danger of feeding them with 
gruel inftead of milk, is fpoken of in Clafs I. I. 2. 5. and II. 1. 
2. 16. 
Many ladies become difeafed by an unnatural refufal of giving 
fuck to their child, which ought to relieve their breads of the 
load of milk, and give confolation to their minds by the ftorge 
or love to their infant. Many ladies indeed experience a diffi- 
culty in nurfing their children from their not having nipples to 
their breafts ; which have been often inflamed and deftroyed in 
their early years, even in their infancy, as I have feen, by the 
hard edge of ftiff ftays rubbing againft them, and fometimes, I 
believe, by the fmall-pox. 
M.Herholdt, of Copenhagen, has announced a difcovery which 
he thinks highly interefting to humanity ; which is, that the 
apparent death of new-born infants arifes from the trachea, or 
wind-pipe, being filled with water ; and that they may be gen- 
erally faved by giving them fuch an inclined polition, that the 
water may run out. Of thirteen children, which were fuppofed 
to be dead or ftill-born, he fays, that twelve recovered by thefe 
Ample means. As the trachea may not have acquired due fen- 
fibility before delivery, in fome feeble or premature births, this 
circumftance may polhbly arife, though it feldom occurs even in 
drowned people. Medical Review, July, 1799. 
Vol. II. 
X 
ORDO 162 
DISEASES 
Class II. 1. 2. 
ORDO I. 
Increafed Senfation. 
GENUS II. 
J^ith the Production of new Vefels by internal Membranes or 
Glands, with Fever. 
In the firft clafs of difeafes two kinds of fevers were defcri- 
bed, one from excefs, and the other from defeat of irritation j 
and were in confequence termed irritative, and inirritative fevers. 
In this fecond clafs of difeafes another kind of fever occurs, 
which is caufed by excefs of fenfation, and termed in confe- 
quence Senfitive Fever. But there is no fever from defed 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 exilt with excefs or defect of 
irritation, two other kinds of fever arife from a combination of 
fenfitive fever with the irritative, and inirritative ones. Making 
five kinds in all. 
i. Irritative fever, defcribed in Clafs I. I. I. I. 
2. Inirritative fever. Clafs I. 2. i. i. 
3. Senfitive fever. Clafs II. 1. 6. 1. 
4. Senfitive irritated fever. Clafs IL 1. 2. I. 
5. Senfitive inirritated fever. Clafs II. 1.3. I. 
As the fenfitive irritated fever attends all the difeafes enumer- 
ated under the genus about to be defcribed, it is placed at the 
head of it. And as the fenfitive inirritated fever accompanies 
the greateft number of the fpecies enumerated under the third 
genus of this order, it is 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 con- 
fifts of difordered tribes or trains of aflbciated motions, it may be 
doubted, whether they ought not all to have been placed in the 
fourth clafs, among!! the difeafes of aflbciation. See Clafs IV. 
2. 4. 11. 
All the fubfequent fpecies of this genus are attended with fen- 
fitive irritated fever ; there are neverthelefs fome fuperficial in- 
flammations, which afl'eCl the fame fituations without much fever, 
as the fcrofulous ophthalmy and fpurious peripneumony, 
which belong to other genera. 
Inflammation is uniformly attended with the production or 
fecretion of new fibres conftituting new veflels; this therefore 
may Class II. 1. 2. 1. 
OF SENSATION. 
163 
may be efteemed its eflential character, or the criterion of its 
cxiftence. The extenfion of the old veflels feems rather a con- 
fequence than a caufe of the germination, or pullulation, of thefe 
new ones ; for the old veflels may be enlarged, and excited with 
unufual energy, without any production of new ones, as in the 
blulh of fliame or of anger. 
When thefe new veflels are formed, if they are not reabforbed 
into the circulation, they fecrete a new fluid called purulent 
matter ; which generally opens itfelf a paflage on the external 
ikin, and produces an ulcer, which either gradually heals, or 
ipreads, and is the caufe of hectic fever ; or they fecrete conta- 
gious matter, which has the property of exciting the fame kind 
of inflammation, and of producing the fame kind of contagious 
matter, when inferted by inoculation into the Ikin of other per- 
fons. Thefe contagious matters form ulcers, which either heal 
fpontaneoufly, or by art; or continue to fpread, and deltroy the 
patient, by other kinds of he<Tic fever. 
In this genus there is an increafe of the fenforial power of ir- 
ritation as well as of fenfation ; whence great arterial energy is 
produced, and the pulfe becomes ftrong and full,as well as quick; 
and the coats of the arteries feel hard under the finger, being 
themfelves thickened and diftended by inflammation. The 
blood drawn, efpecially 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 ftate ; the thinner part being more 
perfectly abforbed by the increafed action of the inflamed abforb- 
ents. See Se£t. XXXIII. 2. 2. This is rendered more prob- 
able, becaufe the hard feel of the pulfe, and the abundance of 
coagulable lymph commence, exift, and ceafe together. 
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 adlion. The in- 
creafed 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 pleu- 
rify, 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 fenfatioij 
befides that of irritation. 
SPECIES. 
I. Febris fenjitiva irritata. Senfitive irritated fever, or in- 
flammatory 164 
DISEASES 
Class II. 1. 2.1. 
flammatory fever. Phlegmafla. A ftrong full pulfe, with in- 
flammation of the coats of the arteries, conftitutes this difeafe. 
It originates from fome topical inflammation, which, if the fever 
is not fubdued, terminates in fuppuration ; and differs from ir- 
ritative fever in refpeCt to the painful fenfation which accompa- 
nies it. For as pleafurable fenfation is the caufe of the growth 
of the new veflels, and diftention of the old ones, in the natural 
enlargement of the body during our infancy ; fo a painful fenfa- 
tion is the caufe of the unnatural production of new veflels, and 
enlargement of old ones in inflammatory difeafes. 
When matter is thus formed in any internal vifcus, or in 
the cellular membrane, as in the lungs or liver; fo long as this 
abfcefs remains without admiflion of air, this inflammatory fever 
is liable to continue, recieving 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 ab- 
fcefles, this kind of fever is changed into a heClic fever in a An- 
gle day. It alfo fometimes happens, that when the abfcefs re- 
mains unopened to the air, if the matter has become putrid, hec- 
tic fever fupervenes, with colliquative fweats, or diarrhoea ; the 
matter in both cafes is fometimes abforbed, and the Ades of the 
abfcefs grow together again without an external aperture. See 
ClafsII. I. 4. 1. and 2. Another termination of inflammation 
is in gangrene, bat this belongs to the inflammation of the ex- 
ternal fkin ; as the production of purulent matter belongs to in- 
flammation of the internal or mucous membranes. Thus when 
the external fkin is the feat of inflammation, as in erythema, or 
eryflpclas, and produces fenfltive irritated fever, no collection of 
purulent matter can be formed 5 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 mult 
be noted, that thefe kinds of inflammation can exift together ; 
and fpme parts of the cellular membrane may fuppurate at the 
fame time that the external fkin is affeCted with erythema, or 
eryflpelas. 
M. M. VenefeClion. Cathartics. Diluents. Cool air. 
Torpentia. Cold bath ? See SeCt. XII. 6. 
The increafed arterial aCtion in this fenfltive irritated fever is 
not Amply owing to the increafed irritability of the arterial fyf- 
tem, or to the ftimuius of the diftention of the veflels, but alfo 
to the increafed acrimony or pungency of the blood ; which 
has now fo far changed its nature as to become more fluid, 
more denfe, and to be loaded with coagulable lymph. Hence 
it becomes neceflary not only to leflen the quantity of blood 
by venefeCtion and by cathartics, but alfo to dilute its acrimo- 
ny» Class II. 1. 2. 2. 
OF SENSATION. 
165 
ny, or pungency, by the introduction of aqueous and mucilagin- 
ous fluids, fuch as barley water, cream and water, fugar and 
water, weak broths ; to which may be added to much of fome 
vegetable eflential oil, as may render them grateful to the ftom- 
ach, and thus promote their abforption ; as by infufing parfley 
or cellery and turnips in the broth j or by balm, mint, or fage 
teas. 
The following fpecies of this genus only diftinguifh the fitua- 
tion of the part previoufly inflamed, and which is the remote 
caufe of the fenfitive irritated, or inflammatory fever, which at- 
tends it. 
2. Ophthalmia interna. Inflammation of the eye is attended, 
with the production of new veflels, which fpread over the tunica 
adjunCtiva, and over the cornea ; thefe new veflels are eaflly 
feen, as they lie on a white ground, and give ocular demonftra- 
tion of their production in inflammation. When this inflamma- 
tion of the cornea fuppurates, it is liable to leave little ulcers, 
which may be feen beneath the furface in the form of little ex- 
cavations ; and as thefe heal, they are liable to be covered with 
an opaque fear. This fear, in fome months or years, is liable to 
wear away, and become tranfparent, without the afliftance of 
any poliffiing powder, as of very finely levigated glafs, as fome 
have recommended. But when the cornea is affected through 
all its thicknefs, the return of its tranfparency becomes hopelefs. 
See Clafs I. i. 3. 14. 
In violent degrees of ophthalmy the internal parts, as the reti- 
na, optic artery, iris, ciliary procefs, become inflamed, as well 
as the external ones ; hence the leaft light admitted to the eye 
occafions intolerable pain. This curious circumftance cannot 
be owing to the aCtion of light on the inflamed veflels of the 
cornea ; it therefore fhews, that the extremity of the optic nerve 
or retina is alfo rendered more exquifltely fenfible to light, by 
partaking of the inflammation ; and I have been told, that red 
colours are in thefe cafes fometimes painfully perceived even 
in perfed darknefs. This fhews that the retina is excited into 
motion by the ftimulus of light; and that, when it is inflamed, 
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 in- 
flamed. > 
M. M. VenefeClion. Cathartics. Diluents. Torpentia. 
Frequently moiflen the eye with cold water by means of a rag. 
Cool airy room. Darknefs. When the inflammation begins to 
decline, white vitriol gr. yi. in an ounce of water is more effica- 
cious 166 
DISEASES 
Class II. 1. 2. 3. 
clous to moiften the eye than folutions of lead. Tin&ure of o- 
pium diluted. Extract of belladonna. New veflels from the 
inflamed tunica adnata frequently fpread like a fly's wing upon 
the tranfparent cornea, which is then called Pterigium. To 
itop the growth of this, the principal veflels fhould be cut through 
with a lancet. When the inflammation begins to decline, after 
clue evacuation any Simulating material put into the eye increas- 
es the abforption, which foon removes the new red veflels ; 
which has given rife to a hundred famous eye-waters, and eye- 
dodtors ; if thefe ftimulating materials are ufed too foon, the 
inflammation is increafed by them. See Seft. XXXII. 2. io 
Clafs I. 2. 2. 13. 
There is another ophthalmia, which attends weak children, 
and is generally efteemed a fymptom of fcrofula, as defcribed 
in Clafs II. 1. 5. 3. and another, which is of venereal origin, 
mentioned in Clafs II. 1. 5. 2. both which may be termed 
ophthalmia fuperficialis. 
3. Phrenitis. Inflammation of the brain is attended with in- 
tolerance of light and found ; which (hews, that the extremities 
of the nerves of thofe fenfes are at the fame time inflamed ; it is 
alfo attended with great pain of the head, with watchfulnefs, and 
furious delirium. The violent efforts, thefe patients are faid 
fometimes to exert, are owing to the increafed fecretion of fenfo- 
rial power in the brain ; as all other inflamed glands have a 
greater circulation of blood palling through them, and a greater 
fecretion in confequence of their peculiar fluids, as in the hepa- 
titis much more bile is generated. 
M. M. Venefe&ion. Cathartics. Torpentia. Foment the 
head with cold water for hours together. Or with warm water. 
Cool airy room. Afterwards cupping on the occiput. Leeches 
to the temples. When the patient is weakened a blifter on the 
head, and after further exhauftion five or fix drops of tincture 
of opium. 
4. Peripneumonia. Inflammation of the lungs. The pulfe is 
not always hard, fometimes foft; which is probably owing to a 
degree of ficknefs or inaction of the ftomach ; with dull pain of 
the cheft ; refpiration conitantly difficult, fometimes with ere£l 
pofture ; the face bloated and purpliffi ; cough generally with 
moift expectoration, often itained 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 inflammation. 
A peripneumony frequently occurs in the chin-cough, 
and deftroys the patient, except immediate recourfe be had to 
the Class II. 1. 2.4. 
OF SENSATION. 
167 
the lancet, or to four or five leeches ; when blood cannot be 
otherwife taken. 
The peripneumony is very fatal to young children, efpecially 
as I believe it is frequently miftaken for a ipaftnodic afthma, or 
for the croup, or cynanche trachealis of Cullen. Both which, 
however, when they occur, require immediate venefetlion by 
the lancet or by leeches, as well as the peripneumony j as men- 
tioned below. 
Inflammation of the lungs is alfo liable to occur in the meafles, 
and in the hooping-cough, and mult be attacked by venefe€lion 
at any time of the difeafe; otherwife either a prefent death, or 
an incurable confumption, is the confequence. 
The peripneumony is frequently combined with inflammation 
of the pleura, and fometimes with that of the diaphragm ; either 
of thefe may generally be diftinguilhed, not only by the pain 
which attends inflammation of thefe membranes, but by infpect- 
ing the naked cheft, and obferving whether the patient breathes 
more by elevating the ribs, or by deprefling 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 fuccef- 
fion, are of peculiar fervice. 
After the termination of peripneumony a collection of coag- 
ulablelymph is frequently left in the cavity of the cheft unabforb- 
ed ; or a common anafarca of the lungs occurs from the prefent 
inaction of the abforbent veflels, which had previoufly been ex- 
cited too violently. This difficulty of breathing is cured or re- 
lieved by the exhibition of digitalis. See Art. IV. 2. 7. 
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 fe- 
ver and difficulty of breathing increafe, which is generally in 
the evening; antimonials, diluents, repeated fmall blifters about 
the cheft, mucilage, pediluvium, warm bath. Is a decoction 
of feneca-root of ufe ? Do not neutral faits increafe the tenden- 
cy to cough by their ftimulus, as they increafe the heat of urine 
in gonorrhoea ? Children in every kind of difficult breathing, 
from whatever caufe, ffiould be kept as upright in bed as may 
be, and continually watched ; fince, if they flip down, they are 
liable to be immediately fuffocated : to prevent which a pillow 
ffiould be put beneath the undermoft ffieet half way down in the 
bed, fo as to receive the pofteriors of the child, and thus coun- 
teract its Aiding down lower ; or drawers on the thighs might 
be occafionally ufed for this purpofe, as mentioned in Clafs III- 
2. 1. 10. And children ffiould have no cap firing tied under 
their 168 
DISEASES* 
Class II. 1. 2. 4. 
their chins, in any cough or difficulty of refpiration, fince if they 
flip down in their bed the friction of the night-cap on the pil- 
low is liable to draw the tape or ribbon under the chin too tight, 
and fuffocate them. After the patient is greatly debilitated, to 
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 1 believe in feveral cafes I 
have faved the patient. A greater quantity of opium in this 
flate of debility cannot be ufed without hazarding the life of the 
perfon. This fmall quantity of an opiate ihould 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 peripneumonia inirritata^ as defcribed in Se<T. XXVII. 2. 
■which belongs to this place. See alfo Superficial Peripneumo- 
ny, Clafs II. j. 3. 7. ' 
Peripneumonia arthritic a. Gouty peripneumony. I believe, 
that there exifts a peripneumony, and a pleurify which owe their 
inflammation to the fympathy of thofe membranes with fome 
other parts of the fyftem, and may then properly be termed 
rheumatic or gouty peripneumony, or pleurify. And that the 
coagulable lymph left upon the inflamed membranes has gener- 
ally been owing to thefe fympathetic inflammations, and that hy- 
drops thoracis, and anafarca pulmonum are generally caufed by 
gouty affections of the lungs, or rheumatic affections of the pleu- 
ra, and not by the more common idiopathic inflammations of 
thofe membranes. See Clafs I. 2. 3. 14. and Clafs IV. 1. 2. 
16. and Clafs IV. 1. 2. 9. 
Peripneumonia trachealis. Croup. The croup is an inflam- 
mation of the upper part, and the peripneumonia 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 believe, 
confined to the upper part of the trachea only, but exifts at the 
fame time in other parts of the lungs ; and as no inflammation of 
the tonfils is generally perceptible, the uncouth name of cynan- 
che trachealis fhould be changed for peripneumonia trachealis. 
Dr. Wichmann, of Hanover, believes, that the acute afthma 
of Millar, or hives, has been confounded with the angina polypofa, 
or croup, which has occafioned the great difference in the treat- 
ment recommended by authors; as the difeafe has been efteem- 
ed inflammatory by fome, and fpafmodic by others. 
The convulfive afthma, which I have witneffed in one child, 
was readily diftinguiffied from the croup ; as there was (imply a 
great exertion in breathing, but without the harlh found which 
attends Class II. i. 2.4. 
OF SENSATION. 
169 
attends the infpirations in the latter, and there was no attendant 
fever; and the difeafe was cured by one venefedlion, and a 
moderate dofe of opium after the venefe&ion. See afthma 
convulfivum. Clafs III. i. i. io. 
A convulfive difficulty of refpiration may thus be eafily dif- 
tinguiffied from the croup ; as in the former the patient draws 
in the breath eafily, and then voluntarily clofes the larynx, and 
voluntarily ufes great exertion in forcing out the breath, with 
defign to relieve fome pain by this violent exertion, as in parox- 
yfms of epilepfy. 
On the contrary, in the croup the breath is eafily expired, 
but the infpirations are attended with the utmoft difficulty. 
This difficulty of infpiration may be feen by viewing the region 
of the ftomach j as when the child raifes the fternum for the 
purpofe of drawing in its breath, the preffure of the atmof- 
phere on the pit of the ftomach preffes the diaphragm upwards, 
and makes a fudden and great hollow in the fcrobiculus cordis. 
This difficulty of infpiration, and not of expiration, is alfo known 
by the harfh found, which only attends the infpiration. 
This difficulty of infpiration may in part be owing to this cir- 
cumftance. In differing thofe children who have died of the 
croup, I believe the upper part of the adherent coagulable lymph, 
or indurated mucus, formed within the trachea, is found to be- 
come loofe, and to feparate from the upper part of the trachea 
before the lower part of that adhefive membranous cruft begins 
to feparate, and hence the loofe upper part at the time of infpira- 
tion is bent downwards into the trachea, and thus becomes dou- 
ble, and obftruifts the paffage ; but this duplicature of it does 
not happen in expiration. See TranfacSL of a Society, Vol. II. 
Account of Croup, by Henry Ramfey, cafe the Sth. Might not 
this be prevented from being fatal, by an aperture into the wind- 
pipe beneath the larynx ? 
I have very lately feen a moft diftintft cafe of this peripneu- 
monia trachealis, or croup. The child, about ten months old, 
had great difficulty in drawing in its breath, with much noife ; 
but had much lefs difficulty in its expiration, with little or gener- 
ally no found. On obferving its naked cheft, the fternum, or 
breaft-bone, was feen to be raifed with great force ; and then the 
diaphragm, and the bowels under it, rofe haftily up into the loxv- 
er part of the cavity of the cheft ; and the air ruihed with diffi- 
culty, and with great found, through the contrafled larynx into 
the upper part of the cheft ; both thefe effects were evidently 
owing to the preffure of the atmofphere, to fupply the vacuity, 
which muft otherwife fucceed the forcibly railing of the fternum. 
Why the difficulty of infpiring was fo much greater than 
Vol. II. of 170 
DISEASES 
Class II. 1. 2. 4. 
of expiring, requires to be further explained. During infpira- 
tion, the preflure of the atmofphere, when the cavity of the 
chert is enlarged by railing the fternum, and deprelhng the dia- 
phragm, a£ts upon the external part of the larynx, as well as on 
the aperture of it, and thus contracts it, and aifirts the difeafe ; 
whereas in expiration there is no increafe of atmofpheric pref- 
fure on the outfide of the larynx, or trachea, to prevent the ex- 
clufion of the air. In the fame manner, if a flexible pipe of foft 
leather was extended upwards a few inches through the bottom 
of a bucket of water, but very little of the water could be dif- 
charged by it j as the preflure on its Tides would foon comprefs 
the pipe, and thus flop up its mouth. 
After repeated venefeclion, and a cathartic of calomel, a blif- 
ter was applied on each fide of the larynx, and the difficulty of 
breathing became greatly relieved ; and though the child had in- 
tervals of eafier refpiration, and without noile, yet it died on the 
fucceeding day. 
Where the difficulty of breathing is very urgent in the croup, 
bronchotomy is recommended by Mr. Field. Memoirs of a 
Medical Society, London, 1773, Vol. IV. 
After repeated venefehtion, and cathartics, perhaps a drop or 
two drops of tinfture of opium, about fix in the evening, might 
be of ufe to prevent the return of the evening paroxyfm, and this 
efpecially if the difficulty of refpiration has an interval or remif- 
fion, as mentioned below. 
A ftrong decoction of feneca root is recommended by Dr. 
Archer, of America. He boils half an ounce of the root, from 
eight ounces of water to four, and gives a tea-fpoonful every 
hour or half hour, lb as to produce vomiting or purging, and 
then gives it in fmallcr quantities. He alfo rubs mercurial 
ointment about the throat, and ufes calomel internally, fo as to 
affeCt the glands of the throat as quickly as poffible, when the 
difeafe is more advanced, and the difficulty of breathing with 
harlh and Ihrill infpiration is more urgent. Medical and Phyfic- 
al Journal, No. I. p. 83. Asa decoction of feneca root partic- 
ulary rtimulates fome parts of the throat, occafioning a difagreea- 
ble fenfation in it, it may in fome cafes contribute to loofen or 
difeharge the adhefive coagulable lymph, which has been fecrc- 
ted on the inflamed membrane of the wind-pipe, and occalions 
the difficulty of infpiration by contracting its aperture ; and 
may therefore be worth trial after repeated venefcClion, and 
cathartics, and blifters on each fide of the throat. 
Dr. Wichmannof Hanover, above mentioned, afferts, that in 
the croup the difeafe continues regularly to increafe, from the 
commencement of it, without intervals of relief from the great 
difficulty Class II. 1. 2. 5. 
OF SENSATION. 
171 
difficulty of breathing ; and gives this as a criterion to diftin- 
guifh the angina polypofa from the althma acutum. Annals of 
Medicine, Vol. I. But in the cafes of true croup, peripneumo- 
nia trachealis, I have ieen with furprife the difficulty of refpira- 
tion to ceafe for a time, and return again with unabated violence. 
Thefe remiffions of the difficult refpiration are alfo mentioned 
by Dr. Ferriar, who then terms it a fpurious croup, but which 
I fufpedl to be owing fimply to the following circumftances. 
In a common catarrh, when the mucous membrane of the 
noftrils is much inflamed, it becomes fo thickened as totally to 
prevent refpiration through them ; yet on fuddenly warming the 
fkin, by drinking tea or by a fire, and fometimes by only cooling 
the membrane of the noltrils by going into the cold air, the fwcl- 
ling of this membrane will fuddenly fubfide, fo as to permit the 
air to pafs through quite eafily for a time, as explained in ca- 
tarrhus calidus. Clafs I. i. 2. 7. The fame circumftance may 
occur to the inflammation of the membrane, which lines the up- 
per part of the trachea, or it may happen from the doubling of 
the loofened upper part of the adhefive mucus. 
M. M. Frequent bleeding by the lancet or leeches. A few 
grams of calomel. Seneca. Blifters about the throat. An 
opiate in fmall quantity at night after previous evacuations. 
Mercurial ointment. Warm bath. Breathing over the fleam 
of warm water, with or without volatile alkali, or ether, or vine- 
gar. Particular attention ffiould be ufed to keep the child railed 
high in bed. Might the fkin be kept agreeably warm, and at 
the fame time might quite cold air be breathed through a tube 
coming from without, through a broken window, or hole in a 
door ? Or might the child be carried out into the cold air very 
warmly clad ? If a folution of fublimate could be fafely ufed, 
as in gonorrhoea, Clafs II. 1.5. 1 ? 
After evacuation by copious venefeflion, might not the fre- 
quent application of ether externally to the throat be ferviceable ? 
And where there occur intervals of eafy refpiration, might not 
breathing over the dull of powdered Peruvian bark prevent a re- 
turn of the thickening of the membrane, as defcribed in Clafs II. 
1. 6. 7. 
5. Pleuritis. Pleurify. Inflammation of the pleura, with 
hard pulfe, pain chiefly of the fide, pungent, particularly increaf- 
ed during infpiration ; lying on either fide uneafy, the cough 
very painful, dry at the beginning,afterwards modi,often bloody. 
One caufe of pleurify is probably a previous adhefion of the 
lungs to a part of the pleura, which envelopes them. This in 
many cafes has been produced in infancy, by fullering children 
to lie too long on one fide. Or by placing them uniformly on one 
fid* 172 
DISEASES 
Class II. i. 2. 6. 
fide of a fire, or window, to which they will be liable always to 
bend themfelves. 
When matter is produced during perlpneumony or pleurify 
in one fide of the cheft, fo long as it is a concealed vomica, the 
fever continues, if the difeafe be great, for many weeks, and even 
months; and requires occafional venefe&ion, till the patient 
links under the inflammatory or fenfitive irritated fever. But if 
air be admitted, by a part of the abfcefs opening itfelf a way inr 
to the air-veifels of the lungs, a hedlic fever, with colliquative 
fweats or diarrhoea, fupervenes, and frequently deftroys the pa- 
tient ; or the abfcefs heals, the lungs adhering to the pleura. 
See pleurodyne rheumatica. Clafs IV. 1.2. 16. 
M, M. The lancet muft be ufed copioufly, and repeated as 
often as the pain and difficult refpiration increafe. A blifter on 
the pained part. Antimonial preparations. Diluents. Cool 
air. Do neutral faits increafe the/tendency to cough ? Pedi- 
luvium or femicupium frequently repeated. 
6. Diaphragmitis. Inflammation of the diaphragm. Pain 
round the lower ribs as if girt with a cord. Difficult refpira- 
tion performed only by elevating the ribs and in an eredl pof- 
ture. The corners of the mouth frequently retracted into a dif- 
agreeable fmile, called rifus Sardonicus. 
Thofe animals, which are furniffied with clavicles, or collar- 
bones, not only ufe their foremoft feet as hands, as men, mon- 
keys, cats, mice, fquirrels, &c. but elevate their ribs in refpira- 
tion as well as deprefs the diaphragm for the purpofe of enlarg- 
ing the cavity of the cheft. Hence an inflammation of the dia- 
phragm is fudden death to thofe animals, as horfes and dogs, 
•which can only breathe by depreffing the diaphragm ; and is I 
fuppofe the caufe of the fudden death of horfes that are over- 
worked ; whereas, in the human animal, when the diaphragm 
is inflamed, fo as to render its motions impoffible from the pain 
they occafion, refpiration can be carried on, though in a lefs per- 
fect manner, by the intercoftal mufcles in the elevation of the 
ribs. In pleurify the ribs are kept motionlefs, and the refpira- 
tion is performed by the diaphragm, as may be readily feen on 
infpecling the naked cheft, and which is generally a bad fymp- 
tom ; in the diaphragmitis the ribs are alternately elevated, and 
deprefied, but the lower part of the belly is not feen to move. 
M. M. As in pleurify and peripneumony. When the pa- 
tient becomes delirious, and fmiles difagreeably by intervals, and 
is become fo weak, that evacuations by the lancet could be ufed 
no further, and I have almoft defpaired of my patient, I have 
found in two or three inftances, that about five or fix drops of 
tincl. thebaic, given an hour before the evening exacerbation, 
have Class II. 1. 2. 7. 
OF SENSATION. 
173 
have had the happieft effect, and cured the patient in this cafe, 
as well as in common peripneurnony ; it muft be repeated two 
or three evenings, fee Clafs II. i. 2. 4. as the exacerbation of 
the fever, and difficult refpiration, and delirium, generally in- 
creafe towards night. 
The ftimulus of this fmall quantity of opium on a patient 
previoufly fo much debilitated, afts by increafing the exertion of 
the abforbent veffels, in the fame manner as a folution of opium, 
or any other ftimulant, put on an inflamed eye after the veffels 
are previoufly emptied by evacuations, Simulates the abforbent 
fyftem, fo as to caufe the remaining new veffels to be immediate- 
ly reabforbed. Which fame ftimulants would have increafed 
the inflammation, if they had been applied before the evacua- 
tions. See Clafs II. 1. 2. 2. Seft. XXXIII. 3. 1. When the 
fanguiferous fyftem is full of blood, the abforbents cannot aft fo 
powerfully, as the progrefs of their contents is oppofed by the 
previous fulnefs of the blood-veffels ; whence ftimulants in that* 
cafe increafe the aftion of the fecerning fyftem more than of the 
abforbent one ; but after copious evacuation this refiftance to 
the progrefs of the abforbed fluids is removed ; and when ftim- 
ulants are then applied, they increafe the aftion of the abforb- 
ent fyftem more than that of the fecerning one. Hence opium, 
given in the commencement of inflammatory difeafes de- 
stroys the patient ; and cures them, if given in very fmall doles 
at the end of inflammatory difeafes. 
7. Carditis. Inflammation of the heart is attended with un- 
equal intermitting pulfe, palpitation, pain in the middle of the 
fternum, and conftant vomiting. It cannot certainly be diftin- 
guifhed from peripneurnony, 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 erefting the 
body. It has probably moft frequently a rheumatic origin. See 
Clafs II. 1. 2. 17. 
9. Mefenteritis. 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 production 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 fcrofulous habits a fatal purulent lever, 
or hopelefs confumption. 
M. M. Venefeftion. Warm bath. Emollient clyfters. 
1 o. Gajlritis. In inflammation of the ftomach the pulfe is 
generally foft, probably occafioned by the ficknefs which attends 
it. 174 
DISEASES 
Class II. 1. 2. u. 
it. The pain and heat of the ftomach are increafed by what- 
ever is fwallowed, with immediate rejection of it. Hiccough. 
This difeafe may be occafioned by acrid or indigeftible mat- 
ters taken into the ftomach, which may chemically or mechanical- 
ly injure its interior coat. There is however a (lighter fpecies of 
inflammation 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 when the fenforial power has been diminifhcd by great ex- 
ertion, and the ftomach has become lefs irritable by having been 
previoufly ftimulated by much heat, it fooner becomes quiefcent 
by the application of cold. In confequence of this flight inflam- 
mation of the ftomach an eruption of the face frequently enfues 
by the fenfitive aflbeiation of this vifcus with the (kin, which is 
called a furfeit. See Clafs IV. I. 2. 13. and II. 1. 4. 6. and II. 
1.3. 19. 
M. M. VenefecSlion. Warm bath. Blifter. Anodyne clyf- 
ters. Almond foap. See Oafs II. 1. 3. 17. 
11. Enteritif. Inflammation of the bowels is often attended 
with foft pulfe, probably owing to the concomitant ficknefs ; 
•which prevents fometimes the early ufe of the lancet, to the de- 
ftruction of the patient. At other times it is attended with 
ftrong and full pulfe like other inflammations of internal mem- 
branes. Can the feat of the difeafe being higher or lower in 
the inteftinal canal, that is, above or below the valve of the co- 
lon, produce this difference of pulfe by the greater fympathy of 
one part of the bowels with the ftomach than another ? In en- 
teritis with ftrong pulfe the pain is great about the navel, with 
vomiting, and the greateft difficulty in procuring a ftool. In the 
other, the pain and fever are 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 exiftence of fever in the former and not in the latter, the 
other fymptoms generally correfponding ; and, fecondly, that 
the enteritis with fofter quick pulfe, differs from the cholera de- 
fcribed in Clafs I. 3. 1. 5. only in the exiftence of fever in the 
former, and not in the latter, the other fymptoms being in gen- 
eral fimilar. See Clafs II. 1. 3. 20. 
Inflammation of the bowels fometimes is owing to extraneous 
indigeftible fubftances, as plum-ftones, efpecially of the dama- 
fm, which has (harp ends. Sometimes to an introfufeeption of 
one part of the inteftine into another, and very frequently to a 
ftrangulated hernia or rupture. In refpecl to the firft, I knew 
an inftance where a damafin (lone, after a long period of time, 
found Class II. 1. 2. 12. 
OF SENSATION. 
175 
found its way out of the body near the groin. I knew another 
child, who vomited fome damafin Hones, which had lain for near 
twenty hours, and given great pain about the navel, by the exhi- 
bition of an emetic given in repeated dofes for about an hour. 
The fwallowing of plum-Hones in large quantities, and even of 
cherry-Hones, is annually fatal to many children. In refpect 
to the introfufccptlon and hernia, fee Ileus, Clafs I. 3. I. 6. 
M. M. Repeated venefetlion. Calomel from ten to twen- 
ty grains given in fmall pills as in ileus; thefe means ufed early 
in the difeafe generally fucceed. After thefe evacuations a blit- 
ter contributes to Hop the vomiting. Warm bath. Crude mercu- 
ry. Aloes one grain-pill every hour will frequently Hay in tire 
Homach. Glauber's fait difiblved in pepper-mint water given by 
repeated fpoonfuls. 
When the patient is much reduced, opium in very fmall do- 
fes mav be given, as a quarter of a grain,as recommended in plcu- 
rify. If the pain fuddenly ceafes,and the patientcontinues to vom- 
it up whatever is given him, it is generally fatal; as it indicates, 
that a mortification of the bowel is already formed. Some au- 
thors have advifed to join cathartic medicines with an opiate in 
inflammation of the bowels, as recommended in colica faturnina. 
This may fucceed in (lighter cafes, but is a dangerous practice 
in general; fince, if the obHrutfion be not removed by the e- 
vacuation, the llimulus of the opium is liable to increafe the 
action of the veflcls, and produce mortification of the bowel, as 
I think I have feen more than once. Mercury injedted by the 
anus, or water by a forcing-pump. See Ileus I. 3. 1. 6. 
12. Hepatitis. Inflammation of the liver is attended with 
ftrong quick pulfe ; tenfion and pain of the right fide ; often 
pungent as in pleurify, oftener dull. A pain is faid to affect 
the clavicle, and top of the right fhoulder ; with difficulty in ly- 
ing on the left fide ; difficult refpiration ; dry cough vomiting 5 
hiccough. 
There is another hepatitis mentioned by authors, in which the 
fever, and other fymptoms, are wanting, or are lefs violent; as 
defcribed in Clafs II. 1. 4. 11. and which is probably fome- 
times relieved by eruptions of the face ; as in thofe who are ha- 
bituated to the intemperate ufe of fermented liquors. 
M. M. Hepatic inflammation is very liable to terminate in 
fuppuration, and the patient is deHroyed by the continuance of 
a fever with fizy blood, but without night fweats, or diarrhoea, 
as in other unopened abfeefies. Whence copious and repeated 
venefection is required early in the difeafe, with repeated dofes 
of calomel, and cathartics. Warm bath. Towards the end of 
the difeafe fmall dofes of opium before the evening paroxyfms, 
and 176 
DISEASES 
Class II. i. 2. 13. 
and laftly the Peruvian bark, and chalybeate wine, at firft in 
fmall doles, as 20 drops twice a day, and afterwards, if necefla- 
ry, in larger. See Art. IV. 2. 6. 
Towards the end of hepatitis, after repeated venefeflion and 
catharfis, an eruption fometimes appears round the lips, which 
is generally a falutary fymptom : and the decoction of Peruvian 
bark given at this time, in the quantity of about two ounces ev- 
ery fix hours, removes the remaining inflammatory tendency, 
and cures in a day or two. 
Mrs. C. a lady in the laft month of her pregnancy, was feiz- 
ed with violent hepatitis, with fymptoms both of peripneumony 
and of pleurify, for it feldom happens in violent inflammations, 
that one vifcus alone is affected ; (he wanted then about a fort- 
night of her delivery, and after frequent venefeftion, with gen- 
tle cathartics, w'ith fomentation or warm bath, fhe recovered and 
was fafely delivered, and both herfelf and child did well. Rheu- 
matic 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 icreafed by preffure. A cafe is defcribed in Clafs I. 2. 3. 18. 
where a tumid fpleen, attended with fever, terminated in fcir- 
rhus of that vifcus. 
14. Nephritis. Inflammation of the kidney feems to be of 
two kinds ; each of them attended with different fymptoms, and 
different modes of termination. One of them I fuppofe to be 
an inflammation of the external membrane of the kidney, ari- 
fing from general caufes of inflammation, and accompanied with 
pain in the loins without vomiting ; and the other to confift in an 
inflammation of the interior parts of the kidney, occafioned by 
the flimulus of gravel in the pelvis of it, which is attended with 
perpetual vomiting, with pain along the courfe of the ureter, and 
retraction of the teflis on that fide, or numbnefs of the thigh. 
The former of thefe kinds of nephritis is diftinguifbed from 
lumbago by its fituation being more exactly 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 calomel, with or without previous venefec- 
tion. 
The other kind of nephritis, or inflammation of the interior 
part of the kidney, generally arifes from the pain occafioned by 
the ftimulus 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 Class II. 1. 2. 15. 
OF SENSATION. 
177 
kidney by the retrograde action o£ the ureter. The kidney is 
neverthelefs inflamed more frequently, though in a lefs degree, 
from other caufes; efpecially from the intemperate ingurgitation 
of ale, or other fermented or fpirituous liquors. This lefs de- 
gree of inflammation is the caule of gravel, as that before men- 
tioned is the effect of it. The mucus fecreted to lubricate the 
internal furface of the uriniferous tubes of the kidney becomes 
fecreted in greater quantity, when thefe veflels are inflamed ; and, 
as the correfpondent abforbent veflels act more energetically at 
the fame time, the abforption of its more fluid parts is mors 
powerfully affected ; on both thefe accounts the mucus becomes 
both changed in quality and more indurated. And in this man- 
ner ftones are produced on almoft every mucous membrane of 
the body ; as in the lungs, bowels, and even in the pericardium, 
as fome writers have affirmed. See Clafs I. i. 3. 9. 
M. M. Venefection. Ten grains of calomel given in fmall 
pills, then infufion of fena with oil. Warm bath. Then opi- 
um a grain and half. See Clafs I. 1.3. 9. for a further ac- 
count of the method of cure. 
Inflammation of the bladder is attended with 
tumor and pain of the lower part of the belly; with difficult 
and painful mifturition ; and tenefmus. It generally is produ- 
ced by the exiftence of a large ftone in the bladder, when in a 
great degree ; or is produced by common caufes, when in a 
flighter degree. 
The ftone in the bladder is generally formed in the kidney, 
and pafling down the ureter into the bladder becomes there grad- 
ually increafed in fize ; and this moft frequently by the appofi- 
tion of concentric fpheres, as may be feen by fawing fome of 
the harder calculi through the middle, and polifliing one furface. 
Thefe new concretions fuperinduced on the nucleus, which de- 
feended from the kidney, as defcribed in Clafs I. 1. 3. 9. and in 
the preceding article of this genus, is not owing to the micro- 
cofmic fait, which is often feen to adhere to the Tides of cham- 
ber-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 (lightly 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 fecre- 
tion, as explained in Clafs I. 1. 3. 9. and IL 1. 2. 14. and 
thus the ftimulus and pain of a ftone in the bladder contribute 
to its enlargement by inflaming the interior coat of it. 
M. M. Venefeftion. Warm bath. Diluents. Anodyne 
clyfters. See Claft I. 1. 3. 9. 
16. Hyjlevitis. Inflammation of the womb is accompanied 
Vol. II. Z with 178 
DISEASES 
Class II. 2. r. 17* 
with heat, tenlion, tumour, and pain of the lower belly. The 
os uteri painful to the touch. Vomiting. This difeafe is gen- 
erally produced by improper management in the delivery of 
pregnant women. I knew an unfortunate cafe, where the pla- 
centa was left till the next day ; and then an unfkilful accouch- 
eur introduced his hand, and forcibly tore it away ; the confe- 
qbence was a moft violent inflammatory fever, with hard throb- 
bing pulfe, great pain, very fizy blood, and the death of the pa- 
tient. Some accoucheurs have had a practice of introducing 
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 victims to this unnat- 
ural practice. 
Others have received injury, where inflammation has been 
beginning, by the univerfal practice of giving a large dofe of o- 
pium immediately 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 fmail dofe, as io 
drops of tincture of opium, or half a grain of folid opium, mult 
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 fymptom, which re- 
quires it; and which has only been introduced into cuftom by 
the ill-employed activity of the prieftsor prieftefles of Lucina ; 
like the concomitant nonfenfe of cramming rue or rhubarb into 
the mouth of the unfortunate young ftranger, who is thus foon 
made td experience the evils of life. See Clafs II. i. i. 12. 
and I. 1. 2. 5. Juli fo fome over-wife beldames force young 
ducks and turkeys, as foon as they are hatched, to fwallow a 
pepper corn. 
M. M. Venefe&ion repeatedly; diluents ; fomentation; the 
patient Ihould be frequently railed up in bed for a Ihort time, 
to give opportunity of difeharge to the putrid lochia; mucilag- 
inous clyfters. See Febris Puerpera. 
17. Lumbago fenfitiva. Senfitive lumbago. When the exten- 
five membranes, or ligaments, which cover the mufcles of the 
back are torpid, as in the cold paroxyfm of ague, they are attend- 
ed with pain in confequence of the inaction of the vefl'els, which 
compofe them. When this inaction continues without a confe- 
quent renewal or increafe of activity, the difeafe becomes chron- 
ical, and forms the lumbago 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 erect polture of 
t .. the Class II. i. 2.18. 
OF SENSATION. 
179 
the body, and the affefled 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 he&ic fever occafioned by the aerated or 
oxygenated matter. 
This difeafe bears no greater analogy to rheumatifm than the 
inflammation of the pleura, or any other membranous inflam- 
mation ; and has therefore unjuftly been arranged under that 
name. It is diltinguilhed from nephritis, as it is feldom attend- 
ed 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 fci- 
atica ; and has been thought to confiit in an inflammation of the 
theca, or covering of the fciatic nerve, as the pain fometimes fo 
exatlly attends the principal branches of that nerve. See Clafs 
I. 2. 4. 15. 16. 
M. M. Venefeflion repeatedly ; calomel; gentle cathartics; 
diluents; warm bath; poultice on the back, confiding of camo- 
mile flowers, turpentine, foap, and opium ; a burgundy-pitch 
plafter. A debility of the inferior limbs from the torpor of the 
mufcles, which had previoufly been too much excited, frequent- 
ly occurs at the end of this difeafe ; in this cafe eleflricity, and 
iflues on each fide of the lumbar vertebra, are recommended. See 
Clafs I. 2. 4. 16. 
18. Ifchias. The ifchias confifts of inflammatory fever, with 
great pain about the pelvis, the os coccygis, and the heads of the 
thigh-bones, preventing the patient from walking or (landing 
ereft, with increafe of pain on going to (tool. This malady, as 
well as the preceding, has been afcribed to rheumatifm ; with 
which it feems to bear no greater analogy, than the inflamma- 
tions of any other membranes. 
The patients are left feeble, and fometimes lame after this 
difeafe ; which is alfo fometimes accompanied with great flow 
of urine, owing to the defective abforption of its aqueous parts ; 
and with confequent third occafioned by the want of fo much 
fluid being returned into the circulation ; a lodgment of faeces 
in the reftum fometimes occurs after this complaint from the 
leflened fenfibility of it. See Clafs I. 2. 4. 15. 
M. M. Venefeftion ; gentle cathartics; diluents ; fomenta- 
tion ; poultice with camomile flowers, turpentine, foap, and 
opium; afterwards the bark. See Clafs I. 1. 3. 5. 
When this inflammation terminates in fuppuration the matter 
generally can be felt to fluctuate in the groin, or near the top of 
the thigh. In this circumftancc, my friend Mr. Bent, furgeon, 
near 180 
DISEASES 
Class II. 1. 2. 1^. 
near Newcaftle in Staffordlhire, propofes to tap the abfeefs by 
means of a trocar, and thus as often as neceflary to difeharge the 
matter without admitting the air. Might a weak injection of 
wine and water, as in the hydrocele, be ufed with great caution 
to inflame the walls of the abfeefs, and caufe them to unite ? 
See Clafs IL i. 6. 9. 
19. Paronychia interna. Inflammation beneath the finger-nail. 
The pain occafioned by the inflammatory action 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 divided by a deep incifion ; which muft pafs quite 
through the periofteum, 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. 
OF SENSATION. 
181 
ORDO I. 
Increafed Senfation. 
GENUS HI. 
JFah the Produfiion of new Vejfels by external Membranes er 
Glands, with Fever. 
The difeafes of this genus are perhaps all productive of con- 
tagious matter ; or which becomes fo by its expofure to the air, 
either through the cuticle, or by immediate contact with it; 
fuch are the matters of the fmall-pox and mealies. The puru- 
lent matter formed on parts covered from the air by thicker 
membranes or mufcles, as in the preceding genus, does not in- 
duce 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 refpecl it differs from the contagious miafmata of fmall-pox 
or mealies, but refembles thofe which have their origin in crowd- 
ed jails ; for thefe produce fever only, which frequently de- 
Itroys 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 aflizes at Oxford, at the be- 
ginning of this century, having infected their phyficians or at- 
tendants. 
If indeed the matter has continued fo long as to become pu- 
trid, 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 ul- 
cer had been opened, and expofed to the common air ; inftan- 
ces of which are not unfrequent. And from thefe circumftan- 
ces it feems probable, that the matters fecreted by the new veffels 
formed in all kinds of phlegmons, or puflules, are not conta- 
gious, till they have acquired fomething from the atmofphere, 
or from the gas produced by putrefaction ; which will account 
for fome phenomena in the lues venerea, cancer, and of other 
contagious fecretions on the ikin without fever, to be mention- 
ed hereafter. See Clals II. i. 4. 14. 
The theory of contagion has been perplexed by comparing it 
with fermenting liquors ; but the contagious material is fhewn 
in SeCtion XXXIII. to be produced like other fecreted matters 
by 182 
DISEASES 
Class II. 1.3. 
by certain animal motions of the terminations of the veflels. 
Hence a new kind of gland is formed at the terminations of the 
vefTels in the eruptions of the fmall-pox ; the animal motions of 
■which produce from the blood variolous matter; as other glands 
produce bile or faliva. Now if fome of this matter is introdu- 
ced beneath the cuticle of a healthy perfon, or enters the circula- 
tion, and excites the extremities of the blood-veflels into thofe 
kinds of difeafed motions, by which it was itfelf produced, either 
by irritation or aflbciation, thefe difeafed motions of the extremi- 
ties of the veflels will produce other fimilar contagious matter. 
SeeSc€t. XXXIII. 2. 5. and 9. Hence contagion feems to be 
propagated two ways ; one, by the ftimulusof contagious mat- 
ter applied to the part, which by an unknown law of nature ex- 
cites the ftimulated veflels to produce a fimilar matter; as in 
venereal ulcers, which thus continue to fpread ; or as when va- 
riolous matter is infcrted 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 contagion feems to be diffufed, is by 
fome diftant parts fympathizing or imitating the motions of the 
part firfl: aftefted as the ftomach and (kin in the eruptions of 
the inoculated fmall-pox, or in the bite of a mad dog ; as treat- 
ed of in SeQ. XXII. 3.3. 
In fome of the difeafes of this genus, the pulfe is Rrong, full, 
and hard, conftituting the fenfitive irritated fever, as defcribed 
in the preceding genus; as in one kind of eryfipelas, which re- 
quires repeated venefedlion. In others the arterial adiion is 
fometimes moderate, fo as to conftitute the fenfitive fever, as in 
the inoculated fmall-pox ; where the action of the arteries is 
neither increafed by the fenforial power of irritation, as in the 
fenfitive irritated fever; nor decreafed by the defeat of that pow- 
er, as in the fenfitive inirritated fever. But in the greatelt num- 
ber of the difeafes of this genus the arterial action is greatly di- 
miniflied in refpeft to ftrength, and confequently the frequen- 
cy of pulfation is proportionally increafed, as explained in Sect. 
XXXII. 2. 1. Which is owing to the deficiency of the fenfo- 
rial povzer of irritation joined with the increafe of that of fenfa- 
tion, and thus conftitutes the fenfitive inirritated fever ; as in 
fcarlatina with gangrenous tonfils. 
From this great debility of the action 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 defeat of 
that buff" or fize upon the blood, which 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 bafin, fcarcely 
coagulates ; Class II. 1. 3. 
OF SENSATION. 
183 
coagulates ; and is faid to be diflblved, and is by Tome fuppofed 
to be in a ftate of actual putrefaction. See SeCl. XXXIIL i. 
3. where the truth of this idea is controverted. But in the fe- 
vers of both this genus and the preceding one, great heat is pro- 
duced from the chemical combinations in the fecretions of new 
velfels and fluids, and pain or uneafinefs from the diftention of 
the old ones j till towards the termination of the difeafe fenfa- 
tion ceafes, as well as irritation, with the mortification of the 
affected parts, and the death of the patient. 
Dyfenteria, as well as t-onfillitis 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 they are expofed to the 
inflammable air, or hydrogen, which is generated in the intef- 
tines ; both which contribute to produce or promote the conta- 
gious quality of thefe fluids ; as mentioned in Clafs II. 1. 6. 
It is not fpeaking accurate language, if we fay, that, in the 
difeafes of this genus the fever is contagious ; fince it is the ma- 
terial produced by the external membranes which is contagious, 
after it has been expofed to air ; while the fever is the confe- 
quence of this contagious matter, and not the caufe of it. As 
appeats from the inoculated fmall-pox, in which the fever does 
not commence, till after fuppuraticn has taken place in the in- 
oculated arm, and from the difeafes of the fifth genus of this 
order, where contagion exifts without fever. See Clafs II. 1. 
5. and II. 1. 3. 18. 
The exiftence of contagious miafmata in the atmofphere was 
believed even in the time of Homer, and was allegorized under 
the title of the arrows of Apollo. See catarrhus contagiofus, 
II. 1. 3. 6. Of thefe it is probable, that fome contagious mat- 
ters are only diffufed in the atmofphere, as that of the fmall- 
pox, as it feems only to infect thofe who are very near the va- 
riolous patient ; and feems to be fwallowed with the faliva, and 
thence to affect the tonfils. Other contagions may be diflolved 
in the atmofphere, as that of the mealies, and of epidemic ca- 
tarrhs, which therefore firft affeCt the membranes of the noftnls 
in men, and of the maxillary finufes alfo in dogs and horfes. 
Contagious materials have been alfo believed from remote 
antiquity to lodge in the walls of rooms where the fick have 
been confined ; as in the wards of hofpitals, jails, (hips, as well 
as in the bedding or clothes of the infected. The methods of 
purifying infected houfes feem alfo to have been ftudied in the 
remote times; the Levitical law directs the walls of the houfe 
of a leprous perfon to be fcraped; and in modern times white- 
walhi ngs 184 
DISEASES 
Class II. 1. 3. 
Wafliings with lime and painting with oil have been directed, I 
believe with great fuccefs. 
Mr. Cruickfhank has lately recommended two or three parts 
of fulphur with one of nitre to be mixed together, and fet in a 
room clofe (hut up, and ignited by dropping a lighted coal up- 
on it; as the nitre will fupply fufheient oxygen to inflame the 
fulphur in a clofe apartment, and thus to fill the whole with the 
fulphurous vapour ; fo as to pafs into every minute aperture of 
the walls or furniture. 
Another means of fweetening the air of hofpitah, where ma- 
ny ulcerous patients are crowded together, has been alfo recom- 
mended, and might perhaps be ufed with falutary effeiSt to re- 
ftore the air of play-houfes, churches, clofe parlours, courts of 
law, and other places^ where many people refort without due 
ventilation, which confdts in well mixing four ounces of com- 
mon fait with two ounces of pulverized manganefe in a bafln, 
to thefe are then to be added about two ounces of water, and af- 
terwards three ounces of concentrated fulphuric acid, in (mall 
portions at a time ; and when managed in this way the gas is 
laid not to be in the leaft offenfive itfelf, and at the fame time 
deflroys difagreeable fmells, and perhaps alfo infectious miaf- 
xnata. Medical Review, No. 32. 
The white vapours, not the red ones, of nitrous acid have been 
employed with wonderful fuccefs, by Dr. C. Smyth, in the hof- 
pital (hips, without removing the patients ; feme fand is made 
hot in crucibles, many of which are brought into the rooms to 
be fumigated; in this hot fand is then fet a tea-cup containing 
about half an ounce of concentrated vitriolic acid, to which, af- 
ter it had acquired a proper heat, an equal quantity of nitre in 
powder is gradually added, and the mixture ftirred with a glafs 
fpatula, till the vapour arifes from it in conGderable quantity. 
The crucible or pipkin is then carried about the wards by the 
nurfes or convalefcents, who walk about with them, like incenfe- 
pots, in their hands, and by thus fumigating the (hip morning 
and night, with the care of wafhing the beds and clothes, and 
expofing them to the air, the contagion appeared to be quickly 
flopped, and the patients already aff'efted foon recovered. 
If any metalic vefl'el be ufed, the white nitrous vapour be- 
comes red, and what was falutary before becomes now noxious, 
as is obferved by Mr. Keir, in his letter on this fubjeft, who 
adds, that though much vital air is extricated from the mixture, 
he rather afcribes its good effect to the known property of ail 
mineral acids in flopping the procefl'es of fermentation and pu- 
trefaflion; as the contagious miafmata are prefumed to confilt 
of Class II. 1.3.1. 
OF SENSATION. 
185 
of animal matter in fome vicious kind of fermentation. Medi« 
cal Review, Vol. III. p. 17* 
SPECIES. 
I. Febris fenfttiva inirritata. Senfitive inirritated fever. Ty- 
phus gravior. Putrid malignant fever. Jail fever. The imme- 
diate caufe of this difeafe is the increafe of the fenforial power of 
fenfation, joined with the decreafe of the fenforial power of ir- 
ritation ; that is, it confifts in the febris fenfitiva joined with the 
febris inirritativa of Clafs I. 2. I. i. as the febris fenfitiva irri- 
tata of the preceding genus confifts of the febris fenfitiva joined 
with the febris irritativa of Clafs I. i. i. i. In both which 
the words irritata, and inirritata, are defigned to exprefs more 
or lefs irritation than the natural quantity j and the fame when 
applied to fome of the difeafes of this genus. 
This fever is frequently accompanied with topical inflamma- 
tion, which is liable, if the arterial ftrength 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 feve s have 
been termed putrid, and have been thought to owe their caufe 
to what is only their confequence. In hot climates this fever is 
frequently induced by the exhalations of ftagnating lakes or 
marfhes, which abound with animal fubftances ; but which in 
colder countries produce fevers with debility only, as the quar- 
tan ague, without inflammation. 
The fenfitive inirritated, or malignant, fever is alfo frequently 
produced by the putrid exhalations and ftagnant air in prifons ; 
but perhaps moft frequently by contact or near approach of the 
perfons who have refided in them. Thefe caufes of malignant 
fevers contributed to produce, and to fupport for a while, the 
feptic and antifeptic theory of them •, fee Seft. XXXIII. i. 3. 
The vibices or bruifes, and petechiae or purples, were believed 
to be owing to the diffolved ftatc of the blood by its incipient 
putrefaction ; but hydroftatical experiments have been made, 
which (hew the fizy blood of the patient in fenfitive irritated or 
inflammatory fever, with ftrong pulfe, is more fluid, while it is 
warm, than this uncoagulable blood taken in this fenfitive inir- 
ritated, or malignant fever ; from whence it is inferred, that thefe 
petechise, and vibices, are owing to the deficient power of abforp- 
tion in the terminations of the veins. See Clafs I. 2. 1. 5. 
This fenfitive inirritated fever, or typhus gravior, is diftin- 
guifhed from the inirritative fever, or typhus mitior, in the ear- 
ly ftages of it, by the colour of the Ikin j which in the latter is 
Vol. II. A a paler 186 
DISEASES 
Class II. 1. 3. 1. 
paler, with lefs heat, owing to the lefs violent action of the ca- 
pillaries ; in this it is higher coloured, and hotter, from the great- 
er energy of the capillary aflion in the production of new vef- 
fels. In the more advanced ftate petechiae, and the production 
of contagious matter from inflamed membranes, as the aphthae 
of the mouth, or ulcers of the throat, diftinguifh this fever from 
the former. Delirium, and dilated pupils of the eyes, are more 
frequent in nervous fevers; and flupor with deafnefs a more 
frequent attendant on malignant fevers. See Clafs I. 2. 5. 6. 
There is another criterion difcernible by the touch of an ex- 
perienced finger ; and that is, the coat of the artery in inflamma- 
tory fevers, both thofe attended with ftrength or pulfation, and 
thefe with weak pulfation, feels harder, or more like a cord ; 
for the coats of the arteries in thefe fevers are themfelves infla- 
med and are confequcntly turgid with blood, and thence are lefs 
eafily comprefled, 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 (harp, by many writers. 
M. M. The indications of cure confift, 1. In procuring a 
regurgitation of any offenfive material, which may be lodged in 
the long mouths of the laftcals or lymphatics, or in their tumid 
glands. 2. To excite the fyftem into necellary aCtion by the 
repeated exhibition of nutrientia, forbentia, and incitantia ; and 
to preferve the due evacuation of the bowels. 3. To prevent 
any unneceflary 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 fhould be given in a little mu- 
cilage, or conferve. Where fomething fwallowed into the ftom- 
ach is the caufe of the fever, it is liable to be arrefted by the lym- 
phatic 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 fiomach or bowel, as evidently happens on the exhibition of 
calomel, as explained in Sect. XXIX. 7. 2. For this reafon 
an emetic and cathartic, with venefection, if indicated by the 
hardnefs and fulnefs of the pulfe, will very frequently remove 
fevers, if exhibited on the firft, fecond, or even third day. 
2. Wine and opium, in fma|l dofes repeated frequently, but 
fo that not the leaf! degree of intoxication follows, for in that 
cafe a greater degree of debility is produced from the expendi- 
ture Class II. 1. 3. 1. 
OF SENSATION. 
187 
ture of fenforial power in unneceflary motions. Many weak 
patients have been thus ftimulated to death. See Seft. XII. 7. 
8. The Peruvian bark Ihould be given alfo in repeated doles 
in fuch quantity only as may Itrengthen digeftion, not impede 
it. For thefe purpofes two ounces of wine, or ot ale, or cyde:*, 
Ihould be given every fix hours; and two ounces of decoction 
of bark, with two drachms of the tindture of bark, and fix drops 
of tincture of opium, Ihould be given allo every fix hours alter- 
nately; that is, each of them four times in twenty-four hours. 
As much rhubarb as may induce a daily evacuation, Ihould be 
given to remove the colluvies of indigefted materials from the 
bowels; which might otherwife increafe the diftrefs of the pa- 
tient by the air it gives out in putrefaction, or by producing 
a diarrhoea by its acrimony ; the putridity of the evacuations 
is owing to the total inability of thedigeftive powers ; and their 
delay in the inteftincs, to the inactivity of that canal in refpeCt 
to its periftaltic motions. 
The quantities of wine or beer and opium, and bark, above- 
mentioned, may be increafed by degrees, if the patient feems 
refrefhed by them ; and if the pulfe becomes Hower on their 
exhibition ; but this with caution, as I have feen irrecover- 
able milchief done by greater quantities both of opium, wine, 
and bark, in this kind of fever ; in which their ufe is to ftrength- 
en the digel lion of the weak patient, rather than to Hop the par- 
oxyfms of fever ; but when they are adminiHered in intermit- 
tents, much larger quantities are neceflary. 
The ftimulus of fmall blifters applied in fucceflion, one every 
three or four days, when the patient becomes weak, is of great 
fervice by ftrengthening digeltion, and by preventing the cold- 
Tiefs of the extremities, owing to the fympathy of the fkin with 
the ftomach, and of one part of the fkin with another. 
In refpetl to nutriment, the patient ihould be fupplied with 
wine and water, with toafted bread, and fugar or fpice in it; or 
with fago with wine ; frefh broth with turnips, cellery, parfley, 
fruit; new milk. Tea with cream and fugar; bread-pudding, 
with lemon-juice and fugar ; chicken, fifh,or whatever is grate- 
ful to the palate of the fick perfon, in fmall quantity repeated fre- 
quently ; 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 unneceflary motions are to be checked, or prevented. 
Hence horizontal poiture, obfeure room, filence, cool air. All 
the parts of the fkin, which feel too hot to the hand, fhould be 
expofed to a current of cool air, or bathed with cold water, 
whether there are eruptions on it or not. Walh the patient 188 
DISEASES 
Class II. 1. 3. 2. 
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 bathing 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 folu- 
tion of alum is to be preferred, as it inftantly takes away the 
flench from ulcers I fuppofe by combining with the volatile al- 
kali which attends it. For this purpofe a folution of alum of an 
ounce to a pint of water fhould be frequently injected by means 
of a fyringe into the mouth. If there are ulcers on the exter- 
nal fkin, fine powder of bark feven parts, and cerufla in fine 
powder one part, fhould be mixed and applied dry on the fore, 
and kept on by lint, and a bandage. 
As Houghs in the mouth are frequently produced by the pre- 
vious drynefs of the membranes which line it, this drynefs fhould 
be prevented by frequently moiftening them, which may be ef- 
fected by injedion with a fyringe, or by a moift fponge, or laft- 
ly in the following manner. Place a glafs of wine and water, 
or of milk and fugar, on a table by the bedfide, a little above the 
level of the mouth of the patient; then, having previoufly moif- 
tened 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 patient; which will thus be fup- 
plied with a conftant oozing of the fluid through the cloth, 
which aCts a capillary fyphon. 
The vifcid phlegm, which adheres to the tongue, fhould be 
coagulated by fome aullere acid, as by lemon-juice evaporated 
to half its quantity, or by crab-juice ; and then it may be fcra- 
ped off by a knife, or rubbed off by flannel, ora fage-leaf dipped 
in vinegar, or in fait and water. 
2. Eryftpelas. St. Anthony's fire may be divided into three 
kinds, which differ in their method of cure, the irritated, the in- 
irritated, and the fenfitive eryfipelas. 
Rryfipelas irritatum is attended with increafe of irritation be- 
fides incraafe of fenfation ; that is, with lirong, hard and full 
pulfe, which requires frequent venefedion, like other inflam- 
mations with arterial ftrength. It is diftinguifhed from the 
phlegmonic inflammations of the laft genus by its fituation on 
the external habit, and by the rednefs, heat, and tumour, not be-, 
ing diftindly circumfcribed ; fo that the eye or finger cannot 
exaClly trace the extent of them. 
When Class II. 1. 3. 2. 
OF SENSATION. 
189 
When the external Ikin is the feat of inflammation, and pro- 
duces feufftive irritated fever, no collection of matter is formed, 
as when a phlegmon is fituated in the cellular membrane beneath 
the Ikin ; but the cuticle rifes as beneath a bliller-plafter, and 
becomes ruptured ; and a yellow material oozes out, and be- 
comes infpiffated, and lies upon its furface; as is feen in this 
kind of eryfipelas, and in the confluent fmall-pox ; or if the new 
veffels are reabforbed the cuticle peels off in fcales. This differ- 
ence of the termination of eryfipelatous and phlegmonic inflam- 
mation feems to be owing in part to the lefs diftenfibility of the 
cuticle than of the cellular membrane, and in part to the ready 
exhalation of the thinner parts of the ferreted 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 Ikin; and is attended 
fometimes with inflammation of the cellular membrane beneath 
the Ikin ; whence a real phlegmon and collection of matter be- 
come joined to the eryfipelas, and either occafion or increafe 
the irritated fever, which attends 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 pre- 
ceded, or attended, or fucceeded, by delirium than internal 
phlegmons. I except the mumps, or parotitis, defcribed below; 
which is properly an external gland, as its excretory du<T opens 
into the air. When pain of the head or delirium 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 acTion is transferred to the fkin 
of the face by fenfitive affociation ; 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 cir- 
cumilance fhould be fupported by further evidence, this difeafe 
fhould be removed into Oafs IV. along with the rheumatifm 
and gout. See Clafs IV. 1.2. 17. 
This fuppofed retropulfion of eryfipelas on the brain from 
the frequent appearance of delirium, has prevented the free ufe 
of the lancet early in this difeafe to the deltrucffion of many; 
as it has prevented the fubduing of the general nflammation, 
and thus has in the end produced the particular one on the 
brain. Mr. B , a delicate gentleman about fixty, had an ery- 
fipelas beginning near one ear, and extending by degrees over 
the whole head, with hard, full, and Itrong pulfe; blood was ta- 
ken 190 
DISEASES 
Class II. 1. 3. 2» 
ken from him four or five times in confiderable quantify, with 
gentle cathartics, with calomel, diluents, and cool air, and he 
recovered without any figns of delirium, or inflammation of the 
meninges of the brain. Mr. W , a ftrong corpulent 
man of inferior life, had erylipelas over his whole head, with 
flrong hard pulfe : he was not evacuated early in the difeafe 
through the timidity of his apothecary, and died delirious. Mrs. 
F had erylipelas on the face, without either ftrong or weak 
pulfe; that is, with fenlitive fever alone, without fuperabun- 
dance 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 inflammation requires it; 
but not where this degree of inflammation is fmall, nor in the 
erylipelas attended with inirritation, as defcribed below, 
M. M. Venefection repeated according to the degree of in- 
flammation. An emetic. Calomel, three grains every other 
night. Cool air. Diluents, emetic tartar in fmall dofes, as a 
quarter of a grain every fix hours. Tea, weak broth, gruel, lem- 
onade, neutral faits. See Sect. XII. 6. 
Such external applications as carry away the heat of the fkin 
may be of fervice, as cold water, cold flour, fnow, ether. Be- 
caufe thefe applications impede the exertions of the fecerning 
veflels, which are now in too great aftion ; but any applica- 
tions of the ftimulant kind, as folutions of lead, iron, copper, 
or of alum, ufed early in the difeafe, muft be injurious ; as they 
ftimulate the fecerning veflels, as well as the abforbent veflels, 
into greater action ; exactly as occurs when ftimulant eye wa- 
ters are ufed too foon in ophtbalmy. See Clafs II. i. 2. 2. 
But as the cuticle peels off in thiscafe after the inflammation ceaf- 
es, it differs from ophthalmy; and ftimulant applications 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 blif- 
ter, the ferous fluid between them is a defence to the new cuti- 
cle, and ihould dry into a fcab by exhalation rather than be re- 
abforbed. Hence we fee how greafy or oily applications, and 
even how moift ones, are injurious in eryfipelas ; becaufe they 
prevent the exhalation of the ferous effufion between the old 
and new cuticle, and thus retard the formation of the latter. 
Eryfipelas inirritatum differs from the former in its being at- 
tended with weak pulfe, and other fymptoms of fenfitive inir- 
ritated fever. The feet and legs are particularly liable to this 
eryfipelas, which precedes or attends the fphacelus or mortinca- 
' tion of thofe parts. A great and long coldnefs firft affe<fts the 
limb, and the eryfipelas on the Ikin feems to occur in confe- 
quence Class II. 1.3. 2. 
OF SENSATION. 
191 
quence of the previous torpor of the interior membranes. As 
this generally attends old age, it becomes more dangerous in 
proportion to the age, and allo to the habitual intemperance of 
the patient in refpeti to the ufe of fermented or fpirituous liquor. 
When the former kind, or irritated eryfipelas, continues long, 
the patient becomes fo weakened as to be liable to all the fymp- 
toms of this inirritated eryfipelas ; efpecially where the menin- 
ges of the brain are primarily affected. 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 fkin, thofe 
meninges become inflamed themfclves, and the patient links un- 
der the difeafe ; in a manner fimilar to that in old gouty patients, 
where the torpor of the liver or ftomach is relieved by affocia- 
tion of the inflammation of the membranes of the feet, and then 
of other joints, and laftly the power of affociation ceafing to a£l, 
but the excefs of fenfation continuing, the liver or ftomach re- 
mains torpid, or becomes itfelf inflamed, and the patient is de- 
ft royed. 
M. M. Where there exifts a beginning gangrene of the ex- 
tremities, the Peruvian bark, and wine, and opium, are to be 
given in large quantities ; fo as to ftrengthen the patient, but 
not to intoxicate, or to impede his digeftion of aliment, as men- 
tioned in the firft 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 ftupor, and flow refpira- 
tion with flow pulfe ; other means muft be applied. Such as, 
firlt, a fomentation on the head with warm water, with or with- 
out aromatic herbs, or fait in it, fhould be continued for an hour 
or two at a time, and frequently repeated. A blifter may alfo 
be applied on the head, and the fomentation neverthelefs occa- 
fionally repeated. Internally very gentle ftimulants, as camphor 
one grain or two in infufion of valerian. Wine and water, or 
fmall beer, weak broth. An enema. Six grains of rhubarb and 
one of calomel. Afterwards five drops of tinfture 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 ? 
Eryfipelas fenjitivum is a third fpecies, differing only in the kind 
of fever which attends it, which is (imply inflammatory, or fen- 
fitive, without either excefs of irritation, as in the firft variety ; 
or the defeat of irritation, as in the fecond variety: all thefe 
kinds of eryfipelas are liable to return by periods in fome people, 
who have paffed 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 fecm to fupply the place of 
the 192 
DISEASES 
Class II. t. 3. 3. 
the receding Catamenia ; when to men, I have fometimes be- 
lieved them to be aflbciated with a torpor of the liver ; as they 
generally occur in thofe who have drunk vinous fpirit exceffive* 
ly, though not opprobrioufly ; and that hence they fnpply 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 tome of the former ; the eryfipelas does 
not appear to be a primary difeafe, and fhould perhaps be re- 
moved to the Clafs of Adbciation. 
3. Tonftllitis. Inflammation of the tonfils. The uncouth term 
Cynanche has been ufed for difeafes fo diflimilar, that I have di- 
vided them in^o Tonfillitis and Parotitis ; and hope to be excufed 
for adding a Greek termination to a Latin word, as one of thofe 
languages may juftly be confidered as a dialect of the other. 
By tonfillitis the inflammation of the tonfils is principally to be 
underftood ; but as all inflammations generally fpread further 
than the part firft affe/ted ; fo, when the fummit of the wind- 
pipe is alfo much inflamed, it may be termed tonfillitis trachea- 
Es, or croup. See Clafs I. 1. 3. 4. and II. 1. 2. 4. ; and 
when the fummit of the gullet is much inflamed along with the 
tonfd, it may be called tonfillitis pharyngea, as defcribed in Dr. 
Cullen's Nofologia, Genus X. p. 92. The inflammation of the 
tonfils may be divided into three kinds, which require different 
methods of cure. 
Tonjillitis interna. Inflammation of the internal tonfih ■ When 
the fwelling is fo confiderable as to produce difficulty of breath- 
ing, the fizc of the tonfd fhould be diminifhed by cutting it with 
a proper lancet, which may either give exit to the matter it con- 
tains, 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, which accompanies all inflammation, 
and fometimes requires venefeclion. An emetic fhould be giv- 
en early in the difeafe, as bv its inducing the retrograde action 
of the veflels about the fauces during the naufea it occafions, it 
may eliminate the very caufe of the inflammation ; which may 
have been taken up by the abforbents, and {fill continue in the 
mouths of the lymphatics or their glands. The patient fhould 
then be induced to fwallow fome aperient liquid, as an infuiion 
of fenna, fo as to induce three or four evacuations. Gargles of 
all kinds are rather hurtful, as the adlion of ufing them is lia- 
ble 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 acts like a warm bath, or fomentation to the inflamed 
part; Class 11. 1. 3. 3. 
OF SENSATION. 
193 
part. Laftly, fome mild ftimulant, as a weak folution of fait 
and water, or of white vitriol and water, may be ufed to wafh 
the fauces with in the decline of the difeafe, to expedite the ab- 
forption of the new veffels, if neceflary, as recommended in 
ophthalmy. 
TonfiUitis fuperficialis. Inflammation of the furface of the 
tonfils. As the tonfils and parts in their vicinity are covered 
with a membrane, which though expofed to currents of air, is 
neverthelefs conftantly kept moift by mucus and faliva, and is 
liable to difeafes of its furface like other mucous membranes, as 
well as to fuppuration of the internal fubftance of the gland ; 
the inflammation of its furface is fucceeded by fmall elevated 
puftules with matter in them, which foon difappears, and the 
parts either readily heal, or ulcers covered with Houghs are left 
on the furface. 
This difeafe is generally attended with only fenfitive fever, 
and therefore is of no danger, and may be diftinguifhed with 
great Certainty from the dangerous inflammation or gangrene 
of the toniils 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 
theft tumours of the ton fils frequently return I have fometimes 
fufpetted them to originate from the abforption of putrid matter 
from decaying teeth. See Clafs I. 2. 3. 21. and II. 2. 2. I. 
'TonJiUitis inirritata. Inflammation of the tonfils with fenfi- 
tive inirritated fever is a fymptom only of contagious fever, 
whether attended with fcarlet eruption, or with confluent fmall- 
pox, or otherwife. The matter of contagion is generally difFu- 
fed, not diflblved in the air; and as this is breathed over the mu- 
cagincus furface of the tonfils, the contagious atoms are liable 
to be arrefted by the tonlil; which therefore becomes the neft 
of the future difeafe, like the inflamed circle round the inocu- 
lated puncture of the arm in fuppofitious fmall-pox. The fwell- 
ing is liable to fuffocate the patient in fmall-pox, and to become 
gangrenous in fcarlet fever, and fome other comagious fevers, 
which have been received in this manner. The exigence of in- 
flammation of the tonfil previous to the fcarlet eruption, as the 
arm inflames in the inoculated fmall-pox, and fuppurates before 
the variolous eruption, fhould be a criterion of the fcarlet fever 
being taken in this manner. 
M. M. All the means which ftrengthen the patient, as in 
the fenfitive inirritated fever, Clafs II. 1. 2. 1. As it is liable 
to continue a whole lunation or more, great attention faould be 
Vol. II. B b - 194 
DISEASES 
Class II. 1. 3. 4. 
ufed to nourifh the patient with acidulous and vinous panada, 
broth with vegetables boiled in it, fugar, cream, beer ; all which 
given frequently will contribute much to moiRent clean, and heal 
the ulcufcles, or Houghs, 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 de- 
fcribed in Clafs IL i. 2. I. A flight folution of blue vitriol, 
as two grains to an ounce, or a folution of fugar of lead of about 
fix grains to an ounce, may be of fervice ; especially the latter, 
applied to the edges of the Houghs, drop by drop by means of 
a fmall glafs tube, or fmall crow-quill with the end cut off, or 
•by a cameEs-hair pencil or fpongejto the end of either of 
which a drop will conveniently hang by capillary attraction ; as 
folutions of lead evidently impede the progrefs of eryfipelas on 
the exterior fkin, 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 re- 
ceived into the lungs by refpiration. 
4. Parotitis. Mumps, or branks, is a contagious inflamma- 
tion of the parotis and maxillary glands, and has generally been 
claffed under the word Cynanche or Angina, to which it bears 
no analogy. It divides itfelf into two kinds, which differ in the 
degree of fever which attends them, and in the method of cure. 
Parotitis Jupp u vans. The fuppurating mumps is to be diftin- 
guifhed by the acutenefs of the pain, and the fenfitive, irritated, 
or inflammatory fever, which attends it. 
M. M. VenefeCtion. Cathartic with calomel three or four 
grains repeatedly. Cool air, diluents. This antiphlogiftic treat- 
ment is to be continued no longer than is neceffary to relieve 
the violence of the pain, as the difeafe is attended with conta- 
gion, and muft run through a certain time, like other fevers 
with contagion. 
Parotitis mutabilis. Mutable parotitis. A fenfitive fever on- 
ly, or a fenfitive irritated fever, generally attends this kind. And 
when the tumour of the parotis and maxillary glands fubfides, 
a new fwelling occurs in fome diftant part of the lyftem ; as 
happens to the hands and feet, at the commencement of the fec- 
ondary fever of the fmall-pox, when the tumor of the face fub- 
fides. This new fwelling in the parotitis mutabilis is liable to 
affeCt the teftes in men, and form a painful tumor, which fhould 
be prevented from fuppuration by very cautious means, if the 
violence of the pain threaten fuch a termination ; as by bathing 
the part with coldilh water for a time, venefedtion, a cathartic j 
or by a bliftcr on the perinacum, or fcrotum, or a poultice. 
Whqn Class II. 1. 3. 4. 
OF SENSATION. 
195 
When women are affected with this complaint, after the 
fwelling of the parotis and maxillary glands fubfides, tumor with 
pain is liable to afleft their breads ; which, however, I have nev- 
er feen terminate in fuppuration. 
On the retroceffion of the tumor of the tedes above defcribed, 
and I fuppofe of that of the breads in women, a delirium of the 
calm kind is very liable to occur j which in fome cafes has been 
the fird fymptom which has alarmed the friends of the patient; 
and it has thence been difficult to difeover the caufe of it with- 
out much inquiry ; the previous fymptorns having been fo flight 
as not to have occafioned any complaints. In this delirium, if 
the pulfe will bear it, venefedlion Ihould be ufed, and three or 
four grains of calomel, with fomentation of the head with warm 
water for an hour together every three or four hours. 
Though this difeaie generally terminates favourably confider- 
ing the numbers attacked by it, when it is epidemic, yet it is 
dangerous at other times in every part of its progrefs. Some- 
times the parotis or maxillary glands fuppurate, producing ul- 
cers which are difficult to cure, and frequently dedroy the pa- 
tient, where there was a previous fcrophulous tendency. The 
tedis in men is alfo liable to fuppurate with great pain, long con- 
finement, and much danger; and laflly, the affection of the 
brain is fatal to many. 
Mr. W. W. had a fwelled throat, which after a few days 
fublidcd. He became delirious or dupid, in which date he was 
dying wAen 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 dupor, with flow 
breathing, and partial delirium. On fomenting his head with 
warm water for an hour thefe fymptorns of dupor were greatly 
leffened, and his opprefl'ed breathing gradually ceafed, and he re- 
covered in one day. 
Mr. C. D. I found walking about the houfe in a calm delir- 
ium without ftupor ; and not without much inquiry of his friends 
could get the previous hidory of the difeafc ; which had been 
attended with parotitis, and fwelled tedis, previous to the deliri- 
um. A few ounces of blood were taken away, a gentle cathar- 
tic was direfled, and his head fomented with warm water for 
an hour, with a fmall blider 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 hidory could be obtained. He was walking a- 
bout the houfe in a calm delirium, but could give no fenfible 
aniwers 196 
DISEASES 
Class II. i. 3. 5. 
anfwers to any thing which was propofed to him. His pulfc 
•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 confiderable ftupor, and 
moderate pulfe, and could give no account of himfelf. He con- 
tinued 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 laft cafes are not related 
as being certainly owing to parotitis, but as they might probably 
have that origin. 
The parotitis fuppurans, or mumps with irritated fever, is at 
times epidemic among cats, and may be called parotitisfelina ; as 
I have reafon to believe from the fwellings under the jaws, 
which frequently fuppurate, and are very fatal to thofe animals. 
In the village of Harwood, in Staffordfliire, 1 remember a 
whole breed of Perfian cats, with long white hair, was deftroy- 
ed by this malady, along with almoft all the common cats of the 
neighbourhood ; and as the parotitis or mumps had not long be- 
fore prevailed amongft human beings in that part of the coun- 
try, I recolleCi being inclined to believe, that the cats received 
the infection from mankind ; though in all other contagious dif- 
eafes, except the rabies canina can be fo called, no different gen- 
era of animals naturally communicate infection to each other; 
and I am informed, that vain efforts have been made to commu- 
nicate the fmall-pox and meafles to fome quadrupeds by inocu- 
lation. A difeafe of the head and neck deftroyed almoft all the 
cats in Weltphalia. Savage, Nofol. Clafs X. Art. 30. 8. 
Since the above was firft pubhlhed, the cow-pox, variolte vac. 
cinse, has been fuccefsfully inoculated on the human fubjecl, 
and produced a difeafe in fome refpebts fimilar to the fmall-pox. 
See Varioke. 
5. Catarrhus fenjitivus confifts of an inflammation of-th^ 
membrane, which lines the noftrils and fauces. It is attended 
with fenfitive fever alone, and is cured by the fleam of warm 
water externally, and by diluents internally, with moderate ven- 
efetlion and gentle cathartics. This may be termed catarrhus 
fenfitivus, to diftinguifh it from the catarrhus contagiofus, and 
is in common language called a violent cold in the head ; it dif- 
fers from the catarrhus calidus, or warm catarrh, of Clafs I. 1, 
2. 7. in the production of new veffels, or inflammation of the 
membrane, and the confequent more purulent appearance of 
the difeharge. 
Jlaucedo catarrlialis,or catarrhal hoarfen^fs, isa frequcntfymp- 
tom Class II. 1. 3. 6. 
OF SENSATION. 
197 
tom of this difeafe, and is occafioned by the pain or forenefs 
which attends the thickened and inflamed membranes of the 
larynx ; which prevents the mufcles of vocality from fufficient- 
ly contracting the aperture of it. It ceafes with the inflamma- 
tion, 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. 1.4. 
6. Catarrhus conta^wfus. This malady attacks fo many at the 
fame time, and fpreads gradually over fo great an extent of coun- 
trv, that there can be no doubt but that it is difTeminated by the 
atmofphere. In the year 1782 the fun was for many weeks ob- 
feured by a dry fog, and appeared red as through a common mill. 
The material, which thus rendered the air muddy, probably cauf- 
ed the epidemic 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 
became contagious, as well as epidemic ; that is, that one perfon 
might receive it from another, as well as by the general unfalu- 
tary nfluence of the atmofphere. This is difficult to compre- 
hend, but maybe conceived by confidering the increafeof conta- 
gious matter in the fmall-pox. In that difeafe one particular of 
contagious matter flimulates the fkin of the arm in inoculation 
into morbid action fo as to produce a thoufand particles fimilar 
to itfelf; the fame thing occurs in catarrh, a few deleterious 
atoms ftimulate the mucous membrane of the noftrils into mor- 
bid actions, which produce a thoufand other particles fimilar to 
themfelves. Thefe contagion^ particles diffufed in the air muft 
have confifted of animal matter, otherwife how could an animal 
body by being (Emulated by them produce fimilar particles ? 
Could they then have had a volcanic origin, or muft they not rath- 
er have been blown from putrid marfhes full of animal matter ? 
But the greateft part of the folid earth has been made from ani- 
mal and vegetable recrements, which may be difperfed by volca- 
noes.-Future difeoveries muft anfwer thefe queftions. 
As the fenfitive fever attending thefe epidemic catarrhs is fel- 
dom either much irritated or inirritated, venefeflion is not al- 
ways either clearly indicated or forbidden; but as thofe who 
have died of thefe catarrhs have generally had inflamed livers, 
with confequent fuppuration in them, venefeeftion is advifable, 
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 neceflary, and a mild cathartic or tw(o 
with 198 
DISEASES 
Class II. i. 3. 6. 
with four grains of calomel; with mucilaginous fubacid dilu- 
ents ; and warm fteam occafionally to alleviate the cough, fin- 
ithed the cure. 
The catarrhus contagiofus is a frequent difeafe amongft horf- 
es and dogs; it feems firft to be diffeminated amongft thefe ani- 
mals by miafmata diffufed in the atmofphere, becaufe fo many of 
them receive it at the fame time ; and afterwards to be communi- 
cable from one horfe or dog to another by contagion, as above 
defcribed. Thefe epidemic or contagious catarrhs more fre- 
quently occur amongft dogs and horfes than amongft men; 
which is probably owing to the greater extenfion and fenlibility 
of the mucous membrane, which covers the organ of fmell, and 
is diffufed over their wide noftrils, and their large maxillary and 
frontal cavities. And to this circumftance may be afcribed the 
greater fatality of it to thefe animals. 
In refpeft to horfes, I fufpecl the fever at the beginning to be 
of the fenfitive, irritated, or inflammatory kind, becaufe there is 
fo great a difeharge of purulent mucus ; and that therefore they 
will bear once bleeding early in the difeafe ; and alfo one mild 
purgative, conflfting of about half an ounce of aloe, and as much 
white hard foap, mixed together. They Ihould be turned out 
to grafs both day and night for the benefit of pure air, unlef?the 
weather be too cold (and in that cafe they Ihould be kept in an 
open airy liable, without being tied), that they may hang down 
their heads to facilitate the difeharge of the mucus from their 
noftrils. Grafs Ihould be offered them, or other frcfii vegeta- 
bles, as carrots ami potatoes, with mafhes of malt, or of oats, and 
with plenty of frelh warm or cold water frequently in a day. 
When fymptoms of debility appear, which may be known by 
the coldnefs of the ears or other extremities, or when Houghs can 
be feen on the membrane, which lines the noftrils, a drink 
conflfting of a pint of ale with half an ounce of tincture of opi- 
um in it, given every fix hours, is likely to be of great utility. 
In dogs I believe the catarrh is generally joined with fymp- 
tems of debility early in the difeafe. Thefe animals Ihould be 
permitted to go about in the open air, and Ihould have conftant 
accefs to frelh water. The ufe of being as much as may be in 
the air is evident, becaufe all the air, which they breathe, paff- 
cs twice over the putrid Houghs of the mortified parts of the 
membrane, which lines the noftrils, and the maxillary and fron- 
tal cavities; that is, both during infpiration and expiration ; 
and muft therefore be loaded with contagious particles. Frelh 
new milk, and frelh broth, fltould be given them very frequently, 
and they Ihould be fuffered to go amongft the grafs, which they 
fometimes eat for thepurpofeof an emetic ; and if poffible Ihould 
have Class II. i. 3. 7. 
OF SENSATION. 
199 
have accefs to a running ftream of water. As the contagious 
mucus of the noftrils, both of thefe animals and of horfes, gener- 
ally drops into the water, they attempt to drink. Bits of raw 
flelh, if the dog will eat them, are preferred to cooked meat; and 
from five to ten drops of timfiure of opium may be given with 
advantage, when fymptoms of debility are evident, according to 
the fize of the dog every fix hours. If floughs can be feen in 
the noftrils, they Ihould be moiftened twice a day, both in horf- 
es 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 fyrmge. 
The lotion may be made by diflblving half an ounce of fugar of 
lead, or of alum, in a pint of water. 
Ancient philofophers feem to have believed, that the conta- 
gious miafmata in their warm climates affected horfes and dogs 
previous to mankind. If thofe contagious particles were fup- 
pofed to be diftufed among ft the heavy inflammable air, or car- 
bonated hydrogen, of putrid 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 quadru- 
peds might receive a difeafe from the fame fource of marfb-pu- 
trefa<Sfion, they might not afterwards be able to infect each other, 
though they might infe£l other animals of the fame genus; as 
the new contagious matter generated in their own bodies might 
not be precifely fimilar to that received ; as happened in the jail- 
fever at Oxford, where thofe who took the contagion and died, 
did not infect others. 
On mules and dogs the infe&ion firft began, 
And, laft, the vengeful arrows fix'd on man. 
Pope's Homer's Iliad, I. 
7. Peripneumonia fuperficialis. The fuperficial or fpurious 
peripneumony confifts in an inflammation of the membrane, 
which lines the bronchia, and bears the fame analogy to the true 
peripneumony, as the inflammation of other membranes do to 
that of the parenchyma, or fubftantial parts of the vifcus, which 
they furround. It atfedls elderly people, and frequently occa- 
fions their death; and exifts at the end of the true peripneumo- 
ny, or along with it; when the lancet has not been ufed fulfi- 
ciently to cure by reabforbing the inflamed parts, or what is term- 
ed by refolution. 
M. M. Diluents, mucilage, antimonials, warmilh air conftant- 
ly changed, venefe6tion once, perhaps twice, if the pulfe will 
bear it. Oily volatile draughts. BaUams ? Neutral faits in- 
creafe the tendency to cough. Blifters in fucceflion about the 
cheft. Warm bath. Mild purgatives. Very weak chicken 
broth 200 
DISEASES 
Class 11. i. 3. 5. 
broth without fair in it. Boiled onions. One grain of cal- 
omel every night for a week. From five drops to ten of tindiure 
of opium at fix every night, when the patient becomes week. 
Digitalis ? See ClaisII. i. 6. 7. 
8. Pertujjis. Tullis convulfiva. Chin-cough refembles pe- 
ripneumonia fuperficialis in its confiding in an inflammation of 
the membrane which lines the air-veflels of the lungs ; but dif- 
fers in the circumftance of its being contagious ; and is on that 
account of very long duration ; as the W'hole of the lungs arc 
probably not infected at the fame time, but the contagious in- 
flammation continues gradually to creep on the membrane. It 
may in this refpecl 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 clafled amongft febrile diforders, 
but a fenfitive fever may generally be perceived to attend it du- 
ring fome part of the day, efpecially in weak patients. And a 
peripneumony very frequently fupervenes, and deftroys great 
numbers of children, except the lancet or four or fix leeches be 
immediately and repeatedly ufed. When the child has perma- 
nent difficulty of breathing, which continues between the cough- 
ing fits : unlefs blood be taken from it, it dies in two, three, or 
four days of the inflammation of the lungs. During this perma- 
nent difficulty of breathing, the hooping cough abates, or 
quite ceafes, and returns again after once or twice bleeding; 
which is then a good fymptom, as the child now pofleffing the 
power to cough thews 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 ; vihere the apoth-*- 
ecary is old or clumfy, or is not furnifhed with a very fharp and 
fine pointed lancet. In this diftreffing fituation the application 
of four leeches to one of the child's legs, the wounds made by 
which ffiould continue to bleed an hour or two, is a fuccedane- 
um ; 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 infection, are 
both difeafes 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 deilroy the patient in both difeafes, if no 
medicine be adminiftered. 
Hence the cure ffiould be fimilar in both thefe difeafes; firft 
general evacuations and diluents, then, after a week or two, I 
have believed the following pills of great advantage. The dofc 
for Class II. 1. 3. 9. 
OF SENSATION. 
201 
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 abfdrption from the mucous membrane, 
and hence contributes to heal it. The mercury prevents ul- 
cers from being formed under the mucous membrane, or cures 
them, as in the lues venerea j and the rhubarb is neccflary to keep 
the bowels open. 
M. M. Antitnonial vomits frequently repeated. Mild ca- 
thartics. Cool air. Tinfture of cantharides, or repeated blis- 
ters ; afterwards opiates in fmall dofes, and the bark. Warm 
bath frequently uled. The fleam of warm water with a little 
vinegar in it may be inhaled twice a day. Thirty drops of Satu- 
rated tinfture of digitalis puerpurea, purple foxglove, were giv- 
en twice a day to a lady, feventy years of age, in this difeafc, 
with great and almofl immediate advantage. I have fince giv- 
en from five to ten drops twice a day to two children, with alto 
great apparent advantage. See Art. IV. 2. 3. 7. Arfenic 
has lately been recommended in the hooping cough. See Art. 
IV. 2. 6. 9. And externally a folution of 20 grains of emetic 
tartar, antimonium tartarifatum, in two ounces of water, to 
which is to be added one ounce of tinflure of cantharides, is rec- 
ommended, by Dr. Struve of America, to be rubbed very fre- 
quently on the region of the ftomach. Could the breathing of 
carbonic acid gas mixed with atmofpheric air be of, fervice ? 
Copious venefeedion, when a difficulty of breathing continues be- 
tween the fits of coughing ; otherwife' the cough and the expec- 
toration ceafe, and the patient is deftroyed. Ulcers of the lungs 
fometimes fupervene, and the phthilis pulmonalis in a few 
weeks terminates in death. Where the cough continues after 
fome weeks without much of the hooping, and a fenfitive fever 
daily fupervenes, fo as to refemble hc£lic fever from ulcers of 
the lungs ; change of air for a week or fortnight adds as a charm, 
and reftores the patient beyond the hopes of the phyfician. 
Young children fhouldlie with their heads and (boulders raif- 
ed ; and (hould be conftantly watched day and night; that when 
the cough occurs, they may be held up eafily, fo as to (land upon 
theirfeet bending a little forwards ; or nicely Supported in that pof- 
ture which they feem to put thcmfelves into. Abowof whalebone, 
about the fize of the bow of a key, is very ufeful to extrafl the 
phlegm out of the mouths of infants at the time of their coughing; 
as a handkerchief, if applied at thetime of their quick infpirations 
after long holding their breath is dangerous, and may fuffocate 
he patient in an inflant, as I believe has fometimeshappened. 
9. Variola dijcrela. The fmall-pox is well divided by Syden- 
Vol. II. C c ham 202 
DISEASES 
Class II. i. 3. 9. 
ham into diftincft and confluent. The former confifts of diftindt 
puftules, which appear on the fourth day of the fever, are cir- 
cumfcribed and turgid ; the fever ceafing when the eruption is 
complete. Head-ach, pain in the loins, vomiting frequently, 
and convulfive fits fometimes, precede the eruption. 
The diftindt fmall-pox is attended with fenfitive fever only, 
when very mild, as in molt inoculated patients; or with fen lb 
tive 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 fecondary fever. For, firft, as the nat- 
ural difeafe is generally taken by particles of the duft of the con- 
tagious 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 ftomach, when they 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 
diftinft fmall-pox can only be abated by venefeclion and cathar- 
tics ; but in the confluent fmall-pox requires cordials and opi- 
ates, as it is attended with arterial debility. See Sedt. 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 fwell ; and the fame 
of the feet in fuccefiion. Thefe fwellings feenr to be owing to 
the abforption of variolous matter, which by its ftimulus excites 
the cutaneous veflels to fecrete more lymph, or ferum, or mucus, 
exadlly as happens by the ftimulus of a blifter. Now, as a blif- 
ter fometimes produces ftrangury many hours after it has rifen, 
it is plain, that a part of the'eantharides is abforbed, and carri- 
ed to the neck of the bladder ; whether it enters the circulation, 
or is carried thither by retrograde 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 conjluens. The confluent fmall-pox confifts of numer- 
ous puftules, which appear on the third day of the fever, flow 
together, are irregularly circumfcribed, flaccid, and little eleva- 
ted ; the fever continuing after the eruption is complete ; con- 
vulfions Class II. 1. 3. 9. 
OF SENSATION. 
203 
vulfions do not precede this kind of fmall-pox, and are fo far to 
be edeemed a favourable fymptom. 
The confluent fmall-pox is attended with fenfitive inirrritated 
fever, or inflammation with arterial debility; whence the dan- 
ger of this difeafe is owing to the general tendency to gangrene, 
with petechias, or purple fpots, and haemorrhages ; bencies 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 generally much more to be dreaded 
in this than in the diftindt fmall-pox defcribed above. 
M. M. The method of treatment muft vary with the degree 
and kind of fever. Venefeftion may be ufed in the diftmtt 
fmall-pox early in the difeafe, according to the ftrength or hard- 
nefs 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 action ? Cold air, and 
even waihing or bathing in cold water, is a powerful means in 
perhaps all eruptive difeafes attended with fever ; as the quan- 
tity of eruption depends on the quantity of the fever, and the 
activity of the cutaneous veifels ; which may be judged of by 
the heat produced on the fkin ; and which latter is immediately 
abated by expofure to external cold. Mercurial purges, as three 
grains of calomel repeated every day during the eruptive fever, 
fo as to induce three or four ftools, contribute to abate inflam- 
mation ; and is believed by fome to have a fpecific effect 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 conceiv- 
ed, that the pits, or marks, left after the fmall-pox, were owing 
to the acrimony of the matter beneath the hard fcabs, which 
not being able to exhale eroded the ficin, and produced ulcers, 
I directed the faces of 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 fo little marked, that one of 
them, who was a young lady, almoft entirely preferved her 
beauty. Perhaps mercurial plafters, or cerates, made without 
turpentine in them, might have been more efficacious in pre- 
venting the marks, and efpecially if applied early in the difeafe, 
even on the firft day of the eruption, and renewed daily. For 
it appears from the experiments of Van Woenfel, that calomel 
or corrofive fublimate, triturated with variolous matter, incapaci- 
tates 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 204 
DISEASES 
Class II. i. 3. 9. 
render the difeafe mild bv the fame author. Exper. on Mercu- 
ry by Van Woenfel, tranflated by Dr. Fowle, Salifbury. 
C .Deflarts, in the fitting of the French national inftitute is faid 
to have adduced a number of facts to prove, that the natural 
fmall-pox is rendered much milder by the ufe of mercurial rem- 
edies ; which I fuppofe is probably true, as mercurials increafe 
the abforption in many other ulcers, and confequently diminifh 
the acrimony of the matter, and forward their healing. 
Variola inoculata. The world is much indebted to the great 
difcoverer of the good effects of inoculation, whofe name is un- 
known ; and our own country to lady Wortley Montague for 
its introduction into this part of Europe. By inferting the vario- 
lous contagion into the arm, it is not received by the tonfils, as 
generally happens, I fuppofe, in the natural fmall-pox ; whence 
there is no dangerous fwelling of the throat, and as the puftules 
are generally few and diftindt, there is feldom any fecondary 
fever ; whence thofe two fources of danger are precluded ; 
hence when the throat in inoculated fmall-pox is much infla- 
med and fwelled, there is reafon to believe, that the difeafe had 
been previoufly taken by the tonfils in the natural way ; which 
alfo, I fuppofe, has generally happened, where the confluent 
kind of fmall-pox has occurred on inoculation. 
I have known two inftances, and have heard of others, where 
the natural fmall-pox began fourteen days after the contagion 
had been received ; one of thefe inltances was of a countryman, 
who went to a market-town many miles from his home, where 
he faw a perfon 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 communicate 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 fcventh day; or after a quarter of 
a lunation ; and on this circumftance probably depends the 
greater mildnefs of the latter. The reafon of which is difficult 
to comprehend ; but fuppofing the facts to be generally as above 
related, the flower progrefs of the contagion indicates a greater 
inirritability of the fyliem, and in confequence a tendency to 
malignant rather than to inflammatory fever. This difference of 
the time between the reception of the infection and the fever in 
the natural and artificial fmall-pox may neverthelefs depend on 
its being inferted into a different feries of veffels ; or to feme un- 
known effect of lunar periods. It is a fubje^T of great curiofity, 
and deferves further invefligation. 
When Class II. 1. 3. 9. 
OF SENSATION. 
205 
When the inoculated fmall-pox is given under all the moll fa- 
vourable circmnftances, I believe (el's than one in a thoufand 
inifcarry, which may be afcribed to fome unavoidable accident, 
fuch as the patient having previoully received the infedlion, or 
being about to be ill of fome other difeafe. Thofe which have late- 
ly mifcarried under inoculation, as far as has come to my knowl- 
edge, have been chiefly children at the breaft ; 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 eftablifhed by more frequent repetition. See Seek 
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 our hazarding inoculation before that age is paff- 
ed, efpecially in crowded towns ; except where the vicinity of 
the natural contagion renders it neccflary, or the convenience of 
inoculating a whole family at a time ; as it then becomes better 
tp venture the lefs favourable circumitances of the age of the pa- 
tient, or the chance of the pain from toothing, than to rilk the 
infedlion in the natural way. 
The moft favourable method confifts in, firft, for a week be- 
fore inoculation, retraining the patients from all kinds of fer- 
mented or fpirituous liquor, and from animal food; and by giv- 
ing them from one grain to three or four of calomel every oth- 
er day for three times. But if the patients be in any the lead 
danger of taking the natural infection, the inoculation had bet- 
ter be immediately performed, and this abftinence then begun ; 
and two or three gentle purges with calomel fhould be given, 
one immediately, and on alternate days. Thefe cathartics 
fhould 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 Ihould be in a fmall 
quantity, and warm, and fluid. Hence it is belt 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 flu- 
idity is likely to occafion its immediate abforption ; and the 
wound fhould be made as fmall and fuperficial as poflible, as 
otherwife ulcers have been fuppofed fometimes to enfue with 
fiibaxillary abfeefles. Add to this, that the making two punc- 
tures either on the fame or one on each arm, fecures the iuccefs 
of the operation in refpedt to communicating the infection. 
Thirdly, at the time of the fever or eruption, the application 
of cool air to thofe parts of the fkiu which are too warm, or ap- 
pear 206 
DISEASES 
Class II. i. 3. 
pear red, nr are covered with what is termed a rafli, Ihould be 
ofed freely, as well as during the whole difeafe. And at the 
fame time, if the feet or hands are colder than natural, thefe 
fhould be covered with flannel. See Clafs IV. 2. 2. 10. 
Where the matter u-ftd is not procured quite frefh, the man- 
ner of preferring it fliould be nicely attended to : as I have been 
informed that a furgeon procured fpme matter in a fluid Rate, 
about a tea-fpoonful, which had been kept fome time in a quill, 
and afterwards in a fmall phial, which he carried fixteen hours in 
his breeches-pocket ; with this he inoculated many children, 
moll of whom had not the fmall-pox in confequence, but were 
affcdted with typhus, one of whom died. Whence it appears, 
that the variolous matter had undergone by putrefaction a de- 
cdmpofition, and that another kind of contagious material had 
been produced ; which agrees with the ingenious obfervations 
of Dr. Jenner, in his treatifes on the variolae vaccinae, or cow- 
pox ; and of Mr. Kite, related in the Memoirs of the Medical 
Society of London, Vol. IV. 
May not the confluent fmall-pox proceed from the contagious 
matter having undergone a partial putrefaction, fo as to contain 
both the variolous and the typhus contagion ? and that, whether 
the difeafe be taken naturally or by inoculation ? and that hence 
the confluent kind confdts of the fmall-pox, with the fever com- 
monly termed putrid ? and that, laftly, as Dr. Jenner obfcrves, 
where the fmall-pox has been laid to recede, or not to rife, the 
difeafe has been fimply a malignant or typhus fever, febris fenfa- 
tiva inirritata, millaken for the fmall-pox ? 
Variola vaccina. Cow-pox. Cows are liable to an eruption 
on their pans or udders, in fome counties, as in Gloucefterlhire 5 
which was occasionally communicated to the hands or arms of 
thofe who milked them, producing an ulcer, and fome degree of 
fever : and it had been long obferved by the people of thofe 
counties, that thofe who had undergone this difeafe, which was 
called the cow-pox, were not liable to the fmall-pox. 
Dr. Jenner, an eminent phyfician in Gloucefterlhire, fortu- 
nately attended to this difeafe, found it to be much milder than 
the fmall-pox, and that the fadt was true, that it fecurcd thofe 
who had been infected with it from afterwards being liable to 
the variolous infection. De alfo obferved, that the vaccine-pox 
is not infectious, but by careful inoculation ; and that, on this 
account, it might be inoculated in a family, without endanger- 
ing others. A circumuance of great confequence to the public, 
as the inoculation of the fmall-pox is known frequently to prop- 
agate that difeafe ; and alfo to private families, when there hap- 
pen; to be a pregnant woman in them, who has not had the 
fmall-pox : Class II. 1. 3. 9. 
OF SENSATION. 
207 
fmall-pox : to all whom in that fituation it is dangerous, as it 
generally produces mifcarriage, and frequently death. Dr. 
Cappe, in an ingenious paper in the York Herald, obferves, that 
the vaccine difeafe is never communicated but by contact, and 
then only when the matter lies on the broken fkin ; and that 
many women during pregnancy have palled through this dif- 
eafe, and none have fullered from it ; and that inltead of being 
peculiarly dangerous to young infants, as the fmall-pox is, it 
feems to be peculiarly mild to them. 
From all thefe circumllances it may be hoped, that the inoc- 
ulation of the cow-pox may become fo general, and performed 
fo early in life, as totally to eradicate the fmall-pox ; by which 
latter difeafe above two thoufand perfons are Ihewn by Dr. 
Cappe, by the bills of mortality, to be annually deftroyed in a 
part of London only. 
As the cow-pox is fo much lefs infe&ious than the fmall-pox, 
it requires much more care in the inoculation to give the difeafe 
with certainty ; whence it fometimes has happened, that a flight 
inflammation from the punfiure of the lancet has been miftaken 
by the unfkilful for the vaccine difeafe : and I have heard of four 
fuch patients in this country who have afterward taken the 
fmall-pox. But as Dr. Woodville inoculated a thoufand people 
with the fmall-pox, who had prcvioufly received the cow-pox, 
without one of them taking the infection, there can be no doubt 
but that the four patients above mentioned had not previoufly 
undergone the vaccine difeafe ; and ought not therefore to dif- 
credit this fortunate and wonderful difeovery. 
In the counties where the cows are fubjeft to this difeafe, the 
milking is performed principally by men-fervants ; and it is 
tkere believed, as Dr. Jenner mentions, that the difeafe was pre- 
vioufly given to the paps of the cows by the hands of the men 
who milked them, and who had previoufly acquired the infec- 
tious matter from the heels of horfes, which discharged an acrid 
fanies, when they had a difeafe called the greafe. This may be 
worth further inveftigation ; as the prefervation of people from 
the fmall-pox, by their having undergone the cow-pox, is fo won- 
derful a phenomenon, fo contrary to our previous knowledge of 
any analogy between tire infectious difeafes of men and quadru- 
peds, that other faffs equally furprifing may exift. May not the 
fmall-pox have been originally acquired from the cow-pox ? 
which latter, having been a much older difeafe, may by procefs 
of time have become milder than the former : as the fmall-pox 
is believed alfo to have become much milder than formerly ; ow- 
ing probably to the incapacity of receiving it, which exifts in 
thofe who have undergone that difeafe, having in procefs of time 
become 208 
DISEASES 
Class 11. i. 3. 16. 
become hereditary. Which incapacity of receiving a fecond 
time the fmall-pox may be explained from the general law of an- 
imation, that ftimuli greater than natural lofe their effect by 
habit, or from their being too violently or too frequently applied. 
As the cow-pox is faid to be fo favourable to infants, great 
benefit might accrue to mankind by their early inoculation, 
which might in time exterminate the fmall-pox. This might 
be perhaps effected by eftablifhing a difpenfary in towns, and 
even villages, and allowing a premium of a few (hillings to eve- 
ry one of the poor who fliould be thus inoculated, as well as their 
daily fuftenance for eight or ten days, that their arms might be 
infpefled by a furgeon, to afeertain that they underwent the 
genuine difeafe. 
10. Rubeola irritata, morbilli. The meafles commence with 
fneezing, red eyes, dry hoarfe cough, and are attended with fen- 
fitive irritated fever. On the fourth day, or a little later, fmall 
thick eruptions appear, fcarcely eminent above the (kin, and, af- 
ter 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 infedt the tonfils in its paflage to the 
ftomach ; fo the contagious material of the meafles may be fuppo- 
fed 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 duel of the lachrymal fac is fubject 
to the fame ftimulus and inflammation, and affects by fympathy 
the lachrymal glands, occafioning a great flow of tears. Sec 
Se6l. XVI. 8. And the rednefs of the eye and eyelids is pro- 
duced in confequence of the tears being in fo great quantity, 
that the /aline part of them is not entirely rcabforbed. See 
Seft. XXIV. 2. 8. 
The contagion of the meafles, if it be taken a fufficient time 
before inoculation, fo that the eruption may commence before 
the variolous fever comes on, (tops the progrefs of the fmall-pox 
in the inoculated wound, and delays it till the meafle-fever has 
finiflied its career. See Sect. XXXIII. 2. 9. 
The meafles are ufually attended with inflammatory fever 
with ftrong pulfe, and bear the lancet in every ftage of the dif- 
eafe. In the early periods of it, venefe&ion renders the fever 
and cough lefs; and, if any fymptoms of peripneumony occur, 
is repeatedly neceflary ; and at the decline of the difeafe, if a 
cough be left after the eruption has ceafed, and the fubfequent 
branny fcales are falling of, venefedlion (hould be immediately 
ufed ; which prevents the danger of confumption. At this time Class II. 1. 3. 11. 
OF SENSATION. 
209 
alfo change of air is of material confequence, and often removes 
the cough like a charm, as mentioned in a fimilar fituation at 
the end of the chin-cough. 
Rubeola inirritata. Meades with inirritated fever, or with 
weak pulfe, has been fpoken of by fome writers. See London 
Med. Obferv. Vol. IV. Art. XI. It has alfo been laid to have 
been attended with fore throat. Edinb. Eifays, Vol. V. Art. II. 
Could the fcarlet fever have been miitaken for the meafles ? or 
might one of them have fucceeded the other, as in the meafles 
and fmall-pox mentioned in Sect. 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 immediate application of the contagious miafmata to theie 
membranes. Some attempts have been made, but a difficulty 
feems to arife in giving the difeafe ; the blood, I conjecture, 
would not infeCI, nor the tears ; perhaps the mucous difeharge 
from the noftrils might fucceed ; or a drop of warm water put 
on the eruptions, and fcraped off again with the edge of a lan- 
cet ; or if the branny fcales were collected, and moiftened with, 
a little warm water ? Further experiments on this fubject would 
be worthy the public attention. 
11. Scarlatina nut is. The fcarlet fever exifts with all degrees 
of virulence, from a flea-bite to the plague. Ihe infectious 
material of this difeafe, like that of the fmall-pox, 1 fuppofe to 
be diffufed, not diffolved, in the air j on which account I fuf- 
peCt that it requires a much nearer approach to the fick for a 
well perfon to receive the infeCtion, than in the meafles; the 
contagion of which I believe to be more volatile, or diffufible, 
in the atmofphere. But as the contagious miafmata of fmall- 
pox and fcarlet fever are fuppofed to be more fixed, they may 
remain for a longer time in clothes or furniture ; as a thread dip- 
ped in variolous matter has given the difeafe by inoculation after 
having been expofed many days to the air, and after having been 
kept many months in a phial. This allo accounts for the flow or 
fporadic progrefs of the fcarlet fever, as it infeCls others at but 
a very fmall diltance from the fick ; and does not produce a 
quantity of pus-like matter, like the fmall-pox, which can ad- 
here to the clothes of the attendants, and when dried is liable 
to be ffiaken off in the form of powder, and thus propagate the 
infedion. 
This contagious powder of the fmall-pox, and of the fcarlet 
fever, becomes mixed with faliva in the mouth, and is thus car- 
ried to the tonfils, the mucus of which arrefts fome particles of 
Vol. II. Id » r* $ 210 
DISEASES 
Class II. i. 3. tt. 
this deleterious material; while other parts of it are carried into 
the ftomach, and are probably decompofed by the power of di- 
geftion ; as feems to happen to the venom of the viper, when 
taken into the ftomach. 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 preferve ourfelves 
from infection. This has been fuppofed to originate 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 
aflembly-room, or tea-room, which is not futficiently ventilated, 
may eafily mix the bad air with the faliva on his tongue fo as to 
tafte it; as I 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 I fuppofe in 
the malignant kind, and very frequently in the mild kind. But 
as this infeCtion may be taken by other means, as by the fkin, 
it alfo happens in the moft mild kind, that there is no inflamma- 
tion of the tonfils at all; in the fame manner as there is gener- 
ally 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 vari- 
ous parts of the ficin in large blotches, at length coalefcing, and 
after three days changing into branny fcales. 
M. M. Cool air. Fruit. Lemonade. Milk and water. 
Scarlatina maligna. The malignant fcarlet fever begins with 
inflamed tonfils; which are fucceeded by dark drab-coloured 
Roughs from three to five lines in diameter, flat, or beneath the 
furrounding furface ; and which conceal beneath them fpreading 
gangrenous ulcers. The fwellings of the tonfils are fenfible to 
the eye and touch externally, and have an elaftic rather than an 
cedematous 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 recovers, it is by flow de- 
grees, and attended with anafarca. 
M. M. A vomit once. Wine. Beer. Cyder. Opium. 
Bark, in fmall repeated dofes. Small fucceflive blifters, if the 
extremities are cooler than natural. Cool air on the hot parts 
of the ficin, 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 without fugar of lead diilblved in it, about fix 
grains Class II. 1. 3. 12. 
OF SENSATION. 
211 
grains to an ounce ; or with a very little blue vitriol diflblved in 
it, as a grain to an ounce ; but nothing fo inftantaneoufly cor- 
rects the putrid finell of ulcers as a folution of alum, about half 
an ounce to a pint of water, which fhould be a little warmifli, 
and injected into the fauces gently by means of a fyringe. Thefe 
fhould be repeated frequently in a day, if it can be done eafiiy, 
and without fatigue to the child. A little powder of bark taken 
frequently into the mouth, as a grain or two, that it may mix 
with the faliva, and thus frequently (timuiate the dying ton- 
fils. Could a warm bath made of decoCfion of bark, or a 
cold alluviation with it, be of fervice ? Could oxygene gas mix- 
ed with common air ftimulate the languid fyltem ? Small elec- 
trie ffiocks 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 Itimulant medicines, if given in quantity, fo as to produce 
more than natural warmth, contribute to expend the already too 
much exhaufted fenforial power ; it appears, that there is noth- 
ing fo neceflary to be nicely attended to as to prevent any un- 
neceflary motions of the fyltem ; this is beft accompliihed by the 
application of cold to tho^e parts of the (kin, which are in the 
leait too hot. Dr. Mofman, of Bradford, directed a boy of 
eight years of age, who was very hot, and covered with the (car- 
let eruption, to be taken naked out of bed, and moillened his 
fkin all over with cold vinegar, by means of a fponge, with great 
and good event. It is probable that cold vinegar might dimin- 
i(h the inflammation and confequent heat of the (kin more ef- 
fectually than cold water, as its application to the lips renders 
them pale, probably by ftimulating the abforbent extremities of 
the veins into greater aCtion. Annals of Medicine, Vol. IV. 
1799. Secondly, that the exhibition of the bark in fuch quan- 
tity as not to opprefs the ftomach and injure digeftion, is next to 
be attended to, as not being liable to increafe the actions of the 
fyftem beyond their natural quantity ; and that opium and wine 
(hould be given with the greateft caution, in very fmall repeated 
quantity, and fo managed as to prevent, if poflible, the cold fits of 
fever ; which probably occur twice in 25 hours,obeying the luna- 
tions lil^e the tides, as mentioned in SeCt. XXXII. 6. that is, 
I fuppofe, the cold periods, and confequent exacerbations of fe- 
ver, in this malignant fcarlatina, occur twice in a lunar day ; 
which is about ten minutes lefs than 25 hours ; fo that if the 
commencement of one cold fit be marked, the commencement of 
the next may be expected (if not difturbed by the exhibition of 
wine, or opium,or the application of blifters) to occur in about 
twelve 212 
DISEASES 
Class II. r. 3. 12. 
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 aft more beneficial to foctety, or glorious 
to himfelf, than by teaching mankind how to inoculate this fa- 
tal difeafe ; and thus to deprive it of its malignity. Matter 
might be taken from the ulcers in the throat, which would prob- 
ably convey the contagion ; or warm water might be put on the 
eruption, and fcraped off again by the edge of a lancet. Thefe 
experiments could be attended with no danger, and fhould be 
tried for the public benefit, and the honour of medical fcience. 
Dr. Harwood, profeffor of anatomy, at Cambridge, favoured 
me with the following curious cafe of this infeftion : Mr. N 
had a violent delirium in the fcarlet fever, with the fkin cracked 
in many places, exuding an ichorous matter ; he was attended 
by a poor man who had recently cut his hand with a glafs bottle, 
and in the ftruggle of confining him to bed his wounded hand 
was frequently applied to the patient's body. This happened 
on the Friday night; his hand was inflamed and the arm fwell- 
ed the next day ; on the Monday following he was feized with 
the fame fever, and died on the Wednefday morning after. This 
would feem to fhew, as far as a fingle cafe can be relied on, that 
the fcarlet fever may be communicated, like the fmall-pox, by 
inoculation, and probably with fimilar fuccefs, if the matter be 
diluted with warm water, ufed in fmall quantity, and by fuper- 
ficial incifions only, through the cuticle. 
12. Aliliaria. 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 with- 
out flannel, has foon ceafed. See Clafs I. i. 2. 3. This, which 
may be called miliaria Judatoria^ 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 fe- 
ver, but did not fufliciently mark their progrefs, which I con- 
ceived 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 
diftinft and larger than the fmall-pox, and the fever was not fub- 
dued without two or three venefeftions, and repeated cathartics 
with calomel. 
The latter, or miliaria inirritata, was attended with great ar- 
terial debility ; and during the courfe of the fever pellucid points 
appeared within the fkin, particularly on the foft parts of the 
fingers. And, in one patient, whom I elteemed near her end, Class II. i. 3. 13. 
OF SENSATION. 
213 
I well recoiled to have obferved round pellucid globule5;, like 
what are often feen on vines in hot-houfes, no larger than the 
fmallelt pins' heads, adhere to her neck and bofom ; which were 
hard to the touch, but were eafily rubbed oft'. Thefe difeafes, 
if they arc allied, do not differ more than the kinds of fmall-pox ; 
but require many further obfervations. 
The eruption fo often feen on children in the cradle, and call- 
ed by the nurfes red-guin, and which is attended with fome de- 
gree of fever, I fufpedt to be produced by too great warmth, and 
the contact of flannel next their tender ficins, like the miliaria 
fudatoria; and like that requires cool air, cool clothes, and lin- 
en next their 1km. 
13. Peflis. The plague, like other difeafes of this clafs, feems 
to be fometimes mild, and fometimes malignant; according to 
the teftimony of different writers. It is faid to be attended 
with inflammation, with the greateft arterial debility, and to be 
very contagious, attended at an uncertain time of the fever with 
buboes and carbuncles. Some authors affirm, that the conta- 
gion of the plague may be repeatedly 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 fufpedt, that 
where it has been fuppofed to have been repeatedly received, 
fome other fever with arterial debility has been miftaken for it, 
as has probably univerfally been the cafe, when the fmall-pox 
has been faid to have been twice experienced. 
M. M. Venefe&ion has been recommenced by fome writers 
on the fir ft day, where the inflammation was fuppofed to be at- 
tended with fufiicient 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 fhews 
the greateft debility of circulation. Whence all the means be- 
fore enumerated in this genus of difeafes to fupport the powers 
of life are to be adminiftered. Currents of cold air, cold water, 
ice, externally on the hot parts of the fkin. 
The methods of preventing the fpreading of this difeafe have 
been much canvafled, and feem to confift in preventing all con- 
gregations of the people, as in churches, or play-houfes; and to 
remove the lick into tents, on fome airy common, by the fide of 
a river, and fupply them with frelh food, both animal and veg- 
etable j with beer and wine, in proper quantities ; and to encour- 
age thofe who can, daily to walh both their clothes and them- 
felves. 
The peftis vaccina, or difeafe amongft the cows, which affliCl- 
ed this ifland about half a century ago, feems to have been a 
contagious 214 
DISEASES 
Class II. i. 3. 14. 
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 gan- 
grene beneath the fkin. In the fenfitive inirritated fevers of 
thefe animals, I fuppofe about fixty grains of opium, with two 
ounces of extract of oak-bark, every fix hours, would fupply 
them with an efficacious medicine j to which might be added 
thirty grains of vitriol of iron, if any tendency to bloody urine 
fhould appear, to which this animal is liable. The method of 
preventing the infection from fpreading, if it fhould ever again 
gain accefs to this ifland, would be immediately to obtain an or- 
der from government to prevent any cattle from being removed, 
which were found within five miles of the place fuppofed to be 
infected, for a few days ; till the certainty of the exigence of 
the peltilence could be afeertained, by a committee of medical 
people. As foon as this was afeertained, all the cattle within 
live miles of the place fhould be immediately flaughtered, and 
confumed within the circumfcribed diftrift; and their hides put 
into lime-water before proper infpeftors. 
14. Pemphigus is a contagious difeafe, attended with blad- 
dery eruptions, 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 feen two inftances; or with irritated, or with in- 
irritated 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, 
fcldom fuppurate,and generally terminate infcales without fears. 
I once faw a lady who mifearried during this difeafe, though all 
her children had it as Rightly as ufual. It foinetimes leaves 
fears or marks on the fkin. This difeafe has been miftaken for 
the fmall-pox, and inoculated 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 innumerable generations may 
have rendered mild, and will in procefs of time annihilate. In 
the fame manner as the fmall-pox, venereal difeafe, and rickets, 
teem to become milder or lefs in quantity every half century. 
While, at the fame time, it is not impiobable, that other new 
difeafes may arife, and, for n d^fon, thin mankind ! 
16. Urticaria. Nettle-rafh begins with mild fenfitive fever, 
which is fometimes fcarcely perceptible. Hence this eruption 
has been thought of two forts, one with and the other without 
fever. Class II. 1. 3. 17. 
OF SENSATION. 
215 
fever. On the fecond day red fpots, like parts Rung with net- 
tles, are feen ; which almoft vanilh during the day, and recur in 
the evening with the fever, fucceeded in a few days by very mi- 
nute fcales. See Tranf. of the College, London. 
17. Aphtha. Thrulh. It has been doubted, whether aphtha 
•or thrulh, which confifts of ulcers in the mouth, fhould be enu- 
merated amongft febrile difeafes ; and whether thefe ulcers arc 
always fymptomatic, 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 purplilh ; floughs or 
ulcers appear firft on the threat and edges of the' tongue, and 
at length over the whole mouth. Thefe floughs are whitilh, 
fometimes diftimft, often coalefcing, and remain an uncertain 
time. Cullen. I fliall concifely mention four cafes of aphtha, 
but do not pretend to determine whether they wpre all of them 
fymptomatic or original difeafes. 
Aphthafenfitiva. A lady during pregnancy was frequently 
fcized 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 teems to be a fimilar difeafe. 
Thefe ulcers refemble thole produced in the fea-feurvy, and have 
probably for their caufe an increafed action of the fecerning 
fyftem from increafed fenfation, with a decreafed atSlion of the 
abforbent fyftem from decreafed irritation. See Clafs I. 2. 1. 14. 
M. M. Solutions of alum, of blue vitriol. Powder of bark 
taken frequently into the mouth in very finall quantity.. See 
Clafs II. 1. 3. 1. 
Aphtha irritata. Inflammatory aphtha. A cafe of this kind 
is related under the title of fuppurative rheumatifm. Clafs IV. 
2. 1. 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 ftomach, and proba- 
bly through the whole inteftinal canal, beginning their courfc 
•with cardialgia, and terminating it with tenefmus ; and might 
perhaps be called an eryfipelas of this mucous membrane. 
M. M. Cool air. A fmall bliftcr on the back. Bark. Wine. 
Opium in fmall repeated quantities. Soap neutralizes the gaf- 
tric acid without effervefcence, and thus relieves the pain of car- 
dialgia, where the ftomach is afletded. Milk alfo deftrqys a part 
of this acid. - Infulion oi fage-leaves two ounces, almond-foap 
from five grains to ten, with fugar and cream, is generally both 
agreeable and ufeful to thefe patients. See I. 2. 4. 5. 
Where the ftomach may be fuppoled to be excoriated by poi- 
fons 216 
DISEASES 
Class II. i. 3. i£ 
fons containing acid, as fublimate of mercury or arfenic ; or if 
it be otherwife inflamed, or very fenflble to the flimulus of the 
gaftric acid ; or where it abounds with acid of any kind, as in 
cardialgia; the exhibition of foap is perhaps a preferable man- 
ner of giving alkali' than any other, as it decompofes in the itom- 
ach without efFervefcence j while the cauftic alkali is too acrid to 
be adminiftered in fuch cafes, and the mild alkali produces car- 
bonic 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 
alkali be added, a fudden elfervefcence arifes, and the paper is 
inftantly deftroyed by the efeape of the fixed air £ in the fame 
manner as lumps of folid lime are broken into powder by the ef- 
cape of the fleam produced from the water, which is poured on 
them. This (hews why a fucceflion of acid and of alkaline cauf- 
tics fooner deftroys a part, than either of them applied feparately. 
18. Dyfenteria. Bloody-flux is attended with fenfitive fever, 
generally with arterial debility; with frequent mucous or bloody 
itools, which contain contagious matter produced by the mem- 
branes of the inteflines ; the alimentary excrement being never- 
thelefs, retained ; with griping pains, and tenefmus. 
Linneus obferved microfcopic animals in the ftools of dyfen- 
teric patients, and concluded from thence that they were the 
caufe of the difeafe ; in the fame manner the animalcula, feen 
by microfcopes, in the puftules of the itch, have been fuppofed 
to be the caufe of thofe eruptions. See Article IV. 2. 1.3. 
Thefe animalcula are neverthelefs feen in almolt all animal fluids 
which have for a time ftagnated; as in the femen, and in all 
liquid evacuations from the inteftines, as afferted by Buffon; 
who efteems them to be organized beings, though not perfect 
animals, in his ingenious treatife on generation. Hifloire Nat- 
urel. 
M. M. Emetics. Antimonials. Peruvian bark. Opium 
and calomel, of each a grain every night. Bolus armenix. 
Earth of alum. Chalk. Calcined hartfhorn. Mucilage. Bee's 
wax mixed with yolk of egg. Cerated glafs of antimony. 
Warm bath. Flannel clothing next to the fkin. 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 fyftem. 
The prevention of this contagion mufl confift principally in 
ventilation and cleanlinefs; hence the patients fhould be re- 
moved into cottages diftant from qach other, or into tents ; and 
their Class II. 1. 3. 19. 
OF SENSATION. 
217 
their faeces buried as foon as may be ; or conveyed into a running 
ftream ; and themfelves fhould be worthed with cold or warm 
water after every evacuation. For the contagious matter confifts 
in the mucous or purulent difcharge from the membrane which 
lines the inteftines; and not from the febrile perfpiration, or 
breath of the patients. For the fever is only the conl'equence 
and not the caufe of contagion ; as appears from Genus the 
Fifth of this Order, where contagion exifts without fever. 
19. Gajlritis fuperficialis. Superficial inflammation of the 
ftomach. An eryfipelatous inflammation of the ftomach is men- 
tioned by Dr. Cullen from his own obfervations ; which is dif- 
tinguiflied from the inflammatory gaftritis by lefs pain and fever, 
and by an eryfipelatous rednefs about the fauces. Does this 
difeafe belong to aphtha ? 
20. Enteritis fuperficialis. Superficial inflammation of the 
bowels is alfo mentioned by Dr. Cullen, from his own obferva- 
tion, under the name of enteritis erythematica ; and is faid to 
be attended with. lefs pain and fever, without vomiting, and with 
diarrhoea. May not this difeafe be referred to aphtha, or to 
dyfentery ? 
Vol. II. 
E E 
ORDO 218 
DISEASES 
Class II. i. 4.1, 
ORDO I. 
Increafed Senjation. 
GENUS IV. 
With the Production of new Vejfeh by internal Membranes or 
Glands, without Fever. 
Where inflammation is producedin a fmall part, which has 
not great natural fenfibility, the additional fenfation does not 
produce an increafed adlion 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 ac- 
tion 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 afledt the aflbciated motions belonging 
to the circulation, occafioning them to proceed with greater fre- 
quency •, that is, a fever is induced. This is well exemplified 
in the internal and fuperficial paronychia ; one of which is at- 
tended with great pain and fever, and the other with little pain 
and no fever. SeeClafs II. i. 2. 19. and IL 1. 4. 5. 
From hence it appears, that the fenfitive fever is an accident- 
al confequence of the topical phlegmon, or inflammation, and 
not a caufe of it; that it is often injurious, but never falutary ; 
and fhould therefore 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 ; or by the bark, opium, cool air, 
and nutrientia, when it is of the inirritated kind. 
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, and are moiftened by perpetual ni&itation 
during the other Sixteen, they may be confidered as internal 
membranes ; and, from the analogy of their inflammation to 
that of other internal membranes, it is arranged under this ge- 
nus ; whilft the tonfillitis is efteemed an inflammation of an ex- 
ternal membrane, becaufe currents of air are perpetually pafling 
both day and night over the fauces. 
The fuperficial ophthalmy has generally been efteemed a 
fymptom Class II. 1.4. 1. 
OF SENSATION. 
219 
fymptom of fcrofula, when it recurs frequently in young per- 
fons ; but is probably only a concomitant of that difeafe, as a 
fymptom of general debility ; ramifications of new red veflels, 
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 intoler- 
ance of light than the ophthalmia interna, defcribed in Clafs IL 
1.2. 2. It occurs in thofe of feeble circulation, efpecially chil- 
dren of a fcrofulous tendency, and feems to arife from a previ- 
ous torpor of the veflels 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 deduction of the 
Itimulus of heat, than would affeft ftronger or more irritable 
habits ; the confequence of this torpor is increafed action, 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 adna- 
ta ; in this the veflels over the fclerotica, or white part of the 
eye, rife confiderably above the cornea, which they furround, are 
lefs red than in the ophthalmia fuperficialis, and appear to be 
fwelled by an accumulation of lymph rather than of blood ; it 
is probably owing to the temporary obftrutlion of a branch of 
the lymphatic fyltem. 
M. M. If the pain be great, venefcftion by leeches on the 
temple, or cutting the temporal artery, and one purge with three 
or four grains of calomel Ihould be premifed. Then the Peru- 
vian 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 diflblved in one 
ounce of water ; a drop or two to be put between the eyelids 
twice a day. Take very fmall eleftric fparks from the eyes eve- 
ry day for a fortnight. Bathe the whole head with fait and wa- 
ter made warm, every night, for fome months. Send fuch chil- 
dren to a fchool near the fea, for the convenience of fea-bathing, 
for many months, annually ; fuch fchools are to be found in or 
near Liverpool. 
When a child is aflii£led with an inflamed eye of this kind, 
he Ihould always fit with his back to the window or candle ; 
but it is generally not neceffary to cover it, or if the uneafy fen- 
fation of light makes this proper, the cover Ihould Itand off from 
the eye, fo as not much to exclude the cool air from it. As 
cc * ering an eye unnecefl'arily is liable to make that eve weaker 
than the other, from its not being fufnciently ufed, and thence 
to produce a fquinting forever afterwards. 
i Neverthelefsj 220 
DISEASES 
Class II. i. 4. 2. 
Neverthelefs, when the pain is great, a poultice muft be ap- 
plied to keep the eyes moift, or a piece of oiled filk bound light- 
ly over them. Or thus, boil an egg till it is hard, cut it longi- 
tudinally into two hemifpheres, 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 moift without any difagreea- 
ble prefliire. See Clafs I. i. 3. 14. 
Ophthalmia equina. An inHammation of this kind is liable to 
affect the eyes of horfes; one caufe of which is owing to a filly 
cuftom 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 li- 
able to fall into their ears from the high racks in ftables ; and 
in both cafes the eye becomes inflamed by fympathy. I once 
direfled the temporal artery of a horfe to be opened, who had 
frequent returns of an inflamed eye j and I believed it was of 
eflential fervice to him; it is probable that the artery was after- 
wards contracted in the wounded part, and that thence lefs blood 
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. Pterigion. Eye-wing. A fpot of inflammation fometimes 
begins on the infide of the lower eyelid, or on the tunica albu- 
ginea, and fpreads an intertexture of red veflels from it, as from 
a centre, which extend on the white part of the eye, and have 
the appearance of the wing of a fly, from whence its name. 
M. M. Cut the ramifications of veflels again and again, with 
the point of a lancet, clofe to the centre of inflammation. Touch 
them repeatedly with lunar cauftic. See Home on the urethra. 
Page 101. 
Mr. Hadley of Derby procured an ingenious inftrument to be 
made to cut the veflels, which had fpread their numerous 
branches over an opaque corneaj after a violent inflammation ; 
by which they were repeatedly divided, with little pain to the 
patient, as there was no neceflity to hold them by a forceps. 
The inftrument was in the form of a corn-fickle, or the early 
crefcent of the new moon, about an inch in length, the inner 
edge of the curve was (harp, and the point fine; the back was 
rounded and fmooth, and the other end fixed in an ivory han- 
dle. The point of this was fuddenly introduced under the 
branches of the new veflels, which were thus cut upwards, and 
there was no occafion to hold the eye, or the trunks of the veflels. 
3. Tarjitis palpebrarum. Inflammation of the edges of *he 
eyelids. This is a difeafe of the glands, which produce the hairs 
of the eyelafhes, and is frequently the caufe of their falling off. 
After Class II. 1. 4. 4. 
OF SENSATION. 
221 
After this inflammation a hard fcar-like ridge is left on the edge 
of the eyelid, which fcratches and inflames the eyeball, and be- 
comes a very troublefome difeafe. 
The Turkith 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 pre- 
vent extraneous light from being refle€ied from thefe edges into 
the eye, and thus ferve the purpofe of the black feathers about 
the eyes of fwans, defcribed in Se6L XXXIX. 5. 1. and may 
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 brulh. 
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 IL 
1. 1. 8. 
4. Hordeolum. Stye. This inflammation begins either on 
or near the edges of the eye-lids, or in the loofe fkin of them, 
and is fometimes very flow either in coming to fuppuration or 
in difperfing. The Ikin beneath the lower eyelid is the molt 
frequent feat of this tumor, which fometimes never fuppurates 
at all, but becomes an encyfted tumor: for as this fkin is very 
loofe for the purpofe of admitting 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 other- 
wife, a darker Ihade of colour is feen beneath the eyes ; which 
is owing to a lefs energetic aflion of the abforbent terminations 
of the veins, whence the currents of dark or venons blood are 
delayed in them. This dark Ihade beneath the eyes, when it is 
permanent, is a fymptom of habitual debility, or inirritability of 
the circulating fyftem. 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. 
5. Paronychia fuperjicialis. Whitlow. An inflammation a- 
bout the roots of the nail beneath the fkin, which fuppurates 
without fever, and fometimes deftroys the nail; which is, how- 
ever, gradually reproduced. This kind of abfeefs, though not 
itfelf dangerous, has given opportunity for the inoculation of 
venereal matter in the hands of accoucheurs, and of putrid mat- 
ter from the diffeCtion of difeafed bodies ; and has thus been the 
caufe of difeafe and death. When putrid matter has been 
thus 222 
DISEASES 
Class II. 1. 4. 6. 
thus abforbed from a dead body, a livid line from the finger to 
thefwelled gland in the axilla is faid to be vifible ; which (hews the 
inflammation of the abforbent vefl'el along its whole courfe to the 
lymphatic gland ; and death has generally been the confequence. 
M. M. In the common paronychia a poultice is generally 
iufficient. 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 fweiled axillary gland be exfe<9> 
cd ? In the abforption of venereal matter the ufual methods of 
cure in fyphilis mult be adminiftered, as in Clafs IL i. 5. 1. 
6. Gutta rofea. The roly drop on the face is of three kinds. 
Firfl the gutta rofea hepatic a, or the red pimples on the faces of 
drunkards, which are probably a kind of crifis, or vicarious in- 
flammation, which fucceeds, or prevents, a torpor of the mem- 
branes of the liver. This and the fucceeding fpecies properly 
belong to Clafs IV. t. 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 flomach ; and may be call- 
ed the gutta rofea Jlomatica. Which is diftinguifhed from the 
former by the habits of the patient in refpeit to drinking; by 
tire colour of the eruptions being lefs deep ; and by the patient 
continuing generally to be troubled with fome degree of apepfia. 
See Clafs I. 3. 1. 3. I knew a lady who had long been afflict- 
ed with pain about the region of the flomach ; and, on drinking 
half a pint of vinegar, as a medicine, fire had a breaking out 
commenced on her face ; which remained, and fire became free 
from the pain about the flomach. Was this a flomachic, or an 
hepatic difeafe ? 
Thirdly, there is a red face, which confifts of fmaller pimples 
than thofe above mentioned ; and which is lefs liable to fuppu- 
rate ; and which feems to be hereditary, or at leaft has no appar- 
ent caufe like thofe above mentioned; which may be termed 
gutta rofea hereditaria, or punfta rofea. 
Mrs. S. had a pimpled face, which I believe arofe from pota- 
tion of ale. She applied alum in a poultice to it, and had foon 
a paralytic ftroke, which difabled her on one fide, and termina- 
ted in her death. 
Mrs. L. had a red pimpled face, which feemed to have been 
derived from her mother, who had probably acquired it by vi- 
nous potation ; < lie applied a quack remedy to it, which I believe 
was a folution of lead, and was feized with epileptic fits, which 
terminated in palfy, and deftroyed her. This fnews the danger 
of ufiag white paint on the face, which is called bifmuth, but is 
in Class II. 1. 4. 6. 
OF SENSATION. 
223 
in reality white lead or cerufla 5 and if it be bifmuth, it may be 
equally deleterious. 
Mr. Y had acquired the gutta rofea on hisnofe, and ap- 
plied a faturnine folution on it for a few nights, and was then 
feized with paralyfis on one fide of his face ; which however he 
gradually recovered, and has fmee acquired the gutta rofea on 
other parts of his face.' 
Thefe fatal effefts were probably caufed by the difagreeable 
fenfation of an inflamed liver, which ufed before to be relieved 
by the fympathetic adlion and confequent inflammation of the 
fkin of the face, which was now prevented by the ftronger ftim- 
ulus of the application of calx of lead. The manner in which 
difagreeable fenfations induce epilepfy and palfy is treated of in 
Clafs III. In fome cafes where habitual difeharges, or eruptions, 
or ulcers, are flopped, a torpor of the fyftem may follow, owing 
to the want of the accuftomed quantity of fenfation or irritation. 
See Clafs I. 1. 2. 9. and II. 1. 5.6. In both thefe fituations 
fome other ftimulus fliould be ufed to fupply the place of 
that which is taken away ; which may either be perpetual, as an 
ilfue ; or periodical, as a cathartic repeated once a fortnight or 
month. 
Mifs W. an elegant young lady, of about twenty, applied a 
mercurial 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); fhe 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 cathar- 
tic, five grains of rhubarb and a quarter of a grain of emetic tar- 
tar every night for many weeks. With this preparation mer- 
curial plafters, 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 Wortley Mon- 
tague, who bliftered her face with balfam of Mecca. 
Mrs. F. had for many years had a difagreeably looking erup- 
tion on her chin. After a cathartic with calomel, flic was ad- 
vifed to blifter her whole chin ; on the healing of the blifter a 
few eruptions again appeared, 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 L. a young lady, about eighteen, had tried variety of ad- 
vice, for pimples over the greateft part of her face, in vain. She 
took 224 
DISEASES 
Class IL i. 4. 7. 
took the above medicines infernally, and blifteredher face by de- 
grees all over, and became quite beautiful. A fpot or two now 
and then appeared, and on this account fne frequently flopt with 
parts of her face covered with mercurial plafter, made without 
turpentine, which was held on 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. If there be turpentine, or 
any other native balfam, mixed with the mercurial plafter, it is 
very liable much to inflame the face (I fuppofe like the balfam of 
Mecca); but if a fmall quantity of flour of brimftone be added, 
I believe it will readily mix. As a mercurial ointment is faid 
to be quickly made by adding only fix grains of flour of fulphur 
to fix drachms of mercury, and two ounces of hog's greafe. 
7. Odontitis. Inflammatory tooth-ach is occafioned by in- 
flammation of the membranes of the tooth, or a caries of the 
bone itfelf. The gum fometimes fuppurates, otherwife a fwell- 
ing of the cheek fucceeds by affociation, and thus the violence 
of the pain in the membranes of the tooth is relieved, and fre- 
quently cured ; and when this happens the difeafe properly be- 
longs to Oafs IV. as it fo far refembles the tranflations of mor- 
bid actions in the gout and rheumatifm. 
At other times the tooth dies without caries, efpecially in peo- 
ple about fixty years of age, or before ; and then it ftimulates its 
involving membrane, like any other extraneous fubftance. The 
membrane 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 up 2 
pus-like mucus is feen difeharged from the gum which furrounds 
it; and the gum fee ms 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 
evacuations, by venefedtion, and a cathartic ; and after its op- 
eration two grains of opium. A blifter may alfo be ufed behind 
the ear, and ether applied to the cheek externally. In /lighter 
cafes two grains of opium with or without as much camphor 
may be held in the mouth, and fuffcred to diffolve near the aE 
fedted tooth, and be gradually fwallowed. See Clafs I. 2. 4. 
12. Odontalgia may be diftinguifhed from otitis by the appli- 
cation of cold water to the affefted tooth ; for as the pain of 
common tooth-ach is owing to torpor, whatever decreafes ftimu- 
lus adds to the torpor and confequent pain ; whereas the pain of 
an inflamed tooth, being caufed by the increafed action of the 
membranes of it, is in fome meafure alleviated by the applica- 
tion of cold. 
8. Otitis. Inflammation and confequent fuppuration of fome 
membranes Ct ASS IL I. 4. 9. 
OF SENSATION. 
225 
hnembranesof the internal ear frequently occur in children, who 
Heep in cold rooms, or near a cold wall, without a night-cap. 
If the bones are affedted, 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 fnculd be 
gently fyringed 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 ; firit about a fourth part, and it fnould be gradually in- 
treafed to half reiliiied fpirit and' half water : if it continues 
long todifcharge 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 
t>f fpirit of wine and water, or a folution of alum in water ; 
which may be poured into the ear, as the head is inclined, and 
fhook out again by turning the head, two or three times morn- 
ing and evening. See Clafs II. i. 4. to. 
9. Fijiula lacrymalis, The lacrymal fack, with its puncta lac- 
rymalia and nafal du<fl, are liable to be deitroyed by fuppuration 
Without fever; the tears then run over the eyelids, and inflame 
the edges of them and the cheeks, by their perpetual moilture 
and faline acrimony. 
M. M. By a nice furgical operation, a new aperture is to be 
i^ade from the internal corner of the eye into the noflril, and a 
fiiver tube introduced, which fupplies the defedl by admitting 
the tears to pafs again into the noftril. See Melanges de Chir- 
hrgie, par M. Pouteau; who thinks he has improved this oper- 
ation. 
10. Fijiula in ano. A mucous difcharge from the anus, call- 
ed by fame White piles, or matter from a fuppurated pile, has 
been miftaken for the matter from a concealed fiftula. 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 unfkilful 
empyric fometimes does more harm in the loofe cellular mem- 
brane of thefe parts than the original ulcer, by making a fiftula 
he did not find. The cure of a filtula in ano, of thofe who have 
been much addicted to drinking fpirituous liquor, or who have 
a tendency to pulmonary confumption, is frequently of danger- 
ous confequence, and is fucceeded by ulcers of the lungs, and 
death. 
M. M. Ward's pafte, or 20 black pepper-corns taken after 
tach meal twice a day; the pcpper-corns ihoul3 be cut each in- 
to two or three pieces. The late Dr. Munro, of Edinburgh, 
VoU. II. F f afiercyd. 226 
DISEASES 
Cldfs II. 1. 4. ii? 
aflerted, in his lectures, that he had known a fiftula in ano cured 
by injecting firft a mixture of rectified fpirit of wine and water ; 
and, by gradually increafing the ftrength of it, till the patient 
could bear rectified fpirit alone •, by the daily ufe of which, at 
length, the Tides of the fiftula became callous, and ceafed to dif- 
charge, though the cavity was left. A French furgeon has 
lately affirmed, that a wire of lead put in' at the external open- 
ing of the ulcer, and brought through the reClum, and twifted 
together, will gradually wear itfelf through the gut, and thus ef- 
fecSt 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. 
11. Fijlula urethra'. Where a ftri&ufe of the urethra exifts, 
from whatever caufe, the patient, in forcing the ftream of urine 
through the ftriCture, 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, occa- 
fioning fiftulas,- which fometimes have large furfaces producing 
much matter, which is prefl'ed out at the time of making water, 
and has been miftaken for a catarrh of die bladder ; thefe fiftu- 
las fometimes acquire an external opening in the perimsum, and- 
part of the urine is difeharged that way. 
Can this matter be diftinguifhed 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 
caoutchouc. The latter may be had at No. 37, Red-lion-ftreet, 
Holborn, London; The former are eafily made, 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 fuccefsfulin one cafe 
the extenfive fiftulas completely healing. The patient Ihould 
introduce a bougie always before he makes water, and endeavour 
to make it as (lowly as polfible. See Clafs I. 2. 3. 24* 
12. Hepatitis chronica. Chronical inflammation of the liver. 
A collection of matter in the liver has frequently been found 011 
difleiftion, which was not fufpeCted in the living fubject. Though 
there may have been no certain figns of fuch a collection of 
matter, owing to the infenfibility of the internal parts of this 
vifeus ; which has thus neither been attended with pain, nor in- 
duced any fever ; yet there may be in fome cafes reafon to fuf- 
pect the exiftence of fuch an abfeefs ; either from a fenfe of ful- 
nels in the right hypochondre, or from tranfient pains fometimes 
felt there, or from pain on preifure, or from lying on the left fide, 
and fometimes from a degree of fenfitive fever attending it. 
Dr. Saunders Class II. 1. 4. 13. 
OF SENSATION. 
227 
Dr. Saunders fufpe£ls the acute hepatitis to exift in the in- 
flammation of the hepatie artery, and the chronical one in that 
of the vena portarum. Treatife on the Liver. Robinfons. 
London. 
13. Scrofula fuppurans. Suppurating fcrofula. The indolent 
tumors of the lymphatic glands are liable, after a long time, to 
regain their fenfibility ; and then, owing to their former torpor, 
an increlfed action of the vefiels, beyond what is natural, with 
inflammation, is the confequence of their new life, and fuppura- 
tion fucceeds. This cure of fcrofula generally happens about 
puberty, when a new energy pervades the whole fyltem, and un- 
folds the glands and organs of reproduction. 
M.. M. SeeClafsI. 2. 3. 21. Where fcrofulous ulcers about 
the neck are difficult to heal, Dr. Beddoes was informed, in Ire- 
land, that an empyric had had iome fuccefs by inflaming them by 
an application of wood forrel, oxalis aceto fella, 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 fcrofulous ul- 
cer on one Iide of the cheft beneath the clavicle, and another 
under his jaw ; he was directed, about three weeks ago, to pro- 
cure 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 few minutes 
ago, to fhew me that both the ulcers are quite healed. The con- 
Rant application of linen rags, moiftened with a folution of an 
ounce of fugar of lead in a pint of water, I think I have feen 
equally efficacious. 
Small dofes internally of a folution of arfenic have been faid 
to contribute to cure thefe ulcers. I Ihould recommend from 
one drop to five of a faturated deception of arfenic, as directed 
in Mat. Med. Art. IV. 2.6. 8. for children, twice or thrice a 
day, according to their age, and from five to ten to grown per- 
fons, diminifhing the quantity if it affedts the bowels. Tinc- 
ture of Digitalis is recommended in Clafs I. 2. 3. 21, 
14. Scorbutus fuppurans. In the fea-feurvy there exifts an 
inactivity of venous abforption, whence vibices and petechiae, 
and fometimes ulcers. As the column of blood preffing on the 
origins of the veins of the lower extremities, when the body is 
erett, oppofes the afeent of the blood in them, they are more 
frequently liable to become enlarged, and to produce varixes, or 
vibices, or, laftly, ulcers about the legs, than on the upper parts 
of the body. The expofure to cold is believed to be another 
caufe of ulcers on the extremities ; as happens to many of the 
poor 228 
DISEASES 
Class II. i. 4. 13, 
poor in winter, at Liibon, who fleep in the open air, without 
flockings, on the fteps of their churches or palaces. See Clafs I, 
2. 1. 15. 
M. M. A bandage fpread with plafter to cover the whole 
limb tight. Rags dipped in a folution of fugar of lead. A 
warm flannel itocking or roller. White lead and oak-bark, 
both in fine powder. Horizontal reft. An ingenious treatife 
on the ufe of bandage, in the cure of ulcers, has lately been pub- 
lifhed by Mr. Baynton, of Briftol ; and another, on the fame fub-? 
ject, by Mr. "Whately, of London, who fucceeds without ufmg 
plafter on the bandage. 
15. Scirrhus J'uppurans. When a feirrhus afte<fts any gland 
of no great extent or fenfibility, it is, after a long period of time, 
liable to fuppurate without inducing fever, like the indolent tu- 
mors of the conglobate or lymphatic glands above mentioned ; 
whence collections of matter are often found after death, both in 
men and other animals ; as in the livers of fwine, which have 
been fed with the grounds of fermented mixtures in the diftil- 
leries. Another termination of feinhus is in cancer, as defcri- 
bed below. See Clafs I. 2. 3. 22. 
16. Carcinoma. Cancer. When a feirrhous tumor regains 
its fenfibility by nature, or by any accidental hurt, new veflels 
ihoot amongft the yet infenfible parts of it, and a new fecretiop 
takes place of a very injurious material. This cancerous mat- 
ter is abforbed, and induces fwelling of the neighbouring lymph- 
atic glands ; which alfo become feirrhous, 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 
hectic 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 the 
breaft. See Clafs II. 1.3. 
. Hence exfeclion before the cancer is open is generally a cure; 
but after the matter has been expofed to the air, it is feldom 
of fervice ; as the neighbouring lymphatic glands are already in- 
fected. I have obferved fome of thefe patients after the opera- 
tion to have had difeafed livers, which might cither have previ- 
oufly exifted, or have been produced by the fear or anxiety at- 
tending the operation. 
Erolion with arfehic, after the cancer is become an open ul- 
cer, has generally no better effect than exfecflion, but has been 
fuccefsful before ulceration. The belt manner of tiling arfeuic, 
is Class II. 1. 4. 16. 
OF SENSATION. 
229 
is by mixing one grain with a drachm of lapis calminaris, and 
ft re wing on the cancer tome of the powder every day, till the 
whole is deRroyed. 
Cancers otl the face are faid to arifefrom the periofteum, and 
that, unlefs this be deftroyed by the knife, or by cauftics, the 
cancer certainly 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 II. I. 
6' 
Two very mterefting cafes have been lately publifhed by Dr. 
Ewart, of Bath, in which carbonic acid gas, or fixed air, was 
kept conitantly in contadl with the open cancerous ulcers of the 
breaft ; which then healed like other common ulcers. This 
is rather to be afcribed to the exclusion of oxygen, than to any 
fpecific virtue in the carbonic acid. As in common ulcers the 
matter does not induce he&ic 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 can- 
cer in one half, or hemifphere, of a large bladder ; the edges are 
made to adhere to the fkin by adhefive plafter, or perhaps a mix- 
ture 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 j and the matter let out at a iinall aperture be- 
neath. 
M. M. Where extirpation is not advifable, as in moll open 
cancers of the breaft, keep the ulcer carefully from the air, either 
by applying carbonic acid gas, as above ; or by covering it with 
charcoal in powder, and a double oiled filk. The charcoal-pow- 
der fhould be renewed once in two or three days, and at thofe 
times it fhould be pufhed oft'by frefh charcoal-powder on lint,fo as 
not for a moment to expofe it to the air. The charcoal fhould 
be frefh taken from the fire, and powdered very fine as foon as 
cool, and kept in a bottle to be as little expofed to the air as pof- 
fible. 
The tumor fhould be fufpended by a fafh or foft cufhion, fo 
as to keep it as eafy as poflible night and day, and fhould be kept 
neither too warm nor too cold, as both extremes are injurious. 
Internally, fix grains of rhubarb every night, for many months, 
and to drink nothing ftronger than common weak fmall beer, 
confifting of three ftrike of malt to the hogfhead, or wine diluted 
with thrice its quantity of water. 
If cauftics cannot be applied fo as to deftroy the whole, even 
before ulceration, I fufpedt that they aggravate the evil, and 
/boner deftroy the patient •, as, I was well informed, occurred 
to 230 
DISEASES 
Class II. 1. 4.iy. 
to a quack who was for a time much reforted to, in this part of 
the country. 
Another method of ufmg charcoal-powder is by mixing it with 
boiled oil, to the confidence of common paint; and to foak a 
piece of flannel with this, and cover the ulcer; and daily to 
fhove or thruft this off by applying the edge of another piece of 
flannel, foaked with the oil and charcoal, to the edge of that up- 
on the ulcer, fo as to change them without the polfibility of let» 
ting any air come into contact with the cancerous fore. 
t 7. Arthrocele. Swelling of the joints feems to have its remote 
caufe in the foftnefs of the bones, for they could notfwell unlefs 
they were previoufly foftened, fee Clafs I. 2. 2. 12/ The epiphyr 
fes, or ends of the bones, being naturally of a loofer texture, are 
moll liable to this difeafe, and perhaps the cartilages and capfu-t- 
lar ligaments may alfo become inflamed and fwelled along with 
the heads of the bones. This malady is liable to diftort the fin- 
gers and knees, and is ufually called gout or rheumatifm j the 
former of which 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, affects 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 circumftances differs frpm 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 inflamed, may be owing to the new vefl'els, which (hoot 
in thepi in their foft Hate, 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 
bonc-afhes, or calcined hartfhorn, twice a day, with decodlion 
of madder ? Soda phofphorata ? 
18. Arthropuojis. Joint-evil. This differs from the former, 
as that never fuppurates; thefe ulcers of the joints are gener- 
ally efteemed to arife from fcrofula ; but as fcrofula is a difeafe 
of the lymphatic or abforbent fyltem, and this confifts in the 
fuppuration of the membranes, 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 un- 
der thisfpecies, with variety of other ulcers, attended with cari- 
ous bones. 
19. Caries or Necrofis A caries of the bones 
may Blass II. i. 4. ip* 
OF SENSATION. 
231 
may be termed a fuppuration of them ; it differs from the above,* 
as it generally is occafionedhy fome external injury, as in decay- 
ing teeth; or by veneral 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 Sett. XXXIII. 3.1. A new and able work on 
the necrofis of bones is publifhed by I. Ruffel, Edinburgh ; 
London, Robinfons. And another by I. P. Weidmann, de Ne- 
crofi Olhum at Francfort; Boofey, London ; which is alfo a 
valuable work. 
M. M. When this difeafe is not formed in fyphilis, or by 
metaftafis in fever, but is fimply an inflammation of the periofte- 
um, or of the folid bone, or of its medullary cells, the method of 
cure fhould confift in evacuations by bleeding and cathartics, 
and by leeches applied to the painful or tumid parts ; and after- 
wards by taking inwardly foda phofphorata and a decodlion of 
rubia tindlorum, madder-root ; as the former is believed to give 
folidity to bones, and the latter, as it colours the bones of young, 
or growing animals, is known to be carried thither during their 
fofter or more fenfitive ftate, and may be therefore worth a triaL 
See Innutritio oflium. Clafs I. 2« 2-14* 
ordO 232 
DISEASES 
Cl ASS if. 1.4. 7. 
ORDQ I. 
Increafed Senfatiom 
GENUS V. 
With the Production of new Veffels by external Membranes 0^ 
Glands, without Fever. 
The ulcers, or eruptions, which are formed on the external 
fitin, or on the mouth or throat, or on the air-cells of the lungs, 
or on the inteftines, all of which are more or lefa expofed to the 
contact of the atmofpheric air, which we breathe, and which iri 
fome proportion we fwallcw with our food and faliva ; or to 
the contact of the inflammable air, or hydrogen, which is fet at 
liberty by the putrefying aliment in the inteltines, or by putre- 
fying matter in large abfeefles *, all of them produce contagious 
matter ; which, on being inoculated into the Ikin of another 
perfon, will produce fever, ora fimilar difeafe. 
In fome cafes even the matter formed beneath the ficin be- 
comes in fome degree contagious, at lead: fo much fo as to pro- 
duce fever of the hectic or malignant kind, as foon as it has pierc- 
ed through the fkin, and has thus gained accefs to fome kind of 
air ; as the frefh pus of a common abfeefs ; or the putrid pus 
of an abfeefs which has been long confined ; or of cancerous 
ulcers. 
From this analogy there is reafon to fufpect that the matter of 
all contagious difeafes, whether with or without fever, is not in- 
fedlious till it has acquired fomething from the air; which, by 
oxygenating the fecreted matter, mav probably produce a new 
acid. And, fecondly, that in heflic fever a part of the purulent 
matter is abforbed ; or acts on the furface of the ulcer ; as va- 
riolous matter affects the inoculated part of the arm. And that 
heftic 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 account for the venereal mat- 
ter from buboes not giving the infection, according to the exper- 
iments of the late Mr. Hunter, and for fome other phenomena 
•f contagion. See Variola difereta, Clafs II. 1. 3. 9. 
SPECIES. 
I. Gonorrhoea venerea. N pus-like contagious material dif- 
charged from the urethra after impure cohabitation, with fmart- 
iag Class II. 1. 5. 1. 
OF SENSATION. 
233 
ing or heat on making water ; which begins at the external ex- 
tremity of the urethra, to which the contagious matter is appli- 
ed, and where it has accefs to the air ; which probably heights 
ens its acrimony. 
M. M. In this ftate of the venereal difeafe, once venefe&ion, 
with mild cathartics of fenna and manna, with mucilage, as al- 
mond emulfion, and gum arabic, taken for two or three weeks, 
abfolve the cure. Is camphor of ufe to relieve the ardor urinae ? 
Do balfams increafe or leflen the heat of urine ? Neutral faits 
certainly increafe the fmarting in making water, by increaiing 
the acrimony of the urine. 
Can the difcharge from the urethra be foon flopped by fatumir.e 
injections, or mercurial ones, or with folution of blue vitriol, at 
firft very dilute, and gradually made ftronger ? And at the fame 
time, left the fyphilis, or general difeafe, fhould fupervene, the 
patient might take a quarter of a grain of corrofive fublimate of 
mercury twice a day, as directed below ? 
There is a curious paper by Mr. Addington, of Weft Bromage, 
in the Contributions of Medical Knowledge, publifired by Dr. 
Beddoes, on the cure of gonorrhoea virulenta, by large dofes of 
corrofive fublimate of mercury, hydrargyrus muriatus. Three 
grains of corrofive fublimate of mercury are diflblved in one ounc? 
of redified fpirit of wine. Half of this mixture is taken undi- 
luted at going to bed ; it produces a copious falivation for an 
hour and a half, or longer, during which the patient fpits a 
quart. Some Glauber's faits are to be taken on the fecond day 
after this operation, and on the evening of that day he is to re- 
peat the draught, and the faits on the day but one following. 
And Mr. Addington witneffed that three or four fuch dofes fre- 
quently cured a venereal gonorrhoea in fo (hort a time, without 
any difagreeable confequence, and was informed that hundreds 
had been cured by it. 
The probable mode of aCtion of this medicine is owing to the 
confent of parts between the throat and the urethra, of which 
many inftances are given in Clafs IV. i. 2. 7. on Hydrophobia. 
Mr. Wright, an elderly furgeon in Derby, thirty years ago, af- 
fured me that he had frequently given half a drachm of corrofive 
fublimate as an emetic, without any inconvenience to the patient; 
and that it was the famous emetic of a celebrated empyric, and 
had been faid to do wonders. 
Might not this dofe of one grain and a half, diflblved in half 
an ounce of reClified fpirit, be given repeatedly, with profpeft 
of advantage, in Hydrophobia ? And perhaps, in an adapted 
ftrength and quantity, in Hydrocephalus ? If in Croup, Perip- 
neumonia trachealis ? 
Vol. II. G c 2. Syphilis. 234 
DISEASES 
Class II. 1. 5. 2. 
1. Syphilis. Venereal difeafe. The contagion (hews itfelf 
in ulcers on the part firft inoculated, as chancres ; ulcere on the 
tonfils fucceed, with eruption on the Ikin, efpecially about the 
roots of the hair ; afterwards on other parts of the (kin, termin- 
ating in dry fcabs ; and, laftly, with pain and fwelling of the 
bones. 
The corona veneris, or crown of Venus, confifts of the erup- 
tions at the roots of the hair appearing molt round the forehead ; 
which is occafioned by this part being more expofed to the air ; 
which we obferved, at the beginning of this genus, either produ- 
ces or increafes the virulence of contagious matter. But it is 
difficult to conceive, from this hiltory, why the throat fhould be 
firft affected ; as it cannot be fuppofed, that the difeafe is fo 
often taken by the faliva, like the fmall-pox, though this may 
fometirnes occur; perhaps very often. The connection be- 
tween the genitals in men and the throat, is treated of in Clafs 
IV. 1.2. 7. Hydrophobia. 
M. M. A quarter of a grain of corrofive fublimate of mer- 
cury, taken thrice a day for five or fix weeks, made into a pill 
with bread-crumbs, or diflblved in a fpoonful of brandy and 
water, is a very efficacious 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, xsr from its being 
fpoiled in the pill by long keeping. Opium contributes much 
to expedite the cure, both of the fimple gonorrhoea and of ve- 
nereal ulcers, by increafing abforption both from the mucous 
membrane and from the furface of ulcers. A quarter of a grain, 
or half a grain, may be given with every dofe of the fublimate. 
Nitrous acid has been lately ftrongly recommended, by Mr. 
Scott, in venereal cafes ; from an idea that the oxygen, which 
it confifts of in part, is loofely combined, and may be feparable in 
the animal fyftem ; and that it may be the oxygen, only, which 
exifts loofely in mercurial calces or oxydes, that afts fo fuccefs- 
fully, when mercurials are exhibited. Some fuccefsful exhibi- 
tions of this acid in venereal cafes are publiffied ; the dofe is one 
drachm and a half, or two drachms, of the ftrong nitric acid 
mixed in two pounds of water, to be drunk daily at repeated in- 
tervals. Mr. Scott has fince ufedthe nitrous acid much diluted 
with water externally as a warm bath, either partially or gener- 
ally, with great fuccefs, at Bombay, in venereal cafes. See Ar- 
ticle II. 2. 4. and IV. 2. 7. 1. in the Materia Medica. 
It has been now ufed in this country with fuccefs by fome, 
and without fuccefs by others, and may perhaps affift the ufe of 
mercurials as well as opium in the cure of veneral ulcers ; but 
fhould not yet be folely depended upon. 
3. Lepra, Class IL I. 5. J. 
OF SENSATION. 
235 
3. Lepra. Leprofy. Leprofy of the Greeks. The fkin is 
rough with white branny fcales, which are full of chinks ; often 
moift beneath, and itching. The fcales on the head or arms of 
fome drinking people arc a difeafe of this kind. The perfpirable 
matter defigned for the purpofe of lubricating the external fkin is 
fecreted in this difeafe in a too vifeid (late, owing to the inflam- 
mation of the fubcutaneous veffels ; and, as the abforbents-adk 
too ftrongly at the fame time, a vifeid mucus is left adhering to 
the furface of the fkin. 
In the leprofy of the Jews, defcribed in the thirteenth and four- 
teenth chapters of Leviticus, the depreflion of the fore beneath 
the furface of the fkin, and the hairs in it becoming white, feem 
to have been the principal circumftances, which the prielt was 
directed to attend to for the purpofe of afeertaining the dif- 
eafe. 
M. M. Eflence of antimony, from 20 drops to too, twice or 
thrice a day, with half a pint of decoction of elm-bark ; or of 
malt-tea ; or tincture of cantharides, from 20 to 60 drops, four 
times a day ; or fublimate of mercury, 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 drunk in large quantities. Warm bath. 
Oil-fkin bound on the part to confine the perfpirable matter. 
Ointment of tar and fuet; or poultice for turn or three days, and 
then cerate with lapis calaminaris. Diet of raifins and bread. 
Abftinence from wine, beer, and all fpirits, is indifpenfably nec - 
effary to the cure. 
4. Elephantiajis. Leprofy of the Arabs. A contagious dif- 
eafe ; the fkin is thickened, wrinkled, rough, unctuous, defti- 
tute 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. Eramboefia. Yaws is fa id to be contagious and hereditary. 
It principally affects the negroes in the Weft indies. Ldinb. 
Eflays, Vol. VI. 
6. Pfora. Itch. A contagious prurient eruption. There 
are two kinds of itch : that which appears between the fingers 
and under the joints of the knees and elbows ; and that which 
feldom is feen in thefe places, but all over the other parts of the 
body. The latter is feldom thought to be the itch, as it does 
noteafily infebt even a bed-feljow, and refills the ufual means of 
cure by brimllone. 
It the itch be cured too haflily, by rubbing mercurial or ar- 
fcnical preparations over the whole body, or on too great a part 
oil 236 
DISEASES 
Clafs II. i. 5. 6. 
of it, many bad fymptoms are produced ; as weaknefs of digef- 
tion, with pale bloated countenance, and tendency to dropfy. 
I have twice feen St. Vitus's dance occur, from the ufe of a mer- 
curial girdle ; and once a fwelled liver. I have alfo feen a fwell- 
ed fpleen and fwelled legs from the external ufe of arfenic in the 
cure of the itch. And very numerous and large phlegmons 
commonly fucceed the too baity cure of it by other means. 
There does not appear a ftridt analogy between the hafty cure 
of the itch, and the retrocelfion of the puftules in the feeondary 
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 puftules recede, as explained in Clafs II. 1. 3. 9. Variola 
difcreta. And a fever is produced by this abforption; neither 
of which happen, when the puftules of the itch are deftroyed by 
mercury or arfenic. 
Nor can thefe 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. 1.4. 6. as in thofe the erup- 
tions on the face were an aflbeiated difeafe with inflammation 
of the liver or ftomach, which they were accuftomed to relieve ; 
whereas the itch is not known to have had any previous catena- 
tion with other difeafes. 
In the itch there exifts not only great irritation in the produc- 
tion of the puftules, but great fenfation is caufed by their acri- 
mony afterwards ; infomuch that the pain of itching without the 
interrupted fmarting occafioned by fcratching, would be intol- 
erable. This great excitement of the two fenforial powers of 
irritation and fenfation is fo great, when the puftules are diflufed 
over the whole furface of the body, that a torpor fucceeds the 
fudden ceafing of it; which aftefts thofe parts of the fyftem 
which were moft catenated with the new motions of the flein, 
as the ftomach, whence indigefton 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 vif- 
cera, cedematous fwellings, and St. Vitus's dance, which is a 
debility of aflbeiation. In the fame manner indigeftion, with 
green evacuations, are faid to follow an injudicious application 
of cerufla to ftop too haftily the exfudation behind the ears of 
children, Clafs 1. 1.2. 9. And dropfies are liable to fucceed 
the cure of old ulcers of the legs, which have long ftimulated 
rhe fyftem. 
M. M. The fize of a large pea, of an ointment confifting of 
one part of white precipitate of mercury, to fix parts of hog's 
bird wed triturated together, to be rubbed on a part of the body 
every Class II. i. 5. 7. 
OF SENSATION. 
237 
every night, and wafhed off with foap and water next morning, 
till every part is cleared ; with lac fulphuris twenty grains to be 
taken every morning inwardly. Warm faline bath, with white 
vitriol in it. Flowers of fulphur mixed with thick gruel, or with 
hog's fat. With either of which the body may be fmeared all 
over. 
Mr. Grille fays, that thofe who get manganefe from its mines 
are not fubjeft to the itch ; and that he found an ointment, com- 
pofed of fix parts of finely levigated manganefe and of fixteeri 
parts of lard, a more efficacious remedy for the itch than thofe ill 
common ufe. Parmentier. 
7. Pfora ebrwrtim. Elderly people, who have been much ad-< 
dieted to fpirituous drinks, as beer, wine, or alcohol, are liable 
to an eruption all over their bodies ; which is attended with 
very afHi<£ting itching, and which they probably propagate 
from one part of their bodies to another with their own nails by 
fcratching themfelves. I faw fatal effects in one fuch patient, 
by a too extenfive ufe of a folution of lead ; the eruption difap- 
peared, he became dropfical, and died ; I fuppofe from the too 
Suddenly ceafing of the great ftimulus caufed by the eruptions 
over the whole Ikin, as in the preceding article. 
M. M. The patient ffiould 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 the fkin at a time. A grain of opium at night in- 
llead of the ufual potation of wine or beer. 
8. Herpes. Herpes confifts of gregarious fpreading excoria- 
tions, which are fucceeded by branny fcales or fcabs. In this 
difeafe there appears to be a deficient abforption of the fubcuta- 
neous 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 the tafte, as fome of thefe pa- 
tients have affured me ; I believe 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 affect the hands, and to return at diftant periods; 
and is probably a fecondary difeafe, as well as the zona ignea,x>r 
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 difcharged fluid, and abate the inflammation ; then cover the 
parts with frefh cerate mixed with lapis calaminaris. On the 
parts not excoriated mercurial ointment, made of one part of 
white calx of mercury and fix of hog's fat. Internally, after vene- 
ftfliou, 238 
DISEASES 
Class II. f. 5. 
fedlion; gentle repeated cathartics. Laftly, the bark. Acid of 
vitriol. Bolus Armenia, or teftacea. Antimonials. Decoc- 
tion of interior bark of elm. 
9. Zona ignea. Shingles. This eruption has been thought a 
fpecies of herpes by fome writers, and by others a fpecies of 
eryfipelas. Yellow or livid veficles appear, producing a corrolive 
ichor, which is fometimes attended with a degree of fever. It 
is faid to infeft fometimes the thorax and ribs, but its moll gen - 
eral fituation is on the fmall of the back, over one kidney, extend- 
ing forward over the courfe of one of the ureters. 
There is reafon to fufpedl, that this alfo is a fecondary or fym- 
pathetic difeafe, 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 believe, that the eruption on the loins was a transla- 
tion of inflammation from the external membrane of the kidney 
to the ikin. 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 without vomiting j by which it was diftinguifhed 
from nephritis interna, or gravel; and without pain down the 
outfide of the thigh, by which it was diftinguifhed from fciatica. 
In other fittiatidns the ihingles may fympathize with other inter- 
nal membranes, as in a cafe publifhed by Dr. Ruflel (De Tabe 
Glandulari), where the retroceflion of the Ihingles was fucceed- 
ed by a ferious dyfpncca. 
M. M. Venefedlion, 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 difl'olved in a pint of water, and taken fo as to emp- 
ty the ftomach and inteftines, is faid much to haften the cure; 
comprefles foaked in a faturuine folution are recommended ex- 
ternally onthe eruption ; and cerate where there are ulcerations. 
Defanet's Surgical Journal, Vol. IL p. 378. If this be a vicari- 
ous difeafe, it ihould continue half a lunation ; left, on its ceaf- 
ing, the bad habits of motion of the primary difeafe ihould not 
have been fo perfectly diffevered, but that they may recur. 
10. Annulus repens. Ring-worm. A prurient eruption 
formed in a circle, affecting children, and would feem to be the 
work of infefts, according to the theory of Linnseus, who afcribes 
the itch and dyfenterv to microfcopic animalcula. Thefe ani- 
malcula are probably the effect, and not the cau fe, of thefe erup- 
tions j as they are to be feen in all putrefeent animal fluids. The 
annular propagation of the ring-worm, and its continuing to en- 
large its periphery, is well accounted for by the acrimony of the 
ichor or faline fluid eroding the ikin in its vicinity. 
M. M. Cover Class II. i. 5. 11. 
OF SENSATION. 
239 
• M. M. Cover the eruption daily with ink. With white mer- 
curial ointment, as defcribed above in herpes. With folution of 
white vitriol ten grains to an ounce. Thefe metallic calces ftim- 
ulate the abforbents into Wronger action, whence the fluid has 
its faline part reabforbed, and that before it has acccls 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 affects 
the roots of the hair, and is generally moft virulent round the 
edges of the hair on the back part of the head ; as the corona 
veneris appears molt on the edges of the hair on the fore part of 
rhe head : for in thefe parts the eruption about the roots of the 
hair is moil: expofed to the external air, by which its acrimony 
or noxious quality is increafed. 
The abforption of the matter thus oxygenated fwells the lymph- 
atics of the neck by its ftimulus, occafioning many little hard 
Jumps beneath the feat of the eruption ; when this happens, the 
fooner it is cured the better, left the larger lymphatics of the 
peck [hould become affected. 
M. M. The art of curing thefe eruptions confifts, firft, in 
abating the inflammation, and confequent fecretion of a noxious 
material. Secondly, in preventing itsaccefs to the air, which fo 
much increafcs its acrimony. And thirdly, in promoting the ab- 
forption of it, before it has been expofed to the air. For thefe 
purpofes venefedtion once, and gentle cathartics, which promote 
abforption by emptying the blood-veffels. Next poultices and 
fomentations, with warm water, abate inflammation by diluting 
the faline acrimony of the fecreted fluid, and abating the painful 
fenfation. Afterwards cerate joined with fome metallic calx, as 
of zinc or lead, or folution of lead, mercury, or copper, or iron, 
which may ftimulatethe abforbent fyftem into ftronger adtion. 
Cover the fhaved head with tar and fuet, and a bladder ; this, 
by keeping the air from the fecreted fluid, much contributes to 
its mildnefs, and the ftimulus of the tar increafcs its abforption. 
See the three preceding fpecies of this genus. 
Mr. Morifon of Dublin cures the tinea capitis by what he terms 
an adhefive pafte, which is made by boiling half a pound of fine 
flour in two pounds of common ale, and then adding four ounces 
of yellow refm in fine powder, and ftirring them well together, 
until they are perfectly incorporated. After removing the hair, 
and poulticing the head for a day or two, to take off' the hard 
fcabs, this pafte is fpread on flips of linen, which are applied 
over the whole affected part, and removed and frefli ones appli- 
ed every morning,-after one or two days, I fufpect, that re- 
moving the plafters feldomer might be more advantageous. 
12. Cruft & 240 
DISEASES 
Class II. 1. 5. 12, 
12. Cru^a laHea. Milk-cruft is a milder difeafe than tinea, 
affefting the face as well as the hairy fcalp of very young chil- 
dren. It is not infectious, nor liable to fwell the lymphatics in its 
vicinity like the tinea. 
M. M. Cover the eruption with cerate made with lapis cala- 
minaris, to be renewed every day. Mix one grain of emetic tar- 
tar with forty grains of chalk, and divide into eight papers, one 
to be taken twice a day, or with magnefia alba, if ftools are want- 
ed. 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 inex- 
tricable knots or plaits of great length, like the fabled head of 
Medufa, with intolerable pain, fo as to confine the fufferer on 
his bed for years. 
ORD© Class II. i. 6. i. 
OF SENSATION. 
241 
ORDO I. 
Increafed Senfation* 
GENUS VI. 
With Fever conjequent io the Production of new Vejfels or Fluids* 
SPECIES. 
i. Febrisfenfitiva. Serifitive fever, when unmixed with either 
irritative or inirritative fever, may be diftinguilhed from either 
of them by 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 generally be taken from the pulmonary con- 
fumption ; in this difeafe patients a're feeri to walk about with 
cafe, and to do all the common offices of life for weeks, and even 
months, with a pulfe of 120 flrokes in a minute ; while in other 
fevers, whether irritated dr inirritated, with a pulfe of this fre- 
quency, the patient generally lies upon the bed and exerts nd 
mufcular efforts without difficulty. 
The caufe of this curious phenomenon is thus to be under- 
flood ; in the fenfitive fever a new fenforial power, viz. that of 
fenfatiort, is fuperaddedto that of irritation ; which in other fevers 
alone carries on the increafed circulation. Whence the power 
of irritation is not much more cxhaufted 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 performance of many cuftomary ac- 
tions, are little impaired. For an account of the irritated fenfi- 
tive fever, fee Clafs II. 1.2. 1.; for the inirritated fenfitive fever, 
Clafs II. 1.3. 1. IV. 2. 4. 11. 
2. Febris a pure clatfo. Fever from enclofed matter is gener- 
ally of the irritated fenfitive kind, and continues for- many weeks-, 
and even months, after the abfeefs is formed ; but is diftinguiffi- 
ed from the fever from aerated matter in open ulcers, becaufe 
there are feldom any night-fweats, or colliquative diarrhoea in 
this, as in the latter. The pulfe is alfo harder, and requires oc- 
cafional venefedlion, and cathartics, 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 deltroys the patient. 
In this fever the matter, not having been expofed to the air, has 
not acquired oxygenation ; in which a new acid, or lome other 
Vol. II. H h noxious 242 
DISEASES 
Class II. r. 6. y 
noxious property, is produced ; which aifts like contagion on the' 
eonftitution inducing fever-fits, called hectic fever, which termin- 
ate with fweats or diarrhoea ; whereas the matter in the clofed 
abfcefs is either not abforbed, or does not fo affect the circula- 
tion as to produce diurnal or he€tic fever-fits ; but the ftimulus 
of the abfcefs excites fo much fenfatibn as to induce perpetual 
pyrexia, or inflammatory fever, without fuch marked remiflions. 
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 general- 
ly in the urine, with occafional wandering pains about 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 the vomica ; as it is attended with difficulty of 
breathing, and requires venefeblion. Mr. B , a child about 
feven years old, lived about feven weeks in this fituation, with a 
pulfe from 150 to 170 in a minute, without fweats, or diarrhoea* 
or fediment in his water, except mucus occafionally ; and took 
fufficient nourishment during the whole time. The blood ta- 
ken was always covered with a flrong cupped fize, and on his 
death three or four pints of matter were found in one fide of the 
cheft ; which had probably, but lately, been eft'ufed from a vom- 
ica. This child was frequently induced to fwing, both in a re- 
ciprocating and in a rotatory fwing, without any apparent abforp- 
tion of matter; in both thefe fwings he exprefled pleafure, anti' 
did not appear to be vertiginous. 
M. M. Repeated emetics. Digitalis ? Perfeverance in ro- 
tatory fwinging. See Clafs II. 1. 6. 7. 
Mr. I. had laboured fome months under a vomica after a pe- 
ripneumony, 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 fe- 
tid matter, and recovered. Hence errhines may be occafionally 
ufed with advantage. 
■4. Empyema. When the matter from an abfcefs in the lungs 
finds its way into the cavity of the cheft, it is called an empye- 
ma. A fervant man, after a violent peripneumony, was feized 
with fymptomsbf empyema, and it was determined, after fome 
time, toperform the operation ; this was explained to him, and' 
ths. Class II. 1. 6. 5. 
OF SENSATION. 
243 
the ufual means were employed by his friends to encourage him, 
v •« by advifmg 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 occafion- 
cd by digitalis ? Fear renders the external fkin pale ; by this 
continued decreafe of the action of the abforbents of the Ikin 
might not thofe of the lungs be excited into greater activity ? and 
thus produce increafed pulmonary abforption by reverfe lympa- 
thy,as it produces pale urine, and even ftools,by direct fympathy ? 
M. M. Digitalis ? 
5. Febris Mejenterica. Fever from matter formed in the mef- 
entery is probably more frequent than is fufpected. It commen- 
ces with pain in the bowels, with irritated fenfitive fever; and 
continues many weeks, and even months, requiring cccafional 
venefedion, and mild cathartics; till at length the continuance 
of the pyrexia, or inflammatory fever, deflroys the patient. This 
is an affection of the lymphatic glands, and properly belongs to 
fcrofula ; but as the matter is not expofed to the air, no hedtic 
fever, properly fo called, is induced. 
6. Febris a pure aerato. Fever from aerated matter. A great 
collection of matter often continues a long time, and is fome- 
times totally abforbed, even from venereal buboes, without pro- 
ducing any disorder in the arterial fyltem. At length, if it be- 
comes putrid by its delay, and one part of the matter thus be- 
comes aerated by the air given out 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 heCtic fever is produced. Whence 
the utility arifes of opening large abfeefles by fetons, as in that 
cafe little or no hedlic fever is induced ; becaufe the matter is 
fqueezed out by the fide of the fpongy threads of cotton, and lit- 
tle or no air is admitted ; or by tapping the abfeefs with a tro- 
car, as mentioned in ifehias, Clafs II. 1. 2. 18. 
In this fever the pulfe is about 120 in a minute, and its accefs 
is generally in an evening, and fometimes about noon alfo, with 
fweats or purging towards morning, or urine with pus- 
like fediment; and the patients bear this fever better than 
any other with fo quick a pulfe : and laftly, when all the matter 
from a concealed ulcer is abforbed, or when an open ulcer is heal- 
ed, the hectic fever ceafes. Here the abforbed matter is fuppo- 
fed to produce the fever, and the diarrhoea, fweats, or copious 
muddy urine, to be Amply the confequence of increafed fecretion, 
and not to confift of the purulent matter, which was fuppofed to 
be abforbed from the ulcer. See Sudor calidus, Clafs I. 1. 2. 3. 
The action of the air on ulcers, as we have already (hewn, in- 
creafei 244 
DISEASES 
Clafs II. 1.6. 6, 
creafes the acrimony of the purulent matter, and even converts 
it into a weaker kind of contagious matter ; that is, to a mate-? 
rial inducing fever. This was afcribed to the union of the azotic 
part of the atmofphere with the effufed pus in Sect. XXVIII. 2. 
but by contemplating more numerous fadts and analogies, I am 
now induced to believe, that it is by the union of oxygen with it; 
lirft, becaufe oxygen fo greedily unites with ether animalfubflances, 
as the blood, that it will pal's through a moift bladder to combine 
with it, according to the experiment of Dr. Prieftley. Secondly, 
becaufe the poifons of venomous creatures are fuppofed to be 
acids of different kinds, and are probably formed by the conta<Sh 
of air after their fecretion. And laltly, becaufe the contagious 
matter from other ulcers, as in itch, or fmall-pox, is formed on 
external membranes, and are probably combinations of animal 
matter and oxygen, producing other new acids. 
Since having written the above, Dr. Mitchill, of New York, 
has fpoken much of the feptic quality of azote, or nitrogen ; and 
thinks that it is the union of this part of the atmofphere with 
the matter of ulcers, which produces or increafes its contagious 
or fever-excjting property ; which I had myfelf at firft believed, 
as mentioned in Part I. Se£t XXVIII. 2. In fupport of this 
opinion, it may be faid, that proper ventilation with purer air is 
believed certainly to diminilh or deftroy infection ; as fpoken of 
in Oafs II. 1. 3. where it is propofed to difengage oxygen from 
manganefe, for the purpofe of purifying crowded apartments. 
But further experiments mull determine this curious inquiry ; 
which might be attended with important confequences, if azote, 
and not oxygen, could be fhewn to prevent the healing of pul- 
monary ulcers ; as oxygen might be refpired alone, or mixed 
with hydrogen or with carbonic acid gas, inftead of with azote. 
It was thought a fubject of confequence by the ^Efculapian 
Society at Edinburgh, to find a criterion which ihould diftin- 
guilh pus from mucus, for the purpofe of more certainly dif- 
covering the prefence of ulcers in pulmonary difeafes, or in 
the urinary paffages. For this purpofe that fociety offer- 
ed their lirff gold medal, which was conferred on the late Mr. 
Charles Darwin, in the year 1778, for his experiments on this 
fubjeft. From which he deduces the following conclufions : 
" 1. Pus and mucus are both foluble in the vitriolic acid, 
though in very different proportions, pus being much the lefs 
foluble. 
" 2. The addition of water to either of thefe compounds dc- 
compofes it; the mucus thus feparated, either fwims on the mix- 
ture, or forms large flocci in it ; whereas the pus falls to the 
bottom, and forms on agitation a uniform turbid mixture. 
" 3. Pus Class II. 1. 6. 7. 
OF SENSATION. 
245 
« 3- Pus is diffufible through a diluted vitriolic acid, though 
mucus is not j the fame occurs with water, or a folution of fea 
fait. 
" 4. Nitrous acid diflblves both pus and mucus; water added 
to the folution of pus produces a precipitate; and the fluid a- 
bove becomes clear and green ; while water and the folution of 
mucus form a dirty coloured fluid. 
" 5. Alkaline lixivium diflblves (though fometimes with diffi- 
culty) mucus, and generally pus. 
" 6. Water precipitates pus from fuch a folution, but does not 
mucus. 
" 7. Where alkaline lixivium does not diflblve pus, it ftill dif- 
finguifhes it from mucus 5 as it then prevents its diflufion through 
water. 
" 8. Coagulable lymph is neither foluble in diluted nor con- 
centrated vitriolic acid. 
" 9. Water produces no change on a folution of ferum in al- 
kaline lixivium, until after long Handing, and then only a very 
flight fediment appears. 
" 10. Corrofive fublimate coagulates mucus, but not pus. 
" From the above experiments it appears, that ftrong vitri- 
olic acid and water, diluted vitriolic acid, and cauftic alkaline 
lixivium and water, will ferve to diftinguifh 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 expectorated material, 
the compofition of which he willies to afcertain, let him diflblve it 
in vitriolic 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 allured that fome pus is prefent. If in neither a 
precipitation occurs, it is a certain teft, that the material is en- 
tirely mucus. If the material cannot be made to diflblve in al- 
kaline lixivium by time and trituration, we have alfo reafon to be- 
lieve that it is pus." Experiments on Pus and Mucus. Cadell. 
London. 
Dr. Cappe, of York, in his inaugural treatife de HeCIica, and 
Dr. Ryan, of Dublin, in his Eflay on Confumption, have repeat- 
ed thefe experiments of Mr. Darwin with nearly fimilar refults. 
7. Pbtbifis pulmonalis. In pulmonary confumption the fever 
is generally fuppofed to be the confequence of the ftimulus of 
abforbed matter circulating in the blood-veflels, and not limply 
of its ftimulus on their extremities in the furface of the ulcers ; 
as mentioned in Clafs II. 1. 5. and Clafs II. 1. 3. 9. The ul- 
cers are probably fometimes occafioned by the putrid acrimony 
of eft'ufed blood remaining in the air-cells of the lungs after an 
haemoptoe. 246 
DISEASES 
Class II. 1. 6. 
hxmoptoe. See Clafs I. 2. i. 9. The remote caufe o£ con^ 
fumption is ingenioufly afcribed by Dr. Beddoes to the hyper- 
oxygenation of the blood, as mentioned Section XXVIII. 2. 
As the patients liable to confumption are of the inirritable 
temperament, as appears by the large pupils of their eyes ; there 
is reafon to believe, that the hacmoptoe 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 Sect. XXX. 1. 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 
lungs ; whence no fcab, or indurated mucus, can be formed fo 
as to adhere on them. Whence thefe naked ulcers are perpet- 
ually expofed to the a&ion of the air on their furfaces, conver- 
ting their mild purulent matter into a contagious ichor ; which 
not only prevents them from healing, but by its action on their 
circumferences, like the matter of itch or tinea, contributes to 
fpread them wider. See the preceding article, and Sect. XXXIII, 
2. 7. where the pulmonary phthifis is fuppofed to be infectious. 
This acidifying principle is found in all the metallic calces, 
as in lapis calaminaris, which is a calciform orc of zinc ; 
and in minium, which is a calx of lead ; two materials 
which are powerful in healing excoriations and ulcers, in a 
fhort time, by their external application. How then does it 
happen, that the oxygen in the atmofphere fhould prevent pul- 
monary ulcers from healing, and even induce them to fpread 
wider ; and yet in its combination with metals, it fhould facili- 
tate their healing ? The healing of ulcers confifls in promoting 
the abforption of the fluids effufed into them, as treated of in 
Section XXXIII. 3. 2. Oxygen in combination with metals, 
when applied in certain quantity, produces this effect by its 
ftimulus j and the metallic oxydes not being decompofed by 
their contatSt with animal matter, no new acid, or contagious 
material, is produced. So that the combined oxygen, when ap- 
plied 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 protect themfelves from 
the air by forming a fcab, the uncombined oxygen of the atmof- 
phere unites with the purulent matter, converting it into a con- 
tagious ichor ; which by infection, not by erofion, enlarges 
the ulcers, as in the itch or tinea ; which might hence, accor- 
ding to Dr. Beddoes's ingenious theory of confumption, be in- 
duced to heal, if expofed to an atmofghere deprived of a part of its 
oxygen. Clafs II. i. 6. 7. 
OF SENSATION. 
247 
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- 
quantity of azote, or mixed with fome proportion of hydrogen, 
or of carbonic acid air, may be tried ; as described in a late pub- 
lication of Dr. Beddoes on the medicinal ufe of factitious airs. 
Johnfon, London. Or laftly, by breathing a mixture of one- 
tenth part of hydrocarbonate mixed with common air, according 
to the difcovery of Mr. Watt, which has a double advantage in 
thefe cafes, of diluting the oxygen of the atnsofpheric air, and 
inducing ficknefs, which increafes pulmonary abforption, as 
mentioned below. An atmofphere diluted with fixed air (car- 
bonic 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 ul- 
cers by combining with the purulent matter. 
Another eafy method 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 defcri- 
bed in Dr. Beddoes' Treatife on Pneumatic Medicine. John- 
fon, London. It confifts of an iron pot, with an arm projecting, 
and a method of letting 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 pro- 
duced 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 poifon formed on pulmonary ulcers by the contaCl of 
oxygen, and thus prevent its deleterious quality, as other acids 
become lefs cauftic, when they are formed into neutral faits with 
alkalis. The volatile fait fhould be put into a tin canifter, with 
two pipes like horns from the top of it, one to fuck the air from, 
and the other to admit it. 
Secondly, the external ulcers in fcrofulous habits are pale and 
flabby, and naturally difinclined to heal, the depofition of fluids 
in them being greater than the abforption ; thefe ulcers have 
their appearance immediately changed by the external application 
•f 248 
Diseases 
Class IT. 1. 6. 
of metallic calxes, and the medicines of the article Sorbentia^ 
fuch as cerufla and the bark in fine powder, fee Clafs I. 2. 3. 214 
and are generally healed in a (bort time by thefe means, indu- 
ced by thefe obfervations, I wifhed to try the external application 
of fuch powders to ulcers in the lungs, and conftfucted a box 
•with a circulating brufli in it, into this box two ounces of fine 
powder of Peruvian bark were put, and two drachms of ccruflh 
in fine powder ; on whirling the central brulh, part of this was 
taifed into a cloud of powder and the patient, applying his mouth 
to one of the tin pipes rifing out of the box, inhaled this powder 
twice a day into his lungs. I obferved it did not produce any 
cough or uneafinefs. This patient was in the lall Hage of con- 
lumption, and was foon tired of the experiment, 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 Rate, might be a better way of 
applying this powder to the lungs, as difcovered by Mr. Watt. 
See Dr. Beddoes on Pneumatic Medicine. Johnfon. 
Thirdly, as the healing of an ulcer confifts in producing a 
tendency to abforption on its furface greater than the depofition 
on it; fee SedT. XXXIII. 3. 2. Other modes of increafing pul- 
monary abforption, which are perhaps more manageable than 
the preceding ones, may be had recourfe to ; fuch as by pro- 
ducing frequent naufea or ficknefs. See Sect. XXIX. 5. 1. and 
Art. IV. 2. The great and fudden abforption of fluid from the 
lungs in the anafarca pulmonum by the ficknefs induced by the 
exhibition of digitalis, aftonifhes thofe who have not before at- 
tended to it, by emptying the fwelled limbs, and removing tire 
difficulty of breathing in a few hours. 
The mod manageable method of ufing digitalis is by making 
a faturated tinfture of it, by infufing two ounces of the powder 
of the leaves in a mixture of four ounces of rectified 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 ficknefs neverthelefs comes on, the patient 
mud 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 Tranfaftions of the College, Vol. III. But I heard, 
that about two years afterwards he rclapfed and died. Mr. 
L , Class II. 1. 6. 7. 
OF SENSATION. 
249 
L , a corpulent man, who had for feme weeks laboured 
under a cough with great expectoration, 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 (hewing 
the power of pulmonary abforption excited by the ufc of this 
drug. 
Since the publication of the above, fome fuccefsful cafes of 
the treatment of confumption by the tinClure of digitalis are re- 
lated in Medical and Phyfical Contributions, edited by Dr. Bed- 
does, Longman, London. Two of the fuccefsful cafes are from 
Dr. Drake, who obferves," that by gradually increafing the dofe 
of the faturated tinClure of digitalis from 20 drops to 100 twice 
a day, all the fymptoms of fever, cough, pain j and dyfpnoea, daily 
grew better, and at length totally ceafed, and that on the quanti- 
ty and quality of the expectorated matter the digitalis foon exert- 
ed a very remarkable effeCt, either promoting its abforption, or 
diminifhing its fecretion, or perhaps both, in a rapid manner ; 
while at the fame time it deprived it of its fetor." Many cafes 
with great relief, or with profperous event, are related bvDr. 
Fowler, and by Dr. Beddoes. One I have alfo lately feen my- 
felf, whom I believed to be confumptive, and who is of a con- 
fumptive family, and after having ufed the faturated tindure 
about fix weeks, or two months, in various dofcs, is now believed 
by herfelf and friends to be perfectly redored to health, but there 
has not been time enough yet elapfed to determine, whether (he 
may not relapfe, now (he difcontinues the medicine. 
Neverthelefs as the digitalis has been given in many cafes 
without fuccefs, there i$ reafon to believe, that it (hould be taken 
early in the difeafe, before too great ulcerations are pro'duced, 
and too great debility exids. As thefe patients are fubjeCt to 
flatter themfelves more than mod others, and are liable, on that 
account, not to apply foon enough for proper affidance, they 
(hould be warned that a cough attended with a pulfe, that beats 
120 times in a minute, is always a difeafe of danger. 
Another method of inducing ficknefs, and pulmonary abforp- 
tion in confequence, is by failing on the fea ; by which many 
confumptive patients have been faid to have received their cure ; 
which has been erroneoufly afcribed to fea-air, in dead of fea- 
ficknefs ; whence many have been fent to breathe the fea-air on 
the coads, who might have done better in higher (ituations, where 
the air probably contains lefs oxygen gas, which is the heavied 
part of it. See a Letter from Dr. J. C; below. 
A third method of inducing ficknefs, and confequent pulmo- 
nary abforption, is by the vertigo occafioned by (winging ; which 
Vol. IL I 1 has 250 
DISEASES 
Class II. i. 6. 7. 
has lately been introduced into practice by Dr. Smith, (Eflay on 
Pulmonary ConRimption), who obferved that by Twinging the 
hectic pulfe became flower, which is explained in Clafs IV. 2. 
1. 10. The ufual way of reciprocating Twinging, like the of- 
cillations oT a pendulum, produces a degree of vertigo in thofe, 
who are unufed to it; but to give it greater effect, the patient 
fhould be placed in a chair TuTpended from the ceiling by two 
parallel cords in contact with each other, the chair fhould then 
be forcibly revolved 20 or 40 times one way, and fuffered to re- 
turn fpontaneoufly ; which induces a degree of ficknefs in molt 
adult people, and is well worthy an exact 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 faits, as of mercury, 
fteel, zinc, and copper, in fmall quantities, have been repeatedly 
ufed in pulmonary confumption ; and may have relieved fome 
of the fymptoms. As mercury cures venereal ulcers, and as pul- 
monary ulcers refemble 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 
folution of gold in aqua regia be worth trying ? When vinegar 
is applied to the lips, it renders them inflantly pale, by promo- 
ting the venous abforption ; if the whole ikin was moiftened with 
warmifli vinegar, would this promote venous abforption in the 
lungs by their fympathy with the fkin ? The veryabftemious di- 
et.on milk and vegetables alone is frequently injurious. Flefh 
meat once a day, with fmall wine and water, or fmall beer, is pref- 
erable. Half a grain of opium twice a day, or a grain, I 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 The was about eighteen, had frequent cough, with quick 
pulfe, a pain of her fide, and the general appearances of a begin- 
ning confumption. 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 comfumption is related by 
a phyfleian of great ability and very extenfive practice ; and, as 
it is his own cafe, abounds with much nice obfervation and ufe- 
ful knowledge ; and, as it has been attended with a favourable 
event, may give confolation to many, who are in a fimilar fitua- 
tic> $ and fhews that Sydenham's recommendation of riding as 
a Class II. 1. 6. 7. 
OF SENSATION. 
251 
a cure for confumption is not fo totally ineffectual, as is now 
commonly believed. 
J. C. aged 27, with black hair, and a ruddy complexion, was 
fubjeCt to cough from the age of puberty, and occafionally to 
fpitting of blood. His maternal grandfather died of confump- 
tion under thirty years of age, and his mother fell a victim 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 1783-4, he was much afflicted 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 difficulty, in about fix weeks he was 
able to leave his bed. At this time the cough was fevere, and 
the expeCloration difficult. A fixed pain remained on the left 
fide, where an iffue was inferted ; regular heflic came on every 
day about an hour after noon, and every night heat and reftleff- 
nefs took place, fucceeded towards morning by general perfpi- 
ration. 
The patient, having formerly been fubjeCl to ague, was (truck 
with the refemblance of the febrile paroxyfm, with what he had 
experienced under that difeafe, and was willing to flatter himfelf it 
might be of the fame nature. He therefore took bark in the in- 
terval of fever, but with an increafe of his cough, and this requir- 
ing venefeCtion, the blood was found highly inflammatory. The 
valt quantity of blood which he had loll from time to time, pro- 
duced a difpofition to fainting, when he refumed the upright 
pofture, and he was therefore obliged to remain almoft conftant- 
ly in a recumbent pofition. Attempting to ride out in a carriage, 
he was furprifed to find that he could fit upright for a confider- 
able time, while in motion, without inconvenience, though, on 
(topping 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 recurrence of the heClic paroxyfms, and that day he miff- 
ed it altogether. This circumftance led him to ride out daily 
in a carriage at the time the febrile acceffion might be expected, 
and fometimes by this means it was prevented, fometimes de- 
ferred, and almoft always mitigated. 
This experience determined him to undertake a journey of 
fome length, andBriftol being, as is ufual in fuch cafes, recom- 
mended, he fet out on the 19th of April, and arrived thereon 
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 up- 
right. 252 
DISEASES 
Class II. i. 6. 7. 
right, but at very fhort intervals, and was obliged to lie at length 
in the diagonal of a coach. The heftic paroxyfms were not in- 
terrupted during the journey, but they were irregular and indif- 
tinCl, and the falutary effects of exercife, or rather of geftation, 
were impreffed on the patient's mind. 
At Briftol he ftayed a month, but reaped no benefit. The 
weather was dry and the roads dufty ; the water infipid and in- 
ert. He attempted 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 neceflity of frequent bleedings kept down his 
ftrength, and his heCtic paroxyfms continued, though lefs fe- 
vere. At this time, fufpedling that his cough was irritated by 
the weft winds bearing the vapour from the fea, he refolved 
to try the effects of an inland fituation, and fet off for Matlock 
in Derbyfhire. 
During the journey he did not find the improvement he ex- 
pected, but the nightly perfpirations began to diminifh; and 
the extraordinary fatigue he experienced proceeded evidently 
from his travelling in a poft-chaife, where he could not indulge 
in a recumbent pofition. The weather at Briftol had been hot, 
and the earth arid and dufty. At Matlock, during the month 
of June 1784, there was almoft a perpetual drizzle, the foil was 
wet, and the air moift and cold. Here, however, the patient's 
cough began to abate, and at intervals he found an opportunity 
of riding more or lefs on horfeback. From two to 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 ride from Mafen's 
Bath to the village of Matlock along the Derwent, and round 
on the oppofite banks, by the works of Mr. Arkwright, back to 
the houfe whence he flatted, 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 haem- 
orrhoids of the moft painful kind, and requiring much lofsof 
blood from the parts affeCted. 
On reflection, it appeared that the only benefit received by 
the patient was during motion, and continued motion could bet- 
ter be obtained in the courfe of a journey than during his refi- 
dence at any particular place. This, and other circumftances of 
a private but painful nature, determined him to fet out from 
Matlock on a journey to Scotland. The weather was now much 
improved, and during the journey he recruited his ftrength. 
Though as yet he could not fit upright at reft for half an hour 
together without a difpofition to giddinefs, dimnefs of fight, and 
diliquium, 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 Clafs II. I. 6. 7. 
OF SENSATION. 
253 
appetite began to improve. Still his cough continued, and his 
hcftic fluffings, though the chills were much abated and very 
irregular. 
The falutary effects of motion being now more ftriking than 
ever, he purchafed a horfe admirably adapted to a valetudinarian 
in Dumfriesfhire, and being now able to fit on horfeback for an 
hour together, he rode out feveral times a day. 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, de- 
feend in different directions; a fituation inland, dry, and healthy, 
and elevated about three hundred feet above the furface of the 
fea. Here his ftrength recovered daily, and he began to eat an- 
imal food, which for feveral months before he had not tailed. 
Perfevering in exercife on horfeback, he gradually increafed the 
length of his rides, according to his ftrength, from four to twenty 
miles a day ; and returning on horfeback to Lancafhire by the 
lakes of Cumberland, he arrived at Liverpool on the firft of Sep- 
tember, having rode the laft day of his journey forty miles. 
The two inferences of moft importance to be drawn from this 
narrative, are, firft, the extraordinary benefit derived from gefta- 
tion in a carriage, and ftill more the mixture of geftation and 
exercife on horfeback, in arrefting or mitigating the hectic par- 
oxyfm ; and fecondly, that in the florid confumption, as Dr. 
Beddocs terms it, an elevated and inland air is in certain circum- 
ftances peculiarly falutary; while an atmofphere loaded with 
the fpray of the fea is irritating and noxious. The vicinity of 
the fea appears very injurious to almoft all vegetables, and fhould 
on that account be fufpedled in refpe^l to its general falubrity, 
though it may neverthelefs be medicinal in fome difeafes, if re- 
forted to for a time in the fummer months, but muft be ineligible 
as a permanent refidence. See Clafs I. 2. 1. 15. 
The benefit derived in this cafe from exercife on horfeback, 
may lead us to doubt whether Sydenham's praife of this remedy 
be as much exaggerated as it has of late been fuppofed. Since the 
publication of Dr. C. Smyth on the effects of fwinging in low- 
ering the pulfe in the he6lic paroxyfm, the fubjedl of this nar- 
rative has repeated his experiments in a great variety of cafes, 
and has confirmed them. He has alfo repeatedly feen the hedlic 
paroxyfm prevented, or cut fhort, by external ablution of the 
naked body with tepid water. 
So much was his power of digeftion impaired or vitiated by 
the immenfe evaucations, and the long continued debility he un- 
derwent, that after the cough was removed, and indeed for fev- 
eral years after the period mentioned, he never could eat animal 
food without heat and fluffing, with frequent pulfe and extreme 
drowfinefs. 254 
DISEASES 
Clais II. i. 6. 
drowfinefs. If this drowfinefs was encouraged, the fever ran 
high, and he awoke from difturbed fleep, wearied and deprefled. 
If it was refolutely refitted by gentle exercife, it went off in about 
an hour, as well as the increased frequency of the pulfe. This 
agitation was however fuch as to incapacitate him during the 
afternoon for ftudy of any kind. The fame effects did not fol- 
low a meal of milk and vegetables, but under this diet his ftrength 
did not recruit j whereas after the ufe of animal food it recov- 
ered rapidly, notwithftanding the inconvenience already men- 
tioned. 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 
poflefles its original efficacy. 
Dr. Falconer, in his Diflertation on the Influence of the Paf- 
fions and Affections of the Mind on Health and Difeafe, fuppo- 
fes that the cheerfulnefs which attends heftic fever, the ever- 
fpringing hope, which brightens the gloom of the confumptive 
patient, increafes the difeafed actions, and haltens his doom. 
And hence he is led to inquire, whether the influence of fear 
might not be fubftituted in fuch cafes to that of hope with ad- 
vantage to the patient ? This queftion I fliall not prefume to 
anfwer, but it leads me to fay fomething of the ftate of the mind 
in the cafe juft related. 
The patient, being a phyfician, was not ignorant of his dan- 
ger, which fome melancholy circumftances ferved to imprefs 
on his mind. It has already been mentioned, that his mother 
and grandfather died of this difeafe. It may be added, that in 
the year preceding that on which he himfelf was attacked, a 
fitter of his was carried off by confumptiou in her 17th year ; 
that in the fame winter in which he fell ill, two other lifters 
were feized with the fame fatal diforder, to which one of them 
fell a victim during hisrefidence at Briftol, and that the hope 
of bidding a laft 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 conjectured 
from thefe circumftances, that whatever benefit may be derived 
from the apprehenfion of death, mutt in this cafe have been 
obtained. The expectation of this iflue was indeed for fome 
time fo fixed that it ceafed to produce much agitation 5 in con- 
formity to that general law of our nature, by which almoft all 
meh fubmit with compofure to a fate that is forefeen, and that 
appears inevitable-. As however the progrefs of difeafe and de- 
hiaty feemed to be arretted, the hope and the love of life reviv- 
ed. Class II. 1. 6. 8. 
OF SENSATION. 
255 
ed, and produced, from time to time, the obfervations 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 ta- 
ken, was even to the laft bufly. Feb. 3, 1795. 
It has lately been aflerted, that the people of Holland are Jefs 
liable to confumption of the lungs, than thofe of many other 
parts of Europe, which has been afcribed to their warmer cloth- 
ing. I am aware of the difficulty of making fuch eftimates with 
any great degree of certainty, but if fuch be the faft, it may in- 
deed be afcribed with fome degree of probability to their ufmg 
very warm clothing, but not very warm rooms during the'winter 
feafon. Whence the lungs are not fo much expofed to the 
great and hidden tranfition from very warm rooms into frofty 
air, as in this country. And though the lungs have not a fen- 
fation of cold or of chilnels like the external (kin, in palling from 
very warm air into great cold, often much below the freezing 
point, yet they are liable to inflammation, like other parts of the 
fyftem. But to this may be objected, that the hereditary pul- 
monary confumption attacks the patient fo infallibly a few years 
after puberty, that it doe$ not appear to depend much on exter- 
nal circumftances. • 
8. Febris fcrofuloja. The heflic 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 diarrhoea. 
M. M. The bark. Opium internally. Externally ceruffa 
and bark in fine powder. Bandage. Sea-bathing. See Clafs 
I. 2. 3. 21. and II. 1. 4. 12. . 
9. Febris ijcbiadica. K heCtic fever from an open ulcer be- 
tween the mufcles of the pelvis, which differs not from the pre- 
ceding. If the matter in this fituation lodges till part of it, I fup- 
pofe, becomes putrid, and aerates the other part ; or till it be- 
comes abforbed from fome other circumllance ; a fimilar hedlic 
fever is produced, with night-fweats, or diarrhoea. 
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 fluctuation of matter could be felt; (he became hec- 
tic with copious night-fweats, and occafional diarrhoea, for four 
or five weeks ; and recovered by, I fuppofe, the total abforption 
of the matter, and the reunion of the walls of the abfeefs. See 
Clafs IT. 1. 2. 18. 
10. Febris Arthropuodica. Fever from the matter of difeafed 
joints. Does the matter from fuppurating bones, which gener- 
ally 256 
DISEASES 
Class II. 1.6. 1 
ally has a very putrid fmell, produce hetftic fever or typhus ? Sec 
Clafs II. 1.4. 16. 
11. Febris a pure contagiojb, Fever from contagious pus. 
When the contagious matters have been produced on the exter- 
nal habit, and in procefs of time become abforbed, a fever is 
produced in confequence of this reabforpcion ; which differs 
with the previous irritability or inirritability, as well as with the 
fenfibility of the patient. 
12. Febris varioloja fecundaria. Secondary fever of fmall-pox. 
In the diftinft fmall-pox the fever is of the fenfitive irritated or 
inflammatory kind ; in the confluent fmall-pox it is of the fenfi- 
tive inirritated kind, or typhus gravior. In both of them the 
fwelling of the face, when the matter there begins to be abforb- 
ed, and of the hands, when the matter there begins to be ab- 
forbed, fhew, that it ftimulates the capillary veffels or glands, 
occafioning an increafed fecretion greater than the abforbents 
can take up, like the afkion of the cantharides in a blifter ; now 
as the application of a blifter on the ikin frequently occafions 
the ftrangury, which fhews, that fome part of the cantharides is 
abforbed ; there is reafon to conclude, that a part of the matter 
of fmall-pox is abforbed, and thus produces the fecondary fever. 
See Clafs II. 1. 3. 9. And not limply by its ftimulus 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. 1. 3. 2. 
The material thus abforbed in the fecondary fever of fmall- 
pox differs from that of open ulcers, as it is only aerated through 
the elevated cuticle ; and fecondly, becaufe there is not a con- 
ftant fupply of frefh matter, when that already in the puflules 
is exhaufted, either by abforption, or by evaporation, or by its 
induration into a fcab. Might not the covering the face af- 
fiduoufly and exactly with platters, as with cerate of calamy, or 
with minium plafter, by precluding the air from the puftules, 
prevent their contracting a contagious, or acefcent, or fever-pro- 
ducing 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 proba- 
ble, both from this theory, and from the facts before mentioned, 
that the matter would not erode the fkin 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 fe- 
ver cured, and the cancer eradicated, by the application of car- 
bonic acid gas, or fixed air. See Clafs II. 1.4. 16. 
14. Febris Class II. 1.6. 14. 
OF SENSATION. 
257 
14. Febris venerea. From the abforption of the matter from 
venereal ulcers and fuppurating bones. See Syphilis, IL 1. 5. 2. 
M. M. Any mercurial calx. Sarfaparilla ? Mezereon ? 
15. Febris a fanie putrida. Fever from putrid fanies. When 
parts of the body are deftroyed by external violence, as a bruife, 
or by mortification, a putrefaClion foon fucceeds; as they are 
kept in that degree of warmth and moillure, by their adhefion 
to the living parts of the body, which moll forwards that proc- 
efs. Thus the Houghs of mortified parts of the tonfils give fe- 
tor to the breath in fome fevers ; the matter from putrefying 
teeth, or other fuppurating bones, is particularly 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 pfocefs. 
16. Febris puerpera. Puerperal fever. It appears from fome 
late diffedions, which have been publifhed, of thofe women who 
have died of the puerperal fever, that matter has been formed in 
the omentum, and found in the cavity of the abdomen, with 
fome blood or fanies. Thefe parts are fuppofed to have been 
injured by the exertions 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 uterus; and as the fever is of the 
inirritative or typhus kind, there is reafon to believe, that the 
previous exhauftion of the patient during labour may contribute 
to its production; as well as the abforption of a material not 
purulent but putrid ; which is formed by the delay of extrava- 
fated or dead matter produced by the bruifes of the Omentum, 
or other vifcera, in the efforts of parturition, rather than by pur- 
ulent matter, the confequence of fuppuration. The pulfe is 
generally about 120 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 pulfe of all very weak patients increaf- 
es in frequency when they fit up ; becaufe the expenditure cf 
fenforial power neceflary to preferve an erefl pollute deducts fo 
much from their general ftrength ; and hence the pulfe becomes 
weaker and in confequence quicker. See SeCl. XII. 1. 4. 
Whence I fufped that the puerperal fever is diftinguilhed 
from the heciic fever, by the former being produced and fup- 
ported by the abforption of a putrid fanies, atifing from dead 
parts of the omentum or mefentery ; and rhe latter being pro- 
duced and fupported by the abforption of purulent matter, 
which is the confequence of inflammation, after it has been ox- 
genated by expofure to the air; and that hence they ri brer in 
Vol. IL K k the 258 
DISEASES 
Class II. 1. 6. i6< 
the greater debility, and confequent quicker pulfe, and more 
rapid progrefs of the former than the latter; but agree, in the 
few patients which I have attended, in the circumftance of the 
patients bearing the quantity of theie fevers better than the 
typhus, as is feen in their frequent rifing from .their beds for 
hours, and even attending to their occupations with a pulfe of 
more than 120 in a minute ; and alfo in another important cir- 
cumftance, which is, that they take folid food, as bread, and 
eggs, and oyfters, and even chicken, in great quantities ; which 
in the inirritative fever, or typhus, is refufed during the whole 
courfe of the difeafe. And hence it feems probable, that the 
caufe or commencement of the inirritative fever, or typhus, may 
have been from the torpor or paralyfis of the ftomach, owing to 
the fwallowing of contagious matter along with our faliva ; and 
the actions of the heart fuller in confequence from fympathy. 
And that hence thefe three kinds of fever may be diftinguilhed 
from each other: the typhus, by the total lofs of appetite for 
folid food ; the hectic fever, by the pulfe being feldom above 
120, and with attendant inflammation ; and the puerperal fever, 
by a quicker and weaker pulfe ; but both the latter exifting 
without the inability to take fome folid nourifhment. 
In this fever time mult be allowed for the abforption of the 
matter. Very large and repeated quantities of the bark, by 
preventing fuihcient food from being taken, as bread, and wine, 
and water, 1 have thought, have much injured the patient; for 
the bark is not here given, as in intermittent fevers, to prevent 
the paroxyfm, butfimply to itrengthen the patient by increafing 
the power of digeftion. About two ounces of decotfion of 
bark, with four drops of laudanum, and a drachm of fweet fpir- 
it of vitriol, once in fix hours, and a glafs of wine between thofe 
times, with panada, or other food, I have thought of moil ad- 
vantage, with a fmall blifter occafionally. 
Where not only the ftomach but alfo the bowels are much 
diftended with air, fo as to found on ftriking them with the fin- 
gers, the cafe is always dangerous, generally hopelefs ; which 
is more fo in proportion 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, with ten grains 
of alum. 
In cne cafe of puerperal fever, which lafted above forty days, 
and was attended for the laft fortnight with perpetual fubfultus 
of the tendons, and even twitching of the hands with unceafing 
delirium, and inability to ileep, mulk given in the dofe of ten 
grains every fix hours, with five drops of tindlure of opium, 
feemed to be of ferviee; and when the abdomen became tumid 
with Class II. 1. 6. 16. 
OF SENSATION. 
259 
with air, about the 36th day from the commencement of the 
fever, alum given in dofcs of about feven grains every three 
hours, feemed of uncommon fervice, as the tumour of the abdo- 
men much fubfided in one day, and the patient immediately be- 
came able to deep two or three hours at a time; but the event 
of the difeafe was fatal. 
In this fituation I fuppofe the fever to have been kept up by 
the abforption of a putrid material in the abdomen, on the 
outfide of the inteftines ; and as alum inftantaneoufly deftroys 
the volatile alkali which occafions a part of the fmell, and per- 
haps the whole of the gas of putrid matter ; which alkali pre- 
cipitates the argillaceous earth from the vitriolic acid ; I fup- 
pofe this effeCt would be produced by alum, though it might 
not be produced by vitriolic acid, as the latter would unite with 
the contents of the ftomach ; but the alum would not unite 
with any thing, till it became expofed to exhalations of putrid 
matter. See Clafs IL 1. 3. 1. Might not a punCture by a lan- 
cet into the tumid abdomen, through the fear of the navel, be 
of ufc, when it is much diltended with air ? 
The want of deep was owing to debility, and ceafed when 
that became leflened. As fome motions of the hands were the 
confequence of her delirious ideas, thefe became tremulous, like 
the hands of very old men, or drunkards, from debility whenev- 
er they were exerted. 
A very interefting account of the puerperal fever, which was 
epidemic at Aberdeen, has been lately publifhed by Dr. Alexan- 
der Gordon. (Robinfons, London.) In feveral diileCtions of 
thofc who died of this difeafe, purulent matter was found in the 
cavity of the abdomen; which he afcribes to an erylipelatous 
inflammation of the peritonaeum, as its principal feat, and of its 
productions, as the omentum, mefentery, and peritonaea! coat 
of the inteftines. 
He believes, that it was infectious, and that the contagion 
was always carried by the accoucheur, or the nurfe, from one ly- 
ing-in woman to another. 
The difeafe began with violent unremitting pain of the abdo- 
men on the day of delivery, or the next day, with fhuddering, 
and very quick pulfe, often 140 in a minute. In this fituation, 
if he faw the patient within 12 or 24 hours of her feizure, he 
took away from 16 to 24 ounces of blood, which was always 
fizy. He then immediately gave a cathartic, confiding of three 
grains of calomel, and forty grains of powder of jalap. After 
this had operated, he gave an opiate at night; and continued 
the purging and the opiate for feveral days. 
Lie aiferts, that almoft all thofe, whom lie was permitted to 
treat 260 
DISEASES 
Class II. 1. 6. 16. 
treat in this manner early in the difeafe, recovered, to the num- 
ber 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 de- 
ftroyed them. Except that he faw two patients who recovered, 
after difebarging a large quantity of matter at the navel. And 
a few who were relieved, by the appearance of external eryfipe- 
las on the extremities. 
This difeafe, confiding of an eryfipelatous inflammation, may 
occafion the great debility fooner to occur than in inflammation 
of the uterus ; which latter is neither eryfipelatous, I fuppofe, 
nor contagious. And the fuccefs of Dr. Gordon's practice 
feems to correfpond with that of Dr. Rufti, in the contagious 
fever or plague at Philadelphia; which appeared to be much af~ 
fifted by early evacuations. One cafe I faw, fome time ago, 
where violent unceafing pain of the whole abdomen occurred, a 
few hours after delivery, with quick pulfe ; which ceafed after 
the patient had twice loft about eight ounces of 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 fir ft than Dr. Gordon 
mentions, and to repeat the operation in a few hours, if the 
continuance of the fymptoms fhould require it. And the fame 
in refpe£l to the cathartic, which might perhaps be given in lefs 
quantity, and repeated every two or three hours. 
Nor fhould I with to give an opiate after the firft venefe&ion 
and cathart ic ; as I fufpeft that this might be injurious, except 
thofe evacuationshad emptied the veflels fo much, that the ftim- 
u'us of the opiate fhould aft only by increafing the abforption 
of the new veflels or fluids produced on the furfaces of the infla- 
med membranes. In other inflammations of the bowels, su'd 
in acute rheumatifm, I have feen the difeafe much prolonged, 
and I believe fometimes rendered fatal, by the too early adminif- 
(ration of opiates, either along with cathartics, or at their inter- 
vals ; while a fmall dofe of opium given after fufficient evacua- 
tions produces abforption only by its ftimulus, and much con- 
tributes to the cure of the patient. We may have vifible tefti- 
mony of this effe& of opium, when a folution of it is put into 
an inflamed eye ; if it be thus ufed previous to fufficient evacua- 
tion, it increafes the inflammation; if it be ufed after fufficient 
evacuation, it increafcs abforption only, and clears the eye in a 
very fmall time. 
1 cannot omit obferving, from confidering thefe circumftances, 
how un wife is the common praiftice of giving an opiate to every 
woman Class II. 1. 6. 17. 
OF SENSATION. 
261 
woman immediately after her delivery, which muft often have 
been of dangerous confequence. 
17. Febris a fphacelo. 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 quantity, fo as to induce confequent debility, and to opprefs 
the power of digeftion. 
ORDO 262 
DISEASES 
Class II. 1. 7. 1. 
ORDO I. 
Increafed Senfaticn. 
GENUS VII. 
With increafed A Elion of the Organs of Senfe. 
SPECIES. 
I. Delirium febrile. Paraphrofyne. The ideas in deliriunj 
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 e xternal irritations or by 
voluntary exertion. Hence the patients do not know the room 
*which they inhabit, or the people who furround them ; nor have 
they any voluntary exertion, where the delirium is complete; fo 
that their efforts in walking about a room or rifing from their 
bed are unfteady, and produced by their catenations with the im- 
mediate affebtionsof pleafureor pain. See Section XXXIII. i. 4. 
By the above circumftances it is diftinguifhed from madnefs, 
in which the patients well know the perfons of their acquaint-' 
ance, and the place where they are ; and perform all the volun- 
tary actions with fteadinefs and determination. See Se<ft. 
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 perfebi delirium. 
At other times a delirium affebts 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 afked him, and to the 
tafte of the food which is offered to him. 
This partial delirium is termed a hallucination of the difor- 
dercd organ ; and may probably arife from the origin of one 
nerve of fenfe being more liable to inflammation than the others ; 
that is, an exuberance of the fenforial power of fenfation may af- 
fect it; which is therefore thrown into action by (lighter fenfi- 
tive 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 
circumftance, as of thofe in our dreams; namely, to the defect 
or paralyfis of the voluntary power ; as in hemiplegia, when one 
fide of the body is paralytic,and thus expends lefs of the fenforial 
power, the limbs on the other fide arc in confidant motion from 
the Clafs II. 1. ). 2. 
OF SENSATION. 
263 
the exuberance of it. Whence lefs fenforial power is exhaufted 
in delirium, than at other times, ns well as in deep; and hence in 
fevers with great debility, it is perhaps, as well as the ftupor, 
rather a favourable circumftance ; and when removed by numer- 
ous biifters, the death of the patient often follows the recovery 
of his underftanding. See Clafs I. 2. 5. 6. and I. 2. 5. io. 
Delirium in difeafes from inirritability is fometimes preceded 
by a propenfity to furprife. See Clafs I. 1. 5. 12. 
M. M. Fomentations of the fhaved head for an hour repeat- 
edly. A blifter on the head. Rifing from bed. Wine and 
opium, and fometimes venefedtion in fmall quantity by cupping, 
if the ftrength of the arterial fyftem will allow it. 
2. Delirium maniacale. Maniacal delirium. There is anoth- 
er kind of delirium, defcribed in Se£t. XXXIIL 1. 4. which has 
the increafe of pleafurable or painful fenfation for its caufe, 
without any diminution of the other fenforial powers j but as 
this excites the patient to the exertion of voluntary actions, for 
the purpofe of obtaining the object of his pleafurable ideas, or 
avoiding the object of his painful ones, fuch as perpetual prayer, 
when it is of the religious kind ; it belongs to the infanities de- 
fcribed in Clafs III. 1. 2. 1. and is more properly* termed hal- 
lucinatio maniacalis. 
3. Delirium ebrietatis. The drunken delirium is in nothing 
different from the delirium attending fevers except in its caufe, 
as from alcohol, or other poifons. When it is attended with an 
apoplectic ftupor, the pulfe is generally low; and venefeCtion 
I believe fometimes deftroys thofe, who would etherwife have 
recovered in a few hours. 
M. M. Diluting liquids. An emetic. 
4. Omnium. Dreams conftitute the moft complete kind of 
delirium. As in thefe no external irritations are attended to, 
and the power of volition is entirely fufpended ; fo that the 
fenfations of pleafure and pain, with their affociations, alone ex- 
cite the endlefs trains of our fleeping ideas ; as explained in 
Sed. XVIH. on deep. 
5. Hallucinatio vifus. Deception of fight. Thefe vifual hal- 
lucinations are perpetual in our dreams ; and fometimes pre- 
cede general delirium in fevers ; and fometimes belong to rev- 
erie, 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 objects are not feen fo diftindlly as to produce the ufual 
ideas affociated with them, but appear to us exactly as they are 
fecn. Thus the trunk of a tree appears a flat furface, inftead of 264 
DISEASES 
Class II. 1. 7. 6. 
a cylinder as by day, and we are deceived and alarmed by fee- 
ing things as they really are feen; See Berkley on Vifion. 
6. Hallucinatio audit&s. Auricular deception frequently oc- 
curs in dreams, and fometimes precedes general delirium in fe- 
vers ; and fometimes belongs to vertigo, and to reverie, and to 
infanity. See Sefl. XX. 7. and Clafs III. 1. 2. 1. and 2. 
7. Rubor a cal ore. The blufh from heat is occafioned by the in- 
creafed action of the cutaneous veffels in confequence of the in- 
creafed fenfation of heat. See Oafs I. 1. 2. 1. and 3. 
8. Rubor jucunditatis. The blufh of joy is owing to the in- 
creafed action of the capillary arteries, along with that of every 
moving veffel in the body, from the increafe of pleafurable fen- 
fation. 
9. Priapifmus amatovius. A material priapifm. The blood 
is poured into the cells of the corpora cavernofa much fafter than 
it can be reabforbed by the vena penis, owing in this cafe to the 
pleafurable fenfation of love increafing the arterial action. See 
Clafs I. 1.4. 6. 
10. Dijlentio tnamularum. The teats of female animals, when 
they give fuck, become rigid and erefled, in the fame manner as 
in the laft artitle, from the pleafurable fenfation of the love of 
the mother to her offspring. Whence the teat may properly be 
called an organ of fenfe. The nipples of men do the fame when 
rubbed with the hand. See Clafs I. 1. 4. 7. 
ORDO Clafs II. 2. 1. 1. 
OF SENSATION. 
265 
ORDO II. 
Decreafed Senfation. 
GENUS I. 
Of the General Syfenh 
SPECIES. 
I. Stultitia injenfbilis. Folly from infenfibility. The pleaf- 
ure or pain generated in the fyftem is not fufficient to promote 
the ufual a&ivity either of the fenfual or mufcular fibres. 
2. Tadium vita. Ennui. Irkfomenefs of life. The pain of 
lazinefs has been thought by fome philofophers to be that prin- 
ciple of aftion, which has excited all our induftry, and diftin- 
guiflied mankind from the brutes of the field. It is certain that, 
where the ennui exifts, it is relieved by the exertions of our 
minds or bodies, as all other painful fenfations are relieved ; 
but it depends much upon our early habits, whether we become 
patient of lazinefs, or inclined to adivity, during the remainder 
of our lives, as other animals do not appear to be affected with this 
malady ; which is perhaps lefs owing to deficiency of the pleaf- 
urable fenfation, than to the fuperabundancy of voluntary pow- 
er which occafions pain in the mufcles by its accumulation ; as 
appears from the perpetual motions of a fquirrel confined in a 
cage. 
3. Partfs fenftiva. Weaknefs of the whole fyftem from in- 
fenfibility. 
Vol. II. 
L L 
GRDO 266 
DISEASES 
Clafs II. 2. 2. I. 
ORDO II. 
Decreafed Senfation. 
GENUS II. 
Of particular Organs. 
SPECIES. 
i. Anorexia. Want of appetite. Some elderly people, and 
thofe 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 digellion becomes fo far im- 
paired. Want of appetite is fometimes produced by the putrid 
matter from many decaying teeth being perpetually mixed with 
the faliva, and thence affecting the organs 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. i. 4. 4. or folution 
of alum in water. Extract the decayed teeth. An emetic. A 
blifter. Chalybeates. Vitriolic acid. Bile of an ox infpiflated, 
and made into pills; 20 grains to be taken before dinner and 
fupper. Opium half a grain twice a day. 
All the ftrength we poflefs is ultimately derived* from the 
food, which we are able to digeft 5 whence a total debility of 
the fyftem frequently follows the want of appetite, and of the 
power of digeftion. Some young ladies I have obferved to fall 
into this general debility, fo as but juft to be able to walk about; 
which I have fometimes afcribed to their voluntary falling, 
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. 
Two young ladies applied to me, who had experienced many 
months of great debility, and of almoft total want of appetite, 
from another caufe, which was from bathing on a warm day in 
a cold fountain of water, which was covered from the fun and 
fupplied by a powerful fpring; but gradually afterwards recov- 
ered their health by the ufe of fix grains of rhubarb with one 
grain of opium every night for fome weeks, and a bitter draught 
twice a day with a flight chalybeate. See Clafs III. 2. 1. 17. 
I have feen other cafes of what may be termed anorexia epi- 
leptica, Class IL 2. 2. 2. 
OF SENSATION. 
267 
leptica, in which a total lofs of appetite, and of the power of di- 
geftion, 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 fre- 
quently with total lofs of appetite. She was relieved by vene- 
feCtion, blifters, and opiates; her ftrength diminifhed, and af- 
ter fome returns of the fits, the took to her bed, and has furvi- 
ved 15 or 20 years; file has in 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, was 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 a 
day. As well as I can recoiled, all thefe patients were attend- 
ed 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 ClafsIII. 1. 1. 7. and III. 1. 2. 20. and Suppl. I. 14. 3. 
2. Adipfta. 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 oberved thefe to labour under bad digeftion, and de- 
bility in confequence 5 which I have afcribed to the too great 
ftimulus of folid food .undiluted, deftroying in procefs of time 
the irritability of the ftomach. 
3. Impotent™ (agenefia.) Impotency much feldomer happens 
to the male fex than fterilify to the female fex. Sometimes a 
temporary impotence occurs from bathfulnefs, or the interfer- 
ence of fome voluntary exertion in the produ&ion of an effeCt, 
which fhould be performed alone by pleafurable fenfation. 
One, who was foon to be married to a lady of fuperior con- 
dition to his own, exprefled fear of not fucceeding on the wed- 
ding 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 bathfulnefs ; 
which fucceeded to his with. 
Mr. John Hunter in his work on the Venereal Difeafe,has given 
an ingenious feCtion on this fubjeCt of mental impotence, in which 
he relates a fuccefsful mode of treatment. He prevailed on aperfon 
in this fituation to promife on his honor to pafs fix nights in bed 
with a young woman without attempting to have connection with 
her, whatever might be his power or inclination. He after- 
wards aflured Mr. Hunter, that this refolution had produced 
fuch a total alteration in the ftate of his mind, that the power of 
connexion foon recurred, for inftead of going to bed with the 
fear 268 
DISEASES 
Class II. 2. 3. 4. 
fear of inability, he went with fears, that he fhould be pofleif- 
ed with too much defire, and too much power, fo as to become 
uneafy to him, which really happened, as he would have been 
happy to have Ihortened the time ; and when he had once 
broken the fpell, his mind and powers went on together; and 
his mind never returned to its former ftate. 
A gentleman about 5 o years of age, who had lived too freely, 
as he informed me, both in refpect to wine and women, com- 
plained, that his defire for the fex remained, and that he occa- 
fionally parted with femen, but with defeat of a perfect tenfio 
penis, and that he had tried 20 drops of laudanum, and 20 drops 
of tin&ure of cantharides on going to bed without effect ; and 
that as the debility or inirritability of the fyftem in this cafe 
rather than any mental afFeftion feemed to be a part of the 
caufe, he was advifed to ftimulate the fphinfler ani by the in- 
trodu&ion of a piece of the root of ginger, as is done by the 
horfe-dealers to fale-horfes. And, however ridiculous the oper- 
ation may appear, he allured me, that it fucceeded ; which I 
fuppofe might be owing to the fympathy between the fphindler 
ani and the penis ; which is fo often the caufe of painful fenfa- 
tion in the former, when a ftone at the neck of the bladder af- 
fe&s the latter; and converfely when painful piles affeft the 
return, a flrangury is fametimes produced by fympathy. 
For reftoring the venereal power M. Le Roy thinks phofpho- 
rus taken in a dofe of a quarter of a grain rubbed with oil or 
yolk of egg, or honey ; or even the acid of phofphorus, to pof- 
fefs great efficacy. Med. Review, Vol. V. p. 204. The water 
in which phofphorus has been kept fomc time, probably pof- 
fefles fome of this acid, and is alfo recommended by M. Le 
Roy. I ought here to add, that I l^ave been lately informed, 
that a gentleman directed four grains of phofphorus to be made 
into pills with conferve, with defign of increafing his venereal 
power. He was feized with intolerable fenfe of heat at Jus 
ftomach, pulfe feeble, but not quickened, livid countenance, 
forenefs of his bowels to the touch, and inceflant vomitings, by 
which he at laft brought up fome blood. His illnefs lafted five 
or fix days. He did not acknowledge any caufe of his fudden 
illnefs, but faid he was certain emetics would cure him, and took 
two by his own requelt. After his death, the apothecary men- 
tioned his having directed the pills as above, which were made 
three days before he was taken ill; and he was believed to have 
taken about half of them. 
M. M. Chalybeates. Opium. Bark. Tinffure of can- 
tharides. 
4. Sterilitas. Barrenncfs. One of the ancient medical wri- 
ters Class II. 2. 2. 5. 
OF SENSATION. 
269 
ters afferts, that the female fex become pregnant with moft cer- 
tainty at or near the time of menftruation. This is not im- 
probable, fince thefe monthly periods feem to referable the 
monthly venereal orgafm of fome female quadrupeds, which be- 
come pregnant at thofe times only; and hence the computation 
of pregnancy is not often erroneous, though taken from the laft 
menftruation. See Section XXXVI. 2. 3. 
M. M. Opium a grain every night. Chalybeates in very 
fmall dofes. Bark. Sea-bathing. 
5. Infenjibilitas artuum. As in fome paralytic limbs. A great 
infenfibility fometimes accompanies the torpor of the fkin in cold 
fits of agues. Some parts have retained the fenfe of heat, but 
not the fenfe of touch. See Sect. XVI. 6. 
M. M. Friction with flannel. A blifter. Warmth. 
6. Dyfuria infenjitiva. Infenfibility of the bladder. A diffi- 
culty or total inability to make water attends fome fevers with 
great debility, owing to the infenfibility or inirritability of the 
bladder. This is a dangerous but not always a fatal fymptom. 
See Clafs III. 2. 1.6. 
M. M. Draw off the water with a catheter. Affift the pa- 
tient 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 
diffolved in it, applied as a liniment rubbed on the region of the 
bladder and perinaeum, and repeated every four hours, was ufed 
in this difeafe with fuccefs by Mr. Latham. Med. Comment. 
1791, p. 213. 
7. Accumulatio alvina. An accumulation of feces in the 
rcilum, 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 abforption of the 
alimentary canal. 
Old milk, and efpecially when boiled, is liable to induce this 
kind of coftivenefs in fome grown perfons ; which is probably 
owing to their not poffeffing fufficient gaftric acid to curdle and 
digeft it; for as both thefe proceffes require gaftric acid, it fol- 
lows, that a greater quantity of it is neceffary, than in the digef- 
tion of other aliments, which do not previoufly require being 
curdled. This ill digefted milk not fufficiently ftimulating the 
redium, remains till it becomes a too folid mafs. On this ac- 
count milk feldom agrees with thofe, who are fubjecl to piles, 
by inducing coftivenefs and large ftools. 
M. M. Extract the hardened fcybala by means of a marrow- 
fpoon ; or by a piece of wire, or of whale-bone bent into a bow, 
and 270 
DISEASES 
Class II. t. 2. 7. 
and introduced. Inje&ions of oil. Caftor oil, or oil of al- 
monds, taken by the mouth. A large clyfter of fmoke of to- 
bacco. Six grains of rhubarb taken every night for many 
months. Aloes. An endeavour to eftablifh a habit of evacua- 
tion at a certain hour daily. See Clafs I. I. 3. 5. 
ORDO Cuss n. 3.1.1. 
OF SENSATION. 
271 
ORDO III. 
Retrograde Senfttive Motions. 
GENUS I. 
Of Excretory DuHs. 
The retrograde aflion of the oefophagus in ruminating ani- 
mals, 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 ; fimilar to that which induces them to fwal- 
low it both before and after this^ fecond maftication ; and then 
this retrograde aflion properly belongs to this place, and is er- 
roneoufly put at the head of the order of irritative retrograde 
motions. Clafs I. 3. 1. t* 
SPECIES. 
i. Ureterum motus retrogrejfus. When a ftone has advanced 
into the ureter from the pelvis of the kidney, it is fometimes lia- 
ble to be returned by the retrograde motion of that canal, and 
the patient obtains fallacious eafe, till the ftone is again puffied 
into the ureter. 
2. Urethra rnotus retrogrejfus. There have been inftances of 
bougies being carried up the urethra into the bladder moft prob- 
ably by an inverted motion of this canal; for which fome have 
undergone an operation fimilar to that for the extraflion of a 
ftone. A cafe is related, in fome medical publication, in which 
a catgut bougie was carried into the bladder, and, after remain- 
ing many weeks, was voided piece-meal in a femi-diflolved ftate. 
Another cafe is related of a French officer, who ufed a leaden 
bougie ; which at length found its way into the bladder, and 
was, by injefling crude mercury, amalgamated and voided. 
In the fame manner the infeflion, from a Ample gonorrhoea, 
is probably carried further along the courfe of the urethra ; and 
fmall ftones frequently dcfcend fome way into the urethra, and are 
again carried upintothe bladder by theinverted aflion of this canak 
3. Ductus choledochi rnotus retrogrefus. The concretions of 
bile, called gall-ftones, frequently enter the bile-dufl, and give 
violent pain for fome hours ; and return again into the gall-blad- 
der, by the retrograde aflion of this dufl. May not oil be car- 
ried up this dufl, when a gail-ftone gives great pain, by its re- 
trograde fpafmodic aflion ? See Clafs I. 1. 3. 8. 
M. M. Opium a grain and half. 
The 272 
DISEASES 
Class III. 1.1. 
The Orders and Genera of the Third Clafs of Difeafes* 
CLASS III. 
DISEASES OF VOLITION. 
ORDO I. 
Increafed Volition. 
GENERA. 
1. With increafed actions of the mufcles. 
2. With increafed actions of the organs of fenfe< 
ORDO II. 
Decreafed Volition. 
GENERA. 
1. With decreafed a&ions of the mufcles. 
2. With decreafed a&ions of the organs of fenfe. 
The Orders, Genera, and Species, of the Third Clafs of 
Difeafes. 
CLASS III. 
DISEASES OF VOLITION. 
ORDO I. 
Increafed Volition. 
GENUS I. 
IVith increafed A flions of the Muffles. 
SPECIES. 
I. ft flit at io. 
2. Tremorfebrilis. 
Reftlefihefs. 
Febrile trembling. 
3. Clamor. Class III. 1.2. 
OF VOLITION. 
273 
3. Clamor. 
4. Rifus. 
5. Convulfto. 
debilis. 
6. dolorifca. 
7. Epilepfa. 
8. dolorifca. 
9. Somnambulifmus. 
10. Afthma convulfvum. 
II. dolorificum. 
12. Stridor dentium. 
13. Tetanus trifmus. 
14. dolorificus. 
15. Hydrophobia. 
Screaming. 
Laughter. 
Convulfion. 
weak. 
painful. 
Epilepfy. 
painful. 
Sleep-walking. 
Afthma convulfive. 
painful. 
Gnalhing of the teeth; 
Cramp of the jaw. 
painful. 
Dread of water. 
GENUS II. 
With increafed Anions of the Organs of Senfe. 
I. Mania mutabilis. 
2. Stadium inane. 
3. Vigilia. 
4. Erotomania. 
5. Amor fui. 
6. Nofalgia. 
7. Spes religiofa. 
8. Superbia femmatis. 
9. Ambitio. 
I ©. Moeror. 
11. Taditim vita. 
12. Deftderium pulchritudinis. 
13. Paupertatis timor. 
14. Lethi timor. 
15. Or ci timor. 
16. Satyriafi. 
17. Ira. 
18. Rabies. 
19. Citta. 
20. Cacoftia. 
21. Syphilis imaginaria. 
22. Pfora imaginaria. 
23. Tabes imaginaria. 
24. Sympathia aliena. 
25. Educatio heroica. 
SPECIES. 
Mutable madnefs. 
Reverie. 
Watchfulness. 
.Sentimental love. 
Vanity. 
Defire of home. 
Superftitious hope. 
Pride of family. 
Ambition. 
Grief. 
Irkfomenefs of life- 
Lofs of Beauty. 
Fear of poverty. 
of death. 
bf Hell. 
Luft. 
Anger. 
Rage. 
Depraved appetite. 
Averfion to food. 
Imaginary pox. 
itch. 
tabes. 
Pity. 
Heroic education. 
Vol. II. 
M M 
ORDO 274 
DISEASES 
Class II. 2. 1* 
ORDO II. 
Decreafed Volition. 
GENUS I. 
With decreafed Actions of the MufeleS. 
SPECIES. 
I. Lafftiudo. 
2. Vacillatio fenilis. 
3. Tremor fenilis. 
4. Brachiorum paralyfis. 
5. Raucedo paralytica. 
6. V ficee urinaria paralyfis. 
7. ReBi paralyfts. 
8. Parefis voluntaria. 
9. Catalepfis. 
IO. Hemiplegia. 
11. Paraplegia. 
12. Somnus. 
13. Incubus. 
14. Lethargus. 
15. Syncope epileptica. 
16. ^poplexia. 
17. Mors a frigore. 
Fatigue. 
See-faw of old age. 
Tremor of old age. 
Palfy of the arms. 
Paralytic hoarfenefs. 
Palfy of the bladder. 
Palfy of the redtum. 
Voluntary debility. 
Catalepfy. 
Palfy of one fide. 
Palfy of the lower limbs. 
Sleep. 
Night-mare. 
Lethargy. 
Epileptic fainting. 
Apoplexy. 
Death from cold. 
GENUS II. 
With decreafed Actions of the Organs of Senfe. 
SPECIES. 
1. Recolleciionis ja clura. 
2. Stultitia uoluntaria. 
3. Credulitaf. 
Lofs of recollection. 
Voluntary folly. 
Credulity. 
CLASS Class III. 1.1. 
OF VOLITION. 
275 
CLASS III. 
DISEASES OF VOLITION. 
ORDO I. 
Increafed Volition. 
GENUS I. 
Increased Anions of the Mufcles. 
WE now ftep forward to confider the difeafes of volition, 
that fuperior faculty of the fenforium, which gives us the pow- 
er of reafon, and by its facility of action diftinguifhes mankind 
from brute animals ; which has effeded 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 defeat 
of the action of the part. (Seft. IV. 5.) Both which circum- 
ftances feem to originate from the accumulation of fenforial 
power in the affected organ. Thus when the Ikin is expofed to 
great cold, the activity of the cutaneous veffels is diminifhed, and 
in confequence an accumulation of fenforial power obtains in 
them, becaufe they are ufually excited into inceiTant motion by 
the ftimulus of heat, as explained in Sett. XII. 5. 2. Contra- 
rywife, when the veffels of the Ikin are expofed to great heat, 
an excefs of fenforial power is alfo produced in them, which is 
derived thither by the increafe of ftimulus 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 thus be in part afcribed to the exhauftion of the fen- 
forial 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 different manner of progreflion of the 
two fenforial powers of fenfation and volition ; one of them com- 
mencing at fome extremity of the fenforium, and being propa- 
gated towards the central parts of it; and the other commenc- 
ing in the central parts of the fenforium, and being propagated 
towards the extremities of it ; as mentioned in SeCl. XI. 2. 1. 
Thefe violent voluntary exertions of our mufcles or ideas to 
relieve the fenfation of pain conftitute convulfious and madnefs; 
and are diftinguilhed from the mufcular actions owing to in- 
creafed fenfation, as in fneezing, or coughing, or parturition, or 
ejedio 276 
DISEASES 
Class III. 1.1. 
ejeflio 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 women with their firft child, I have 
feen general convulfions occur from excefs of voluntary exer- 
tion, as above defcribed, inftead of the actions of particular muf- 
<ples, which ought to have been excited by fenfation for the ex- 
clufion of the fetus. They both became infenfible, and died af- 
ter fome hours ; from one of them the fetus was extrafled in 
vain. I have heard alfo of general convulfions being excited 
inftead of the actions of the mufculi acceleratores in the ejeftio 
feminis, which terminated fatally. See Clafs III. i. i. 7. 
Thefe violent exertions are moft frequently excited in con- 
fequence of thofe pains, which originate from defect of the 
aftion of the part. See Sect. XXXIV. 1. and 2. The pains 
from excefs and defeat of the action of the part are diftin- 
guifhable from each other by the former being attended with 
increafe of heat in the pained part, or of the whole body; 
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 foon as thefe violent actions of our mufcular or fenfual 
fibres for the purpofe of relieving pain ceafe to be exerted, the 
pain recurs ; whence the reciprocal contraction and relaxation 
of the mufcles in convulfion, and the intervals of madnefs. 
Otherwife thefe violent exertions continue, till fo great a part of 
the fenforial power is exhaufted, that no more of it is excitable 
by the faculty of volition ; and a temporary apoplexy fucceeds, 
with fnoring as in profound Heep ; which fo generally termin- 
ates epileptic fits. 
When thefe voluntary exertions become fo connected with 
certain difagreeable fenfations, or with irritations, that the ef- 
fort of the will cannot reftrain them, they can no longer in com- 
mon 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 actions. See 
Sett. XXXIV. 1. where many motions in common language 
termed involuntary are fliewn to depend on excefs of volition. 
When thefe exertions from excefs of volition, which in com- 
mon language are termed involuntary motions, either of mind 
or body, are perpetually exerted in weak conftitutions, the pulfe 
becomes quick ; which is occafioned by the too great expendi- 
ture of the fenforial power in thefe unceafing modes of activity. 
In the fame manner as in very weak people in fevers, the pulle 
fometimes increafes in frequency to 140 ftrokes in a minute, 
when the patients ftand up or endeavour to walk ; and lubiides 
to Class III. 1. 1. 
OF VOLITION. 
277 
to iio, when they he down again in their beds. Whence it 
appears, that when a very quick pulfe accompanies convulfion 
or infanity, it /imply indicates the weaknefs of the patient; that 
is, that the expenditure of fenforial power is too great for the 
fupply of it. But if the ftrength of the patient is not previoufly 
exhaufted, the exertions of the mufcles are attended with tem- 
porary increafe of circulation, the reciprocal fwellings and elon- 
gations of their bellies pu/h forwards the arterial blood, and 
promote the abforption of the venous blood ; whence a tempo- 
rary increafe of fecretion and of heat, and a ftronger pulfe. 
A correfpondent acquaints me, that he finds difficulty in un- 
derftanding how the convulfions of the limbs in epilepfy can be 
induced by voluntary exertions. This I fufpeCl fir fl to have 
arifen from the double meaning of the words " involuntary mo- 
tions which are fometimes ufed for thofe motions, which are 
performed without the interference of volition, as the pul Nations 
of the heart and arteries; and at other times for thofe aflions, 
which occur, where two counter volitions oppofe each other, 
and the ftronger prevails; as in endeavouring to fupprefs laugh- 
ter, and to flop the fhudderings when expofed to cold. Thus 
when the poet writes, 
video meliora, proboque, 
Deteriora fequor.- 
The ftronger volition actuates the fyftem, but not without the 
counteraction of unavailing fmallcr ones; which conftitute de- 
liberation. 
A fecond difficulty may have arifen from the confined ufe of 
the words " to will," which in common difeourfe generally 
mean to choofe after deliberation ; and hence our will or voli- 
tion is fuppofed to be always in our own power. But the will 
or voluntary power, acts always from motive, as explained in 
Sea XXXIV. i. and in Clafs IV. i. 3. 2, and III. 2. I. 12. 
which motive can frequently be examined previous to action, 
and balanced againft oppofite motives, which is called delibera- 
tion ; at other times the motive is fo powerful as immediately 
to excite the fenforial power of volition into aclion, without a 
previous balancing of oppofite motives, or counter volitions. 
The former of thefe volitions is cxercifed in the common pur- 
pofes of life, and the latter in the exertions of epileply and in- 
fanity. 
It is difficult to think without words, which however all thofe 
mull do, who difeover new truths by reafoning ; and Till more 
difficult, when the words in common ufe deceive us by their 
twofold 278 
DISEASES 
Class III. 1.i.1. 
twofold meanings, or by the inaccuracy of the ideas, which they 
fuggeft. 
SPECIES. 
i. JaTitatio. Reftleflhefs. There is one kind of reftleflhefs 
attending fevers, which confifts in a frequent change of pofture 
to relieve the uneafinefs of the preflure of one part of the body 
upon another, when the fenfibility of the fyftem, or of fome 
parts of it, is increafed by inflammation, as in the lumbago; 
which may fometimes be diftinguiihed in its early ftage by the 
inceflant defire of the patient to turn himfelf in bed. But there 
is another reftleflhefs, which approaches towards writhing or 
contortions of the body, which is a voluntary effort to relieve 
pain ; and may be cfteemed a (lighter kind of convulfion, not 
totally unreftrainable by oppofite or counteracting volitions. 
Thus when a fquirrel is confined in a cage, he feels uneafi- 
nefs from the accumulation of fenforial power, in his mufcles, 
which were before in continual violent exertion in his habits 
of life ; and in this fituation finds relief by perpetually jump- 
ing about his cage to expend a part of this accumulated fenfo- 
rial power. 
For the fame reafon thofe children, who are eonftrained to fit 
in fome fchools for hours together, are liable to acquire habits of 
moving fome mufcles of their faces, or hands, or feet, which are 
called tricks, to exhauft a part of the accumulated fenforial pow- 
er. Hence reftleflhefs is occafioned by increafe of ftimulus, or 
by accumulation of fenforial power. 
M. M. A bliftcr. Opium. Warm bath. Bandage on 
the moving mufcles. See Convulfio debilis, Clafs III. i. i. 5. 
exercife. 
2. Tremor febrliis. Reciprocal convulfions of the fubcu- 
taneous mufcles, originating from the pain of the fenfe of 
heat, owing to defect of its ufual ftimulus, and confequent 
accumulation of fenforial power in it. The aiflual defi- 
ciency of heat may exift in one part of the body, and the 
pain of cold be felt moil vividly in fome other part aflbeiated 
with it by fenfitive fympathy. So a chilnefs down the back is 
firft attended to in ague-fits, though the difeafe perhaps com- 
mences with the torpor and confequent coldnefs of fome inter- 
nal vifeus. But in whatever part of the fyftem the defeat of 
heat exifts, or the fenfation of it, the convulfions of the fubcu- 
taneous mufcles exerted to relieve it are very general ; and, if 
the pain is (till greater, a chattering of the teeth is added, the 
more Class III. 1.1.3. 
OF VOLITION. 
279 
more fuddenly to exhauft the fenforial power, and becaufe the 
teeth are very fenfible to cold. 
Thefe convulfive motions are neverthelefs reftrainable by vi- 
olent voluntary counteranion ; and as their intervals are owing 
to the pain of cold being for a time relieved by their exertion, 
they may be compared to laughter, except that there is no in- 
terval of pleafure preceding each moment of pain in this as in 
the latter. 
M. M. See I. 2. 2. 1. 
3. Clamor. Screaming from pain. The talkative animals, 
as dogs, and fwine, and children, fcream moll, when they are in 
pain, and even from fear ; as they have ufed this kind of, exer- 
tion from their birth moll frequently and molt forcibly; and 
can therefore fooner exhauft the accumulation of fenforial pow- 
er in the affefled mufcular or fenfual organs by this mode of 
exertion; as defcribed in Se6l. XXXIV. 1. 3. This facility of 
relieving pain by fcreaming is the fource of laughter, as explain- 
ed below. 
4. Rifus. The pleafurable fenfations, which occafion laugh- 
ter, are perpetually palling into the bounds of pain ; for pleaf- 
ure 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 foies 
©f the feet in children is a painful fenfation 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 ftop it again, as we are unwilling 
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 Sett. XXXIV. 1. 3. 
Every one has been in a fituation, where fome ludicrous cir- 
cumftance has excited him to laugh ; and at the fame time a 
fenfe of decorum has forbid the exertion of thefe interrupted 
fcreams ; and then the pain has become fo violent, as to occa- 
Con him to ufe fome other great adtion, as biting his tongue, 
and pinching himfelf, in lieu of the reiterated fcreams which 
conftitute laughter. 
5. Convulfio. Convulfion. When the pains from defect or 
excefs of motion are more diftreffing than thofe already defcrib- 
ed, and are not relievable by fuch partial exertions, as in fcream- 
ing, or laughter, more general convulfions occur; which vary 
perhaps according to the fituation of the pained part, or to fome 
previous affociations formed by the early habits of life. When 
thefe convuliive motions bend the body forwards, they are term- 
ed 280 
DISEASES 
Class III. 1. r. 
ed cmprofthotonoi,; when they bend it backward, they are term- 
ed opifthotonoi. They frequently fucceed each other, but the 
epifthotonoi are generally more violent j as the mufcles, which 
creel the body, and keep it ereCl, are naturally in more conftant 
and more forcible aClion than their antagonitis. 
The caufes of convulfion are very numerous, as from tooth- 
ing in children, from worms or acidity in their bowels, from 
eruption of the dillinfl fmall-pox, and laftly, from breathing 
too long the air of an unventilated bed-room. Sir G. Baker, 
in the TranfaClions of the College, defcribed this difeafe, and 
detected its caufe ; where many children in an orphan-houfe 
were crowded together in one chamber without a chimney, and 
were almoft all of them affected with convulfion ; in the hof- 
pital at Dublin, many died of convulfions before the real caufe 
was underltood. See Dr. Beddoes's Guide to Self-prefervation. 
In a large family, which I attended, where many female fervants 
flept in one room, which they had contrived to render inaccefli- 
ble to every blaft of air ; I faw four who were thus feized with 
convulfions, and who were believed to have been affeCled by 
fympathy from the firft who fell ill. They were removed into 
more airy apartments, but were fome weeks before they all re- 
gained their perfeft health. 
Convulfion is diftinguifhed from epilepfy, as the patient does 
not intirely lofe all perception during the paroxyfin. Which 
onlv (hews, that a lefs exhauftion of fenforial power renders tol- 
erable the pains which caufe convulfion, than thofe which caufe 
epilepfy. The hyfteric convulfions are diftinguifhed from thofe, 
owing to other caufes, by the prefence of the expectation of 
death, which precedes and fucceeds them, and generally by a 
flow of pale urine ; thefe convulfions do not conftantly attend 
the hyfteric difeafe, but are occafionally fuperinduced by the 
difagreeable fenfation arifing from the torpor or inverfion of a 
part of the alimentary canal. Whence the convulfion of laugh- 
ter is frequently fufficient toreftrain thefe hyfteric pains, which 
accounts for the fits of laughter frequently attendant on this 
difeafe. 
M. M. To remove the peculiar pain which excites the con- 
vulfions. VenefeClion. An emetic. A cathartic with calo- 
mel. Warm-bath. Opium in large quantities, beginning with 
fmaller ones. Mercurial friClions. Electricity. Cold-bath in 
the paroxyfm ; or cold afperfion. See Memoirs of Med. Soci- 
ety, Lon. Vol. III. p. 147. a paper by Dr. Currie. 
5. Convulfio debilis. 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 Class III. 1. 1.6. 
OF VOLITION. 
281 
occafions their death, or of faintnefs from want of due diften- 
tion of the blood veiTels. Similar to this in a lefs degree is the 
fubfultus tendinum, or ftarti'ng of the tendons, in fevers with de- 
bility -, thefe actions of the mufcles are too weak to move the 
limb, but the belly of the acting mufcles is feen to fwell, and 
the tendon to be ftretched. Thefe weak convulfions, 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 atl of dying. 
See a cafe of convulfion of a mufcle of the arm, and of the fore- 
arm, without moving the bones to which they were attached, 
Sefl. XVII. i. 8. See twitchingsof the face, Clafs IV. i. 3. 2. 
6. Convulfto dolorifica. Raphania. Painful convulfion. In 
this difeafe the mufcles of the arms and legs are exerted to re- 
lieve the pains left after the rheumatifm in young and delicate 
people ; it recurs once or twice a day, and has been miftaken for 
the chorea, or St. Vitus's dance ; but differs from it, as the un- 
due motions in that difeafe only occur, when the patient endeav- 
ours 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 diftinguifhed from rheumatifm, as the pains recur by peri- 
ods once or twice a day; whereas in the chronic rheumatifm 
they only occur on moving the affected mufcles. And by the 
warmth of a bed the pains of the chronic rheumatifm are in- 
creafed, as the mufcles or membranes then become more fenfi- 
ble to the llimulus of the extraneous mucaginous material de- 
pofited under them. Whereas the pains of the raphania, or 
painful convulfion, commence with coldnefs of the part, or 
of the extremities. See Rheumatifmus chronicus. Clafs I. 
I- 3; I2- 
The pains which accompany the contraflions of the mufcles 
in this difeafe, feem to arife from the too great violence of thofe 
contraflions, as happens in the cramp of the calf of the leg ; 
from which they differ in thofe being fixed, and thefe being re- 
iterated contraflions. Thus thefe convulfions are generally of 
the lower limbs, and recur at periodical times from fome unea- 
fy fenfation from defefl of aflion, like other periodic difeafes; 
and the convulfions of the limbs relieve the original uneafy pain- 
ful fenfation, and then produce a greater pain from their own 
too vehement contraflions. There is however another way of 
accounting for thefe pains, when they fucceed the acute rheu- 
matifm ; and that is by the coagulable lymph, which may be 
Vol. II. Nn ' left 282 
DISEASES 
Class III. i. 1.7, 
ftill unabforbed on the membranes; and which may be in too 
fmall quantity to affedt 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. 
M M. Venefe&ion. Calomel. Opium. Bark. One grain 
of calomel and one of opium for ten fucceflive nights. A ban- 
dage fpread with emplaftrum de minio put tight on the affected 
part. 
7. Epilepfta is originally induced, like other convulfions, by a 
voluntary exertion to relieve fome pain. This pain is moft fre- 
quently about the pit of the ftomach, or termination of the bile- 
duct ; and in fome cafes the torpor of the ftomach, which prob- 
ably occafioned the epileptic fits, remains afterwards, and pro- 
duces 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 pubiifhed by Dr. Short, in the Med. Eflays. 
Edinb. I once faw a child about ten years old, who frequently 
fell down in convulfions, as flie was running about in play; on 
examination a wart was found on one ancle, which was ragged 
and inflamed ; which was directed to be cut off, and the fits 
never recurred. 
When epilepfy fir ft commences, the patients are liable to ut- 
ter one fcream before they fall down ; afterwards the convul- 
fions fo immediately follow the pain, which occafions them, 
that the patient does not recollect or feem fenfible of the pre- 
ceding pain. Thus in laughter, when it is not exceflive, a per- 
fon is not confcious of the pain, which fo often recurs, and cauf- 
es the fucceflive fcrcams or exertions of laughter, which give a 
temporary relief to it. 
Epileptic fits frequently recur in deep from the increafe of 
fcnflbility at that time, explained in Sect. XVIII. 14. In two 
fuch cafes, both of young women, one grain of opium given at 
night, and continued many months, had fuccefs; in one of them 
the opium was omitted twice at different times, and the fit re- 
curred on both the nights. In the more violent cafe, defcribed 
in Sect. XVIII. 15, opium had no effedt. 
Epileptic fits generally commence with fetting the teeth, by 
which means the tongue is frequently wounded •, and with roll- 
ing the eye-balls in every kind of direction ; for the mufcles 
which fufpend the jaw, as well as thofe which move the eyes, 
are in perpetuai motion during our waking hours ; and yet con- 
tinue fubfervient to volition ; hence their more facile and forci- 
ble actions for the purpofe of relieving pain by the exhauftion 
• ffenforial power. See Section XXXIV. 1. 4. 
Epileptic convulfions are not attended with the fear of death. 
as Class III. 1.1.7. 
OF VOLITION. 
283 
as in the hyfteric difeafe, and the urine is of a ftraw colour. 
However it muft be noted, that the difagreeable fenfations in 
hyfteric difeafes fometimes are the caufe of true epileptic con- 
vulfions, of fyncope, and of madnefs. 
The pain, which occafions fome fits of epilepfy, is felt for a 
time in a diftant part of the fyftem, as in a toe or heel; and is 
laid by the patient gradually to afcend to the head, before the 
general convulfions commence. This afcending fenlation has 
been called aura epileptica, and is faid to have been prevented 
from affecting the head by a tight bandage round the limb. In 
this malady the pain, probably of fome torpid membrane, or dif- 
eafed tendon, is at firft only fo great as to induce flight fpafms 
of the mufcular fibres in its vicinity; which flight fpafms ceafe 
on the numbnefs introduced by a tight bandage ; when no band- 
age is applied, the pain gradually increafes, till general convul- 
fions are exerted to relieve it. The courfe of a lymphatic, as 
when poifonous matter is ablorbed ; or of a nerve, as in the 
fciatica, may, by the fympathy exifting between their extremi- 
ties and origins, give an idea of the afcent of an aura or va- 
pour. 
In difficult parturition it fometimes happens, that general con- 
vulfions are excited to relieve the pain of labour, inftead of the 
exertions of thofe mufcles of the abdomen and diaphragm, which 
ought to forward the exclufion of the child. See Clafs III. I. i. 
That is, inftead of the particular mufcular actions, which ought to 
be excited by fenfation to remove the offending caufe, general con- 
vulfions are produced by the power of volition, which (till the 
pain, as in common epilepfy, without removing the caufe; and, 
as the parturition is not thus promoted, the convulfions con- 
tinue, till the fenforial power is totally exhaufted, that is, till 
death. In patients afflicted with epilepfy from other caufes, 
I have feen the moft violent convulfions recur frequently dur- 
ing pregnancy without mifearriage ; as they did not tend to 
forward the exclufion of the fetus. 
Pains of this kind have been called falfe pains by fome writers 
on midwifery, and are directed to be relieved by an opiate, and 
then they fay the true pains will commence. M. Daventer di- 
rects the accoucheur to attend to the os tincx, to diftinguifh 
them from each other, which dilates with every true pain, but 
contrails with every falfe one, .that is, the voluntary actions of 
other mufcles to relieve pain are attended with thofe of the os 
uteri, as mentioned in Genus I. of this Clafs and Order prece- 
ding the defcription of the Species. 
M. M. Venefeition. A large dofe of opium. Delivery. 
The later in life epileptic fits are firft experienced, the more 
dangerous 284 
DISEASES 
Class III. i.1.7. 
dangerous they may be efteemed in general; as in thefe cafes 
the caufe has generally been acquired by the habits of the pa- 
tient, or by the decay of fome part, and is thus probably in an 
increafing Rate. Whereas in children the change in the fyf- 
tem, as they advance to puberty, fometimes removes the caufe. 
So in toothing, fits of convulfion with ftupor frequently occur, 
and ceafe when the tooth advances; but this is not to be ex- 
pelled 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 habitual, and then had them extracted in vain, 
and in a few months funk under the difeafe. 
Mr. H. M. was feized with pain in the adductor mufcle of 
the right thumb, and had epileptic convulfions in confequence ; 
thefe gradually increafed in ftrength and frequency ; a bandage 
on the arm, drawn very tight as foon as the pain of the ball of 
the thumb commenced, prevented the epileptic fits, I fuppofe 
by leflening the pain by the numbnefs occafioned by comprefllng 
the nerve. 1 advifed the nerves of this mufcle to be cut, which 
was done or attempted, and was fuppofed for a time to have 
cured the difeafe, as I was informed. Afterwards it recurred 
and deftroyed the patient, who might have probably been faved 
by the lofs of a hand, which I fhould have advifed, but was not 
again confulted. 
I have to add, that the tic douloureux, or hemicrania idio- 
pathica, I believe to be a difeafe of this kind, owing to a torpor 
of the extremity of fome branch of a nerve, and fhould recom- 
mend, when the nerve cannot be bifefted, to pafs through it 
for many hours or even days, a current of galvanic eleCtncity 
from Volta's pillar of zinc, and filver, and cloth moiftened with 
fait and water. 
Mr. F , who had lived intemperately, and had been oc- 
cafionally affected with the gout, was fuddenly feized with epi- 
leptic fits ; the convulfions were fucceeded by apoplectic fnor- 
ing ; from which he was, in about 20 minutes, difturbed by 
frefh 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 obferved, that the apoplectic tor- 
por continued about 20 minutes,! directed him to be forcibly raif- 
ed up in bed, after he had thus lain about fifteen minutes, to gain 
an interval between the termination of the deep, and the reno- 
vation of convulfion. In this interval he was induced to fwal- 
low forty drops of laudanum. Twenty more were given him 
in Class III. 1.1. 7. 
OF VOLITION. 
285 
in the fame manner in about half an hour, both which evidently 
ihortened the convulfion fits, and the confequent ftupor ; he 
then took thirty more drops, which for the prefent removed the 
fits. He became rather infane the next day, and after about 
three more days loft the infanity, and recovered his ufual ftate 
of health. 
The cafe mentioned in Se<ft. XXVII. 2. where the patient 
was left after epileptic fits with a fuffufion of blood beneath the 
tunica adjuncliva of the eye, was in almoft every refpeft fimilar 
to the preceding, and fubmitted to the fame treatment. Both 
of them fullered frequent relapfes, which were relieved by the 
fame means, and at length perifhed, I believe, by the epileptic fits. 
In thofe patients, who have not been fubjedt to epilepfy be- 
fore they have arrived to about forty years of age, and who 
have been intemperate in refpect to fpirituous potation, I 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 face ; and thus by fome ftimulant application had pre- 
vented an inflammation taking place on the (kin of the face in- 
ftead of on fome part of the liver. Secondly, as in thefe cafes in- 
fanity had repeatedly occurred, which could not be traced from 
an hereditary fource ; there is reafon to believe, that this as well 
as the epileptic convulGons were caufed by fpirituous potation ; 
and that this therefore is the original fource both of epilepfy 
and of infanity in thofe families, which are afllifled with them. 
This idea however brings fome confolation with it; as it maybe 
inferred, that in a few fobcr generations thefe difeafes may be 
eradicated, which otherwife deftroy the family. 
M. M. Venefedlion. Opium. Bark. Steel. Arfenic. 
Opium one grain twice a day for years together. See the pre- 
ceding article, and the fucceeding one. 
Anorexia epileptica^ as mentioned in OafsII. 2. 2. I. is a dread- 
ful difeafe, originating, I believe, from a paralyfis of the ftom- 
ach, and generally occafioned by the application of great exter- 
nal cold to the Ikin. A young lady, whom I faw yefterday, who 
had long experienced a weak ftate of health, went to church on 
an uncommonly cold Sunday, when the thermometer was faid 
to ftand below 20 during the whole day. She became immedi- 
ately indifpofed, and was feized in a day or two with tremors 
and convulfions in her fleep ; and which returned every two or 
three days. Her extremities are now always uncommonly cold, 
and her appetite to food totally defective. She took three drops 
of a faturated folutionof arfenic and a bitter draught twice a day 
.for a fortnight, and gradually recqvered her former ftate of health. 
Another 286 
DISEASES 
Class III. i. i. 8. 
Another young lady, whom I lately faw, began to Rart fome- 
what like a violent hiccough many times in an hour, after ufing 
a very cold fhower-bath repeatedly. This had continued daily 
at uncertain times for many months, and received temporary 
advantage from one drop of oil of cinnamon, three of four 
times a day, on powdered fugar; this cafe belongs to convulfion 
rather than epilepfy, but was attended, like the former, with 
great defeat of appetite. In both thefe cafes I fufpeft, that the 
great torpor of the llomach was caufed by too violent or too 
long continued coldnefs applied to the Ikin ; whence the fenfo- 
rial power of aflbeiation, which ought to have been excited by 
the action of the cutaneous veflels, and to have then contributed 
to the action of the Romach, did not exiR ; and that the Rom- 
ach in confequence became torpid. See Suppl. I. 14. 3. and 
Art. IV. 2. 6. 8. and Clafs III. 2. 1. 17. 
Dr. Wilfon, of Spalding, has lately much recommended the 
argentum nitratum in epilepfy ; he gives two grains and a half 
three times a day, mixed with bread crumbs into pills, as he af- 
fects, with the huppieft fuccefs. Annals of Medicine, 1797. 
8. Epilepfta ilolc'ifiea. Painful epilepfy. In the common 
epilepfy the convulfions are immediately induced, as foon as the 
difagreeable fenfation, which caufes them, commences; but in 
this the pain continues long with cold extremities, gradually in- 
creafing for two or three hours, till at length convulfions or mad- 
nefs come on ; which terminate the daily paroxyfm, and ceaf» 
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 
pudendum ; it recurs daily for five or fix weeks, and then ceafes 
for feveral months. The pain is owing to defect of action, that 
is, to the accumulation of fenforial power in the part, which 
probably fympathizes with fome other part, as explained in 
Seft. XXXV. 2. XII. 5. 3. and Clafs II. 1. 1. 11. 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 hoar with 
violent pain on the right fide of her bowels about the fituation 
ef the lower edge of the liver, without fever, which increafed 
for an hour or two, till it became totally intolerable. After 
violent fcreaming Ihe fell into convulfions, which terminated 
fometimes in fainting, with or without Rertor, as in common 
epilepfy ; at other times a temporary 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 by large dofes of opium, like the fits of re- 
verie Class III. 1.1. 8. 
OF VOLITION. 
287 
verie or fomnambulation. About half an hour before the ex- 
pected return of the fit three or four grains of opium were ex- 
hibited, and then tinCture of opium was given in warm brandy 
and water about twenty or thirty 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 effects 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 actions of all the irritative mo- 
tions, by the flimulus of fuch large quantities of opium and vi- 
nous fpirit ; together with the production of much fenfation, 
and many movements of the organs of fenfe or ideas in confe- 
quence of that fenfation ; and laftly, even the motions of the 
arterial fyflem become accelerated by this degree of intoxica- 
tion, all which loon exhaufled fo much fenforial power as to re- 
lieve the pain ; which would otherwife have caufed convulfions 
or infanity, which are other means of expending fenforial pow- 
er. The general debility on the fucceeding day, and the partic- 
ular debility of the llomach, attended in confequence with fick- 
nefs and frequent efforts to vomit, were occalioned by the fyf- 
tem having previoufly been fo flrongly flimulated, and thofe 
parts in particular on which the opium and wine more imme- 
diately a<Sed. This ficknefs continued fo many hours as to 
break the catenation of motions, which had daily reproduced 
the paroxyfm ; and thus it generally happened, that the whole 
difeafe ceafed for fomc 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 fyflem oc- 
cafions the production of pain in that part, as in SeCt. XII. i. 6. 
This defeCl or excefs of fibrous action is generally induced by 
cxcefs or defect of the flimulus of objects external to the mov- 
ing organ. But there is another fource of exceflive fibrous ac- 
tion, and confequent pain, which is from excefs of volition, 
which is liable to afFeCt thofe mufcles, that have weak antago- 
nifts ; 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 tr painful contractions, as in trifmus, 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 contraCtion arifing from 
"xcefs of volition in the parr from the want of the counteraction 
of 288 
DISEASES 
Class III. 1.1.8. 
of antagonift mufcles, may give occasional caufe to epileptic fits, 
and may be relieved in the fame way, either by exciting irrita- 
tive and fenfitive motions by the ftimulus of opium and wine ; 
or by convulfions or infanity, as defcribed above, which are only 
different methods of exhaufting the general quantity of fenfori- 
al power. 
Confidering the great refemblance between this kind of pain- 
ful epilepfy and the colic of Japan, as defcribed by Kaempfer ; 
and that that difeafe was laid to be cured by acupuncture, or the 
prick of a needle ; I directed 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 punCture, occafioned the ceffation 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 acupunCture eliminates the air, which is fuppofed to 
diftend the bowel. But though the aperture thus made is too fmall 
to admit of the eduCtion of air ; yet as the ftimulus of fo fmall 
a punCture may either excite a torpid part into aCtion, or caufe 
a fpafmodic one to ceafe to aCt ; and laftly, as no injury could 
be likely to enfue from fo fmall a perforation, I fhould be in- 
clined at fome future time to give this a fairer trial in fimilar 
circumftances. 
Another thing worth trial at the commencement of this de- 
plorable difeafe would be eleCtricity, by paffmg ftrong fhocks 
through the painful part; which, whether the pain was owing 
to the inaClion of that part, or of fome other membrane affoci- 
ated with it, might ftimulate them into exertion ; or into inac- 
tivity, if owing to fixed painful contraction. 
And laftly, the cold bath, or afperfions with cold water on the 
affeCted part, according to the method of Dr. Currie in the Me- 
moirs of a Med. Soc. London, Vol. III. p. 147, might produce 
great effeCt at the commencement of the pain. Neverthelefs 
opium duly adminiftered, fo as to precede the expected parox- 
yfm, and in fuch dofes, given by degrees, as to induce intoxica- 
tion, is principally to be depended upon in this deplorable mala- 
dy. To which fhould be added, that if venefeCtion can be previ- 
oufly performed, even to but few ounces, the effeCt of the opium 
is much more certain ; and (till more fo, if there be time to pre- 
mife a brdk cathartic, or even an emetic. The effeCt of increaf- 
ed Class III. 1.1.9. 
OF VOLITION. 
289 
ed ftimulus is fo much greater after previous defect of ftimulus ; 
and this is ftill of greater advantage, where the caufe of the dif- 
eafe happens to confift in a material, which can be abforbed. 
See Art. IV. 2. 8. 
M. M. Vencfeflion. An emetic. A cathartic. Warm 
bath. Opium a grain every half hour. Wine. Spirit of wine. 
If the patient becomes intoxicated by the above means, the fit 
ceafes, and violent vomitings and debility fucceed on the fubfe- 
quent day, and prevent a return. Blifters or finapifms on the 
fmall of the leg, taken off when they give much pain, are of ufe 
in {lighter convulfions. Acupuncture. Electricity. Afper- 
fion with cold water on the painful part. A bag of ihow or ice 
applied on the pained part. 
9. Somnambulifmus. Sleep-walking is a part of reverie, or 
{ludium inane, defcribed in Seit. XIX. In this malady the pa- 
tients have only the general appearance of being afleep in re- 
fpect to their inattention to the ftimulus of external objects, but, 
like the epilepfies above defcribed, it confifts in voluntary exer- 
tions to relieve pain. The mufcles are fubfervient to the will, 
as appears by the patient's walking about, and fometimes doing 
the common offices of life. The ideas of the mind alfo are obe- 
dient to the will, becaufe the patient's difcourfe is confident, 
though he anfwers imaginary queftions. The irritative ideas of 
external objects continue in this malady, becaufe the patients do 
not run againft the furniture of the room ; and when they ap- 
ply their volition to their organs of fenfe, they become fenfible 
of the objects they attend to, but not otherwise, as general fen- 
fation is deftroyed by the violence of their voluntary exertions. 
At the fame time the fenfations of pleafure in confequence of 
ideas excited by volition are vividly experienced, and other ideas 
feem to be excited by thefe pleafurable fenfations, as appears in 
the cafe of Mafter A. Se6t. XXXIV. 3. 1. where a hiftory of a 
hunting fcene was voluntarily recalled, with all the pleafurable 
ideas which attended it. In melancholy madnefs the patient is 
employed in voluntarily exciting one idea, with thofe which are 
connected with it by voluntary affociations only, but not fo vio- 
lently as to exclude the ftimuli of external objects. In reverie 
variety of ideas are occafionally excited by volition, and thofe 
which are connected with them either by fenfitive or voluntary 
affociations, and that fo violently as to exclude the ftimuli of ex- 
ternal objects. Thefe two fituations of cur fenfual motions, or 
ideas, refemble convulsion and epilepfy ; as in the former the 
ftimulus of external objects is ftill perceived, but not in the lat- 
ter. Whence this dikale, fo far from being connected with 
flecp, though it has by univerfal miftakc acquired its nunc from 
Vol. II. O o it, 290 
DISEASES 
Class III. i. i. io. 
it, arifes from excefs of volition, and not from a fufpenfion of it; 
and though, like other kinds of epilepfy, it often attacks the paa 
tients in their fleep,yet thofe two, whom I faw, were more fre- 
quently feized with it while awake, the fleep-walking being a 
part of the reverie. See Seft. XIX. and XXXIV. 3. and Clafs 
II. 1. 7. 4. and III. 1. 2. 18. 
M. M. Opium in large dofes before the expected paroxyfm. 
10. Afthma convulftvum. 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 Ihivering does not fuc- 
ceed, but inftead of it violent efforts of refpiration ; which have 
no tendency, as in the humoral afthma, to diflodge any offend- 
ing material, but only to relieve the pain by exertion, like the 
fhuddering in the beginning of ague-fits, as explained Clafs 
HI. 1. 1. 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 ; 
which is another argument in favour of the exiftence of a peculiar 
fet of nerves for the purpofe of perceiving the univerfal fluid 
matter of heat, in which all things are immerfed. See SeQ. 
XIV. 6. Yet are the lungs neverthelefs very fenfible to the de- 
ficiency of oxygen in the atmofphcre, as all people experience, 
when they go into a room crowded with company and candles, 
and complain, that 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 veflels of the lungs, 
eonfifting of the terminations of the pulmonary and bronchial 
arteries and veins, and their attendant lymphatics ; in this cir- 
cumftance it refembles 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. 1. 2. 3. 
And the coldnefs, which attends the inaction of thefe veflels, 
prevents the ufual quantity of exhalation. Some fits ceafe be- 
fore this congeftion takes place, and in them no violent fweat- 
ing nor any expuition of phlegm occurs. This is the humoral 
afthma, defcribed at Clafs II. 1. 1. 7. 
The fecond kind of afthma confifts in the convulfive actions 
in confequence of the difagreeable fenfations thus induced ; 
which in fome fits of afthma are very great, as appears in the 
violent efforts to raife the ribs, and to deprefs the diaphragm, 
by lifting the (boulders. Thefe, fo long as they contribute to 
remove Class III. 1.1. i». 
OF VOLITION. 
291 
remove the caufe of the difeafe, are not properly convulfions, 
but exertions immediately caufed by fenfation; but in this kind 
of afthma they are only efforts to relieve pain, and are frequent- 
ly preceded by other epileptic convulfions. 
Thefe two kinds of afthma have fo many refembling features, 
and are fo frequently intermixed, that it often requires great at- 
tention to diftinguifh them ; but as one of them is allied to ana- 
farca, and die other to epilepfy, we fhall acquire a clearer idea 
of them by comparing them with thofe diforders. A criterion 
of the humoral or hydropic afthma is, that it is relieved by copi- 
ous fweats about the head and breaft, which are to be afcribed 
to the fenficive exertions of the pulmonary veflels to relieve the 
pain occafioned by the anafarcous congeftion in the air-cells ; 
and which is effected by the increafed abforption of the mucus, 
and its elimination by the retrograde a&ion of thofe lymphatics 
of the Ikin, the branches of which communicate with the pul- 
monary 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 occa- 
fionally been fubjeft to convulfions of the limbs, as in the com- 
mon epilepfy. 
It may thus frequently happen, that in the humoral afthma 
fome exertions of the lungs may occur, which may not contrib- 
ute to difeharge the anafarcous lymph, but may be efforts fimply 
to relieve pain ; betides thofe efforts, which produce the increaf- 
ed abforption 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 purpofe of relieving pain. 
It may likewife fometimes happen, that the difagreeable fen- 
fation, occafioned by the congeftion of lymph in the air-cells in 
the humoral or hydropic afthma, may induce voluntary convul- 
fions of the rsfpiratory 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 lame 
caufe may occafionally induce either the humoral or convulfive 
afthma. 
The humoral afthma has but one remote caufe, which is the 
torpor of the pulmonary veffels, like that which occurs on goim 
into the cold bath; or the want of abforption of the pulmon •. 
lymphatics to take up the lymph effufed into the air 
Whereas the convulfive aftfona, like other convulfions. < 
let' 292 
DISEASES 
Class III. i. i. io. 
lepfies, may be occafioned by pain in almoft any remote part of 
the fyftem. But in fome of the adult patients in this difeafe, as 
in many epilepfies, I have fufpe^led the remote caufe to be a 
pain of the liver, or of the biliary du€ts. 
The afthmas, which have been induced in confequence of the 
rccefs of eruptions, efpecially of the leprous kind, countenance 
this opinion. One lady I knew, who for many years laboured 
under an afthma, which ceafed on her being afflicted with pain, 
fwelling, and diftortion of fome of her large joints, which were 
efteemed gouty, but perhaps erroneoufly. And a young man, 
whom I faw yefterday, was feized with afthma on the retrocef- 
fion, or ceafing of eruptions on his face. 
The convulfive afthma, as well as the hydropic, is more lia- 
ble to 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 infpira- 
tion. They are both moft liable to occur after the fir ft Heep, 
which is therefore a general criterion of afthma. The caufe of 
this is explained in Sedt. XVIII. 15. and applies to both of 
them, as our fenfibility to internal uneafy fenfation increafes 
during fleep. 
When children are gaining teeth, long before they appear, 
the pain of the gums often induces convulfions. This pain is 
relieved in fome by fobbing and fcreaming; but in others a la- 
borious refpiration is exerted to relieve the pain ; and this con- 
ftitutes the true afthma convulfivum. In other children again 
general convulfions, or epileptic paroxyfms, are induced for this 
purpofe ; which, like other epilepfies, become eftablifhed by 
habit, and recur before the irritation has time to produce the 
painful fenfation, which originally caufed them. 
The afthma convulfivum is alfo fometimes induced by worms, 
or by acidity in the ftomachs of children, and by other painful 
fenfations in adults; in whom it is generally called nervous 
afthma, and is often joined with other epileptic fymptoms. 
This afthma is diftinguilhed from the peripneumony, and 
from the croup, by the prefence of fever in the two latter. It 
is diftinguifbed from the humoral afthma, as in that the patients 
are more liable to run to the cold air for relief, are more fubjeft 
to cold extremities, and experience the returns of it more fre- 
quently after their firft Heep. It is diftinguiflied from the hy- 
drops thoracis, as that has no intervals, and the patient fits con- 
ftantly upright, and the breath is colder ; and, where the peri- 
'ardium is afleded, the pulfe is quick and unequal. See Hy- 
^ps Thoracis, I. 2. 3. 14. 
M. Venfcclion once. A cathartic with calomel once. 
Opium. Class III. 1. 1. 11. 
OF VOLITION. 
293 
Opium. Afafoetida. Warm bath. If the caufe can be detcdl- 
ed, as in toothing or worms, it (hould be removed. As thit 
fpecies of afthma is fo liable to recur during fleep, like epileptic 
fits, as mentioned in Section XVIII. 15. there was reafon to be- 
lieve, that the refpiration of an atmofphere mixed with hydro- 
gen, or any other innocuous air, which might dilute the oxygen, 
would be ufeful in preventing the paroxyfms by decreafing the 
fenfibility of the fyltem. This, I am informed by Dr. Beddoes, 
has been ufed with decided fuccefs by Dr. Ferriar. See Clafs 
II. 1. 1. 7. 
11. AJlhma dolorificum. Angina pedloris. The painful 
afthma was firft defcribed by Dr. Heberden in the Tranfadlions 
of the College ; its principal fymptoms confift in a pain about 
the middle of the fternum, or rather lower, on every increafe of 
pulmonary or mufcular exertion, as in walking fafter than ufual, 
or going quick up a hill, or even up ftairs ; with great difficul- 
ty of breathing, fo as to occafion the patient inftantly to Hop. 
A pain in the arms about the infection of the tendon of the pec- 
toral mufcle generally attends, and a defire of refting by hang- 
ing on a door or branch of a tree by the arms is fometimes ob- 
ferved. Which is explained in Clafs I. 2. 3. 14. and in Sedt. 
XXIX. 5. 2. 
Thefe patients generally die fuddeniy; and on examining the 
thorax no certain caufe, or feat, of the difeafe has been detect- 
ed ; fome have fuppofed the valves of the arteries, or of the 
heart, were imperfect; and others that the accumulation of fat 
about this vifeus or the lungs olrftrudied their due action ; but 
other obfervations do not accord with thefe fuppolitions. 
Mr. W , an elderly gentleman, was feized with afthma 
during the hot part of laft fummer ; he always waked from his 
firlt 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 about 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 venefe&ion, a ca- 
thartic, and then by a grain of opium given at going to bed, with 
ether and tindlure of opium when the pain or afthma recurred, 
and laftly with the bark, but was feveral days before it was per- 
fedily fubdued. 
This led me to conceive, that in this painful afthma the dia- 
phragm, as well as the other mufcles of refpiration, was thrown 
into convulfive adtion, and that the fibres of this mufcle not hav- 
ing proper antagonifts, a painful fixed fpatm of it, like that of 
the mufcles in the calf of the leg in the cramp, might be the 
caufe of death in the angina pedloris, which I have thence ar- 
ranged 294 
DISEASES 
Class III. i. i. it. 
ranged 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 detith, the cafe feems to 
have been of this kind, complicated with vertigo and confequent 
affe&ion of the ftomach. The remote caufe feems to have arifen 
from offifications of the coronary arteries ; and the immediate 
caufe of his death from fixed fpafm of the heart. Other hifto- 
ries and difleftions are Hill required to put this matter out of 
doubt ; as it is pollible, that either a fixed fpafm of the dia- 
phragm, or of the heart, which are both furnifhed with but 
weak antagonifts, may occafion hidden death ; and thefe may 
conftitute two diltinft difeafes. 
Four patients I have now in my recollection, all of whom I 
believed to labour under the angina pedtoris 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 firft 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 ufual potation of fermented liquor. 
The ufe of femoral iflues in angina pedloris was firft recom- 
mended by Dr. Macbride, phyfician at Dublin, Med. Obferv. 
and Enquir. Vol. VI. And I was further induced to make trial 
of them, not only becaufe the means which I had before ufed 
were inadequate, but from the ill effedl 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 affift a difficult refpiration. 
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 difcharged a pellucid fluid, which fhe called a ley-water, 
daily for fourteen years, with a great deal of pain ; on which 
account fhe applied to a furgeon, who, by means of bandage and 
a faturnine application, foon healed the fore, unheedful of the 
confcquenccs. In lefs than two months after this I faw her with 
great difficulty of breathing, which with univerfal anafarca foon 
deflroyed her. 
The theory of the double eflefl of iflues, as above related, 
one in 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 effects from cutaneous erup- 
tions and from blitters are mentioned in Clafs I. i. 2. 9. In 
thefe cafes it feems probable, that the pain occafioned by iflues, 
and perhaps the abforption of a fmall quantity of aerated puru- 
lent Class III. 1. 1.12. 
OF VOLITION. 
295 
lent matter, ftimulate the whole fyftem into greater energy of 
action, and thus prevent the torpor which is the beginning of 
fo many difeafes. In confirmation of this effect of pain on the 
fyftem, I remember the cafe of a lady of an ingenious and ac- 
tive mind, who, for many of the latter years of her life, was 
perpetually fubjeA to great pains of her head from decaying 
teeth. When all her teeth were gone, (he became quite low 
fpirited, and melancholy in the popular fenfe of that word, and 
after a year or two became 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 tho- 
racis attended with pain in the left arm, fo as to be miftaken 
for afthma dolorificum, in which femoral iflues, though applied 
early in the difeafe, had no effect. 
12. Stridor dentium. The clattering of the teeth on going 
into cold water, or in the beginning of ague-fits, is an exertion 
along with tire tremblings of the fkin 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 fcreaming 
from more acute pain. Thus the poet, 
Put but your toes into cold water, 
Your correfpondent teeth will clatter. 
Prior. 
In more acute pains the jaws are gnafhed together with great 
vehemence, infomuch that fometimes the teeth are faid to have 
been broken by the force. See Seft. XXXIV. i. 3. In thefe 
cafes fomething fhould be offered to the patient to bite, us a 
towel, otherwife they are Hable to tear their own arms, or to 
bite their attendants, as I have witnefled in the painful epi- 
lepfy. 
13. Tetanus trifmus. Cramp. The tetanus confiftsof a fix- 
ed fpafm of almoft all the mufcles of the body ; but the trifmus, 
or locked jaw, is the molt frequent difeafe of this kind. It is 
generally believed to arife from fympathy with an injured ten- 
don. In one cafe where it occurred in confequence of a broken 
ancle from a fall from a horfe, it was preceded by evident hy- 
drophobia. Amputation was advifed but not fubmitted to ; 
two wounds were laid into one with fciflbrs, but the patient di- 
sd about the feventh day from the accident. In this cafe the 
wounded 296 
DISEASES 
Class III. r. 1.14, 
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 witnelTed the locked jaw from a pain beneath the 
fternum, about the part where it is complained of in painful 
afthma, or angina peCloris, in the fame lady at fome years dif- 
tance of time. The laft time it had continued two days, and 
fhe wrote her mind, or exprefled herfelf by figns. On obferv- 
ing a broken tooth, which made a fmall aperture into her mouth, 
I rolled up five 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 flie fwal- 
lowed her faliva, and in lefs than half an hour fhe opened her 
mouth and converfed as ufual. 
Men are taught to be afhamed of fcreaming from pain in 
their early years ; hence they are prone to exert the mufcles of 
the jaws inftead, which they have learnt to exert frequently and 
violently from their infancy ; whence the locked jaw. This 
and the following fpafm have no alternative relaxations, like the 
preceding ones; which is perhaps owing, fir ft, to the weaknefs 
of their antagonift mufcles, thofe which elevate the jaw being 
very ftrong for the purpofe of biting and mafticating hard fub- 
ftances, and for fupporting the under jaw, with very weak an- 
tagonilf mufcles ; and fecondly, to their not giving fufficient re- 
lief even for a moment to the pain, or its preceding irritation, 
which excited them. 
M. M. Opium in very large quantities. Mercurial oint- 
ment ufed extenfively. Electricity. Cold bath. Dilate the 
wound, and fill it with lint moiftened with fpiri,t of turpen- 
tine ; which inflames the wound, and cures or prevents the con- 
vulfions. See a cafe, TranfaCt. of American Society, Vol. IL 
p- 22? 
"Wine in large quantities in one cafe was more fuccefsful 
than opium ; 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 opi- 
um. Ib. 
14. Tetanus dolorificus. 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 by 
the too great previous extenfion of the mufcles, whence fome 
people' get the cramp in the extenfor mufcles of the toes after 
walking Class III. 1. 1.15. 
OF VOLITION. 
297 
walking down hill, and of thofe of the calf of the leg after walk- 
ing up a fteep eminence. For the reafon why thefe cramps 
commence in deep, fee Seif. XVIII. 15. 
The mufcle in this difeafe contracts itfelf to relieve fome 
fmaller pain, either from irritation or aflbciation, and then falls 
into great pain itfelf, from the too great action of its own fibres. 
Hence any mufcle, by being too vehemently exerted, falls into 
cramp, as in fwimming too forcibly in water, which is painfully 
cold ; and a fecondary pain is then induced by the too violent 
contraction of the mufcle ; though the pain, which was the 
caufe of the contraCtion, ceafes. Which accounts for the con- 
tinuance of the contraCiion, and diftinguifhes this difeafe from 
other convulfions, which are relaxed and exerted alternately. 
Hence whatever may be the caufe of the primary pain, which 
occafions the cramp of the calf of the leg, the fecondary one is 
relievable by {landing up, and thus by the weight of the body 
on the toes forcibly extending the contracted mufcles. For the 
caufe which induces thefe mufcles of the calf of the leg to fall 
into more violent contraCtion than other fpafmodic mufcles, 
proceeds from the weaknefs of their antagonift mufcles; as 
they are generally extended again after aCtion by the weight 
of the body on the balls of the toes. See the preceding article. 
M. M. Rub the legs with camphor diflblved in oil, and let 
the patient wear flockings 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 preflure is faid 
to prevent the undue contraCiions of the mufeuli gaftrocnemii, 
which conftitute the calf of the leg. In gouty patients, or 
where the bowels are affeCted with acidity, half a grain of opi- 
um, and fix grains of rhubarb, and fix of chalk, every night. 
Flefh-meat for 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 ca- 
nine madnefs. I was witnefs to a cafe, where this difeafe pre- 
ceded the locked jaw from a wound in the ancle, 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 pa- 
tient 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 confequence of a 
pained tendon, than of a contagious poifon. And is fo far anal- 
ogous to tetanus, according with the opinions of Dr. Rufli and 
Dr. Percival. 
Vol. II. P p In 298 
DISEASES 
Class Ill. 1.1.15. 
In other refpe&s, as it is produced by the faliva of an enrag- 
ed animal inftilled into a wound, it would feem analogous to 
the poifon of venomous animals. And from the manner of its ac- 
cefs fo long after the bite, and of its termination in a fhort time* 
it would feem to refemble the progrefs of contagious fevers. 
See Seft. XXII. 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 prob- 
able it might cure it; as I fufpecl the caufe ftill remains in the 
wounded tendon, and not in a diffufed infection tainting the 
blood. Hence there are generally uneafy fenfations, as cold or 
numbnefs, in the old cicatrix, before the hydrophobia commenc- 
es. See a cafe in Medical Communications, Vol. 11. p. 19s. 
If the difeafed tendon coUld be inflamed without cutting it 
out, as by cupping, or cauftic, or blifter after cupping, and this 
in the old wound long fince healed, after the hydrophobia com- 
mences, it might prevent the fpafms about the throat. As in- 
flaming the teeth by the ufe of mercury is of ufe in fome kinds 
of hemicrania. Put fpirit of turpentine on the wound, walh it 
well. See Clafs I. 3. 1. ii.IV. i.2. 7. 
M. M. Wine, mulk, oil, internally. Opium, mercurial oint- 
ment, ufed extenfively. Mercurial fumigation. Turpeth min- 
eral. To falivate the patient as foon as poflible. Exfedion 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, ca- 
outchouc, be introduced into the cefophagus by the mouth or 
noftril, and liquid nourilhment be thus conveyed into the Itom- 
ach ? 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 cefophagus for a month, by which means the patient was 
iiourifhed and preferved. 
It is recommended by Dr. Bardfley to give oil internally by a 
fimilar method contrived by Mr. John Hunter. He covered a 
probang 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 ligature ; to the other end of the eel fkin 
or gut was fixed a bladder and pipe. The probang thus cover- 
ed wa« introduced into the ftomach, and the liquid food Or med- 
icine was put into the bladder and fqueezed down through the 
eel-lkin. Mem. of Society at Manchefter. See Clafs I. 2. 3. 25. 
Dr. Bardfley has endeavoured to prove, that dogs never ex- 
perience the hydrophobia, or canine madnefs, without having 
been previoufly bitten or infected ; and fecondly, that the dif- 
eafe Class III. 1.1. 15. 
OF VOLITION. 
299 
eafe in thia fpecies of animal always (hews 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 (hutting 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 inflict- 
ed by venomous animals than to thofe from other pontagious 
matter, yet thefe obfervations are well worthy further atten- 
tion ; which the author promifes. 
In Dr. Hamilton's elaborate treatife on hydrophobia, Long- 
man, London, it is propofed to try the effect of arfenic in this dif- 
eafe, which is faid to be the principal ingredient of the Tanjore 
pill, which is faid to cure thofe who are difeafed by the bite of 
ferpents, and to cure the hydrophobia. 
A folution of fublimate of mercury in rectified fpirits is alfq 
worthy a triah mentioned in Clafs I. 3. 1. 11. 
ORDQ 300 
DISEASES 
Class III. i. 2. 
ORDO I. 
* 
Increafed Volition. 
GENUS II. 
With increafed Alliens of the Organs of Senfe. 
In every fpecies of madnefs there is a peculiar idea either of 
defire or averfion, which is perpetually excited in the mind with 
all its connections. In fome conftitutions this is connected with 
pleafurable ideas without the exertion of much mufcular action, 
in others it produces violent mufcular action to gain or avoid the 
objeCt of it, in others it is attended with defpair and inaCtion. 
Mania is the general word for the two former of thefe, and 
melancholia for the latter ; but the fpecies of them are as nu- 
merous as the defires and averfions of mankind. 
In the prefent age the pleafurable infanities are moft fre- 
quently induced by fuperftitious hopes of Heaven, by fentimen- 
tal 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 innumer- 
able others. 
Quicquid agunt homines, votum, timor, ira, voluptas, 
Gaudia, difeurfus, noftri eft farrago libelli. 
Juven. I. 85. 
This idea, however, which induces madnefs or melancholy, 
is generally untrue ; that is, the objeCt is a miltaken faCt. 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 occafious. So that the objeCt of madnefs is generally 
a delirious idea, and thence cannot be conquered by reafon ; be- 
caufe it continues to be excited by painful fenfation, which is a 
ftronger ftimulus 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 moft frequently the 
caufe of madnefs originally, but fometimes of convulfion. Thus 
[ have feen a young lady become convulfed from a fright, and 
die in a few days ; and a temporary madnefs frequently termin- 
ates the paroxyfms of the epilepfia dolorifica, and an infanity of 
greater permanence is frequently induced by the pains or bruif- 
es of parturition. 
Where the patient is debilitated a quick pulfe fometimes at- 
tends Class III. 1. 2. 
OF VOLITION. 
301 
tends infane people, which is neverthelefs generally only a fymp- 
tom of the debility owing to the too great expenditure of fenfo- 
rial power ; or of the paucity of its production, as in irritative, 
or infenfitive inirritated fever. See Clafs III. i. i. 
But neverthelefs where the quick pulfe is permanent, it (hews 
the prefence of fever ; and as the madnefs then generally arifes 
from the difagreeable fenfations attending the fever, it is fo far 
a good fymptom ; becaufe when the fever is cured, or ceafes 
fpontaneoufly, the infanity molt frequently vanifhes at the fame 
time. 
The ftimulus of fo much volition fupports infane people un- 
der variety of hardfhips, and contributes to the cure of difeafes 
from debility, as fometimes occurs towards the end of fevers. 
See Se<T. XXXIV. 2. 5. And, on the fame account, they bear 
large dofes of medicines to procure any operation on them ; as 
ametics, and cathartics, which, before they produce their effect 
in inverting the motions of the ftomach in vomiting, or of the 
abforbents of the bowels in purging, mult firft weaken the natur- 
al aCtions of thofe organs, as (hewn in Sect. XXXV. 1. 13. 
From thefe confiderations it appears, that the indications of 
cure muft confift in removing the caufe of the pain, whether it 
arifes from a delirious idea, or from a real fact, or from bodily 
difeafe ; or fecondly, if this cannot be done, by relieving the 
pain in confequence of fuch idea or difeafe. The firlt is fome- 
times effected by prefenting frequently in a day contrary ideas 
to fhew the fallacy, or the too great eflimation, of the painful 
ideas. 2dly. By change of place, and thus prefenting the ftim- 
ulus of new objeCls, as a long journey. gdly. By producing 
forgetfulnefs of the idea or objeCt, which caufes their pain ; by 
removing all things which recal it to their minds ; and avoiding 
all converfation on fimilar fubjeCts. For I fuppofe no difeafe 
of the mind is fo perfectly cured by other means as by forget- 
fulnefs. 
Secondly, the pain in confequence of the ideas or bodily dif- 
eafes above defcribed is to be removed, firft, by evacuations, as 
venefeCtion, emetics, and cathartics ; and then by large dofes 
of opium, or by the vertigo occafioned by a circulating fwing, or 
by a fca-voyage, which, as they affect the organs of fenfe as well 
as evacuate the ftomach, may contribute to anfwer both indica- 
tions of cure. 
Where maniacs are outrageous, there can be no doubt but co- 
ercion is neceflary ; which may be done by means of a (trait 
waiftcoat ; which difarms them without hurting them ; and by 
tying a handkerchief round their ankles to prevent their efcape. 
In others there can be no doubt, but that confinement retards 
rather 302 
DISEASES 
Class III. 1. 2, 
rather than promotes their cure; which is forwarded by change 
of ideas in confequence of change of place and of objects, as by 
travelling or failing. 
The circumftances which render confinement neceffary, are 
firft, if the lunatic is liable to injure others, which muft be judg- 
ed of by the outrage he has already committed. 2dly. If he is 
likely to injure himfelf; this alfo muft be judged of by the def- 
pondency of his mind, if fuch exifts. gdly. If he cannot take 
care of his affairs. Where none of thefe circumftances exift, 
there fhould 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 can only be term- 
ed delirious. If every one, who pofleffes miftaken ideas, or who 
puts falfe eftimates on things, was liable to confinement, I know 
not who of my readers might not tremble at the fight of a mad- 
houfe ! 
The moft convenient diftribution of infanities will be into 
general, as mania mutabilis, ftudium inane, and vigilia ; and 
into partial infanities. Thefe laft again may be fubdivided into 
defires and averfions, many of which are fucceeded by pleafura- 
ble or painful ideas, by fury or dejection, according to the de- 
gree or violence of their exertions. Hence the analogy between 
the infanities of the mind, and the convulfions of the mufcles 
defcribed in the preceding genus, is curioufly exaft. The con- 
vulfions without ftupor, are either juft fuflicient to obliterate the 
pain, which occafions them ; or are fucceeded by greater pain, 
as in the convulfio dolorifica. So the exertions in the mania 
mutabilis are cither juft fufficient to allay the pain which occa- 
fions them, and the patient dwells comparatively in a quiet 
ftate •, or thofe exertions excite painful ideas, which are fucceed- 
ed by furious difeomfes, or outrageous adtions. The ftudium 
inane, or reverie, refembles epilepfy, in which there is no fenfi- 
bility to the ftimuli of external objects. Vigilia, or watchful- 
nefs, may be compared to the general writhing of the body ; 
which is juft a fulficient exertion to relieve the pain which occa- 
flans it. Erotomania may be compared to trifmus, or other muf- 
cular fixed fpafm, without much fubfequent pain ; and mccror 
to cramp of the mufcles of the leg, or other fixed fpafm with 
fubfequent pain. All thefe coincidences contribute to fhew, as; 
explained in Sect. III. 5, that our ideas are motions of the im- 
mediate organs of fenfc obeying the fame laws as our mufcular 
motions. 
The violence of aftion accompanying infinity depends much 
on the education of the perfon ; thofe who have been proudly 
educated with unreftrained paffions, are liable to greater fury j 
and Class UI. 1. 2. 
OF VOLITION. 
303 
and thofe, whofe education has been humble, to greater defpqn* 
dency. Where the delirious idea, above defcribed, produces 
pleafurable fenfations, as in perfonal vanity or religious enthufi* 
afm ; it is almoft a pity to fnatch them from their fool's para* 
dife, and reduce them again to the common lot of humanity ; 
left they fhould complain of their cure, like the patient defcrib- 
ed in Horace, 
Pol ! me occidifti's, amici, 
Non fervaftia, ait, cui fic extorta volupUS, 
Et deniptua per vim mentis gratiffimus error ' 
As infanities arife from excefs of action of the fenfotial pow- 
er of volition, this excefs of action may be owing either to the 
increafe of motive or ftimulus, or to an increafed quantity or 
accumulation of that fenforial power. And hence, though the 
greateft number of infanities originate from increafed motive to 
voluntary action, as to avoid pain or to acquire pleafure ; yet 
there appear to be fome, which have for their caufe an accumu- 
lation of the fenforial power of volition. 
Thus thofe, who have been accuftomed to perpetual exer- 
tions of volition in carrying on fome extenfive employment of 
profeflion during the firft half of their lives, are liable to be- 
come melancholy, and even to deftroy themfelves, if they fud- 
denly leave off their very active and anxious exertions, and re- 
tire to a fituation without employment, of which many inftances 
have occurred. This feems to originate from the pain occafion- 
ed by the accumulation of the fenforial power of volition, which 
now ceafes to be expended for want of motive. The tdedium 
vitae defcribed in No. X. of this genus of difeafes affects indo* 
lent people, who poffefs accumulated fenforial power, but want 
motive to excite it into fuch actions of the mufcles or ideas, as 
might in part expend it. 
The accumulation of fenforial power from the defecA of ac- 
cdftomed actions feems to give rife to fome inordinate mufcular 
motions, as the inccffant jumping of a fquirrel confined in a cage, 
and fome of the motions of children confined too long in fphools, 
which are called tricks. See Clafs III. i. i. i. and IV. i. 3. 
And I am inclined to think, that thefe infanities, which are term- 
ed melancholy, where no previous misfortune has occurred, as in 
grief or difappointed love, but where the patient fits perpetually 
brooding over fome painful idea, which was not previoufly ex- 
cited by any external event, as in the Medium vitae, are in gener- 
al occafioned by accumulations of fenforial powdr; and the vio- 
lent infanities to increafe of motive; that is, to thofe pains or 
want of pleafure, which excite averfion or defire. 
There 304 
DISEASES 
Class III. 1. 2. 
There is finally rcafon to believe, that not only fenforial power 
in general is capable of accumulation in thofe parts which 
have been accuftomed to almoft perpetual atftion ; but alfo that 
each kind or fpecies of fenforial power, as that of irritation, 
fenfation, volition, and aflociation, is feparately capable of accu- 
mulation in the parts, which have almoft perpetually been actu- 
ated by it : which I hope fometime to confider more at large, as 
I fufpeit it may fupply a key to many of the phenomena not 
only of infanities and convulfions, but to thofe of fever. 
The difpofition to infanity, as well as to convulfion, is believ- 
ed to be hereditary ; and in confequence to be induced in thofe 
families from (lighter caufes than in others. Convulfions have 
been (hewn to have been moft frequently induced by pains ow- 
ing to defeat of ftimulus, as the fhuddering from cold, and not 
from pains from excefs of ftimulus, which are generally fucceed- 
ed by inflammation. But infanities are on the contrary gener- 
ally induced by pains from excefs of ftimulus, as from the too 
violent actions of our ideas, as in common anger, which is an 
infanity of (bort duration ; for infanities generally, though not 
always, arife from pains of the organs of fenfe ; but convulfions 
generally, though not always, from pains of the membranes or 
glands. And it has been previoufly explained, that though the 
membranes and glands, as the ftomach and fkin, receive great 
pain from want of ftimulus ; yet that the organs of fenfe, as the 
eye and ear, receive no pain from defeat of ftimulus. 
Hence it follows, that the conftitutions moft liable to convul- 
fion, are thofe which moft readily become torpid in fome part 
.of the fyftem, that is which poffefs lefs irritability ; and that 
thofe moft liable to infanity, are fuch as have excefs of fenfibil- 
ity ; and laftlv, that thefe two circumftances generally exift in 
the fame conftitution ; as explained in Sect. XXXI. 2. on Tem- 
peraments. Thefe obfervations explain why epilepfy and infan- 
ity frequently fucceed or reciprocate with each other, and why 
inirritable habits, as fcrofulous ones, are liable to infanity, of 
which I have known fome inftances. 
In many cafes however there is no appearance of the difpofi- 
tion to epilepfy or infanity of the parent being tranfmitted to 
the progeny. Firft, where the infanity has arifenfrom fome vi- 
olent difappointment, 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 procrea- 
tion of his children. Which habits I fuppofe to be the general 
caufe of the difpofition to infanity in this country. See Clafs 
III. i. i. 7. 
As the difpofition to gout, dropfy, epilepfy, and infanity, ap- 
pears Class III. 1. 2.1. 
OF VOLITION. 
305 
pears to be produced by the intemperate ufe of fpirituous po- 
tation, and is in all of them hereditary ; it feems probable, that 
this difpofition gradually increafes from generation to generation, 
in thofe families which continue for many generations to be in- 
temperate in this refpefl; till at length thefe difeafes are produc- 
ed ; that is, the irritability of the fyftem gradually is decreafed 
by this powerful ftimulus, and the fenfibility at the fame time 
increafed, as explained in Se<T. XXXI. i. and 2. This difpofi- 
tion is communicated to the progeny, and becomes ftill increaf- 
ed, if the fame ftimulus be continued, and fo on by a third and 
fourth generation ; which accounts for the appearance of epilep- 
fy in the children of fome families, where it was never known 
before to have exifted, and could not be afcribed to their own 
intemperance. A parity of reafoning (hews, that a few fober 
generations may gradually in the fame manner reftore a due de- 
gree of irritability to the family, and decreafe the excefs of fenfi- 
bility. 
From hence it would appear probable, that fcrofula and drop- 
fy are difeafes from inirritability ; but that in epilepfy and infan- 
ity an excefs of fenfibility is added, and the two faulty temper- 
aments are thus conjoined. 
SPECIES. 
I. Mania mutabilis. 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 infan- 
ity, they are liable in a few months to find another fource in 
fome new miftaken or imaginary idea, and to aft from this new 
idea. The idea belongs to delirium, when it is an imaginary or 
miftaken one ; but it is the voluntary actions exerted in confe- 
quence of this miftaken idea, which conftitute infanity. 
In this difeafe the patient is liable carefully to conceal the 
objeft of his defire or averfion. But a conftant inordinate fuf- 
picion of all people, and a careleffhefs of cleanlinefs, and of de- 
cency, are generally concomitants of madnefs. Their deiigns 
cannot be counteracted, till you can inveftigate the delirious 
idea or object 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 
parlour, and, with cocked piftols in his hands, ordered her to 
ftrip herfelf naked ; he then infpeCted her with fome attention, 
and difmiffed her untouched. Then he ftripped two of his 
male fervants in the fame manner, to the great terror of the 
neighbourhood. After he was fecurcd, with much difficulty he 
Vol. II. was 306 
DISEASES 
Class III. 1.2.!. 
was perfuaded to tell me, that he had got the itch, and had ex- 
amined fome of his fervants to find out from whom he had re- 
ceived 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 believe of a difeafed liver, like convulfion and epilepfy ; at 
other times it is caufed by very painful ideas occafioned by ex- 
ternal circumftances, 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 fenfes is often 
produced in an inftant, and generally becomes-gradually weak- 
ened in procefs of time, by the perpetual ftimulus of external 
obje€ls, or by the fucceffions or other catenations of ideas, or by 
the operations of medicines ; and when the maniacal hallucina- 
tion 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 part of the feal of a letter, 
which he had juft then received ; one of his companions feeing 
him alarmed, cried out in humour, " It will feal your bowels up." 
He became melancholy from that inftant, and in a day or two 
refufed to fwallow any kind of nourilhmcnt. On being preffed to 
give a reafon for this refufal, he anfwered he knew nothing would 
pafs through him. A cathartic was given, which produced a 
great many evacuations, but he ftill perfifted, that nothing pair- 
ed through him ; and though 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. 
Mils , a fenfible and ingenious lady, about thirty, faid 
fhe had feen an angel ; who told her, that Ihe need not eat, 
though all others were under the neceffity of fupporting their 
earthly exiftence by food. After fruitlefs perfuafions to take 
food, the ftarved herfelf to death.-It was ptopofed to fend an 
angel of a 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 ihe was 
at her toilet, " Repent, or you will be damned." From that 
moment fhe became melancholy, and this hallucination affected 
her Class III. i. 2. 1. 
OF VOLITION. 
307 
her in greater or lefs degree for about two years; fhe then re- 
covered perfectly, and is now a cheerful old woman. 
Mrs. , a farmer's wife, going up Hairs to drefs, found 
the curtains of her bed drawn, and on undrawing them, (lie be- 
lieved that (he faw the corpfe of her filter, who was then ill at 
the diltance of twenty miles, and became from that time infane ; 
and as her filter died about that time, Ihe could not be produc- 
ed to counteract the infane hallucination, but Hie perfectly re- 
covered in a few months. 
Mrs. , a molt elegant, beautiful, and aceomplilhed la- 
dy, about twenty-two years of age, had been married about two 
months to an elegant, polilhed, and affluent young man, and it 
was well known to be a love-match on both fides. She fudden- 
ly became melancholy, and yet not to fo great a degree, but 
that Ihe could command herfelf to do the honours of her table 
with grace and apparent eafe. After many days intreaty, fhe 
at length told me, that Ihe thought her marrying her hulband 
had made him unhappy ; and that this idea Ihe 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 ex- 
pectation that the ficknefs as well as change of objeCts, might 
remove the infane hallucination, by introducing other energetic 
ideas ; this was not complied with, but Ihe travelled about Eng- 
land with her friends and her hulband for many months, and 
at length perfectly recovered, and is now I am informed in health 
and fpirits. 
Thefe cafes are related to fhew the utility of endeavouring to 
inveftigate the maniacal idea, or hallucination ; as it may not 
only acquaint us with the probable defigns of the patient, from 
whence may be deduced the neceffity of confinement; but alfo 
may fome time lead to the molt effectual plan of cure. 
I received good information of the truth of the following cafe, 
which was publifhed a few years ago in the ncwfpapers. A 
young farmer in Warwicklhire, finding his hedges broke, and 
the flicks carried away during a frolty feafon, determined to 
watch for the thief. He lay many cold hours under a hay- 
Itack, and at length an old woman, like a witch in a play, ap- 
proached, and began to pull up the hedge ; he waited till fhe had 
tied up her bottle of Hicks, and was carrying them off, that he 
might convict her of the theft, and then Springing from his con- 
cealment, he feized his prey with violent threats. After fome 
altercation, in which her load was left 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 al- 
ready (hivering with cold, " Heaven grant, that thou never mayeft 
know 308 
DISEASES 
Class III. 1. 2. 1. 
know again the bleffing to be warm.p He complained of cold 
all the next day, and wore an upper coat, and in a few days 
another, 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 in- 
fane 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 muft conftitute the 
method of cure. See SeCT. XXXIV. 3. 4. VenefeCtion. 
Vomits of from five grains to ten of emetic tartar, repeated ev- 
ery 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 reftored 
the patient. Dr. Brandreth gave 400 drops of laudanum to a 
maniac in the greateft poffible furor, and in a few hours he be- 
came calm and rational. Med. Comment, for 1791, p. 384. 
Prognojlic. 
The temporary quick pulfe attending fome maniacal cafes is 
fimply a fymptom of debility, and is the confequence of too 
great exertions ; but a permanent quick pulfe fhews the pref- 
cnce of fever, and is frequently a falutary fign ; becaufe, if the 
life of the patient be fafe, when the fever ceafes, the infanity 
generally vanifhes along with it, as mentioned above. In this 
cafe the kind of fever muft direft the method of curing the in- 
fanity ; which muft confilt of moderate evacuations and diluents, 
if the pulfe be ftrong ; or of 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 Rate, 
are removed. In thefe cafes the child fliould be brought fre- 
quently to the mother, and applied to her breaR, if Rie will fuf- 
fer it, and this whether Rte at firR attends to it or not; as by a 
few trials it frequently excites the Rorge, or maternal afl^eftion, 
and removes the infanity, as I have witnefled. 
When the madnefs is occafioned by pain of the teeth, which 
I believe is no uncommon cafe, thefe muR be extrafted ; and 
the cure follows the extinftion of the pain. There is however 
fome difficulty in detefting the delinquent tooth in this cafe, as 
in Class III. i. 2. 2. 
OF VOLITION. 
309 
in hemicrania, unlefs by its apparent decay, or by fome previ- 
ous information of its pain having been complained of; be- 
caufe the pain of the tooth ceafes, as foon as the exertions of in- 
fanity commence. In this cafe falivation might be tried. 
When a perfon becomes infane, who has a family of fmall 
children to folicit his attention, the prognoftic is very unfavour- 
able ; as it (hews the maniacal hallucination to be more pow- 
erful than thofe ideas which generally intcreft us the molt. 
When an infane young man Ihews no lafcivious idea, when 
an opportunity of gratifying the paflion of love is prefented t® 
him, as in the cafe above mentioned of Z. Z. or when an in- 
fane young lady ihews no fymptom of attachment, when ad- 
dreffed honourably by a proper lover, the prognoftic is unfa- 
vourable, as it ihews the maniacal hallucination to affeCt the 
mind ftronger than the natural paflion of love, which in civilized 
fociety is flrengthened by reltraint. 
Paralytic affections are faid by Mr. Hallam, to be frequently 
fucceeded by infanity, and that in thefe cafes the inactivity of 
fome paralytic mufcles about the face or limbs with defective 
memory continue along with the infanity ; and he adds that thefe 
patients are feldom relieved. Obfervations on Infanity by J. 
Hallam, 8vo. Rivington. It was before obferved, that when 
fome limbs become paralytic, as in the common hemiplegia, 
that the other limbs are liable to be for fome time in almoft per- 
petual aCtion, owing to the fuperfluity of volition, which was 
previoully expended by the aCtion of thofe mufcles, which are 
now rendered difobedient to the fenforial power of volition, 
though they may continue to be excitable by irritation or fenfa- 
tion, as in the act of pandiculation, or by eleCtric (hocks. Now 
if this fuperfluity of voluntary activity be exerted on the organs 
of fenfe, delirious hallucinations and infane aCtions are the con- 
fequence ; and as the power of life is already injured in a part 
of the fyftem, they are lefs liable to recover, and die like other 
paralytic patients. And thus the infanities in confequence of 
paralytic affeCtions, as well as thofe in confequence of pain- 
ful fenfations or ideas, countenance the theory, that they 
arife from the exceflive aCtivity of the fenforial power of voli»- 
tion. 
2. Stadium inane. Reverie confiffsof violent voluntary exer- 
tions of ideas to relieve pain, with all the trains or tribes con- 
nected with them by fenfations or afl'oeiations. It frequently 
alternates with epileptic convulfions ; with which it correfponds, 
in refpeCt to the infenfibility of the mind to the itimuli of ex- 
ternal objeCts, in the fame manner as madnefs correfponds with 
common 310 
DISEASES 
Class III. 1. 2. 2. 
common convulfion, in the patient's poffeffing at the fame time a 
fenfibility of the itimuli of external objects. 
Some have been reported to have been involved in reverie fo 
perfectly, as not to have been dilturbed by the difcharge of a 
cannon ; and others to have been infenfible to torture, as the 
martyrs for religious opinions ; but thefe feem more properly 
to belong to particular infancies than to reverie, like noftalgia 
and erotomania. 
Reverie is diftinguifhcd from madnefs as defcribed above ; 
and from delirium, becaufe the trains of ideas are kept confift- 
ent by the power of volition, as the perfon reafons and delib- 
erates in it. Somnambulifmus is a part of reverie, fomnambu- 
hfm confifting in the exertions of the locomotive mufcles, and 
reverie in the exertions of the organs of fenfe ; See Clafs I. x. 
j. 9. and Sect. 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 or- 
gans of fenfe, they can occafionally perceive the ftimuli of ex- 
ternal objects, as explained in SecSt. XIX. And in this cafe ifi 
refembles fometimes an hallucination of the fenfes, as there is a 
mixture of facSt and imagination in their difeourfe ; but may be 
thus diftinguifhed : hallucinations of the fenfes are allied to de- 
lirium, and are attended generally with quick pulfe, and other 
fymptoms of great debility; but reverie is without fever, and 
generally alternates with convulfions ; and fo much intuitive 
analogy (fee Sett. XVII. 3. 7.)is retained in its paroxyfms, as to 
preferve a confiftency in the trains of ideas. 
Mifs G , whole cafe is related in SecSt. III. 5. 8. faid as 
I 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 nibbling the nofe 
off." On my walking to the place which (lie looked at, and 
returning, and alluring her that her nofe was unhurt, fhe be- 
came pacified, though I was doubtful whether fhe attended to 
me. See Clafs III. 1. 1.9. and Clafs III. t. 2. 2. 
M. M. Large dofes of opium given before the expecSted par- 
oxyfm, as in epilepfia dolorifica, Clafs III. 1. 1. 8. 
The hallucinatio ftudiofa, or falfe ideas in reverie, differ 
from maniacal hallucinations above defcribed, as no infane ex- 
ertions fucceed, and in the patients whom I have feen they 
have always been totally forgotten, when the paroxyfm was 
over. 
Matter , a fchool-boy about twelve years old, after he 
came out of a convulfion fit and fat up in bed, faid to me, 
44 Dont you fee my father Handing at the feet of the bed, he is 
come a long way on foot to fee me." I anfwered, no : " What 
colour Class III. 1.1. 3. 
OF VOLITION. 
311 
colour is his coat ?" He replied, " A drab colour.'* « And 
■what buttons ?" " Metal ones," he anfvzered, and added, " how 
fadly his legs are fwelled." In a few minutes he faid, with ap- 
parent furprife, " He is gone,'' and returned to his perfect mind- 
Other cafes are related in Se6t XIX. and XXXIV. 3. and in 
Clafs III. 1. 2. 2. with further obfertations on this kind of 
hallucination; which however is not the caufe of reverie, but 
conftitutes a part of it, the caufe being generally fome uneafy 
fenfation of the body. 
3. Vigilia. Watchfulnefs confifts in the unceafing exertion 
of volition ; which is generally caufed by fome degree of pain 
either of mind or of body, or from defect of the ufual quantity 
of pleafurable fen fation ; hence if thofe, who are accuftomed to 
wine at night, take tea inftead, they cannot fleep. The fame 
happens from want of folid food for fupper, to thofe who are 
accuftomed to ufe it; as in thefe cafes there is pain or defeft of 
pleafure in the ftomach. 
Sometimes the anxiety about fleeping, 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. 1. 10. as the interference of the will 
prevents the effect defired. 
Another fource of watchfulnefs may be from the too 'great 
fecretion 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 actions of the 
fyftem occafioned by the ftimulus of thefe drugs can be fuppo- 
fed to be lefs than the increafed fecretion of it. 
M. M. 1. Solid food to fupper. Wine. Opium. Warm 
bath. 2. The patient ftiould be told that his want of fleep is of 
no confequence to his health. 3. VcnefeCtion by cupping. Ab* 
ftinence from wine. 4. A blifter by ftimulating the fkin, and 
rhubarb by ftimulating the bowels, will fometimes induce fleep. 
Exercife. An uniform found, as of a paufing drop of water> 
or the murmur of bees. Other means are defcribed in Seft. 
win. 20. 
4. Erotomania. Sentimental love. Defcribed in its excefs 
by romance writers and poets. As the object of love is beauty, 
and as our perception of beauty confifts in a recognition by the 
fenfe of vifion of thofe objects, which have before infpired our 
love, by the pleafure they have afforded to many of our fenfl § 
(Se<T. XVI. 6.) ; and as brute animals have lefs accuracy < f 
their fenfe of vifion than mankind (ib.); we fee the reafon why 
this kind of love is not frequently obfervable in the brute crea- 
tion, except perhaps in fome married birds, or in the affection of 
the 312 
DISEASES 
TIlassIII. i. 2. 3. 
the mother to her offspring. Men who have not had leifure to 
cultivate their tafte for vifible objects, and who have not read the 
works of poets and romance-writers, are lefs liable to fentimen- 
tal love ; and as ladies are educated rather with an idea of being 
chofen, than of choofing *, there are many men and more wom- 
en, who have not much of this infinity ; and are therefore more 
eafdy induced to marry for convenience or intereft, or from the 
flattery of one fex to the other. 
In its fortunate gratification fentimcntal love is fuppofed to 
fupply the pureit fource of human felicity ; and from the fud- 
dennefs with which many of thofe patients, defcribed in fpecies 
I. of this genus, were feized with the maniacal hallucination, 
there is reafon to believe, that the molt violent fentimental love 
may be acquired in a moment of time, as reprefented by Shakf- 
peare in the beginning of his Romeo and Juliet, as originally 
written. 
Some have endeavoured to make a difiinction between beau- 
ty and grace, and have made them as it were rivals for the pof- 
feflion of the human heart; but grace may be defined beauty in 
action ; for a fleeping beauty cannot be called graceful in what- 
ever attitude fhe may recline ; the mufcles muft be in action to 
produce a graceful attitude, and the limbs to produce a grace- 
fid motion. But though the object of love is beauty, yet the 
idea is neverthelefs much enhanced by the imagination of the 
lover ; which appears from this curious circumftance, that the 
lady of his paflion fcldom appears fo beautiful to the lover after 
a few months reparation, as his ideas had painted her in his 
abfence ; and there is on that account, always a little difappoint- 
ment felt for a minute at their next interview from this halluci- 
nation of his ideas. 
This paffion of love produces reverie in its fir ft Rate, which 
exertion alleviates the pain of it, and by the affiftance of hope 
converts it into pleafure. Then the lover feeks folitude, left 
this agreeable reverie fhould be interrupted by external ftimuli, 
as defcribed by Virgil. 
Tantum inter denfas, unibrofa cacutnina, fagos 
Aflidue veniebat, ibi hxc incondita folus 
Montibus et fylvis ftudio jadlabat inani. 
When the pain of love is fo great, as not to be relieved by the 
exertions of reverie, as above defcribed ; as when it is mifplaced 
on an object, of which the lover cannot poflefs himfelf; it may 
fl ill be counteracted or conquered by the itoic philofophy, which 
flrips all things of their ornaments, and inculcates " nil admira- 
ri." Of which leffons may be found in the meditations of Mar- 
cus Class III. 1. 2. 4. 
OF VOLITION. 
313 
cus Antoninus. The maniacal idea is faid in fome lovers to 
have been weakened by the a&ion 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 fhipwrecked. In 
thofe cafes the violence of the new idea for a while expends fo 
much fenforial power as to prevent the exertion of the mania- 
cal one ; and new catenations fucceed. On this theory the lov- 
er's leap, fo celebrated by poets, might effect a cure, if the pa- 
tient 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 ; the maniacal idea is fo painful 
as not to be for a moment relievable by the exertions of reverie, 
but is inftantly followed by furious or melancholy infanity ; and 
fuicide, or revenge, have frequently been the confequence. As 
was lately exemplified in Mr. Hackman, who fhot Mifs Ray in 
the lobby of the playhoufe. So the poet defcribes the pallion 
of Dido, 
Moriamur inultx ?- 
At moriamur, ait,-fie, fic, juvat ire fiib umbras! 
The ftoty of Medsea feems to have been contrived by Ovid^ 
who was a good judge of the fubjedt, to reprefent the favage 
madnefs occafioned 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. 
Dryden. 
Hence it appears that though fentimental love does not fo 
frequently arife fpontaneoully in female bofoms, yet that it is 
liable to become as violent, when it has been excited by the 
courtlhip of the other fex, and though, when it is rejected, after 
courtlhip has produced it, it is not always fucceeded by fuch vi- 
olent effects as thofe above mentioned ; which may be afcribed 
to the greater modefty and referve of their education ; yet the 
difappointed paffion is liable to prey upon their minds even to 
the hazard of their lives, of which 1 have witneffed two inftan- 
ces, in both which the effects approached to that occafioned by 
great grief. See Mccror, Clafs III. i. 2. to. 
One of thefe ladies, about 30 years of age, was deferted by an 
Irilh gentleman, who was foon to have married her; Ihe was 
feized fuddenly with a liupor, which by thofe, who were not 
acquainted with the caufe, was miftaken for a kind of apoplexy ; 
fhe gradually recovered fo as to apply to her ufual habits of life, 
Vol. II. R k and 314 
DISEASES 
Class III. 1. 2. 5. 
and in four or five years regained her cheerfulnefs, and married 
another man. The other was affected with long ftupor, lofs of 
digeftion, and total inability of mind and body, which contin- 
ued a year or two, and from which (he alfo gradually re- 
covered. 
5. Amor fui. Vanity confifts of an agreeable reverie, and is 
well ridiculed in the ftory of Narciffus, who fo long contemplat- 
ed his own beautiful image in the water, that he died from neg- 
left of taking fuftenance. 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 might difcern by his perpetual 
attention to himfelf, and the difficulty with which he arranged 
his converfation, that the idea of himfelf intruded itfelf at every 
comma or paufe of his difcourfe. In this degree vanity mull 
afford great pleafure to the poffeflbr ; and when it exifts with- 
in moderate bounds, may contribute much to the happinefs of 
focial life. 
My friend Mr. once complained to me, that he was 
much troubled with bafhfulnefs in company, and believed that 
it arofe from his want of perfonal vanity ; on this account he de- 
termined on a journey to Paris, when Paris was the centre of 
politenefs ; he there learnt to drefs, to dance, and to move his 
hands gracefully in converfation ; and returned a molt confum- 
mate coxcomb. But after a very few years he relapfed into rut 
ticity of drefs and manners. 
M. M. The cure of vanity may be attempted by excefs of 
flattery, which will at length appear ridiculous, or by its famil- 
iarity will ceafe to be defired. I remember to have heard a 
ftory of a nobleman in the court of France, when France had a 
court, wl^o was fo difagreeably vain in converfation, that the 
king was pleafed to dire<ft his cure, which was thus performed. 
Two gentlemen were directed always to attend him, one was 
to ftand behind his chair, and the other at a refpe&ful diftance 
before him; whenever his lordffiip began to fpeak,one of them al- 
ways,pronounced "Lord Gallimaufre is going tofay the belt thing 
in the world." And,as foon as hisLordlhip had done fpeaking,the 
other attendant pronounced, " Lord Gallimaufre has fpoken the 
beft thing in the world." Till in a few weeks this noble lord 
was fo difgufted with praife that he ceafed to be vain; and his 
majefty difmiffed his keepers. 
6. Nojtalgia. Maladie de Pais. Calenture. An unconquer- 
able defire 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 Class III. 1. 2. 7. 
OF VOLITION. 
315 
when taken into foreign 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. Zwingerus. 
Dear is that Ihed, to which his foul conforms, 
And dear that hill, which lifts him to the ftorms. 
Goldsmith. 
7. Spes religtoja. Superftitious hope. This maniacal hallu- 
cination in its milder ftate produces, like fentimental love, an 
agreeable reverie ; but when joined with works of fupereroga- 
tion, it has occafioned many enormities. In India devotees con- 
fign themfelves by vows to moft painful and unceafing tortures, 
fuch as holding up their hands, till they cannot retract them ; 
hanging up by hooks put into the thick (kin over their (boulders, 
fitting upon (harp points, and other felf torments. While in 
our part of the globe failing and mortification, as flagellation, 
has been believed to pleafe a merciful Deity ! The ferenity, with 
which many have fuflered cruel martyrdoms, is to be afcribed to 
this powerful reverie. 
Mr. , a clergyman, formerly of this neighbourhood, be- 
gan to bruife and wound himfelf for the fake of religious morti- 
fication, and pafl'ed much time in prayer, and continued whole 
nights alone in the church. As he had a wife and family of 
fmall children, I believed the cafe to be incurable ; as otherwife 
the affection and employment in his family connexions would 
have oppofed the beginning of this infanity. He was taken to 
a madhoufe without effeX, and after he returned home, continu- 
ed to beat and bruife himfelf, and by this kind of mortification, 
and by fometimes long fading, 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 fup- 
pofed he worfhipped the devil." He was ftruck with this 
idea, and promifed me not to beat himfelf for three days, and 
I believe kept his word for one day. If this idea had been fre- 
quently 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, maflacres, has not this infanity 
introduced into the world !-A commander, who had been very 
aXive in leading and encouraging the bloody deeds of St. Bar- - 
tholomew's day at Paris, on confefling his fins to a worthy ec- 
clefiaftic on his death-bed, was alked, " Have you nothing to 
fay about St Bartholomew ?" " On that day," he replied, « God 
Almighty 316 
DISEASES 
Class III. 1. 2. 8. 
Almighty was obliged to me !"-The fear of Hell is another 
infanity, which will be fpoken of below. 
8. Superbia ftemmat'u. Pride of family has frequently form- 
ed a maniacal hallucination, which in its mild ftate has confifted 
in agreeable reverie, but when it has been fo painful as to de- 
mand homage from others, it has frequently induced infane ex- 
ertions. This infanity feems to have exifted in the flourifhing 
ftate of Rome, as now all over Germany, and is attacked by Ju- 
venal with great feverity, a fmall part of which I Ihall 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 roll'd, 
Name after name, thy coxcomb hands unfold ; 
Though wreathed patriots crowd thy marble halls, 
Or fteel-clad warriors frown along the walls; 
While on broad canvas in the gilded frame 
All virtues flourifh, and all glories flame ?- 
Say,-if ere noon with idiot laugh you lie 
Wallowing in wine, or cog the dubious die, 
Or a<ft unlhamed, by each indignant buft. 
The midnight orgies of promifeuous luft ! 
Go, lead mankind to Virtue's holy fhrine. 
With morals mend them, and with arts refine, 
Or lift, with golden characters upfurl'd, 
The flag of peace, and fave a warring world !- 
-So fhall 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. Ambitio. Inordinate defire of fame. A careleflhefs about 
the opinions of others is faid by Xenophon to be the fource of 
impudence ; certainly a proper regard for what others think of 
us frequently incites us to virtuous atftions, and deters us from 
vicious ones ; and increafes our happinefs by enlarging our 
fphere of fvmpathy, and by flattering our vanity. 
Abftradl what others feel, what others think, 
All pleasures ficken, and all glories fink. 
Pope. 
When this reverie of ambition excites to conquer nations, or 
to enflave them, it has been the fource of innumerable wars, and 
the occafion of a great devaftation of mankind. Caefar is re- 
ported to have boafted, that he had deftroyed three millions of 
his enemies, and one million of his friends. 
The works of Homer are 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 Class III. i. 2. io. 
OF VOLITION. 
317 
butcher amid a flock of fheep appears the hero of the Iliad, in 
the following fine lines of Mr. Pope, which conclude the twen- 
tieth book. 
His fiery courfers, as the chariot rolls, 
Tread down whole ranks, and crulh out heroes' fouls; 
Dalh'd from their hoofs, as o'er the dead they fly, 
Black bloody drops the fmoking 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 ftood, 
All grim with duft, all horrible with blood ; 
Yet ftill infatiate, ilill with rage on flame, 
Such is the luft of never dying fame ! 
The cure muft be taken from moral writers. Woolafton 
fays, Caefar 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 name confifted of the letters P, o, m, p, e, y, and 
that this is all that remains of either of them. Juvenal alfo at- 
tacks this mode of infanity, Sat. X. 166. 
I, demens, et fsevas curre per Alpes, 
Ut pueris placeas, et declamatio fias! 
Which is thus tranflated by Dr. Johnfon, 
And left a name, at which the world grew pale. 
To point a moral, or adorn a tale ! 
io. Mceror. Grief. A perpetual voluntary contemplation 
of all the circumftances of fome great lofs, as of a favourite 
child. In general the painful ideas gradually decreafe in ener- 
gy, and at length the recollection becomes more tender and lefs 
painful. The letter of Sulpicius to Cicero on the lofs of his 
daughter is ingenious. The example of David on the lofs of his 
child is heroic. 
A widow lady was left in narrow circumftances with a boy 
and a girl, two beautiful and lively children, the one fix, and 
the other feven years of age; as her circumftances allowed her 
to keep but one maid-fervant, thefe two children were the foie 
attention, employment, and confolation of her life ; fhe fed 
them, dreffed them, flept with them, and taught them herfelf; 
they were both fnatched from her by the gangrenous fore throat 
in one week : fo that fhe loft at once all that employed her, as 
well as all that was dear to her. For the fir ft three or four 
days after their death, when any friend vifited her, fhe fat up- 
right, with her eyes wide open, without (bedding tears, and af- 
fected to fpeak of indifferent things. Afterwards fhe began to 
weep much, and for fome weeks talked to her friends of noth- 
ing 318 
DISEASES 
Class III. 1. 2.11. 
ing clfe 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 fymp- 
tom ; becaufe then the actions caufed by fenGtive aflbciation take 
the place of thofe caufed by volition ; that is, they prevent the 
voluntary exertions of ideas, or mufcular actions, which confti- 
tute infanity. 
The fobbing and fighing attendant upon grief are not convul- 
five movements, they are occafioned by the fenforial power be- 
ing fo expended on the painful ideas, and their connexions, 
that the perfon negleXs to breathe for a time, and then a vio- 
lent figh or fob is neceffary 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 occafioned by long 
grief are fpoken of in Clafs IV. 2. 1.9. 
The melioration of grief by time, and its being at length even 
attended with pleafure, depends on our retaining a diftinX idea 
of the loft objeX, and forgetting for a time the idea of the lofs 
of it. This pleafure of grief is beautifully defcribed by Aken- 
fide. Pleafures of Imagination, Book II. 1. 680. 
' ■■ Aflc the faithful youth. 
Why the cold urn of her, whom long he loved, 
So often fills his arms; fo often draws 
His lonely footfteps at the filent hour 
To pay the mournful tribute of his tears ? 
Oh ! he will tell thee, that the wealth of worlds 
Should ne'er feduce his bofom to forego 
That facred hour ; when, ftealing from the noife 
Of care and envy, fweet remembrance foothes 
With Virtue's kindeft looks his aching breaft. 
And turns his tears to rapture. 
M. M. Confolation is beft fupplied by the Chriftian doXrine 
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 by his own fault." And 
the author of Telemachus begins his work by faying, that Ca- 
lypfo could not confole herfelf for the lofs of Ulyffes, and found 
herfelf unhappy in being immortal. In the firft hours of grief 
the method of confolation ufed by uncle Toby, in Triftram 
Shandy, is probably the beft ; " he fat down in an arm chair by 
the bed of his diftreffed friend, and faid nothing." 
11. Tadium vita. Ennui. Irkfomenefs of life. The inani- 
ty of fublunary things has afforded a theme to philofophers, 
moralifts, Class III. 1.2. 11. 
OF VOLITION. 
319 
moralifts, and divines, from the earlicft records of antiquity ; 
« Vanity of vanities 1" fays the preacher, " all is vanity !" Sol- 
omon. " Man is-the dream of a ihadow !" Sxw; 
Pindar. O ! quantum eft in rebus inane ! Juvenal. Nor is 
there any one, I fuppofe, who has palled the meridian of life, 
who has not at fome moments felt the nihility of all things. 
Wearinefs of life or ennui in its moderate degree has been ef- 
teemed a motive to action by fome philofophers. See Seft. 
XXXIV. 2. 3. But in thofe men, who have run through the 
ufual amufements of life early in refpecl: of their age ; and who 
have not induftry or ability to cultivate thofe fciences, which af- 
ford a perpetual fund of novelty, and of confeq uent entertain- 
ment, 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 ihed 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, are all that life affords." He 
was perfuaded to have an iffue on the top of his head, as he com- 
plained of a dull head-ach, which being unlkilfully 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 (hot 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 fhe 
was believed to ufe him very ill, and even to beat him. He be- 
came melancholy in two days from the want of his ufual ftimu- 
lus to atftion, and cut his throat on the third fo completely, that 
he died immediately. 
Mr. Anfon, the brother to the late lord Anfon, related to me 
the following anecdote of the death of lord Sc . His lord- 
fhip fent to fee Mr. Anfon on the Monday preceeding his 
death, and faid, " You are the only friend I value in the world, 
I determined therefore to acquaint you, that I am tired of the 
infipidity of life, and intend to morrow to leave it." Mr. Anfon 
faid, after much converfation, that he was obliged to leave town 
till Friday, and added, "As you profefs a friendlhip for me, do 
me this laft favour, 1 entreat you, live till I return." Lord 
Sc believed this to be a pious artifice to gain time, but nev- 
erthelefs agreed, if he ihould return by four o'clock on that day. 
Mr. Anfon did not return till five, and perceived by the coun- 
tenances of the domeftics, that the deed was done. He went 
into 320 
DISEASES 
Class III. t. 2. 12. 
into his chamber and found the corpfe of his friend leaning over 
the arm of a great chair, with the piftol on the ground by him, 
the ball of which had been difcharged into the roof of his mouth, 
and paffed into his brain. 
Mr. and Mr. , two young men, heirs to confiderable 
fortunes, (hot themfelves at the age of four or five and twenty, 
without their friends being able to conjecture any caufe for thofe 
rafh actions. One of them I had long known to exprefs himfelf 
with diffatisfaCtion of the world; at eighteen years of age he 
complained, that he could not entertain himfelf; he tried to 
ftudy the law at Cambridge, and afterwards went abroad for a 
year or two by my advice ; but returned diffatisfied with all 
things. As he had an eruption for fome years on a part of his 
face, which he probably endeavoured to remove by external ap- 
plications ; I was induced to afcribe his perpetual ennui to the 
pain or difagreeable fenfation of a difeafed liver. The other 
young gentleman fhot himfelf in his bed-room, and I was inform- 
ed that there was found written on a fcrap of paper on his tabic, 
" I am impotent, and therefore not fit to live." From whence 
there was reafon to conclude, that this was the hallucinatio ma-, 
niacalis, the delirious idea, which caufed him to deftroy himfelf. 
The cafe therefore belongs to mania mutabilis, and not to taedi- 
um vitae. 
Thofe, who have been employed during the firft half of their 
lives in fome very aCiive bufinefs, and fuddenly leave it, are li- 
able to this kind of infanity, and even to fuicide ; of which I 
have known two inftances, one of them a Birmingham manu- 
facturer, and the other a great and fuccefsful commander. This 
may be afcribed to the accumulation of the fenforial power of 
volition, and the want of motive to exert or expend it, and 
which thence becomes painful. See pain of cold from the 
want of ftimulus. III. 2. 1. 17. 
This may afford confolation to thofe, whofe fituation in life 
obliges them to ufe perpetual induftry in their occupations : they 
may fay, that as they have been long in the habit of exerting 
much voluntary aCtion, they muft continue to employ them- 
felves ; otherwife that they fhall fink into low fpirits, as it is call- 
ed, and become unhappy. And as the continuance of activity 
is now neceffary to their happinefs, they had better employ 
themfelves on fuch objects, as are ufeful to themfelves or their 
connections, than to confume their time, and mifapply their la- 
bour, in card-playing, wine-drinking, or fox-hunting, which are 
other methods of relieving ennui or the irkfomcnels of life by 
exertion, and confequent expenditure of voluntary power. 
Lefs degrees of this malady are erroiicoufly termed hypochon- 
driacifm, CLass IIL t. i. 11; 
OF VOLtTIOK 
321 
driacifm, fee Clafs I. 2. 4. 10. by the people, and are general- 
ly afcribed to the want of voluntary power, or of induftry ; but 
I believe it is generally owing to want of motive or ftimulus t 
and that the pain attending this (late of oUr ideas br mufcles is 
occafioned by accumulation of voluntary power, as above men-* 
tioned. The cure of this difeafe, is popularly known to confift 
in any kind of voluntary exertion of the mind, of of the body j 
one of our poets has perfonified hypochondriacifm, and well ad- 
vifestheufeof exercife,or exertion to oppofe the monfter,andfaySj 
" Throw but a ftone, the giant dies." 
To this fhould be added, that thofe, who have been educated 
in indolence, do not find or feel ennui, or the pain of exiftencej, 
when they are inactive ; like our domeftic animals, as dogs and 
Cats, who fleep by the fire without inclination to hang or drowh 
themfelves; as thefe beings, not having been long accuftomed 
to expend much voluntary power, are hot liable to rhUch accu- 
mulation of it, and uneafinefs in cohftquence ; which is not fo 
however with the more active fquirrel before mentioned. 
But on the contrary, thofe, whofe education has induced them 
to ufe much voluntary exertion, and have afterWards had no 
active employment, as happens to feme Unmarried ladies, are 
more liable, as I have repeatedly witnefled, to this malady ; an 
idea, which fhould be attended to in female education. 
Another foUrce of ennui dr taedium vitse is alfo derived from 
Wrong education, and is immediately owing to the want of ftim- 
ulus rather than to the great accumulation of voluntary power J 
and is liable to attend fome ladies in high life, whefe exertions 
during their early years were excited by the flattery of numer- 
ous menial fervants. And afterwards, when this flattery ceafes 
by their living with their equals, they want their accuftomed 
motive to activity, and in confequence become indolent and un- 
happy, as further described in Clafs III. 2. i. 8. under the name 
of Parefis voluntaria. 
M. M. The prevention of this malady muft Confift in the 
due care of education. Thofe who are not defigned for very 
active life, particularly young ladies, fhould not be forced in 
their early years to ufe too violent or too conftant voluntary ex- 
ertions. They fhould not be flattered into all their exertions, 
but fhould be taught to aft from duty to themfelves and Others, 
or for their future advantage as well as for their prefent amufe- 
ment. 
Some reftraint in CxhaUfting the ufual pleafufes of the world 
in Carly life fhould be laid on young men of fortune J and after- 
wards the pleafures and folitudes of a matrimonial life are 
Vol. II. 8 3 ftrongly 322 
DISEASES 
Class III. i. 2.12. 
ftrongly to be recommended ; and finally the cultivation of fei- 
ence, 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, when irkfomenefs of life has been the 
oftenfible caufe of fuicide, there has probably exifted a maniacal 
hallucination, a painful idea, which the patient has concealed 
even to his dying hour ; except where the mania has evidently 
arifen from hereditary or acquired difeafe of the membranous or 
glandular parts of the fyftem. 
12. Pulcbrltudinis deftderium. The lofs of beauty, either by 
difeafe, as by the fmall-pox, or by age, as life advances, is fome- 
times painfully felt by ladies, who have been much flattered on 
account of it. There is a curious cafe of this kind related in 
Ie Sage's Bachelor of Salamanca, which is too nicely defcribed 
to be totally imaginary. 
In this fituation fome ladies apply to what are termed cofmet- 
ics 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 (hops for 
this purpofe ; but it is either, I am informed, in part or entirely 
white lead or cerulTa. The pernicious effects of the external 
life 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 effect. 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 (kin like other filth. 
The tan of the Ikin occafioned 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 then put upon the 
hand or face, after a fecond of time, as toon as the tan difap- 
pears, the part muft be wafhed with a wet towel and much 
warm water. Freckles lie too deep for this operation, nor are 
they in general removable by a blifter, as I once experienced. 
See Clafs I. 2. 2. 9. 
It is probable, that thofe materials which ftain 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 of my hand by marine acid oxygenated by 
manganefe, which fo inftantly whitens cotton. 
The cure therefore muft be fought from moral writers, and 
the Class III. 1. 2. 13. 
OF VOLITION. 
323 
the cultivation of the graces of the mind, which are frequently 
a more valuable poffeffion than celebrated beauty. 
13. Paupertatis timor. The fear of poverty is one kind of 
avarice ; it is liable to affeCt people who have left off a profita- 
ble and aCtive bufinefs ; as they are thus deprived of their ufual 
exertions, and are liable to obferve the daily expenditure of mon- 
ey, without calculating the fource from whence it flows. It is 
alfo liable to occur with a fudden and unexpected increafe of 
fortune. Mr. , a furgeon, about fifty years of age, who 
was always rather of a parlimonious difpofition, had a large 
houfe, with a fortune of forty thoufand pounds, left him by a 
diftant relation ; and in a few weeks became infane from the 
fear of poverty, lamenting that he fhould die in a jail or a work- 
houfe. He had left off a laborious country bufinefs, and the 
daily perception of profit in his books; he alfo now faw greater 
expenfes going forwards in his new houfe, than he had been 
accuftomed to obferve, and did not fo diftinCtly fee the fource 
of fupply ; which feems to have occafioned the maniacal hallu- 
cination.-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 circumftances ; more perhaps than 
any other maniacal hallucination, except the fear of Hell. 
The covetoufnefs of age is more liable to affeX fingle men, 
than thofe who have families ; 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 connexions 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 unprotected, as his ftrength declines, and 
is thus led to depend for affiftance on money, and on that ac- 
count wifhes to accumulate it. Whereas the father of a family 
has not only thofe connections, which demand the frequent ex- 
penditure of money, but feels a confolation in the friendfhip of 
his children, when age may render their good offices neceffary 
to him. 
M. M. I have been well informed of a medical perfon in 
good circumftances in London, who always carries an account 
of his affairs, as debtor and creditor, in his pocket-book ; and 
looks over it frequently in a day, when this diteafe returns upon 
him ; and thus, by counteracting the maniacal hallucination, 
wifely prevents the increafe of his infanity. Another medical 
perfon, in London, is faid to have cured himfelf of this difeafe 
by ftudying mathematics with great attention ; which exertion 
of the mind relieved the pain of the maniacal hallucination. 
Many moral writers have ftigmatifed this infanity ; the covet- 
ous, 324 
DISEASES 
Class IH. i. 2. <4,. 
quS) they fay, commit crimes and mortify themfelves without 
hopes of reward ; and thus become miferable both in this world 
and the next. Thus Juvenal: 
Cum furor haud 4ubius, cunufit manifefta phrenitis, 
Ut locuples moriaris, egenti vivefe fato ! 
The covetous man thought he gave good advice to th^t 
fpendthrift, when he faid, <* Live like me," who well anfwered 
him, 
~---. Like you. Sir John ? 
" That I can do, when all I have is gone!" 
Pope. 
14. Lethi timer, The fear of death perpetually employs the 
thoughts of thefe patients: hence they are devifing new medfa 
eines, and applying to phyficians and quacks without dumber, 
ft is confounded with hyp°chondriafis, Clafs J. g. 3. 9. in pop- 
ular converfation, but is in reality an infanity. 
A young gentleman, whom I advifed to go abroad as a cure 
for this difeafe, allured me, that during the three years he was 
in Italy and France he never pafled a quarter of an hour withn 
out fearing he Ihould die, But he has now for above twenty 
years experienced the contrary. 
The fufferers under this malady are generally at once difcov- 
Stable by their telling you, amidlt an unconnected defcriptiop 
of their complaints, that they are neverthelefs not afraid of dy- 
ing. They are alfo eafily led to complain of pains in almoft any 
part of the body, and are thus foon difeovered. 
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 re-^ 
lated to them of people dying without pain. Some of thefe, 
which I think curious, I (ball concifely relate, a? a part of the 
method of cure. 
Mr. , an cMeily 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 gentlemap about fixty, lay in 
the ail of dying, with difficult refpiration like groaning, but in a 
kind of llupor or coma vigil, and every ten or twelve minutes^ 
Xvhifa X fat by him, he waked, looked up, and faid, " who is it 
groans Class III. 1. 2. 15. 
OF VOLITION. 
325 
groans fo, I am fure there is fomebody dying in the room," and 
then funk again into a kind of deep. From thefe two cafes 
there appeared to be no pain in the aft of dying, which may 
afford confolation to all, but particularly to thofe who are afflict- 
ed with the fear of death. 
15. Orel timer. The fear of Hell. Many theatric preachers 
among the Methodifts fuccefsfully infpire this terror, and live 
comfortably upon the folly of their hearers. In this kind of 
maadnefs the poor patients frequently commit fuicide ; although 
they believe they run headlong into the Hell, which they dread ! 
Such is the power of oratory, and fuch the debility of the hu- 
man understanding I 
Thofe, who fuffer under this infanity, are generally the moft 
innocent and harmlefs people j who are then liable to accufe 
themfelves of the greatelf imaginary crimes, and have fo much 
intellectual cowardice, that they dare not reafon about thofe 
things, which they are directed by their pricfts to believe, how- 
ever contradictory to human apprehenfion, 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 be- 
come free from it. 
M. M. Where the intellectual cowardice is great, the voice 
of reafon is ineffectual; but that of ridicule may fave many 
from thofe mad-making doCtors; though it is too weak to cure 
thofe, who are already hallucinated. Foote's Farces are recom- 
mended for this purpofe, 
16. Satyriafts, An ungovernable delire of venereal indul- 
gence, The remote caufe is probably the ftimulus of the fe- 
mcn ; whence the phallus becomes diitended with blood by the 
arterial propultion of it being more ftrongly excited than the 
correfpondent venous abforption. At the fame time a new fenfe 
is produced in the other termination of the urethra ; which, like 
itching, requires fome exterior trillion to facilitate the removal 
of the caufe of the maniacal actions, which may probably be in- 
created in thofe cafes by fome affociated hallucinations of ideass 
It differs from priapifmus chronicus in the defire of its appro- 
priated objeCt, which is not experienced in the latter, Clafs I, 
1, 4. 6. and from the priapifmus amatorius, Clafs II. 1. 7. 9. in 
the maniacal actions in confequence of defire. The furor ute- 
rinus, or nymphomania, is a fimilar difeafe, 
M. M. VenefeCtion- Cathartics. Torpentia. Marriage, 
17. Ira. Anger is caufed by offended pride, We are not 
angry at breaking a bone, but become quite infane from the 
fmalleft ftrokeof a whip from an inferior, Ira furor brevis. An- 
ger ia not only itfclf a temporary madnefs, but is a frequent at* 
tendant 326 
DISEASES 
Class III. 1. 2.18. 
tendant on other infanities, and as, whenever it appears, it dif- 
tjnguifhes infinity from delirium, it is generally a good fign in 
fevers with debility. 
An injury voluntarily inflicted on us by others excites our ex- 
ertions of felf-defence or of revenge againft 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 produces fuch violent and general ex- 
ertions of our mufcles and ideas, as to difappoint the revenge 
we meditate, and vainly to exhauft our fenforial power. Hence 
angry people, if not further excited by difagreeable language, 
are liable in an hour or two to become humble, and forry for their 
violence, 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 counte- 
nance, or gefticulations of the arms, or clenched fifts ; as thefe 
by their former afl'oeiations with anger will contribute to in- 
creafe it. I have been told of a fergeant or corporal, who be- 
gan moderately to cane his foldiers, when they were awkward 
in their exercife, but being addicted to fwearing and coarfe lan- 
guage, he ufed foon to enrage himfelf by his own expreflions Of 
anger, till toward the end he was liable to beat the delinquents 
unmercifully. 
18. Rabies. Rage. A defire of biting others, moft frequent- 
ly attendant on canine madnefs. Animals in great pain, as in 
the colica faturnina, are faid to bite the ground they lie upon, 
and even their own flefh. I have feen patients bite the attend- 
ants, and even their own arms, in the epilepfia dolorifica. It 
feems to be an exertion to relieve pain, as explained in Seft. 
XXXIV. 1.3. The dread of water in hydrophobia is occafion- 
ed by the repeated painful attempts to fwallow it, and is there- 
fore not an eflential or original part of the difeafe called canine 
madnefs. See Clafs III. 1. 1. 15. 
There is a mania reported to exift in fome parts of the eaft, 
in which a man is faid to run a muck ; and thefe furious mani- 
acs are believed to have induced their calamity by unlucky gam- 
ing, and afterwards by taking large quantities of opium ; whence 
rhe pain of defpair is joined with the energy of drunkennefs ; 
they are then faid to fally forth into the moft populous ftreets, 
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 pain- 
ful epilepfy, the end of a rolled up towel, or a wedge of foft 
wood, fliould be put into the mouth of the patient. As a bul- 
let Class III. 1.2.19. 
OF VOLITION. 
327 
let is faid fometimes to be given to a foldier, who is to be fe- 
verely flogged, that he may by biting it better bear his punifli- 
ment. 
19. Citta. A defire to fwallow indigeftible fubftances. I 
once faw a young lady, about ten years of age, who filled her 
ftomach with the earth out of a flowcr-pot, and vomited it up 
with fmall ftones, bits of wood, and wings of infers amongft it. 
She had the bombycinous complexion, and looked like a chloro- 
tic patient, though fo young ; this generally proceeds from an 
acid in the ftomach. 
M. M. A vomit. Magnefia alba. Armenian bole. Rhu- 
barb. Bark. Steel. A blifter. See Clafs I. 2. 4. 5. 
20. Cacofitia. Averfion to food. This may arife, without 
difeafe of the ftomach, from connecting 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 
nourifliment, Oafs III. 1. 2. 1. 
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 tailing the griftle of fturgeon, afked 
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 perfuaded 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. Aflbciate agreeable ideas with thofe which difguft ; 
as call a fpider ingenious, a frog clean and innocent; and reprefs 
all expreflions of difguft by the countenance, as fuch exprelfions 
contribute to preferve, or even to increafe the energy of the ideas 
aflbciated with them ; as mentioned above in Species 17. Ira. 
21. Syphilis imagin aria. The fear that they are infected 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 
muft be given, and hopes of a cure added weekly and gradually 
by interview or correfpondence for fix or eight weeks. Many 
of thefe patients have been repeatedly falivated without curing 
the mind 1 
22. Pfora itnaginaria. I have twice feen an imaginary itch, 
and twice an imaginary diabetes, where there was not the leaft 
veftige of either of thofe difeafes, and once an imaginary deaf- 
nefs, where the patient heard perfectly well. In all thefe cafes the 
hallucinated idea is fo powerfully excited, that it is not to be 
changed 328 
DISEASES 
Class HI. n 2. up 
changed fuddenly "by ocular fenfation, or reafon. Yet great 
perfeverance in the frequently prefenting Contrary ideas will 
fometimes flowly remove this hallucination, or in great length 
of time oblivion, or forgetfulnefs, performs a cure, by other 
means in vain attempted. 
13. Tubes imaginariiu This imaginary difeafe, or hallucina- 
tion, is caufed by the fuppofed too great frequency of parting 
.with the femen, and had long impofed upon the phyfician as 
well as the patient, till Mr. John Hunter firft endeavoured to 
ihew, that in general the morbid effects of this pollution were 
in the imagination ; and that thofe were only liable to thofe ef- 
fects in general, who had been terrified by the villanous 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 impreflion of 
fear and felf-condemnation on their minds, and might be led to 
make contradictory complaints in almoft any part of the body, 
and if their confeflions could be depended on, had not ufed this 
pollution to any great excefs. 
M. M. 1. Aflure them if the lofs of the femen happens but 
twice a week, it will not injure them. 2. Marry them. The 
laft is a certain cure ; whether the difeafe be real or imaginary, 
Cold partial bath, and aftringent medicines frequently taken, on- 
ly recal the mind to the difeafe, or to the delinquency ; and 
thence increafe the imaginary effects and the real caufe, if fuch 
exifts. Mr. deftroyed himfelf to get free from the pain 
of fear of the fuppofed ill confequences of felf-pollution, without 
any other apparent difeafe ; whofe parents I had in vain advifed 
to marry him, if pofhble. 
24. Sympathia aliena. Pity. Our fympathy with the pleas- 
ures and pains of others diftinguifhes men from other animals j 
and is probably the foundation of what is termed our moral fenfe । 
and the fource of all our virtues. See Seft. XXII. 3. 3. 
When our fympathy with thofe miferies of mankind, which we 
cannot alleviate, rifes to excefs, the mind becomes its own tor- 
mentor ; and we add to the aggregate fum of human mifery, 
which we ought to labour to diminifh; as in the following elo- 
quent lamentation from Akenfide's Plcafures of Imagination, 
Book II. 1. 200. 
-« -- Dark, 
As midnight ftorms, the feene of human things 
Appear'd before me ; deferts, burning fands, 
Where the parch'd adder dies ; the frozen fouth ; 
And defolation blafting ail the weft 
With rapine and with murder. Tyrant power 
Here fits enthroned in blood ; the baleful charms 
OF Class III. i. 2. 25. 
OF1 VOLITION. 
329 
Of fuperftition there infeft the ikies, 
And turn the fun to horror. Gracious Heaven 1 
What is the life of man ? Or cannot thefe, 
Not thefe portents thy awful will fuffice ? 
That, propagated thus beyond their fcopet 
They, rife to a<ft their cruelties anew 
In my afflidled bofom, thus decreed 
The univerfal fenfitive of pain, 
'l'he wretched heir of evils not its own ! 
A poet of antiquity, whofe name I do not recollect, is laid to 
have written a book defcribing the miferies of the world, and to 
have deftroyed himfelfat the conclufion of his talk. This fym- 
pathy, 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 in feds to prey upon their bodies. 
Such is however the condition of mortality, that the firft law of 
nature is, " Eat or be eaten." We cannot long exift without 
the deltrudlion of other animal or vegetable beings, either in 
their mature or their embryon ftatc. Unlefs the fruits, which 
iurround the feeds of fome vegetables, or the honey ftolen from 
them by the bee, may be faid to be an exception to this afler- 
tion. See Botanic Garden, P. I. Cant. 1.1. 278. Note. Hence, 
from the neceflity of our nature, we may be fuppofed to have a 
right to kill thofe creatures, which we want to eat, or which 
want to eat us. But to deftroy even infects wantonly ihews an 
unreflecting mind or a depraved heart. 
Neverthelefs mankind may be well divided into the felfilh and 
the focial ; that is, into thofe whofe pleafures arife from grati- 
fying their appetites, and thofe whofe pleafures arife from their 
fympathifmg with others. And according to the prevalence of 
thefe oppofing propenfities we value or diflike the pofleflbr of 
them. 
In conducting 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 dif- 
trefs. We Ihould endeavour to make them alive to lympathize 
with all remediable evils, and at the fame time to arm them with 
fortitude to bear the fight of fuch irremediable evils, as the acci- 
dents of life muft frequently prefent before their eyes. ' About 
this I have treated more at large in a plan tor the conduct of a 
boarding-fchool for ladies, which I intend to publith in the courfe 
of the next year. 
25. Educatio heroica. From the kinds and degrees of infan- 
cies already enumerated, the reader will probably recollect ma- 
Vol. II. T t ny 330 
DISEASES 
Class III. i. 2. 25. 
ny more from his own obfervation ; he will perceive that all 
extraordinary exertions of voluntary a<flion in confequence of 
fome falfe idea or hallucination, which ftrongly affefts us, may 
philofophically, though not popularly, be termed an infanity ; 
he will then be liable to divide thefe voluntary exertions into 
difagreeable, pernicious, deteftable, or into meritorious, delecta- 
ble, and even amiable, infanities. And will laftly be induced 
to conceive, that a good education confifts in the art of produc- 
ing fuch happy hallucinations of ideas, as may be followed by 
fuch voluntary exertions, as may be termed meritorious or ami- 
able infanities. 
The old man of the mountain in Syria, who governed a fmall 
nation of people called Aflaflines, is recorded thus to have edu- 
cated thofe of his army who were defigned to aflaflinate the 
princes with whom he was at war. A young man of natural 
activity was chofen for the purpofe, and thrown into a deep 
Heep by opium mixed with his food; he was then carried into 
a garden made to reprefent the paradife of Mahomet, with flow- 
ers of great beauty and fragrance, fruits of delicious flavour, and 
beautiful Houries beckoning him into the (hades. After a 
while, on being a fecond time ftupificd with opium, the young 
enthufiaft was reconveyed to his apartment; and on the next day 
was affured by a prieft, that he was defigned for fome great ex- 
ploit, arid that by obeying the commands of their prince, im- 
mortal happinefs awaited him. 
Hence it is eafy to collect how the firft impreflions made on 
ns by accidental circumftances in our infancy continue through 
life to bias our affections, or miflead our judgments. One of 
my acquaintance can trace the origin of his own energies of ac- 
tion from fome fuch remote fources, which juftifies the obferva- 
tion of M. Roufleau, that the feeds of future virtues or vices 
are oftcner fown by the mother than the tutor. 
ORDO Class III. 2. 1. 
OF VOLITION. 
331 
ORDO II. 
Decreafed Volition. 
GENUS I. 
With decreafed Anions of the Mufcles. 
Our mufcles become fatigued by long contraction, and ceafe 
for a time to be excitable by the will; owing to exhauftion of 
the fenforial power, which refides in them. After a (hort inter- 
val of relaxation the mufcle regains its power of voluntary con- 
traCtion ; which is probably occafioned by a new fupply of the 
fpirit of animation. In weaker people thefe contractions ceafe 
fooner, and therefore recur more frequently, and are attended 
with fhorter intervals of relaxation, as exemplified in the quick- 
nefs 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 gradually reltored by the reft of 
the mufcle, and even accumulated in thofe mufcles, which are 
moft frequently ufed ; as in thofe which conftitute the capilla- 
ries 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 reftorcd by their quiefcence, or in fleep (for fleep af- 
fects 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 voli- 
tion, explains to us one caufe of their greater tendency to para- 
lytic affection. 
It muft be obferved, that thofe parts of the fyftem, which 
have been for a time quiefcent from want of ftimulus, as the 
veflels of the fkin, when expofed to cold, acquire an accumula- 
tion of fenforial power during their inactivity; but this does 
not happen at all, or in much lefs quantity, from their quief- 
cence after great expenditure of fenforial power by a previous 
exceflive ftimulus, as after intoxication. In this cafe the muf- 
cles or organs of fenfe gradually acquire their natural quantity 
of fenforial power, as after fleep ; but not an accumulation or 
fupcrabundance of it. And by frequent repetitions of exhauf- 
tion by great ftimulus, thefe veflels ceafe to acquire their whole 
natural quantity of fenforial power; as in the fcirrhous ftom- 
ach, and fcirrhous liver, occafioned by the great and frequent 
ftimulus 332 
DISEASES 
Class III. 2. 1.1. 
ftimulus of vinous fpirit; which may properly be termed irrita- 
tive paralyfis of thofe parts of the fyftem. 
In the fame manner in common palfies the inaCtion of the 
paralytic mufcle feems not to be owing to defeCt of the ftimu- 
lus of the will, but to exhauftion of fenforial power. Whence 
it frequently follows great exertion, as in SeCt. XXXIV. i. 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 
vifeera •, and others to afl'oeiation, as in impediment of fpeech ; 
yet though all thefe may become inexcitable, or dead, in refpeCl 
to that kind of ftimulus, which has previoufly exhaufted them, 
whether of volition, or fenfation, or irritation, or afl'oeiation, 
they may ftill in many cafes be excited by the others. 
SPECIES. 
I. LaJJitudo. Fatigue or wearinefs after much voluntary ex-? 
ertion. From the too great expenditure of fenforial power the 
mufcles are with difficulty brought again into voluntary con- 
traction ; and feem to require a greater quantity or energy of vo- 
lition for this purpofe. At the fame time they ftill remain obe- 
dient to the itimulus of agreeable 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 SeCt. XXXIV. 2. 6. Thefe muf- 
cles are likewife ftill obedient to the fenforial power of afTocia- 
tion, becaufe the motions when thus excited, are performed in 
their defigned directions, and are not broken into variety of gef- 
ticulation, as in St. Vitus's dance. 
A laffitude likewife frequently occurs with yawning at the 
beginning of ague-fits ; where the production of fenforial pow- 
er in the brain is lefs than its expenditure. For in this cafe the 
torpor may either originate in the brain, or the torpor-of feme 
diitant parts of the lyltem may by fympathy affeCt the brain, 
though in a lefs proportionate degree than the parts primarily 
affeCted. 
2. Facillatiofenilis. Some elderly people acquire a fee-faw 
motion of their bodies from one fide to the other, as they fit, 
like the ofcillation of a pendulum. By thefe motions the mui- 
cles, which preferve the perpendicularity of the body, are alter- 
nately quiefeent, and exerted ; and are thus lefs liable to fatigue 
or exhauftion. This therefore refembles 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- Class III. 2. 1. 3. 
OF VOLITION. 
333 
3- 2. 2. which originate from excefs of fenforial power, or from 
efforts to relieve difagreeable fenfation, and are afterwards con- 
tinued by habit. 
3. Tremor fenilis. Tremor of old age confifts of a perpetual 
trembling 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. Thefe tremors only exift when the affect- 
cd mufcles are excited into action, as in lifting a glafs to the 
mouth, or in writing, or in keeping rhe body upright; and ceafe 
again, when no voluntary exertion is attempted, as in lying 
down. Hence thefe tremors evidently originate from the too 
quick exhauftion of the leffened quantity of the fpirit of anima- 
tion. So many people tremble from fear or anger, when too 
great a parr of the fenforial power is exerted on the organs of 
fenfe, fo as to deprive the mufcles, which fupport the body 
ere<T, of their due quantity. 
4. Bracbiorum paralyfis. A numbnefs of the arms is a fre- 
quent fymptom in hydrops thoracis, as explained in Clafs I. 2. 
3. 14. and in Seif. XXIX. 5. 2.; it alfo accompanies the afthma 
dolorificum, Clafs III. 1. 1. 11. and is owing probably to the 
fame caufe in both. In the colica faturnina a paralyfis affects 
the wrifts, as appears on the patient extending his arm horizon- 
tally with the palm downwards, and is often attended with a tu- 
mor on the carpal or metacarpal bones. See Clafs IV. 2. 2. 10. 
and I. 2. 4. 8. 
Mr. M , a miner and well-Tinker, about three years ago, 
loft the power of contracting both his thumbs ; the balls or muf- 
cles 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 benumbed before, fo that he could not 
without difficulty clench them ; 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 dif- 
ferent kinds ; one the violent and continued action of the muf- 
cles, which deftroys by exhaufting the fenforial power ; and the 
other, the application of cold, which deftroys by defetft of ftim- 
ulus. The cold feems to have contributed to the paralyfis by 
its long application, as well as the continued exertion; but as 
during the torpor occalioned by the expofure to cold, if the de- 
gree of it be not fo great as to extinguifh life, the fenforial pow- 
er becomes accumulated; there is reafon to believe, that the ex- 
pofing a paralytic limb to the cold for a certain time, as by cov- 
ering 334 
DISEASES 
Class III. 2. 1.5. 
cring 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 reftore 
it to a Hate of voluntary excitability. As this accumulation of 
fenforial power, and confequent glow, feem, in the prefent cafe, 
feveral times to have contributed to reftore the numbnefs or ina- 
bility of thofe mufcles, which at length became paralytic. See 
Clafs I. 2. 3. 21. 
M. M. Ether externally. Friftion. Saline warm bath. 
Eleftricity. Mercurial ointment. See Clafs I. 2. 4. 8. 
5. Raucedo paralytica. Paralytic hoarfenefs confifts in the al- 
moft 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 open- 
ing or clofing the larynx. The voice generally returns fuddenly, 
even fo as to alarm the patient. A young lady, who had many 
months been aflefted 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 fhe was dancing at an aflembly. Was this 
owing to a greater exertion of volition than ufual I like the 
dumb young man, the fon of Crcefus, who is related to have 
cried out, when he faw his father's life endangered by the fword 
of his enemy, and to have continued to fpeak ever afterwards. 
Two young ladies in this complaint feemed to be cured by elec- 
tric (hocks pafled through the larynx every day for a fortnight. 
See Raucedo catarrhalis, Clafs II. 1. 3. 5. 
M. M. An emetic. Electric (hocks. Muftard-feed, a large 
fpoonful fwallowed whole, or a little bruifed, every morning. 
Valerian. Burnt fponge. Blifters on each fide of the larynx. 
Sea-bathing. A gargle of decoition of feneca. Friftion. Fre- 
quent endeavours to ihout and (ing. 
6. Vejica urinaria paralyfis. Paralyfis of the bladder is fre- 
quently a fymptom in irritative fever ; in this cafe the patient 
makes no water for a day or two ; and the tumor of the blad- 
der diftended with urine may be feen by the (hape of the abdo- 
men, as if girt by a cord below the navel, or diftinguiflied by 
the hand. Many patients in this fituation make no complaint, 
and fufler great injury by the inattention 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 prefled by the 
hand, whilft the patient is kept in a fitting or ereft pofture. See 
Clafs II. 2. 2. 6. 
M. M. Bark. Wine. Opium, a quarter of a grain every 
fix hours. Balfam of copaiva or of Peru. Tinfture of can- 
tharides 20 drops twice a day, or repeated fmall blifters. 
An Class III. 2. i. 7. 
OF VOLITION. 
335 
An inability to empty the bladder frequently occurs to elder- 
ly men, and is often fatal. This fom^times arifes from their 
having too long been reftrained from making water from acci- 
dental confinement in public fociety, or otherwife; whence the 
bladder has become fo far diftended as to become paralytic ; and 
not only this, but the neck of the bladder has become contracted 
fo as to refill the introduction of the catheter. In this deplora- 
ble cafe it has frequently happened, that the forcible efforts to 
introduce the catheter have perforated the urethra ; and the in- 
ftrument has been fuppofed to pafs into the bladder, when it has 
only patTed into the cellular membrane along the fide of it; of 
which I believe I have feen two or three in fiances ; and after- 
wards the part has become fo much inflamed as to render the 
introduction 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 reCtum ; which I believe is generally followed by an 
incurable ulcer. One patient, whom I faw in this fituation, be- 
gan to make a fpoonful of water after fix or feven days, and grad- 
ually in a few days emptied his bladder to about half its fize, 
and recovered ; but I believe he never afterwards was able com- 
pletely to evacuate it. 
In this fituation I lately advifed about two pounds of crude 
quickfilver to be poured down a glafs tube, which was part of a 
barometer 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 palled, as was 
fuppofed, into the bladder; on {landing ereft it did not return, 
but on kneeling down, and lying horizontally on his hands, the 
mercury readily returned ; and on this account it was believed 
to have pafled into the bladder, as it fo eafily returned, when the 
neck of the bladder was lower than the fundus of it. But nev- 
erthelefs 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 previous efforts to introduce a cathe- 
ter and bougie ; and that the mercury had palled on the outfide 
of the bladder into the cellular membrane. 
As the urethra is fo liable to be perforated by the forcible ef- 
forts to introduce the catheter, when the bladder is violent1} dif- 
tended in this deplorable difeafe, I Ihould ftrongly recommend 
the injection of a pound or two of crude mercury into the ure- 
thra to open by its weight the neck of the bladder previous to 
any violent or very frequent eflays with a catheter whether of 
metal or of elaftic refin. 
7. Recti paralyjis. Palfy of the return. The reHum intef- 
tinum, 336 
DISEASES 
Class III. 2. 1. 8, 
tinum, like the urinary bladder in the preceding article, pofTefles 
voluntary power of motion ; though thefe volitions are at times 
uncontrolable by the will, when the acrimony of the contained 
feces, or their bulk, ftimulates it to a greater degree. Hence it 
happen^, that this part is liable to lofe its voluntary power by 
paialyfis, but is dill liable to be ftimulated into action 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 voluntarily has ceafed, which occafions thefe two ref- 
ervoirs fo foon to regain, as the fever ceafes, their obedience to 
volition ; becaufe the paralyfis is thus Ihewn 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 fphinfler ani to pre- 
vent the conftant difcharge, which fhould have a firing put 
through it, by which it may be retracted. 
8. Parefts voluntaria. Indolence ; or inaptitude to voluntary 
action. This debility of the exertion of voluntary efforts pre- 
vents the accomplifhment of all great events in life. It often 
originates from a miftaken education, in which'pleafure or flat- 
tery is made the immediate motive of adtion, and not futue ad- 
vantage ; or what is termed duty. This obfervation is of great 
value to thofe, who attend to the education of their own chil- 
dren. I have feen one or two young married ladies of fortune, 
who perpetually became uneafy, and believed themfelves ill, a 
week after their arrival in the country, and continued fo uniform- 
ly during their ftay; yet on their return to London or Bath im- 
mediately lofi 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 tor- 
pid for want of this fiimulus, and could not amufe themfelves 
by any voluntary employment; but required ever after, either 
to be amufed by other people, or to be flattered into activity. 
This I fuppofe, in the other fex, to have fupplied one fource of 
ennui and fuicide. See Clafs III. i. 2. 11. 
9. Catalepfis is fometimes ufed for fixed fpafmodic contractions 
or tetanus, as defcribed in Seft. XXXIV. 1. 5. and in Clafs 
111. 1. 1. 13. but is properly Amply 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 appeared univerfally torpid. He fat in a 
chair in anv pofture he was put, ami held a glafs to his mouth 
for Class III. 2. 1. 10. 
OF VOLITION. 
337 
for many minutes without attempting to drink, or withdrawing 
his hand. He never fpoke, and it was at firft neceffary to 
compel him to drink broth ; he recovered in a few weeks with- 
out relapfe. 
io. Hemiplegia. Palfy of one fide confifts in the total difo- 
bedience of the affected mufcles to the power of volition. As 
the voluntary motions are not perpetually exerted, there is little 
fenforial power accumulated during their quiefcence, whence 
they are lefs liable to recover from torpor, and are thus more 
frequently left paralytic, or difobedient to the power of volition, 
though they are fometimes Hill alive to painful fenfation, as to 
the prick of a pin, and to heat; alfo to irritation, as in (iretch- 
ing and yawning; or to eledtric (hocks. 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 re- 
quired for this putpofe, it becomes difficult to know, whether 
the cure is owing to the effe& of medicines, or to the repeated, 
efforts of the voluntary power. 
The difpute, whether the nerves decuffate or crofs each other 
before they leave the cavities of the (kull or fpine, feems to be 
decided in the affirmative by comparative anatomy ; as the op- 
tic nerves of fome fiffi have been ihewn evidently to crofs each 
other; as feen by Haller, Eiem. Phyfiol. t. v. p. 349. Hence 
the application of blifters or of ether, or of warm fomentations, 
ffiouid be bn the fide of the head oppofite to that of the affected 
mufcles. This fubject ffiouid neverthelefs be nicely determin- 
ed, before any one ffiouid trepan for the hydrocephalus inter- 
nus, when the difeafe is (hewn to exift only on one fide of the 
brain, by a fquinting affecting but one eye ; as propofed in 
Clafs I. 2. 5. 4. Dr. Sommering has (hewn, that a true decuf- 
fation of the optic nerves in the human fubjeCt actually exifts, 
Elem. of Phyfiology by Blumenbach, tranflated by C. Caldwell, 
Philadelphia. This further appears probable from the oblique 
direction and infertion of each optic nerve, into the fide of the 
eye next to the nofe, in a dirett line from the oppofite fide of 
the brain. 
The vomiting, which generally attends the attack of hemiple- 
gia, is mentioned in Sect. XX. 8. and is fimilar to that attend- 
ing vertigo in fea-ficknefs, and at the commencement of fome 
fevers. Black (tools fometimes attend the commencement of 
hemiplegia, which is probaoly an effufion of blood from the 
biliary dudt, where the liver is previoully affected ; or fome blood 
may be derived to the intefiines by its efcaping from the vena 
cava into the receptacle of chyle during the diftrefs of the para- 
lytic attack ; and may be conveyed from thence into the intef- 
Vol. II. U u tines 338 
DISEASES 
Class III. 2. 1. 10. 
tines by the retrograde motions of the lafteals; as probably 
fometimes happens in diabetes. See SedT XXVII. 2. Palfyof 
one fide of the face is mentioned in Clafs II. 1. 4. 6. Paralyfis 
of the labieals, of the liver, and of the veins, which are defcrib- 
ed in Se6l. XXVIII. XXX. and XXVII. do not belong to this 
clafs, as they are not difeafes of voluntary motions. 
M. M. The electric fparks and fhocks, if ufed early in the 
difeafe, are frequently of lervice. A purge of aloes, or calo- 
mel. 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. Sud- 
den alarm. Frequent voluntary efforts. Externally ether. 
Volatile alkali. Fomentation on the head. Fridlion. When 
children, who have fuffered a hemiplegia, begin to ufe the af- 
fected arm, the other hand Ihould be tied up for half an hour 
three or four times a day; which obliges them at their play to 
ufe more frequent voluntary efforts with the difeafed limb, and 
thus fooner to reftore the diffevered affociations of motion. 
In hemiplegia, as well as toward the end of fome fevers with 
great debility, the parts about the loins are liable to mortify by 
the preffure of a continued recumbency upon them, and in part 
by the fridtion of thofe parts againft the fheet, as the patient 
Hides down again after being frequently raifed higher in his bed, 
to prevent which a pillow fhould be put beneath the under- 
fheet half way down the bed, as in Clafs II. 1. 2. 4. A folu- 
tion of fugar of lead, or white lead in fine powder, or a cerate 
of lapis calaminaris contributes to heal or to prevent thefe ex- 
coriations. But the moft efficacious preventive confifts in the 
patient's wearing a pair of linen drawers; by which means, 
when he Hides down in his bed, the friction will be between the 
fheet and his drawers, not between the Iheet and his Hein ; and 
this greater fridlion will in general prevent his Hiding down in 
bed, when his head and (boulders are raifed on more pillows, 
which will on this account alfo contribute much to his comfort; 
this is alfo worthy the attention of thofe dropfical patients, who 
are neceffitated to lie with the head raifed high in bed. 
When thefe patients have any difficulty of fwallowing, they 
fhould be raifed up when any fluid is put into the mouth, left it 
fhould fuffocate them. See Apopjexia, No. 16. Nor fhould 
young children be fed as they he on their backs, as they are 
then obliged to fwallow as much as the nurfc pleafes; like one 
of the punifhments formerly ufed in the inquifition, where the 
delinquent was made to fwallow many quarts of water, as he 
was chained down on his back, and was fuffbeated by it. 
Ln paralyfis of the wrifts from lead, Mr. Clutterbuck has late- 
ly Class III. 2. 1. 11. 
OF VOLITION. 
339 
ly publifhed fome fuccefsful cafes of the ufc of mercurial oint- 
ment. See Colica Saturnina, I. 2. 4. 8. See Clafs III. 2. 1.4. 
Dr. J. Alderton has lately much recommended the leaves of 
rhus toxicodendron (fumach), from i. gr. to iv. of the dried 
powder to be taken three or four times a day. Effay on Rhus 
Toxic. Johnton, London, 1793. But it is difficult to know 
what medicine is of fervice, as the movements of the mufcles 
mult again be learned, as in infancy, by frequent efforts. 
11. Paraplegia. A palfy of the lower half of the body di- 
vided horizontally. Animals may be conceived to have double 
bodies, one half in general refembling to exactly 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 vertebrae of the back ; by which 
all the nerves iituated 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 confequence 
difobedient to the power of volition. 
This fometimes occurs from an external injury, as a fall from 
an eminence ; of which I faw a deplorable inftance, where the 
bladder and redtum, as well as the. lower limbs, were deprived 
of to 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 action by irritation, as 
in ftretching or pandiculation, defcribed in Sedf. VII. 1. 3. 
But the moft frequent caufe of paraplegia is from a protuber- 
ance of one of the fpinal vertebrae ; which is owing to the in- 
nutrition or foftnefs of bones, defcribed in Clafs 1. 2. 2. 17. 
The cure of this deplorable difeafe is frequently effected by the 
flimulus of an iffue placed on each fide of the prominent fpine, 
as firlt publifhed by Mr. Pott. The other means recommend- 
ed in foftnefs of bones fhould alto be attended to ; both in re- 
fpedt to the internal medicines, and to the mechanical methods 
of fupperting, or extending the fpine ; which laft, however, in 
this cafe requires particular caution. 
12. Samnus. In deep all voluntary power is fufpended, fee 
Se€t. XVIII. An unufual quantity of deep is often produc- 
ed by weaknefs. In this cafe fmall dofes of opium, wine, 
and bark, may be given with advantage. For the periods of 
deep, fee Clafs IV. 2. 4. 1. 
The fubfequent ingenious obfervations on the frequency of 
the 340 
DISEASES 
Class III. 2. r. 12. 
the pulfe, which fometimes occurs in fleep, are copied front a 
letter of Dr. Currie of Liverpool to the autl^pr. 
" 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 in- 
creafe the frequency of my pulfe, while I fit upright, and have 
my attention engaged. But if I take a recumbent pofture af- 
ter eating, my pulfe becomes more frequent, efpecially if my 
mind be vacant, and I become drowfy ; and, if I flumber, 
this increafed frequency is more confiderable with heat and 
flufhing. 
" This I apprehend to be a general truth. The obfervation 
may be frequently made upon children ; and the reftlefs and fe- 
verifh nights experienced by many people after a full fupper are, 
I believe, owing to this caufe. The fupper occafions no incon- 
venience, whilft the perfon is upright and awake ; but, when 
he lies down and begins to fleep, efpecially if he does not per- 
fpire, the fymptoms above mentioned occur. Which may be 
thus explained in parr from your principles. When the power 
of volition is abolifhed, rhe other fenforial actions are increafed. 
In ordinary fleep this does not occafion increafed frequency of 
the pulfe ; but where fleep takes place during the procefs of di- 
gcftion, the digeftion itfelf goes on with increafed rapidity. 
Heat is excited in the fyftem fafter than it is expended ; and 
operating on the fenfitive actions, it carries them beyond the 
limitation of pleafure, producing, as is common in fuch 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 evo- 
lution of heat from the food in the procefs of digeftion. I doubt 
if this takes place to any confiderable degree, for I do not ob- 
ferve that the parts incumbent on the ftomach are increafed in 
heat during the moft hurried digeftion. It is on fome parts of 
the furface, but more particularly on the extremities of the body, 
that the increafed heat excited by digeftion appears, and the 
heat thus produced arifes, as it Ihould feem, from the fympa- 
thy between the ftomach and the veflels of the Ikin. The parts 
moft affected are the palms of the hands, and the foies of the 
feet. Even there the thermometer feldom rifes above 97 or 98 
degrees, a temperature not higher than that of the trunk of the 
body ; but three or four degrees higher than the common tem- 
perature of thefe parts, and therefore producing an uneafy fen- 
fation of heat, a fenfation increafed by the great fenfibility of the 
parts affefled. 
« That the increafed heat excited by digeftion in fleep is the 
caufe Class III. 2. 1. 12. 
OF VOLITION. 
341 
caufe of the accompanying fever, feems to be confirmed by ob- 
ferving, that if an incrcafed expenditure of heat accompanies 
the increafed generation of it (as when perfpiration on the ex- 
tremities or furfacc attends this kind of fleep) the frequent pulfe 
and flushed countenance do not occur, as I know by experi- 
ment. If, during the feverifh fleep already mentioned, I am 
awakened, and my attention engaged powerfully, my pulfe 
becomes almoft immediately flower, and the fever gradually fub- 
fides." 
From thefe obfervations of Dr. Currie it appears, that, while 
in common fleep the actions of the heart, arteries, and capillaries, 
are ftrengthened by the accumulation of fenforial power during 
the fufpenfion of voluntary action, and the pulfe in confequence 
becomes fuller and flower; in the feverifh fleep above defcrib- 
ed the actions of the heart, arteries, and capillaries, are quicken- 
ed as well as ftrengthened by their confent with the increafed 
actions of the ftomach, as well as by the ftimulus of the new 
chyle introduced into the circulation. For the ftomach, and all 
other parts of the fyftem, being more fenfible and more irritable 
during fleep, SecSt. XVIII. 15. and probably more ready to a<Et 
from aflbciation, are now exerted with greater velocity as well 
as ftrength, conftituting a temporary fever of the fenfitive irri- 
tated kind, refembling the fever excited by wine in the begin- 
ning of intoxication ; or in fome people by a full meal in their 
waking hours. SecSt. XXXV. 1. 
On waking, this increafed fenfibility and irritability of the 
fyftem ceafes by the renewed exertions of volition ; in the fame 
manner as more violent exertions of volition deftroy greater 
pains; and the pulfe in confequence fubfides along with the in- 
creafe of heat; if more violent efforts of volition are exerted, 
the fyftem becomes ftill lefs affecSted by fenfation or irritation. 
Hence the fever and vertigo of intoxication are leffened by in- 
tenfe thinking, SecSt. XXI. 8 ; and infane people are known to 
bear the pain of cold and hunger better than others, SecSt. 
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 acStion, and a voluntary fever is induced, as 
appears 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 naturah de- 
gree diminifhes the increafed fenfibility, and irritability, and 
probably the increafed affociability, which occur during ileep ; 
and thus reduces the frequency of the pulfe in the feverifh fleep 
after a full meal. In its more powerful ftate of exertion, it di- 
minifhes 342 
DISEASES 
Class III. 2. 1. 13. 
miniflies or cleftroys fenfations and irritations, which are ftronger 
than natural, as in intoxication, or which precede convulfions, 
or infanity. In its ftill more powerful degree, the fuperabun- 
dance 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 an- 
ger, or outrageous infanities. 
If, in the feverifli fleep above defcribed, the Ikin becomes cool- 
ed by the evaporation of much perfpirable matter, or by the ap- 
plication of cooler air, or thinner clothes, the actions of the cu- 
taneous capillaries are leflened by defeat 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 
leflened ftimulus of the particles of blood thus cooled in the cu- 
taneous and pulmonary veflels. Hence the admiflion of cold 
air, or ablution with fubtepid or with cold water, in fevers with 
hot Ikin, whether they be attended with arterial ftrength, or ar- 
terial debility, renders the pulfe flower ; in the former cafe by 
diminilhing the ftimulus of tire blood, and in the latter by lef- 
fening the expenditure of fenforial power. See Suppl. I. 8. 
and 15. 
13. Incubus. The night-mare is an imperfecT fleep, where 
the defire of locomotion is vehement, but the mufcles do not 
obey the will; it is attended with great uneafinefs, a fenfe of 
fuffbeation, and frequently 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 com- 
plaint 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 fu- 
pervene ; as in fome haemorrhages of the lungs, which occur 
during fleep; and in patients much debilitated by fevers. See 
Somnus interruptus, Clafs I. 2. 1.3. and I. 2. 1. 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 
fyftem is much decreafed by fatigue, as it exhaufts the fenforial 
power ; and fecondly, too much wine and ftimulating 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 great quantity of aliment; and in increafing 
the motions of the organs of fenfe in confequence of fome de- 
gree Class III. 2. 1.14. 
OF VOLITION. 
343 
gree of intoxication, whence difficulty of breathing may occur 
from the inirritability of the lungs, as in Clafs I. 2. 1. 3. 
This explains an apparent paradox, why people who are fee- 
ble, digeft their dinners belt, if they lie down and Heep, as molt 
animals do, when their ftomachs are full. Yet many weak peo- 
ple fleep very uneafily after a large fupper. If the debility of 
the patient be not very great, and the dinner he has taken, be 
moderate, the fufpenfion of voluntary aft ion during fleep pre- 
vents the expenditure of fo much fenforial power, which may 
be employed on the actions of the flomach, and thus facilitate 
the digeftive procefs. If the patient be further exhaufted as in 
the evening, or his debility greater, and fleep enfues after a co- 
pious or Simulating fupper, fo much fenforial power will be 
exerted on the a&ions of the ftomach for digeftion, that the 
circulation of the blood through the lungs will be impeded from 
the diminiffied irritability to external ftimuli, and the abfence 
of volition, as in the incubus, and fomnus interruptus. 
M. M. To fleep on a hard bed with the head raifed. Mod- 
erate fupper. The bark. By fleeping on a harder bed the pa- 
tient will turn himfelf more frequently, and not be liable to 
fleep too profoundly, 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 preflure on the brain, and 
is faid to be produced by compreffing the fpinal marrow, where 
there is a deficiency of the bone in the fpina bifida. See Se£l. 
XVIII. 20. Whereas in the hydrocephalus there is only a par- 
tial preflure of the brain ; and probably in nervous fevers with 
ftupor the preflure 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 apopledtic ftu- 
por the pulfe is flow as in fleep, whereas in nervous fever the 
pulfe is very quick and feeble, and generally fo in hydrocephalus. 
In cafes of obftru&ed kidneys, whether owing to the tubuli 
uriniferi being totally obftrufted 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 epHeptica, is a temporary apoplexy, the pulfe con- 
tinuing in its natural ftate, and the voluntary power fufpended. 
This terminates the paroxyfms of epilepfy. 
When the animal power is much exhaufted by the preced- 
ing convulfions, fo that the motions from fenfation as well as 
thofe from volition are fufpended ; in a quarter or half an hour 
the 344 
DISEASES 
Class III. 2. 1. 16* 
the fenforial power becomes reftored, and if no pain, or irrita- 
tion 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 fyn- 
cope. See Epilepfy, Clafs III. i. i. 7. 
16. Apcplexia. Apoplexy may be termed an univerfal palfy, 
or a permanent fleep. In which, where the pulfe is weak, co- 
pious bleeding mult 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 receive no benefit from this operation ; but 
gradually funk, and lived but a day or two. 
If apoplexy arifes from the preflure of blood extravafated on 
the brain, one moderate venefeCtion may be of fervice to pre- 
vent the further efFulion of blood ; but copious venefeCtion mull 
be injurious by weakening the patient; fince the effufed blood 
muft have time, as in common vibices or bruifes, to undergo a 
chemico-animal procefs, fo to change its nature as to fit it for 
abforption; which may take two or three weeks, which time a 
patient weakened by repeated venefetlion or arteriotomy may 
not furvive. 
Mrs. about 40 years old, had an apoplectic feizure af- 
ter great exertion from fear ; fhe had lain about 24 hours with- 
out fpeech, or having fwallowed any liquid. She was then forci- 
bly railed in bed, and a fpoonful of folution of aloes in wine put 
into her mouth, and the end of the fpoon withdrawn, that ihe 
might more eaiily fwallow the liquid.-This was done every 
hour, with broth, and wine and water intervening, till evacua- 
tions were procured ; which with other means had good effect, 
and fhe recovered, except that a confiderable degree of hemiple- 
gia remained, and fome imperfection of her fpeech. 
Many people, who have taken fo much vinous fpirit as to ac- 
quire the temporary apoplexy of intoxication, and are not im- 
properly faid to be dead-drunk, have died after copious veuefec- 
tion, I fuppofe in confequence 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 degrees of intox- 
ication. 
M. M. Cupping on the occiput. Venefe&ion once in mod- 
erate CtAss III. 2. 1.17. 
OF VOLITION. 
345 
erate quantity. Warm fomentations long continued and fre- 
qu<?ntly repeated on the fhaved head. Solution of aloes. Clyf- 
ters with folution of aloes and oil of amber. A blifter on the 
fpine. An emetic. Afterwards the bark, and fmall dofes of 
chalybeates. Small electric {hocks through the head. Errhines. 
If fmall dofes of opium ? mercurial ointment rubbed on the 
head or neck ? 
Where there is a difficulty of fwallowing in apoplectic or par- 
alytic patients, or in thofe near death in fevers, or other difeaf- 
es, no fluid fhould be put into their mouths as they lie upon 
their backs, left it fhould choke them; but they fhould be raifed 
and fupported upright in their beds, and ftimulated by ftrong 
light, and fpoken to in a louder voice, defiring them to (wallow, 
as the fluid is put into the mouth, and the fpoon fhould be im- 
mediately withdrawn, that they may clofe their mouths. Hence 
if they cannot fwallow, it will flow out of their mouths, and not 
endanger fuffocating them. See Hemiplegia, Spec, to, of this 
genus. 
17. Mors a fr'tgore. Death from cold. The unfortunate 
travellers, who almoft every winter perifh in the (now, are much 
exhaufted by their efforts to proceed on their journey, as 
well as benumbed by cold. And as much greater exercife 
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 wafte of fenforial power; it may 
be inferred, that the fatigued traveller becomes paralytic from 
violent exertion as well as by the application of cold. 
Great degrees of cold affeCt the motions of thofe veffels moft, 
which have been generally excited into action 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 objects, 
the voluntary mufcles retain their motions, and we continue to 
walk on ; the fame happens to the fingers of children in throw- 
ing fnow-balls, the voluntary motions of the mufcles continue, 
though thofe of the cutaneous veffels are benumbed into inac- 
tivity. 
Mr. Thompfon, an elderly gentleman of Shrewihury, 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 exertion to fave his relation, perifhed himfelf. Sec 
Sect. XXXIV. 1. 7. 
Whence I conclude, that, though heat is a fluid neceffary to 
mufcular motion, both perhaps by its ftimulus, and by its keep- 
ing the minute component parts of the ultimate fibrils of the 
Vol. II. W w mufcles 346 
DISEASES 
Class III. 2.1.i7- 
mufcles or organs of fenfe at a proper diftance from each other ; 
yet paralyfis, properly fo called, is the confequence of exhauf- 
tion of fenforial power by exertion. And that the accumula- 
tions 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 inftrumental in recovering the ufe of paralytic limbs, 
or of the motions of other paralytic parts of the fyltem. See 
Spec. 4. of this genus. 
Animal bodies refill the power of cold probably by their ex- 
ertions 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 exhauft the fenforial power in producing un- 
neceflary motions, the animal will probably fooner perifh. Thus 
a moderate quantity of wine or fpirit repeated at proper inter- 
vals of time might be of fervice to thofe, who are long expofed 
to excefiive cold, both by increafing the action of the capillary 
veflels, 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 glafles 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 af- 
fiftance his companion could afford him ; and the other perform- 
ed his journey with fafety. In this cafe the fenforial power was 
exhaulled by the unneceflary 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 dellroyed him ; that is, he had not power to produce fuf- 
ficient mufcular or arterial action, and in confequence fufficient 
heat, to fupply the great expenditure of it. Hence the capilla- 
ries of the ikin firft ceafed to a6l, and became pale and empty; 
next thofe which are immediately aflbeiated with them, as the 
extremities of the pulmonary 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 affected by its compref- 
lion ; becaufe thefe patients are faid to deep, or to become apo- 
plectic, before they die. I overtook a fifherman 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 fre- 
quently be faved by covering themfclves in it, except a final! 
aperture for air ; in which fituation the lives of hares, fheep, 
and Class III. 2. 1. 17. 
OF VOLITION. 
347 
and other animals, are fo often preferred. The fnow, both in 
refpeft 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 dif- 
folves, is attracted into the pores of the remainder of it, the fit- 
uation 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 
ist 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 Ane- 
mone, Barometz, and Mufcus. If thefe fa&s were more gen- 
erally underftood, it might annually fave the lives of many. 
After any part of the vafcular fyllem of the body has been 
long expofed to the cold, the fenforial power is fo much accu- 
mulated in it, that on coming into a warm room the pain of hot- 
ach is produced, and inflammation, and confequent mortifica- 
tion, owing to the great exertion of thofe veflels, when again ex- 
pofed to a moderate degree of warmth. See Sett. 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 flate of 
diflblving, which is at 32 degrees 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, they do not lofe their tafte ; if this fadt 
was well afeertained, it might teach us how to preferve other 
ripe fruits in ice-houfes for winter confumption. See Suppl. I. 
14- 3- 
The pain of coldis probably owing to the accumulation of the 
fenforial power of irritation. As the Ikins of thofe, who have 
been conftantly Simulated into great action by external heat, 
mull foon poflefs an accumulation of that fenforial power, when 
the ftimulus of heat is withdrawn. See taedium vitae from ac- 
cumulation of the fenforial power of volition. III. 1. 2. 11. 
ORDO 348 
DISEASES 
Class III. 2. 2. 1. 
ORDO II. 
Decreafed Volition. 
GENUS II. 
With decreafed Actions of the Organs of Senfe. 
SPECIES. 
j. RecolleHionis jaflura. Lofs of recollection. This is the 
defeCt of memory in old people, who forget the aCtions of yef- 
ferday, being incapable of voluntary recollection, and yet re- 
member thole of their youth, which by frequent repetition arc 
introduced by aflbciation or fuggeftion. This is properly the 
paralyfis of the mind ; the organs of fenfe do not obey the vol- 
untary power ; that is, our ideas cannot be recolleCted, or aCted 
over again by the will. 
After an apopleCtic attack the patients, on beginning to re- 
cover, find themfelves moft at a lofs in recolleCling proper names 
of perfons or places; as thofe words have not been fo frequent- 
ly aflbciated with the ideas they ftand for, as the common words 
of a language. Mr. , a man of ftrong mind, of a ihort- 
necked family, many of whom had fuffered by apoplexy, after 
an apopleCtic fit, on his recovering the ufe of fpeech, after re- 
peated trials to remember the name of a perfon or place, applaud- 
ed himfelf, when he fucceeded, with fuch a childifh fmile on the 
partial return of his fagacity, as very much affected me.-Not 
long, alas ! to return; for another attack in a few weeks de- 
ftroyed the whole. See Clafs IV. 2. 3. 8. 
I taw a child after the fmall-pox, which was left in this fitua- 
tion ; it was lively, aCtive, and even vigorous ; but fhewed that 
kind of furprife, which novelty excites, at every objeCt it view- 
ed ; and that as often as it viewed it. I never heard the termin- 
ation of the cafe. 
2. Stultitia voluntaria. Voluntary folly. The abfence 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 aClion only 
by their prefent painful or pleafurable fenfations. Hence though 
they are liable to furprife, when their palling trains of ideas are 
diffevered by violent ftimuli; yet are they not afleCled with 
wonder or allonilhment at the novelty of objeCts; as they pof- 
fcfs but in a very inferior degree, that voluntary power of com- 
paring Class III. 2. 2. 3. 
OF VOLITION. 
349 
paring the prefent ideas with thofe previouily acquired, which 
diftinguifhes 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 confident with truth and nature. See 
Sed. XVII. 3. 7. 
3. Ratiocinatio verbofa. Verbal reafoning. This arifes from 
the feeble or inaccurate exertions of the faculty of volition in the 
aft of recalling the ideas of things, and thus miftaking the ideas 
of words for them. One great imperfeftion of language con- 
fifts in the ufe of what Mr. Horne Tooke calls general terms, as 
mentioned in Seft. XV. 1. 5. and Seft. XVI. 17. of this work, 
and which Mr. Locke fuppofcd to exprefs abfti afted or general 
ideas, fuch as the word caftle or army, which in common con- 
verfation includes any part or property of thofe complex things, 
and is thus liable to miflead inaccurate thinkers. Thus it was 
faid lad night, " That horfe drikes fire as he pafles along the 
pavement." And it was added jocularly, " that his feet mud 
be as hard as iron," which midake might arife from the general 
term, horfe, including in common converfation both every part 
of the animal and his accoutrements. 
A fecond fource of falfe reafoning may arife from the fame 
word having two lignifications totally different from each oth- 
er ; which may miflead thofe who reafon from ideas of words 
indead of ideas of things. Thefe are generally edeemed witti- 
cifms, and are called puns or quibbles ; as the jocular fyllogifm 
on the word fpirit. " Brandy is a fpirit; the Devil is a fpirit j 
therefore brandy is the devil." 
A third fource of falfe reafoning is derived from the two-fold 
meaning of fome fentences, or phrafes in all languages ; this is 
alfo ufed defignedly in jocular compofitions, and conftitutes the 
wit of fome comedies. An old miller riding on his fack of 
flour was accolted by two young Cantabs, who rode on each fide 
of him, with " Gentlemen of your profeflion have fomctimes a 
doubtful charafter-pray, miller, do you think yourfelf more 
knave or fool ?" the witty miller anfwered, looking firft at one 
of them and then at the other, " I think myfelf at prefent be- 
tween both." This double entendre of a fentence was ufed by 
the priefts of the ancient oracles to deceive the inquirer into fu- 
ture events. As that of 
Aio te, ^acide, Romanos vincere poffe. 
1 fay, that you, TEacides, the Romans {hall conquer. 
There is a fourth mode of verbofe ratiocination, which con- 
Cfts in the conclufion of the fyllogifm sontaining an imaginary, 
but 350 
DISEASES 
Class III. 2. 2. 4. 
but not even a verbal analogy to the preceding propositions. 
Thus a ruftic devotee faid to his prieft, " I have often wonder- 
ed, why God rklmighty called the firft man Adam ?" " Don't 
you know," replied the teacher, "that A is the firft letter of the 
alphabet ?" « Aye, fo it is," anfwered the contented inquirer. 
Another kind of falfe reafoning is called by logicians a logic- 
al vice ; and another kind arifes from the firft propofition being 
untrue in refpeft to its exiftence : buc as all thefe, and perhaps 
many other Sources of falfe reafonings, may be refolved into the 
miftaken ufe of ideas of words, or general terms, inftead of ideas 
of the things, or parts of things, which they ought to fuggeft ; 
they belong properly to this article of ratiocinatio verbofa : 
while the rare faculty of reafoning without words by comparing 
ideas of things, as in the invention of new machines, and other 
new difeoveries, diftinguifhes the philofopher from the fophift. 
M. hl. Children ihould be permitted to ufe their hands early 
in their infancy, and Ihould be fupplied with pencils, pens, and 
various tools ; by which they will acquire accurate ideas of ex- 
ternal things by the organ of touch, at the fame time that they 
acquire words; and will thence be lefs liable to be feriouily de- 
ceived by general terms, or by the double meanings of words, 
or of Sentences, or laftly by falfe propofitions or inconclufive de- 
ductions ; and will thus be enabled to compare the analogies of 
things, and to think without words ; the faculty, which confti- 
tutes genius, and which fo few poflefs ! 
4. Credulitas. Credulity. Life is fhort, opportunities of 
knowledge rare; our fenfes are fallacious, our reafonings un- 
certain, man therefore ftruggles 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 
Satisfied in the belief of fadts 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 
milled and enllavtd mankind ; philofophy has in all ages en- 
deavoured to oppofe their progrefs, and to loofen the (hackles 
they had impofed ; philofophers have on this account been called 
unbelievers: unbelievers of what ? of the fictions of fancy, of 
witchcraft, hobgobblins, apparitions, vampires, fairies ; of the 
influence of ftars on human actions, miracles wrought by the 
bones of faints, the flights of ominous birds, the predictions 
from the bowels of dying animals, expounders of dreams, for- 
tune-tellers, conjurors, modern prophets, necromancy, cheiro- 
mancy, animal magnetifm, metallic tractors, with endlefs varie- 
ty Class III. 2. 2. 4. 
OF VOLITION. 
351 
ty of folly ? Thefe they have dilbelieved and defpifed, but have 
ever bowed their hoary heads to Truth and Nature. 
Mankind may be divided in refpeCt to the facility of their be- 
lief or conviction into two clafles ; thofe, who are ready to af- 
fent to fingle fads from the evidence of their fenfes, or from the 
ferious afl'ertions of others ; and thofe, who require analogy to 
corroborate or authenticate them. 
Our firft knowledge is acquired by our fenfes; but thefe are 
liable to deceive us, and we learn to dete& thefe deceptions by 
comparing the ideas prefented to us by one fenfe with thofe pre- 
fented by another. Thus when we Hr ft view a cylinder, it ap- 
pears to the eye as a flat furface with different fhades on it, till we 
correCt 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 own image in a looking-glafs, it believes that anoth- 
er animal exifts before it, and detects this fallacy by going be- 
hind the glafsto examine, if another tangible animal really exilts 
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 inftruftois, which affeCt all our future reafoning by their 
perpetual intrufions ; as thofe habits of mufcular aClions of the 
face or limbs, which are called tricks, when contracted in infan- 
cy continue to the end of our lives. 
A third great fource of error is the vivacity of our ideas of 
imagination, which perpetually intrude themfelves by various 
aflbeiations, 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 fucceflions 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 men- 
tioned, 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 
'poflefling much knowledge of the ufual courfe of nature ; and 
fecondly, thofe are 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 eleClrized coat- 
ed 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 fimilar in nature to 
compare 352 
DISEASES 
Class III. 2. 2. 4^ 
compare them to, he would again and again repeat the experi- 
ment, before he would give it his entire credence ; till by thefe 
repetitions it would ceafe to be a Tingle fait, and would there- 
fore gain the evidence of analogy. But the latter, as having lefs 
knowledge of nature, and lefs facility of voluntary exertion, 
would more readily believe the aflertions of others, or a fingle 
fact, as prefented to his own obfervation. Of this kind are the 
bulk of mankind ; they continue throughout their lives in a hate 
of childhood, and have thus been the dupes of priefts and poli- 
ticians in all countries and in all ages of the world. 
In regard to religious matters, there is an intellectual coward- 
ice inftilled into the minds of the people from their infancy; 
which prevents their inquiry : credulity is made an indifpenfable 
virtue ; to inquire or exert their reafon in religious matters is de- 
nounced as finful ; and in the catholic church is punifhed with 
more fevere penances than moral crimes. But in refpeCt to 
our belief of the fuppofed medical faCts, which are published by 
variety of authors ; many of whom are ignorant, and therefore 
credulous ; the golden rule of David Hume may be applied 
with great advantage. « When two miraculous aflertions op- 
pofe 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 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 appears 
therefore lefs miraculous, that the aflertor of this fuppofed fait 
has been deceived, or wifhes to deceive, than that it has fo hap- 
pened 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 coun- 
teract the fallacies of our fenfes, to emancipate ourfelves from 
the falfc impreflions, which we have imbibed in our infancy, and 
to fet the faculty of reafon above that of imagination. 
The Class IV. 
OF ASSOCIATION. 
353 
The Orders and Genera of the fourth Olafs of Difeafes* 
CLASS IV. 
DISEASES OF ASSOCIATION. 
ORDO I. 
Increafed Ajfociate Motions. 
GENERA. 
I. Catenated with irritative motions. 
2. Catenated with fenfitive motions. 
3. Catenated with voluntary motions. 
4. Catenated with external influenced. 
ORDO II. 
Decreafed Ajfociate Motions. 
GENERA. 
t. Catenated with irritative motions. 
2. Catenated with fenfitive motions. 
3- Catenated with voluntary motions. 
4. Catenated with external influences. 
ORDO III. 
Retrograde Ajfociate Motions. 
GENERA. 
i. Catenated with irritative motions. 
2. Catenated with fenfitive motions. 
3. Catenated with voluntary motions. 
4. Catenated with external influences. 
Vot. II/ 
Xx 
The 354 
DISEASES 
Class IV. t. h 
The Orders, Genera, and Species, of the Fourth Clafs of 
Dijeafes. 
CLASS IV. 
DISEASES OF ASSOCIATION. 
ORDO I. 
Increafed AJJociate Motions. 
GENUS I. 
Catenated 'with Irritative Motions. 
SPECIES. 
I. Rubor vultus pranforum. 
2. Sudorjragulis intmerforum. 
3. Cejfatio cegritudinis cute ex^ 
citata. 
4. Digejlio aucla jrigore cuta- 
nea. 
5. Catarrhus a frigore cutaneo. 
6. Abforptio cellularis aucia 
vomttu. 
Singultus nephriticus. 
8. Febris irritativa. 
Flulhing of the face after din* 
ner. 
Sweat from covering the face 
in bed. 
Cure of ficknefs by ftimulating 
the fkin. 
Digeftion increafed by cold* 
nefs of the (kin. 
Catarrh from cold Ikin. 
Cellular abforption increafed 
by vomiting. 
Nephritic hiccough. 
Irritative fever. 
GENUS II. 
Catenated 'With Senfitive Motions. 
I. Lacrymarum fluxits fympa- 
theticus. 
2. Sternutatio a lumine. 
3. Dolor dentium a jlridore. 
4. Rifus fardonicus. 
5. Saliva jluxus cibo vifo. 
6. Tenjio mammuldrum vifo 
puerula. 
7. Tenjio penis in hydrophobia. 
SPECIES. 
Sympathetic tears. 
Sneezing from light. 
Tooth-edge from grating 
founds. 
Sardonic fmile. 
Flux of faliva at fight of food. 
Tenfion of the nipples of lac* 
tefcent women at fight of 
the child. 
Tenfion of the penis in hydro- 
phobia. 
8. Tenefmue Class IV. 1. 3. 
OF ASSOCIATION. 
355 
8. 'Tenefmus calculafus. 
9. Polypus narium ex afcaride. 
IO. Crampus fur arum in diar- 
rhoea. 
11. 'Zona ignea nephritica, 
12. Erupt io variolarum. 
13. Gutta rofeaJlomatica. 
14. hepatica, 
15. Podagra. 
16. Rheumatifmus. 
17. Eryfipelas. 
18. Tejlium tumor in gonorrhoea. 
19. ■ „ in parotitide. 
Tenefmus from ftone. 
Polypus of the nofe from af- 
carides. 
Cramp from diarrhoea. 
Nephritic thingies. 
Eruption of fmall-pox. 
Stomatic rofy drop. 
Hepatic rofy drop. 
Gout. 
Rheumatifm. 
Eryfipelas. 
Swelled teftis in gonorrhoea. 
in mumps. 
GENUS III. 
Catenated with Voluntary Motions, 
SPECIES. 
I. Deglutitio invita. 
2. Niflitatio invita. 
3. Rifus invitus. 
4. Lufus digitorum invitus. 
$. Unguium morjiuncula invita. 
6. Vigilia invita. 
Involuntary deglutition. 
nictitation. 
laughter. 
aClions with the 
fingers. 
biting the nails. 
watchfulnefs. 
GENUS IV. 
Catenated with External Influences. 
SPECIES. 
i. Vita ovi. 
2. Vita hiemi-dormientium. 
3. Pullulatio arborum. 
4. Orgajinatis venerei periodus. 
5. Brachii concujjio eleBrica. 
6. Oxygenatio fanguinis. 
7. Humeftatio corporis. 
Life of an egg. 
Life of winter-fleepers. 
Budding of trees. 
Periods of venereal defire, 
Electric fhock through the arm. 
Oxygenation of the blood. 
Uume€Iation of the body. 
ORDO II. 
Dccreafed Ajjbciate Motions. 
GENUS I. 
Catenated with Irritative Motions. 
SPECIES. 
I. Cutis frigida pranforum. 
Chillnefs after dinner. 
2. Pallor 356 
DISEASES 
Class IV. 2. 
2. Pallor urincc pranforum. 
3. afrigore cutanea. 
4. Pallor ex icgrit udine. 
5. Dyfpnoea a balneo frigido. 
6. Dyfpepfa a pedibus frigidis. 
7. Tujfis a pedibus frigidis. 
8. hepatica. 
9. arthritica. 
io. Vertigo rotatoria. 
II. vifualii) 
12. ebriofa. 
13. febriculofa. 
14. cerebro/a. 
15. Murmur aurium vertigin- 
efum. 
16. Tact us, gujius, olfactus ver- 
tiginofi. 
17. Pulfus mollis a vomit ione. 
18. irterniittens a ven- 
triculo. 
Ip. Febris inirritativa. 
Pale urine after dinner. 
from cold Ikin. 
Palenefs from ficknefs. 
Shortnefs of breath from cold 
bathing. 
Indigeftion.from cold feet. . 
Cough from cold feet. 
Liver-cough. 
Gout-cough. - .1 
Vertigo rotatory. 
vifual. 
■ inebriate, 
• feverifh. 
from the brain. 
Noife in the ears. 
Vertiginous touch, tafte, fmelL 
Soft pulfe in vomitting. 
Intermittent pulfe from the 
ftomach. 
Inirritative fever. 
GENUS II. 
Catenated with Senfitive Motions. 
SPECIES. 
I. Torpor genic a dolore dentis. 
Z. Stranguria a dolore vfica. 
3. . convulfva. 
4. Dolor termini duclus chole- 
dochi. 
5. Dolor pharyngis abacido gaf- 
trico. 
6. Pruritus nariumavermibus. 
7. Cephalcea. 
8. Hemicrania et otalgia. 
9. Dolor humeri in hepatidide. 
I o. Torpor pedum variola erum- 
pente. • 
It. Tejlium dolor nephriticus. 
12. Dolor digiti minimi fympa- 
thtticus. 
Coldnefs of the cheek from 
tooth-ach. 
Strangury from pain of the 
bladder. . . 
Convulfive ftrangury. 
Pain of the end of the bile-* 
du€t. 
Pain of the throat from gaftric 
acid. 
Itching of thenofe from worms. 
Head-ach. 
Partial head-ach, and ear-ach. 
Pain of fhoulder in hepatitis. 
Cold feet in eruption of fmall- 
pox. 
Nephritic pain of teftis. 
Pain of little finger from fym- 
pathy, 
13. Daler Class IV. 2. 3. 
OF ASSOCIATION. 
357 
13. Dolor brachii in hydrope pec- 
toris. 
14. Diarrhoea a dentitions. 
Pain of the arm in dropfy cf 
the chelt. 
Diarrhoea from toothing. 
GENUS III. 
Catenated •with Voluntary Motions. 
SPECIES. 
I. Titubatio Ungu#. 
2. Chorea fancti Viti. 
3- Rif"s- 
4. Tre mo re 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. 
Slownefs from palfy. 
of age. 
• Q 
GENUS IV. 
Catenated 'with External Influences. 
I. Somni periodus. 
2. Studii inanis periodus. 
3. Hemicrania periodus. 
4. Epilepfue dolorificie periodus. 
Convulflonis dolor 'ifica peri, 
odus. 
6. Tuflis periodica periodus. 
7. Catamenia: periodus. 
8. Hamorrhoidis periodus. 
9. Podagra periodus. 
jo. Eryjipilatis periodus. 
j 1. Febrium periodus.- 
SPECIES, 
Periods of fleep. 
of reverie. 
-• of head-ach. 
of painful epilepfy. 
of painful convulfion, 
of periodic cough. 
• of catamenia. 
of the piles. 
• of the gout. 
of eryfipelas. 
- of fevers. 
ORDO III. 
Retrograde Ajflociate Motions. 
GENUS I. 
Catenated •with Irritative Motions. 
SPECIES. 
I. Diabetes irrltata. 
2. Sudor firigidus in ajlhmate. 
3. Diabetes a timore. 
4. Diarrhoea a timore, 
Diabetes from irritation. 
Cold fweat in afthma. 
Diabetes from fear. 
Diarrhoea from fear. 
5. Pallor 358 
DISEASES 
Class IV. 3. 2. 
5. Pallor et tremor a timore. 
6. Palpitatio cordis a timers. 
*]. Abortio a timore. 
8. Hfleria a timore. 
Palenefs and trembling from 
fear. 
Palpitation of the heart from 
fear. 
Abortion from fear. 
Hyfterics from fear. 
GENUS II. 
Catenated with Sensitive Motions. 
I. Naufea idealis. 
2. a conceptu. 
3. Vomitio vertiginofa. 
4. a calculo in uretere. 
5. ah infultu paralyt- 
ica. 
6. - - a titillatione fau- 
cium. 
7. ---- cute fympatbetica. 
SPECIES. 
Naufea from ideas. 
Naufea from conception. 
Vomiting from vertigo. 
from ftone in the u- 
reter. 
from ftroke of palfy. 
-- from tickling the 
throat. 
■ ■ ■ - from fympathy with 
the (kin. 
GENUS III. 
Catenated with Voluntary Motions. 
SPECIES. 
I. Ruminatio. 
2. Vomitio voluntaria. 
3. EruHatio voluntaria. 
Rumination. 
Voluntary vomiting. 
eructation. 
GENUS IV. 
Catenated, with External Influences. 
I. Catarrhus periodic us. 
2. Tufis periodica. 
3. Hyjleria a frigore. 
4. Naufea pluvialis. 
SPECIES. 
Periodical catarrh. 
Periodic cough. 
Hyfterics from cold. 
Sicknefs againft rain. 
CLASS Class IV. 1.1. 
OF ASSOCIATION. 
359 
CLASS IV. 
DISEASES OF ASSOCIATION. 
ORDO I. 
Increafed Ajfociate Motions. 
GENUS I. 
Catenated with Irritative Motions. 
The importance of the fubfequent clafs not only confifts in 
its elucidating all the fympathetic difeafes, but in its opening a 
road to the knowledge of fever. The difficulty and novelty of the 
fubjeCt muft plead in excufe for the prefent imperfect ftate of 
it. The reader is entreated previoufly to attend to the follow- 
ing circumltances for the greater facility of inveftigating their 
intricate connections ; which I (hall enumerate under the fol- 
lowing heads. 
A. Afibciate motions diftinguiflied from catenations. 
B. Afibciate motions of three kinds. 
C. Aflbciations afleCted by external influences. 
D. Aflbciations affected by other fenforial motions. 
E. Aflbciations Catenated with fenfation. 
F. DireCt and reverfe fympathy. 
G. Aflbciations affeCted four ways. 
H. Origin of aflbciations. 
I. Of the aCtion of vomiting. 
K. Tertian aflbciations. 
A. Affociate Motions difinguijhedfrom Catenations. 
Aflbciate 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 afibciate train of motions, are excluded from this definition, 
as not being themfelves caufed by the fenforial power of aflbcia- 
tion, but by irritation, or fenfation, or volition. I (hall give for ex- 
ample the flufliing of the face after dinner ; the capillary veflels of 
the face increafe their actions in confequence of their catenation, 
not their afibciation, with thofe of the ftomach ; which latter art 
caufed to aCt with greater energy by the irritation excited by 
the ftimulus of food. Thefe capillaries of the face are afibcia- 
ted 360 
DISEASES 
Clas^IV. i. L 
ted with each other reciprocally, as being all of them excited 
by the fenforial power of aflbeiation ; but they are only catenated 
with thofe of the ftomach, which are not in this cafe aflbeiate 
motions but irritative ones. The common ufe of the word af- 
fociation 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. Ajfociate Motions of three Kinds. 
Thofe trains or tribes of aflbeiate motions, the introductory 
links of which confifts of an irritative motion, are termed irrita- 
tive aflbeiations ; as when the mulcles of the eyelids clofe the 
eye in common nictitation. Thofe, whofe introductory link 
confifts of a fenfitive motion, are termed fenfitive aflbeiations ; as 
when the peCloral and intercoftal mufcles aCt in fneezing. 
And laftly, thofe whofe introductory link confifts of a voluntary 
motion, are termed voluntary aflbeiations ; as when the mufcles 
of the lower limbs aCt in concert with thofe of the arm in fencing. 
C. Ajjbciat'ions affected by external Influences. 
Circles of a fib ci ate"' motions, as well as trains and tribes of 
them, are liable to be affefted by external influences, which con- 
fift 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 
in unufual quantity. We have a fenfe adapted to the perception 
of the excels or defect of one of thefe fluids ; I mean that of 
elementary heat; in which all things are immerfed. See Clafs 
IV. i 4. i. But there are others of them, which as we have 
no power to evade their influence, fo we have no fenfe to per- 
ceive it; thefe are the folar, and lunar, and terreftrial gravitation, 
in which alfo all things are immerfed; the electric aura, which 
pervades us, and is perpetually varying. See Clafs IV. 1. 4. 
5 ; the magnetic fluid, Clafs IV. I. 4. 6 ; and laftly, the great 
life-preferver oxygen gas, and the aqueous vapour of the atmof- 
phere, fee Clafs IV. I. 4. 6. and 7. and 2. 
Of thefe external influences thofe of heat, and of gravity, 
have diurnal periods of increafe and decreafe ; befides their 
greater periods of monthly or annual variation. The manner 
in which they aCt by periodical increments on the fyftem, till 
fome effeCt is produced, is fpoken of in Seif. XXXII. 3. and 6. 
D. Aflbeiations Class IV. 1. 1. 
OF ASSOCIATION. 
361 
D. Affociations affected by other Senforial Motions. 
Circles and trains of affociate motions are alfo liable to be af- 
fected by their catenations with other fenforial powers, as of ir- 
ritation, or fenfation, or volition ; which other fenforial powers ei- 
ther thus limply form fome of the links of the catenation, or add 
to the energy 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 
Ikin 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 accuftomed affoci- 
ation with the actions of the heart and arteries* And laftly, in 
the blufli of anger the fenforial power of volition is added to 
that of affociation, and irritation, to excite the capillaries of the 
face with increafed action. See Clafs IV. 2. 3. 5. 
E. Affectations catenated 'with Senfation. 
Pain frequently accompanies affociate trains or circles of mo- 
tion without its being a caufe, or a link, of them, but Pimply an 
attendant fymptom ; 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 aflbeiation is 
the proximate caufe; the preceding increafed a&ion of the bow- 
els is the remote caufe; and the proximate effeft is the violent 
contractions of the mufeuli gaftrocnemii j but the pain oi 
thefe mufcles is only an attendant fymptom, or a remote effect- 
See Sect. XVIII. 15. Other fenfitive affociations are mention- 
ed in Clafs IV. 1. 2. and IV. 1. 2. 15. 
Thus, if the flulhing of the face above mentioned after dinner 
be called a difeafe, the immediate or proximate caufe is the in- 
creafed power of affociation, the remote caufe is the increaf- 
ed irritative motions of the ftomach in confequence of the Rim- 
ulus 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 cutaneous veffels. 
F. Direct and reverfe Sympathy. 
The increafed actions of the primary part of the trains of af- 
fociated motions are fomctimes fucceeded by increafed actions 
Vol. II. Y y of 362 
DISEASES 
Class IV. 1. r. 
of the fecondary part of the train ; and fometimes by decreafed 
actions of it. So likewife the decreafed actions of the primary 
part of a train of aflbciate motions are fometimes fucceeded by 
decreafed actions of the fecondary part, and fometimes by 
increafed actions of it. The former of thefe fituations is called 
direft fympathy, and the latter reverfe fympathy. In general I 
believe, where the primary part of the train of aflbciated motions 
is exerted more than natural, it produces direft fympathy in 
ftrong people, and reverfe fympathy in weak ones, as a full meal 
makes fome people hot, and others chill. And where the pri- 
mary part of the train is exerted lefs than natural, it produces 
direft fympathy in weak people, and reverfe fympathy in ftrong 
ones, as on being expofed for a certain length of time on horfe- 
back in a cold day gives indigeftion and confequent heart-burn 
to weak people, and ftrengthens the digeftion, and induces con- 
fequent hunger in ftrong ones. See Seft. XXXV. i. 
This may perhaps be more eafily underftood, by confidering 
ftrength and weaknefs, when applied to animal bodies, as con- 
lifting in the quantity of fenforial power refiding in the con- 
trafting fibres, and the quantity of ftimulus applied, as (hewn 
in Seft. XII. 2. 1. Now when defeftive ftimulus, within certain 
limits, is partially applied to parts fubjeft to perpetual motion, 
the expenditure of fenforial power is for a while leflened, 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 
aflbciate train of motions be deprived in part of its accuftomed 
ftimulus, its aCtion becomes diminilhed; and the fenforial pow- 
er becomes accumulated, and by its fuperabundance, or over- 
flowing as it were, increases the action of the fecond tribe of 
the aflbciate actions by reverfe fympathy. As expofing the 
warm ikin for a moderate time to cold air increafes the aClion 
of the ftomach, and thus ftrengthens the power of digeftion. 
On the reverfe, when additional ftimulus within certain lim- 
its is partially applied to parts, which are deficient in refpeCt to 
the natural quantity of fenforial power, the expenditure of fen- 
forial power is increafed, but in a lefs degree than the increafed 
production of it in the brain, or its increafed derivation into the 
ftrongly-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 fubjeCted 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 fccond tribe of the aflbciate motions by direCt fympathy. 
Thus Class IV. i. i. 
OF ASSOCIATION. 
363 
Thus when vomiting occurs with cold extremities, a blifter on 
the back in a few hours occafions 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, occafions univerfal warmth of it, and 
checks or cures the diarrhoea. 
In fome aflbciate trains of action neverthelefs reverfe fympa- 
thies more frequently occur than direct ones, and in others di- 
rect ones more frequently than reverfe ones. Thus in continu- 
ed fever with debility there appears to be a reverfe fympathy be- 
tween the capillary veflels of the flomach and thofe of the fkin; 
becaufe there exifis a total averfion to folid food, and conflant 
heat on the furface of the body. Yet thefe two fyftems of vef- 
fels are at other times actuated by direct fympathy, as when 
palenefs attends ficknefs, or cold feet induces indigeflion. This 
fubjet requires to be further inveftigated, as it probably depends 
not only on the prefent or previous plus or minus of the fenfo- 
rial power of aflbeiation, but alfo on the introduction of other 
kinds of fenforial power, as in Clafs IV. i. i. D ; or the in- 
creafed 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 flomach, if 
there be no fuperfluity of fenforial power in the fyftem, that is, 
none to be fpared from the continual actions of it, a palenefs and 
chillnefs fucceed for a time ; becaufe now the expenditure of 
it by the increafed actions of the flomach is greater than the 
prefent production of it. In a little time however the flimulus 
of the food and wine increafes the production of fenforial pow- 
er in the brain, and this produces a fuperfluity of it in the fyf- 
tem ; in confequence of which the fkin now becomes warm 
and florid, which was at firft cold and pale ; and thus the reverfe 
fympathy is (hortly converted into a direct one ; which is prob- 
ably owing to the introduction of a fecond fenforial power, that 
of pleafurable fenfation. 
On the contrary, when an emetic drug produces fleknefs, the 
fkin is at firft pale for a time by direct fympathy with the capil- 
laries of the flomach; but in a few minutes, by the accumula- 
tion of fenforial power in the flomach during its lefs active ftate 
in ficknefs, the capillaries of the fkin, which are aflbeiated with 
thofe of the flomach, act with greater energy by reverfe fympa- 
thy, 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 fenforial power, or prefent diminution 
of flimulus, the fecond part of the train becomes torpid by di- 
rect fympathy. And when the quantity of action of the firft 
part 364 
DISEASES 
Class IV. 1. 1. 
part becomes increafed by the accumulation of fenforial power 
during its previous torpor, or by increafe of ftimulus, the actions 
of the fecond part of it likewifc become increafed by diredd: fym- 
pathy. 
In moderate hunger the Ikin is pale, as before dinner, and in 
moderate 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 powrer becomes fo great as to affebt the arterial and 
capillary fyftem, and fever is produced in both cafes. 
In contagious fevers with arterial debility commencing with 
torpor of the ftomach, why is the aeftion 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 aflbciation between 
the mufcular fibres of the ftomach and thofe of the heart have 
been uniformly aflbciated by direbl fympathy; and the capilla,- 
ries of the ftomach and thofe of the ikin have been more fre- 
quently aflbciated by reverfe fympathy ? 
Where the abiions of the ftomach have been previoufly ex- 
haufted by long ftimulus, as on the day after intoxication, little 
or no accumulation of fenforial power occurs, during the tor- 
por of the organ, beyond what is required to replace the defi- 
ciency of it, and hence fever feldom follows intoxication. And 
a repetition of the ftimulus fometimes becomes neceflary even to 
induce its natural atiion, as in dram-drinkers. 
Where there has been no previous exbauftion of fenforial 
power, and the primary link of aflbeiate motions is violently 
actuated by the fenforial power of fenfation, the fecondary link 
is allo violently actuated by direbl fympathy ; as in inflammato- 
ry fevers. Where however the fenforial power of the fyftem is 
lefs than natural, the fecondary link of aflbciated motions be- 
comes torpid by reverfe fympathy, as in the inoculated fmall-pox 
during the eruption on the face the feet are frequently cold. 
G. Ajjociatitms offered four Ways. 
Hence aflbciated trains or circles of motions may be affe&ed 
four different ways. I. By the greater or lefs energy of action 
of the firff link with which they are catenated, and from which 
they take their names; as irritative, fenfitive, or voluntary aflb- 
ciations. 2. By being excited by two or more fcnforial powers 
at the fame time, as by irritation and aflbciation, as in the in- 
itance of the application of the ftimulus of increafed external 
beat to the cutaneous capillaries. 3. By catenation with other 
. fenforial Class IV. 1.1. 
OF ASSOCIATION. 
365 
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, excite the fenforial power of aflbciation into 
action; as the pain at the neck of the gall-bladder occafioned 
by a gall-ftone is transferred to the other end of that canal, and 
becomes a link of catenation between the action 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 moif- 
ture and oxygen gas as conftituting neceflary parts of the fyf- 
tem, rather than ftimuli to excite it into action. 
H. The Origin of Ajfociations. 
Some trains or circles of aflbciate motions mud have been 
formed before our nativity, as thofe of the heart, arteries, and 
capillaries ; others have been aflbciated, as occafion required 
them, as the mufcles of the diaphragm and abdomen in vomit- 
ing ; and others by perpetual habit, as thofe of the ftomach with 
the heart and arteries directly, as in weak pulfe during ficknefs; 
with the capillaries direblly, as in the flufhed (kin after dinner ; 
and laftly, with the cellular abforbents reverfely, as in the in- 
creafed abforption in anafarca during ficknefs ; and with the ir- 
ritative motions of the organs of fenfe reverfely, as in vertigo, 
or fea-ficknefs. Some of thefe aflbciations ihall be here fhortly 
defcribed to facilitate the invelligation of others. 
Firft, other congeries of glands occupy but a particular part 
of the fyltem, or conftitute a particular organ, as the liver, or 
kidneys ; but thofe glands, which fecrete the mucus, and per- 
fpirable 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 cavity of 
the body ; and the pcrfpirable matter, which foftens and lubri- 
cates the whole furface of the fkin, and the more extenfive fur- 
face of the air-veflels, which compofe the lungs. Thefe are 
fupplied with blood by the perpetual aftion of the heart and ar- 
teries, and have therefore their motions aflbciated with the form- 
er, and with each other, by fympathy, which is fometimes di- 
rect, and fometimes reverie. 
One branch of this aflbciation, the capillaries of the fkin, is 
very irritable by the increafed quantities of cold and heat; anoth- 
er branch, that of the lungs, has not the perception of cold 
and heat, but is liable by direct fympathy to at! in concert with 
the former, as in going into the cold bath. And it is probable 
the capillaries of the internal membranes are likewife direftly 
affected 366 
DISEASES 
Class IV. 1.1. 
aftedied by their fympathy with thofe of the ficin, as appears from 
the defedt of fecretion in ulcers during the cold fits of agues. 
The motions of this extenfive fyftem of capillaries, thus aflb- 
ciated by diredt fympathy, are alfo affociated with thofe of the 
heart and arteries, fometimes by reverfe and fometimes by di- 
rect fympathy; and thus conftitute fimple fever. The cold 
paroxyfm of which confifts in their torpor, and the hot one in 
their orgafm, or increafed a&ivity. 
I. Of the AAisn of Vuniting. 
The manner, in which the ftomach and the diaphragm and 
abdominal mufcles acquire their alTociate action in vomiting, 
requires fome attention. It is not probable, that this adtion of 
vomiting occurs before nativity; as the uniform application of 
the nutritive liquor amnii to the mouth of the foetus, and the 
uniform expenditure of its nourifhment, would 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 occafionally too much 
diftended with milk ; as previous hunger may induce it to over- 
gorge itfelf; and by repeated efforts the a6t of vomiting is learn- 
ed, 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 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 action of the diaphragm and 
abdominal mufcles by fqueezing the ftomach affifts its retro- 
grade exertion to difgorge its contents. In the fame manner 
when a piece of gravel is pulhed into the urethra, or a piece of 
indurated bile into the neck of the gall-bladder, after they have 
been in vain preffed forward by the ufual motions of thofe 
du<fts, they return into the bladders of gall and urine by the re- 
trograde motions of them. 
That this is one mode, in which vomiting is induced, appears 
from the inftantaneous rejection from the ftomach occafioned 
by fome naufeous drug, or from fome naufeous idea; and laft- 
ly, 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 neverthelefs many modes by which thefe inverted 
motions Class IV. i. i. 
OF ASSOCIATION. 
367 
motions of the ftomach and oefophagus are induced, and which 
it is of confequence to diftinguifli from each other. The firft 
is the mode above defcribed, where an effort is made to diflodge 
fomething, which ftimulates the ftomach into difagreeable fen- 
fation ; 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 re- 
verted by painful fenfation ; and the abdominal mufcles and di- 
aphragm by repeated efforts become affociated with them. Now 
as lefs fenforial power is expended on the retrograde adlions of 
the ftomach, and of the lymphatics, which open their mouths 
on its furface, than by their natural motions, an accumulation 
of fenforial power in the fibres of the ftomach follows the ex- 
hibition of an emetic, and on that account an emetic will fomc- 
times flop a fpontaneous vomiting which was owing to fenfori- 
al deficiency. See Se<T. XXXV. i. 3. and Art. V. 2. 1. 
As bitters and metallic faits, exhibited in fmall dofes, ftimu- 
late the ftomach into greater aftion, as appears by their increaf- 
ing the power of digeftion, and yet become emetic, when given 
in larger dofes; one might fufpefl, 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 effecfled in a moment 
without producing pain, and in confequence without our per- 
ceiving it. But on the contrary, there does not in general ap- 
pear on the exhibition of emetics to be any previous exhauftion 
of fenforial power ; becaufe there is evidently an accumulation 
of it during the ficknefs, as appears from the digeftion being 
ftronger afterwards ; and from the increafed aftion of the cel- 
lular and cutaneous abforbents during its operation. See Art. 
V. 2. 1. 
Another mode by which vomiting is induced, is owing to de- 
bility or deficiency of fenforial power, from the previous ex- 
hauftion 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 power, as the di- 
geftion ftill remains weak and imperfect. 
Another mode by which ficknefs or vomiting is induced, is 
by defecft 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 
liimuli. Other means of inducing ficknefs by vertigo, or by 
naufeous ideas, will be mentioned below. 
We 368 
DISEASES 
Class IV. 1. 1* 
We (hall only add, that the motions of the mufcular fibres of 
the ftomach are aflbeiated 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 aflbeiated with the cellular and cutaneous abfor- 
bents by reverfe fympathy, as is inewn 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 vifeus. 
In cold paroxyfms of fever the ftomach partakes of the gen- 
eral torpor, and vomiting is induced by its debility, either by 
its aflbeiation with the torpid capillaries, or other torpid parts, or 
by its own torpor commencing firft, and caufing the cold fit. 
The difordered motions of the ftomach frequently feem to be the 
caufe or primary feat of fever, as where contagious miafma are 
fwallowed with the faliva,and where fever is produced by fea-fick- 
nefs, which I once faw. Neverthelefs a diforder of the ftomach 
does not always induce fever, as in that cafe it fhould conftantly 
attend indigeftion,and vertigo, and fea-fickncfs ; but is itfelf fre- 
quently induced by aflbeiation 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 connection of the motions of the ftomach with irritative 
ideas, or motions of the organs of fenfe, in vertigo, is fhewn in 
Sect. XX. and thus it appears, that many circles of aflbeiation 
are either direCtly or reverfely aflbeiated, or catenated, with this 
vifeus ; which will much contribute to unfold fome of the fymp- 
toms of fever. 
K. Tertian Affiliations. 
The third link of affociate trains of motion is fometimes actu- 
ated by reverfe fympathy, with the fecond link, and that by re- 
verfe fympathy with the firft link ; fo that the firft and third link 
may act by direCt fympathy, and the intermediate one by re- 
verfe fympatjry. Of this, inftances are given in the fingultus 
nephriticus, Clafs IV. i. i. 7. and IV. 2. I. At other times 
the tertian or quartan links of afibciate motions are aCtuated by 
direCt fympathy ; and that fometimes forwards and fometimes 
backwards in refpcCt to the ufual order of thofe trains of aflbei- 
ate motions, as in Clafs IV. 1. 2. 1. 
SPECIES. 
i. Ruhr vultus pranforum. Flufhing of the face after dinner Class IV. r. i. a. 
OF ASSOCIATION. 
369 
is explained in Sect. XXXV. i. In the beginning of intoxica- 
tion the whole Ikin becomes florid from the aflbciation of the ac- 
tions of the cutaneous arteries with thofe of the ftomaeh, be- 
caufe vinous fpirit excites the fibres of the ftomaeh into more 
violent aftion than the ftimuluS of common food ; and the cu- 
taneous capillaries of the face, from their more frequent expo- 
fure to the viciflitudes of cold and heat, poflefs more mobility or 
irritability than thofe Of other parts of the Ikin, as further ex- 
plained in Seft. XXXIII. 2. 10. Vinegar is liable to produce 
this flufhing of the face, which probably is owing to the quanti- 
ty of vinous fpirit it contains, as I believe the unfermeuted veget- 
able acids do not produce this effect. In every kind of blufh 
the arterial blood is propelled into the capillaries falter than the 
Venous abforption can carry it forwards into the veins, in this 
refpeft refembling the tenfio phalli. 
Can the beginning vinous or acetous fermentation of the ali- 
ment in weak ftomachs contribute to this effect ? or is it to be 
afcribed to the greater power of aflbciation between the arteries 
of the face and the fibres of the ftomaeh 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 drunk at 
meals. Let the drefs over the ftomaeh and bowels be loofe. 
Ufe no fermented liquors, or vinegar, or fpice. 
2. SudorJlragulis immerforum. Sweat from being covered in 
bed. In the commehcement of an epidemic fever, in which the 
perpetual efforts to vomit was a diftrefling fymptom, Dr. Syd- 
enham difeovered, that if the patient's head was for a Ihort time 
covered over with the bed-clothes, warmth was produced, and 
a fweat broke out upon the fkin, and the tendency to vomit ceafi- 
ed. In this curious faft two trains of aflbeiated motions are 
exerted into increafed action. Firft, the veflvls of the lungs are 
known to have their motion aflbeiated with thofe of the Ikin by 
the difficulty of breathing on going into the cold bath, as defcrib- 
ed in Seft. 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 adulterated by frequent breathing, 
thofe of the external Ikin foon become excited by their aflbcia- 
tion into more energetic action, and generate more heat along 
with a greater fecretion of perfpirabie matter. Secondly, the 
fympathy between the ftomaeh and Ikin 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 ftomaeh by re- 
verfe fympathy, but deoreafes it if continued too long by direft 
fympathy; fo in the circumftance above mentioned, the action 
Vol. II. Z z of 370 
DISEASES 
Class IV. 1.i, 3, 
of the ftomach is increafed by direct fympathy with that of the 
fkin ; and the tendency to votnit, which was owing to its di- 
miniffied action, ceafes. 
3. Cejjatio agritudinis cute excitatd. The cure of ficknefs by 
flimulating the fkin. This is explained in the preceding arti- 
cle ; and further noticed in IV. .2. 2/4. and in IV. 1. 1. F. 
Similar to thefe is the effect of a blifter on the back in reliev- 
ing ficknefs, indigeftion, and heart-burn ; and, on the contrary, 
by thefe fymptoms being frequently induced by coldnefs of the 
extremities. The blifter ftimulates the cutaneous veflels into 
greater adlion; whence warmth and pain are produced at the 
fame time, and the fibres of the ftomach are excited into greater 
action by their affociation with thofe of the (kin. It does not 
appear, that the concommitant pain of the blifter caufes the in- 
creafed energy of the ftomach, becaufe the motions of it are not 
greater than natural; though it is fometimes difficult to deter- 
mine, whether the primary part of fome aflbciated trains be 
conne&ed with irritative or fenfitive niotions. 
In the fame manner a flannel ffiirt, 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 effi- 
cacious in checking fome chronical diarrhoeas, which are not at- 
tended with fever ; for the abforbents of the fkin are thus ftim- 
ulated into greater adtion, with which thofe of the inteftines 
confent by difedt fympathy. 
This effect cannot be afcribed to the warmth alone of the 
flannel fliirt, as being a covering of loofe texture, and confining 
air in its pores, like a fponge, which air is known to be a bad 
condudtor of heat, fince in that cafe its ufe ffiould be equally 
efficacious, if it were worn over a linen ffiirt j and an increafed 
warmth of the room of the patient would be equally ferviceable. 
4. Digejlio auEta frigore cutanea. Digeftion increafed bycold- 
nei's 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 veflels; bpt, as thefe confent with 
thofe of the ftomach and bowels, this faving of fenforial power 
is transferred by reverfe fympathy from the cutaneous capilla- 
ries and abforbents to thofe of the ftomach and inteftines. 
Hence weak people ffiould ufe the cold air of winter as a cold 
bath; that is, they ffiould ftay in it but a fhort time at once, 
but ffiould immerfe themfelves in it many times a day. 
5. Catarrbus afrigore cutanea. Catarrh from cold fkin. This 
has been already explained in Clafs I. 1.2. 7. and is further 
deferibed in, Se£E XXXV. 1. 3. In this difeafe the veflels of 
,. the Class IV. 1. 1. 6. 
OF ASSOCIATION. 
371 
the membrane, which lines the noftrils, are excited into greater 
a&ion; when thofe of the Ikin, with which they are aflbciated, 
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 aflbciated with 
thofe of the cutaneous veflels, and not with the pain of them, 
becaufe no inflammation follows. 
6. Abforptio cellularis auHa vomitu. In the act of vomiting 
the irritative motions of the ftomach are inverted, and of the 
abforbents, which open their mouths into it; while the cutane- 
ous, cellular, and pulmonary abforbents are induced, by reverfe 
fympathy with them, to aft with greater energy. This is feen 
in cafes of anafarca, when long ficknefs and vomiting are cauf- 
ed by fquills, or antimonial faits, or moft of all by the decoftion 
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 fenforial pow- 
er 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 aflbciated with the 
abforbents of the ftomach by reverfe fympathy. 
The reverfe fympathy between the lacteal and lymphatic 
branches of the abforbent fyftem have been produced by the one 
branch being lefs excited to adl, when the other fupplies fuffi- 
cient fluid or nutriment to the fanguiferous veflels. Thus when 
the ftomach is full, and the fupply of chyle, and mucus, and 
water is in fufficient quantity ; the pulmonary, cellular, and cu- 
taneous lymphatics are not excited into adtion ; whence the 
urine is pale, and the ikin moift, from the defect of abforption 
on thofe furfaces. 
7. Singultus nephriticus. When a ftone 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 com- 
mon 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 
aflbciation with the ftomach by a fecond reverfe fympathy. This 
hiccough may neverthelefs admit of another explanation, and 
be fubpofed to be a convulfive exertion of the diaphragm to re- 
1 Jieve 372 
DISEASES 
£i,assIV. b 
lieve the difagreeable fepfatian of the ftomach in confequence 
pf its difbrdered irritative afipciatiens ; and in that cafe it would 
belong to Clafs III. i. v §ee Clafs IV. 2, J. for another ex- 
ample of tertiary aflbciatiej^ 
M. M. Venefefiion. Emetic. Calomel. Cathartic, opium, 
oil of cinnamon, from two to ten drops. Aerated alcaline water. 
Peruvian bark. 
8. Febris irritative,. Irritative fever, deferibed in Clafs I. I. 
i. u The difeafes above explained in this genus are chiefly 
concerning the fympathies of the abforbent fyftem, or the ali- 
mentary canal, which are not fo much aflbeiated with the arte- 
rial fyftem as to throw it into diforder, when they are flightly 
deranged ; but when any great congeries of conglomerate glands, 
which may be confidered as the extremities of the arterial fyf- 
tem, are afFefled with torpor, the whole arterial fyftem and the 
heart fympathize with the torpid glands, and aft with lefs ener- 
gy ; which conftitutes the cold fit of fever; which is therefore 
at firft a decreafed aftion of the aflbeiate organ; but as this de- 
creafe of aftion is only a temporary effect, 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 pplfe, properly belongs to this clafs and genus of 
difeafes. 
ORDO Class IV. 1. 
OF ASSOCIATION. 
373 
ORDO I. 
Increajed Ajjbciate Motions. 
GENUS II. 
Catenated with Senjiiive Motions. 
The primary links of the aflbciated 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 
are attended with inflammation. All inflammations, which do 
not arife in the part which was previoufly torpid, belong to this 
genus ; as the gout, rheumatifm, eryfipelas. It is probable many 
other inflammations may, by future obfervation, require to be 
tranfplanted into this clafs. 
The circles of fenfitive aflbciate motions confift chiefly of the 
excretory dutfls of the capillaries and of the mouths of the ab- 
forbent veflels, which conftitute the membranes; and which 
have been induced into action at the fame time ; or they confift 
of the terminations of canals; or of parts which are endued 
with greater fenfibility than thofe which form the firft link of 
the aflociation. An inftance of the firft of thofe is the fympa- 
thy between the membranes of the alveolar precedes of the jaws, 
anti the membranes above or beneath the mufcles about the 
temples in hemicrania. An inftance of the fecond is in the 
fympathy between the excretory duff of the lachrymal gland, and 
tlw nafal du€t of the lachrymal fac. 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. 
I. Lacbrymarum jluxus f^mpatheticus. A flow of tears from 
grief or joy. When the termination of the duft of the lachry- 
mal fac in the noftrils becomes affected either by painful or 
pleafurable fenfations, in confequence of external ftimulus, or 
by its afl'ociation with agreeable or difagreeable ideas, the mo- 
tions of the lachrymal gland are at the fame time exerted with 
greater energy, and a profufion of tears fucceeds by fenfitive af- 
fociatiqn, as explained in Se£l. XVI. 8. 2. 
In this cafe there exifts a chain of aflbciated aftions, the fe- 
cretion of the lachrymal gland is increafed by whatever ftimu- 
latcs 374 
DISEASES 
Class IV. 1.2. 2. 
lates the furface of the eye, at the fame time the increafed abun- 
dance of tears ftimulates the punCta lachrymalia into greater ac- 
tion ; and the fluid thus abforbed ftimulates the lachrymal fac, 
and its nafal duct in the nofe into greater action. In a contra- 
ry direction of this chain of aflbeiation the prefent increafe of 
adtion is induced. Firft, the nafal duCt of the lachrymal fac is 
excited into increafed action, by fome pleafurable or painful idea, 
as defcribed in SeCl. XVI. 8. 2. 2d. The punfta lacrymalia 
or other extremity of the lachrymal fac fympathizes with it (as 
the two ends of all other canals fympathize with each other.) 
3d. With thefe increafed motions of the punfta lacrymalia thofe 
of the excretory du£l of the lachrymal gland are aflbeiated from 
their having fo perpetually aCted together. And, laftly, with 
the increafed actions of the excretory duCt of this gland are af- 
lociated thofe of the other end of it bv their frequently acting 
together; in the fame manner as the extremities of other ca- 
nals are aflbeiated, and thus a greater flow of tears is poured in- 
to 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 fenfations, when great, excite the faculty of volition ; 
and the perfon continues voluntarily to call up or perform thofe 
ideas, which occafion the painful fenfation ; that is, the afflict- 
ed perfon becomes fo far infane or melancholy ; but tears are 
produced by the fenforial faculty of aflbeiation, and (hew that 
the pain is fo far relieved as not to excite the exceflive power of 
volition, or infanity, and are therefore a fign of the abatement of 
the 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 Iky in a morning after coming out of a dark 
bed room. The olfaClory nerves are brought into too great ac- 
tion by their fympathy with the optic nerves, or by their refpec- 
tive fympathies with fome intervening parts, as probably with 
the two extremities of the lachrymal fac ; that is, with the punc- 
ta lacrymalia and the nafal du£t. See Clafs II. 1. 1. 3. 
3. Dolor dentium a Jlridore. Tooth-edge from grating founds, 
and from the touch of certain fubftances, and even from im- 
agination alone, is defcribed and explained in Seft. XVI. 10. 
The increafed actions of the alveolar veflels or membranes are 
aflbeiated with the ideas, or fenfual motions of the auditory 
nerves in the firft cafe; and of thofe of the fenfe of touch, in 
the fecoud cafe; and by imagination, or ideas exerted of painful 
fenfation alone, in the laft. 
Rifts fnrdonicus. A difagreeable fmile attends inflammations 
of Class IV. 1. 2. 5. 
OF ASSOCIATION. 
375 
of the diaphragm arifing from the affociations of the reiterated 
exertions of that fnufcle with thofe of the lips and cheeks in 
laughing. See Diaphragmitis, .Clafs IL i. 2. 6. 
5. Saliva fiuxus cibo vifo. The flow of faliva into the mouths 
of hungry animals at the fight or fmell of food is feen in dogs 
(landing round a dinner-table.' The increafed a£tions of the 
falivary glands have been ufually produced by the llimuluS of 
agreeable food on their excretory duels during the maftication 
of it 5 and with this increafed a€lion of their excretory du£ls the 
other terminations of thofe glands in the capillary arteries have 
been excited into increafed adlion by the mutual aflbeiation 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 accom- 
panied this increafed fecretion of faliva. Hence this chain of 
motions becomes affociated with thofe vifual or olfadlory ideas, 
or with the pleafure, which produces or attends them. 
6. Tenfo mammularum vifo puerulo. The nipples of la£lefcent 
women are liable to become turgid at the fight of their young 
offspring. The nipple has generally 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 turgef- 
cence of the tubes, which conftitute the nipple. Hence the 
vifual idea of the child, and the pleafure which attends it, be- 
come affociated with thofe increafed arterial actions, which 
fwell the cells of the mammula, and extend its tubes; which is 
very fimilar to the tenfio phalli vifa muliere nuda etiam in in- 
fomnio. 
7. <Tenfio penis in hydrophobia. An erection of the penis oc- 
curs in the hydrophobia, and is a troublefome fymptom, as ob- 
ferved by Coelius Aurclianus, Fothergill, and Vaughan, 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 fubfide, the tefticles are liable to fwell. Venereal in- 
fection received by the penis is very liable to affect the throat 
with ulcers. Violent coughs, with forenefs or rawnefs about 
the fauces are often attended with ereclion of the penis ; which 
is alfo faid to happen to male animals, that are hanged ; whhh 
lafl circumftance has generally been afcribed to the obftruclion 
of the circulation of the blood, but is more probably occafionpd 
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 376 
DISEASES 
Class IV. 1. 2. S. 
In men the throat becomes fo thickened at the time of puber- 
ty, that a meafure of this is ufed to afcertaih the payment of a 
poll-tax on males in fome of the iflands of the MeditOrrahean, 
which commences at puberty ; a firing is wrapped twite 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 fubject is taxable. 
It is difficult to point out by what circumftance the fenfitive 
motions of the penis and of the throat and nofe become aflbci- 
ated ; I can only obferve, that thefe parts are fubjefted to great- 
er 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 aflbciation of 
their fenfitive motions by their being eminently fenfible to pleaf- 
ure. See Clafs I. 3. 1. n. and III. 1. r. 15. and Sed. XVI. 
5. See Gonorrhoea venerea, II. 1. 5. 1. 
In the female fex this aflbciation betvzeen 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 probably from there being in them 
a more exquifite fenifitve fympathy between the pubis and the 
breafts. Hence their breafts fwell at the time of puberty, and 
fccrete milk at the time of parturition. And in the parotitis, or 
mumps, the breafts of women fwell, when the tumor of the pa- 
rotitis fubfides. See Clafs I. 1. 2. 15. Whence it would ap- 
pear, that their breafts pofiefs an intermediate fympathy between 
the pubis and the throat; as they are the feat of a paffion, which 
men do not poflefs, that of fuckling children. 
8. Tenefmus calculofus. The fphinbler of the re&um becomes 
painful or inflamed from the aflbciation of its fenfitive motions 
with thofe of the fphincler of the bladder, when the latter is 
ftimulated into violent pain or inflammation by a ftonei 
9. Polypus narium ex afcaridibus ? The ftimulation of afcari- 
des in the rebtum 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 in the nofe, who were all affebted 
with afcarides ; to the perpetual ftimulation of which, and 
the confequent fenfitive aflbciation, I was led to afcribe the 
inflammation and thickening of the membrane of the noftrils. 
I o. Crampus 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 fym- 
pathize with uneafy fenfation in the bowels. See Clafs III. 1. 
n 14. This aflbciation4s not eafily accounted for, but is anal- 
ogous Class IV. i. 2. 11. 
OF ASSOCIATION. 
377 
ogous in fome degree to the paralyfis of the mufcles of the arms 
in 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 fympa- 
thy with the higher parts of them. See Cholera and Ileus. 
it. Zona ignea nephritica. Nephritic fhingles. The exter- 
nal fkin about the loins and fides of the belly I fuppofe to have 
greater mobility in refpeft to fenfitive aflbciation, than the ex- 
ternal membrane of the kidney ; and that their motions are by 
fome unknown means thus affociated. When the torpor or be- 
ginning inflammation of this membrane ccafes, the external fkin 
becomes inflamed in its (lead, and a kind of herpes, called the 
fhingles, covers the loins and fides of the belly. See Clafs IL 
!• 5'9' ; 
12. Eruptio •variolarum. After the inflammation of the in- 
oculated arm has fpread for a quarter of a lunation, it affebts the 
ftomach by reverfe fympathy ; that is, the actions of the ftom- 
ach are aflbciated with thofe of the fkin ; and as much fenfori- 
al power is now exerted on the inflamed fkin, the other part of 
this fenfitive aflbciation is deprived of its natural fhare, and be- 
comes 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 aflbciated 
with it, as that of the face firft, are thrown into partial in- 
flammation ; that is the eruptions of the fmall-pox appear on 
the face. 
For that the variolus matter afFedts the ftomach previous to 
its eruption on the fkin, appears from the ficknefs at the com- 
mencement of the fever ■, and becaufe, when the morbid motions 
affebt the fkin, thofe of the ftomach ceafe •, as in the gout and 
eryfipelas, mentioned below. The confent between the ftom- 
ach and the fkin appears in variety of other difeafes; and as 
they both confift of furfaces, which abfdrb and fecrete a quanti- 
ty of moifture, their motions muft frequently be produced to- 
gether, or in fucceflion ; which is the foundation of all the fym- 
pathies of animal motionsj whether of the irritative^ fenfitive, or 
voluntary .kinds. 
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 poflefles more mobility to fenfitive aflbciatidns, not on- 
ly than the ftomach, but than any other part of the fkin ; and 
is thence affe&ed at the eruption of the fmall-pox with violent 
action and confequent inflammation, by the aflbciation of its mo- 
tions with thofe of the ftomach, a day before the other parts of 
Vol. II. A a a the 378 
DISEASES 
Class IV. i. 2.13. 
the Ikin ; and becomes fuller of puftules, than any other part of 
the body.' See Oafs II. 1. 3. 9. 
It might be fuppofed, that the fucceflive 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 un- 
known aflbciations of thofe parts of the fyftem ; but thefe fuc- 
ceflions 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 Ikin. 
13. Gutta rofea Jlomatica. Stomatic red face. On drinking 
cold water, or cold milk, when heated with exercifey or on eat- 
ing cold vegetables, as raw turnips, many people in harveft-time 
have been afflicted with what has been called a forfeit. The 
ftomach becomes painful, with indigeftion 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 indigeftion are liable to continue even to old age. 
M. M. Venefe&ion. A cathartic with calomel. Then half 
a grain of opium twice a day for many weeks. If faturated fo- 
hition of arfenic three or five drops twice or thrice a day for a 
week ? 
14. Gutta rofea hepaiica. 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 expofed to greater variation of heat and 
cold than the membranes of the liver, poflefles more mobility 
than thofe hepatic membranes; and hence by whatever means 
thefe membranes are induced to fympathize, when this fenfitive 
aflbeiation occurs, the cutaneous veflels of the face run into 
greater degrees of thofe motions, which conftitute inflammation, 
than previoufly exifted in the membranes of the liver ; and then 
thofe motions of the liver ceafe. SeeClafsII. 1. 4. 6. 
As inflammation of the liver fo frequently attends the great 
potation of vinous fpirit, there is reafon to fufpedt, that this vif- 
cus itfelf becomes inflamed by fenfitive aflbeiation with the 
ftomach 5 or that, when one termination of the bile-duft, which 
enters the duodenum, is ftimulated violently, the other end may 
become inflamed by fenfitive aflbeiation. 
15. Podagra. The gout, except when it affedts the liver or 
ftomach, feems always to be a fecondary difeafe, and, like the 
rheumatifm and eryfipelas mentioned below, begins with the 
torpor of fome diftant part of the fyftem. 
The molt frequent primary feat of the gout I fuppofe to be 
the Class IV. 1. 2.15. 
OF ASSOCIATION. 
379 
the liver, which is probably affected with torpor not only previ- 
ous to the annual paroxyfms of the gout, but to every change 
of its fituation from one limb to another. The reafons, which 
induce me to fufpeft the liver to be firft adeemed, are not only 
becaufe the jaundice fometimes attends the commencement of 
gout, as defcribed in Se£t. XXIV. 2. 8. but a pain alfo over the 
pit of the ftomach, which I fuppofe to be of the termination of 
the bile-dudt in the duodenum, and which is erroneoufly fup- 
pofed to be the gout of the ftomach, with indigeftion and flatu- 
lency, generally attends the commencement of the inflamma- 
tion 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 
preceded by jaundice, there was a cold Ihivering fit attended the 
inflammation of the foot, and a pain at the pit of the ftom- 
ach; which ceafed along with the jaundice, as foon as the 
foot became inflamed. This led me to fufpect, that there was a 
torpor of the liver, and perhaps of the foot alfo, but neverthe- 
lefs the liver might alfo in this cafe be previoufly inflamed, as 
obferved in Sett. XXIV. 2. 8. > 
Now'' as the membranes of the joints of the feet fufFer greater 
variations of heat and cold than the membranes of the liver, and 
are more habituated to extenfion and contraction than other 
parts of the Ikin in their vicinity; I fuppofe them to be more 
mobile, that is, more liable to run into extremes, of exertion or 
quiefcence ; and are thence more fufceptible of inflammation, 
than fuch parts as are lefs expofed to great variations of heat 
and cold, or of extenfion and contraition. 
When a ftone prefles into the fphincler of the bladder, the 
glans penis is afleCted with greater pain by fympathy, owing to 
its greater fenfibility, than the fphin&er of the bladder ; and 
when this pain commences, that of the fphincTer 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 membranous part of a torpid or in- 
flamed liver ; this membrane of the toe falls into that kind of 
acSlion, whether of torpor or inflammation, with greater energy, 
than thofe actions excited in the difcafed liver; and when this 
new torpor or inflammation commences, that with which it fym- 
pathizes ceafes; which I believe to be a general law of aflbciat- 
ed inflammations. 
The paroxyfms of the gout would feem to be catenated with 
folar influence, both in refpeeft to their larger annual periods, 
and to their diurnal periods-See Se&. 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 an- 
nual 380 
DISEASES 
Class IV. 1. 2. 15. 
nual periods may depend on the fucceflion of great viciflitudes 
of cold and heat, and the diurnal ones on our increafed fenfibiii- 
ty to internal fenfations during fleep, as in the fits of afthma, 
and of fome epilepfies. See Seft. XVIIL 15. 
In refpeft to the pre-remote caufe or difpofition to the gout, 
there can be no doubt of its individually arifing from the pota- 
tion of fermented or fpirituous liquors in this country ; wheth- 
er opium produces the fame effeCf in the countries, where it is 
in daily ufe, I have never been well informed. See Seft. XXL 
1 o. where this fubjeft is treated of ; to which I have to add, 
that I have feen fome, and heard of others, who have moderat- 
ed their paroxyfms of gout, by diminifhing the quantity of fer- 
mented liquors, which they had been accuftomed to ; and oth- 
ers who, by a total abftinence from fermented liquors, have en- 
tirely freed themfelves from this excruciating malady ; which 
other wife grows with our years, and curtails or renders mifera- 
ble rhe latter half, or third, of the lives of thofe, who are fub- 
je<Sh to it. The remote caufe is whatever induces temporary 
torpor or weaknefs of the fyllem; and the proximate caufe is 
the inirritability, or defective irritation, of fome part of the fyf- 
tem ; whence torpor and confequent inflammation. The great 
Sydenham faw the beneficial effects of the abftinence from fer- 
mented liquors in preventing the gout, and adds, " if an empiric 
" could give fmall-beer only to gouty patients as a noftrum, and 
« perfuade them not to drink any other fpirituous fluids, he 
** might refcue thoufands from this difeafe, and acquire a for- 
** tune for his ingenuity." Yet it is to be lamented, that this 
accurate obferver of difeafes had not refolution to practife his own 
prefcription, and thus to have fet an example to the world of 
the truth of his do&rine ; but, on the contrary, recommended 
Madeira, the ftrongeft 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 perifhed a martyr to the difeafe, which he knew 
how to fubdue ! 
As example has more forcible effe<T than fimple aflertion, I 
fhall now concifely relate my own cafe, and that of one of my 
moll refpe£ted friends. E. D. was about forty years of age, 
when he wasrfirft feized with a fit of the gout. The ball of his 
right great toe was yery painful, and much fwelled and inflam- 
ed, which continued five or fix days in fpite of venefedlion, a 
a brilk 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 himfelf to fmalbbeer, or wine di- 
luted with about thrice its quantity of water. In about a year 
lie fullered two other fits of the gout, in lefs violent degree. He 
then Class IV. 1. 2. 15. 
OF ASSOCIATION. 
381 
then totally abftained from all fermented liquors, not even tail- 
ing fmall-beer, or a drop of any kind of wine ; but ate plenti- 
fully of fleih-meat, and all kinds of vegetables, and fruit, ufing 
for his drink at meals chiefly water alone, or lemonade, or cream 
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 in- 
dulgence 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 he 
has now for above twenty years kept in perpetual health, ex- 
cept accidental colds from the changes of the feafons. Before 
he abftained from fermented or fpirituous liquors, he was fre- 
quently fubjeft 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 required more cautious treat- 
ment. The Rev. R. W. was feized with the gout about the age 
of thirty-two, which increafed fo rapidly that at the age of for- 
ty-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 digef- 
tion wrere fomewhat weakened, he was advifed not entirely to 
leave ofF all fermented liquors ; and as fmall-beer is of fuch va- 
rious ftrength, he was advifed to drink exactly two wine-glafles, 
about four ounces, of wine mixed with three or four times its 
quantity of water, with or without lemon and fugar, for his dai- 
ly potation at dinner, and no other fermented liquor of any 
kind ; and was advifed to eat flefh-meat with any kind of boil- 
ed vegetables, and fruit, with or without fpice. He has now 
fcrupuloufly 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 fubjetSl at my entreaty. 
" I entered into the army with an excellent conftitution at 
the age of fifteen. The corps I ferved in was diftinguilhed by 
its regularity, that is, the regular allowance of the mefs was on- 
ly 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 382 
DISEASES 
Class IV. I. 2. 15. 
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 contin- 
ued, when with the regiment, till the latter end of the year 
1769, 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 effects of it. I was then feized with a violent inflamma- 
tory 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 than a fortnight; and was three 
months, before I could confider my health perfectly reeftablifh- 
ed. Dr. Dealtry told me, that I fliould be fubjeft to fimilar at- 
tacks for many years ; and that he had no doubt, from the ten- 
dency he. found in my habit to inflammation, that, when I was 
farther advanced in life, I fliould change that complaint for the 
gout. He predicted 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 continuance of cold 
bathing during the whole of that winter ; after that I never 
efcaped it, till I had a regular and fevere fit of the gout: after 
the firft attack of rheumatic fever I was more abftemious in my 
manner of living, though when in company I never fubje&ed 
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 excefs; in 1776 and 1777 I was in the habit of drink- 
ing a good deal of wine very frequently, though not conftantly. 
Alter that period till the year 1781,1 drank a larger quantity 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 however obferve, that at no part of my life was I accuftom- 
ed 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 1781 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 ; be- 
fides which I was fubje^l to very profufe night-fweats, and bad 
frequently boils break out all over me, efpecially in the fpring 
and autumn ; for which I took no medicine, except a little of 
the flowers 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 at- 
tack Class IV. i. 2.15. 
OF ASSOCIATION. 
383 
tack of gout; that fit was very fevere, and of many weeks con- 
tinuance. I now determined upon a more abftemious method 
of living, in refpedl to wine ; and indeed the fociety, in which 
I had before been accuftomed to live, being confiderably chang- 
ed, I had lefs frequent temptations to excels. From this time 1 
enjoyed the molt perfect good ftate of health till Auguft 1784, 
when I had my fecond attack of gout. I never perfectly recov- 
ered 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 Ihould 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 travelled 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 pof- 
fibility of the leaft degree of removal 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 
lince had feveral equally-fevere. In the courfe of this fummer 
1 had a fall with my horfe ; and foon after it, having difcovered 
an enlargement on one elbow, I concluded I had hurt it at that 
time ; but in the courfe of this laft attack having a fimilar en- 
largement 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 af- 
ter fimilar enlargements on my heels; the right heel being fe- 
verely bruifed, I was under the neceflity of having it lanced, and 
a large quantity of chalky matter was difeharged from it; and 
have fince that time frequently had chalky matter taken from 
it, and fometimes fmall bits of apparently perfedt chalk. My 
right hand was foon afflifted in the fame way, and I have fcarce- 
ly a joint on thofe fingers now in a natural ftate. My left hand 
has efcaped tolerably well. After this laft attack (viz. October 
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 
beganto feel the gout about me very much, but was not confin- 
ed by it. I was in this ftate advifed to try what is called the 
American Recipe (gum guaiacum and nitre diflblved in fpirits); 
it had apparently been of eflential fervice to a friend of mine, 
who from the inability to walk a mile for fome years, was be- 
bevrd to be reftored bv the nfe of this medicine to a good ftate 
of 384 
DISEASES 
Class IV. i. 2. 15. 
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 fatisfaclion, and with very little doubt, the perfect 
reiloration of my health and ilrength ; but I was miferably de- 
ceived ; for in September 1788 I was feized with the gout in a 
degree that none but arthritics, and indeed but few of thefe, 
can eafdy conceive. From this time till Auguft 1789 I fcarcely 
ever palled a comfortable day ; feven months of this time I had 
been confined, my health feemed much impaired, my Ilrength 
was diminiihed, and my appetite almoft gone. In this (late my 
friends prefled me to confult you. I was unwilling for fame 
time to do it, as I had loll all hope of relief; however, when I 
had detrmined to apply to you, I likewife determined to give up 
every prejudice of my own refpe&ing my cafe, and to adhere 
moft ftriclly to your advice. On the 20th of Auguft 1789 I 
confulted you, on the 25th I entered upon the regimen, which 
vou prefcribed, and which was as follows. 
" Drink no malt liquor on any account. Let your beverage at 
" dinner confift of two glades of wine diluted with three half- 
<' pints of water. On no account drink any more wine or fpir- 
" ituous 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 conflant- 
" ly at dinner, and with any kind of tender vegetables you pleafe. 
" Keep the body open by two evacuations daily, if poifiblc 
« without medicine, if not take the fize of a nutmeg of lenitive 
" electuary occafionally, or five grains of rhubarb every night. 
" Ufe no violent exercife, which may fubjedt yourfelf to fudden 
« changes from heat to cold ; but as much moderate exercife as 
« may be, without being much fatigued or ftarved with cold. 
« Take fome fupper every night; a fmall quantity of animal 
" food is preferred ; but if your palate refufes this, take veg- 
" ctable food, as fruit-pie, or milk ; foinething fhould be eaten, 
« as it might be injurious to you to fail too long." To the whole 
of this I adhered moft fcrupuloufly, and foon found my appetite 
improve, and with it my ilrength and fpirits. I had in Decem- 
ber a fevere attack, and two or three flight ones in the courfe of 
twelve months; but the improvement in the general flate of my 
health induced me to perfevere. On the 18th of Augufl 1790 
I had another fevere attack, but it went oil' caller than before, 
and T foon recovered fuflicicntly to go to Buxton, which you ad- 
vifed ClassIV. 1. 2.15. 
OF ASSOCIATION. 
385 
vifed me to, and from which I reaped great benefit; neverthe- 
lefs on the 29th of December I had a flight attack in compari- 
fon of fome that I had before experienced, and from that 
time I was free from gout, and enjoyed my health perfectly well 
till the fourth week in October 1791 ; from that till the third 
week in October 1792 ; from that till the third week in Octo- 
ber 1793 ; and from that till June 1794. From what happen- 
ed for the laft three years I dreaded the month of October; 
but I efcaped then, and have enjoyed my health molt perfectly 
ever fince till within the laft week, that I have had a flight at- 
tack 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 moft fcrupUloufly for the fir ft y£ar ; 
and in regard to the not drinking malt liquor, and taking only 
the two glades of wine with water, I have never deviated but 
two days; and then the firft 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 I have gouty fymptoms upon me, and in fuch fituations 
I find it of infinite fervice ; and in other refpe&s I continue to 
live according to your direftion. 
t( Many perfons have laughed at the idea of my perfeverance 
in a fyftem, which has not been able to cure the gout after five 
years' trial; but fuch perfons are either ignorant of what I be- 
fore fuffered, or totally unacquainted with the nature of the dif- 
order. Under the blefling of Providence, by an adherence to 
your advice, I am reaping all the benefit you flattered me 1 
might expeft from it, viz. my attacks lefs frequent, my fufFer- 
ings lefs acute, and an improvement in the general ftate of my 
health. 
" I have been particular in this account of myfelf at your re- 
queft, and am, Sir, &c. 
Morley, near Derby, 
February 10th, 1795. Robert Wilmot." 
There are fituations neverthelefs in which a paroxyfm of gout 
has been believed to be defirable, as relieving the patient from 
other difagreeable difeafes, 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 inflam- 
ed 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 
Vol. II. B b b cheft. 386 
DISEASES 
Class IV. 1. 2. 15. 
cheft, which they fuppofe a fit of the gout would relieve. But 
in all thefe cafes the attempt to procure a paroxyfm of gout by 
wine, or aromatics, or volatiles, or blifters, or mineral waters, 
feldom fucceeds ; and the patients are obliged to apply to oth- 
er methods of relief adapted to other particular cafes. In the 
two foriher fituations fmall repeated dofes of calomel, or mer- 
curial unflion on the region of the liver, may fucceed, by giv- 
ing new activity to the veflels 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 laft cafe the 
tinflure of digitalis, and afterwards the clafs of forbentia, mult 
be applied to. 
M. M. In young ftrong patients the gout fhould be cured 
by venefeftion and cathartics and diluents, with poultices ex- 
ternally. But it has a natural crifis by producing calcareous 
matter on the inflamed membrane, and therefore in old enfee- 
bled people it is fafeft to wait for this crifis, attending to the 
natural evacuations and the degree 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 fudorifics, as neutral faits, and to give the bark at 
the decline of the fit ; which is particularly ufeful where the 
patient is much debilitated. See Arthritis ventriculi, Clafs I. 
2. 4. 6. and Sed. XXV. 17. 
Mr. Kelly, furgeon in the navy, in an ingenious treatife, 
printed at Edinb. 1797, termed Obfervations on Compreflion 
by the Tourniquet, advifes in both inflammatory and chronic 
rheumatifm to comprefs the artery of the afFeaed limb by the 
tourniquet, for 15 or 20 minutes, relaxing or tightening the 
bandage, as the patient feems to bear it. And in inflammatory 
rheumatifm, he advifes to take blood from a vein below the 
bandage, which he fays relieves the pain and deftroys the in- 
flammation. Could not this experiment be ufed fafely in the 
gout of young or ftrong patients ? and perhaps with fpeedy 
fuccefs ? 
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 timSlure of opium, or one grain of folid opi- 
um, may be taken every night with advantage. Externally a 
pafte made with double the quantity of yeft is a good poultice ; 
and booterkins made with oiled filk, as they confine the perfpir- 
able matter, keep the part moift and fupple, and thence relieve 
the pain like poultices. 
The only fafe way of moderating the difeafe is by an uniform 
and equal diminution, or a total abftinence from fermented 
liquors, Class IV. 1. 2. 16. 
OF ASSOCIATION. 
387 
liquors, with the cautions directed in Sett. XII. 7. 8. The 
continued ufe of ftrong bitters, as of Portland's powder, or bark, 
has been frequently injurious, as fpokenof in the Materia Med- 
ica, Art. IV. 2. 11. 
One of my acquaintance, who was much afRifted with the 
gout, abftained 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 ftronger and freer from the gout than ufual. This how- 
ever did not long continue, 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 effect 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 fyftem, acquired during the leflened 
ufe of fermented liquor. 
For the fame reafon an ounce of fpirituous tin<Slure of guaia- 
cum, or of bark, is faid to have for fome time prevented returns 
of the gout; which has afterwards, like all other great ftimuli 
when long continued, been fucceeded by greater debility, and 
deltroyed the patient. This feems to have been exemplified in 
the cafe of the ingenious Dr. Brown, fee Preface to his Ele- 
menta Medicine ; he found temporary relief from the ftimulus 
of wine, regardlefs of its future effects. 
Laftly, as the gouty inflammation, like the rheumatic fwellings 
of the wrifts and ankles, is not a primary difeafe ; and is like 
them not liable to fuppurate ; there is reafon to believe that opi- 
ates may be given with lefs danger than in other inflammations, 
and with a profpeft of advantage; fihee by preventing the pe- 
riods of torpor of the liver, or other part, primarily affected, the 
diurnal additional attack, or its producing inflammation of 
another limb, may fometimes be prevented. A perfon a few 
days ago affured me, that when the gout came into his foot, his 
practice was to take thirty drops of tin&ure of opium ; and in 
half an hour thirty drops more ; and even a third dofe, if the 
pain did not fubfide ; and that the fit foon ceafed. I fhould 
think this a dangerous experiment. A Mr. Warner wrote a 
book recommending opium in the gout, but died foon after its 
publication. 
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 the confequence of a 
tranflation of morbid action from one part of the fyftein to 
another. This idea is countenanced by the frequent change of 
place of rheumatic-like gouty inflammations, and from their at- 
tacking 388 
DISEASES 
ClassIV. i. 2.16 
tucking two fimilar parts at the fame time, as both ankles and 
both wrifts, and thefc attacks being in fucceflion 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 moifture ; and lefs fo that thefe fhould oc- 
cur in fucceflion. Laftly, from the inflammatory diathefis in 
this difeafe being more difficult to fubdue, and more dangerous 
in event, than other common inflammations, efpecially to preg- 
nant women, and in weak conftitutions. 
From this? idea of the rheumatifm being not a primary dif- 
eafe, like the gout, but a transferred morbid aftion owing to the 
previous torpor of fome other part of the fyftem, we perceive 
why it attacks weak people with greater pertinacity than ftrong 
ones; refilling or recurring again and again after frequent evac- 
uations, in a manner very different from primary inflammations ; 
becaufe the caufe is not removed, which is at a diflance from the 
feat of the inflammation. 
This alfo accounts for rheumatic inflammations fo very rarely 
terminating in fuppuration, becaufe like the gout the original 
caufe is not in the inflamed part, and therefore does not con- 
tinue to act after the inflammation commences. Inftead of fup- 
puration in this difeafe, as well as in the gout, a quantity of 
muctis or coagulable lymph is formed on the inflamed mem- 
brane 5 which in the gout changes into chalk-ftones, and in the 
rheumatifm is either reabforbed, or lies on the membrane, pro- 
ducing pains on motion long after the termination of the inflam- 
mation, which pains are called chronic rheumatifm. The mem- 
branes, which have thus been once or repeatedly inflamed,become 
lefs mobile, or lefs liable to be affeCled by fympathy, as appears 
by the gout affediing new parts, when the joints of the foot 
have been frequently inflamed by it; hence as the caufe of the 
inflammation does not exift in the inflamed part, and as this 
part becomes lefs liable to future attacks, it feldom fuppurates. 
♦ Pleurodyne rheumatica. When rheumatifm affects the 
mufcles of the cheff, it produces fymptoms fimilar to pleu- 
rify, but diftinguifhed from it by the patient having previoufly 
fufl'ered rheumatic affections in other parts, and by the perti- 
nacity or continuance of the inflammatory Itate of the patient. 
This fhould be termed pleurodyne rheumatica. 
Enteralgia rheumatica. When rheumatic inflammation af- 
feCts the bowels, it produces a difeafe very different from en- 
teritis, or common inflammation of the bowels, and fhould be 
termed interalgia rheumatica. The pain is lefs than in enteri- 
tis, and the difeafe of longer continuance, with harder pulfe, and 
the blood equally fizy. It is attended with frequent dejeClions, 
with Class IV. 1. 2.16. 
OF ASSOCIATION. 
389 
with much mucus, and previous griping pains, but without 
vomiting; and differs perhaps from dyfentery from its not be- 
ing attended with bloody ftools, and not being infectious. 
Rheumatic inflammations, which I believe to arife from the 
fympathy of the inflamed part with the torpor of fome diftant 
part, may I think be certainly diftinguifhed from thofe inflam- 
mations of the fame part, which have not arifen from fympathy 
with the torpor of fome diftant part, but where the caufe of the 
inflammation began in the part where the inflammation exifts, 
by this circumftance ; that in rheumatic inflammation the hard 
or fliarp pulfe continues at about 118 in a minute after the pain 
abates or ceafes. Whereas in the latter the inflammatory fever 
ceafes along with the pain. 
In two cafes of pain of the fide, and difficult refpiration, 
which I efteemed rheumatic, as the hard pulfe of 118 with fized 
blood continued after repeated venefeftion, gentle cathartics, 
and mild antimonials, I found ten drops of faturated tincture of 
digitalis given every fix hours appear to produce great good ef- 
fect, and to abate and remove the inflammatory diathefis in three 
or four days. 
Hence when a fever has continued more than one lunar pe- 
riod, attended with a hard or fliarp pulfe of 118 or 120 in a 
minute, and is not attended with cough or fymptoms of abforb- 
ed matter, it may be efteemed of rheumatic origin, though no 
local pain or inflammation at prefent exifts; and this with great- 
er certainty, if pain had previoufly exifted : for no fevers, ex- 
cept the he&ic fevers from abforbed matter, and this attended 
with inflammatory diathefis, and which may be called rheumat- 
ic, ever properly extend, I believe, beyond one lunation ; though 
fymptoms of debility may continue a while longer. This ob- 
fervation is worth attending to in practice, as it diftinguilhea 
the kind of fever, in which when the bark is erroneously givien, 
it does no fervice, and in which I believe faturated tindture of 
digitalis given as above to be the moft efficacious medicine. 
Rheumatifmus juppurans. There is another kind of rheuma- 
tifm attended with debility, which fuppurates, and fhould be 
termed rheumatifinus fuppurans. It is generally believed to be 
the gout, till fuppuration takes place on the fwelled joint; and, 
as the patient finks, there are floughs formed over the whole 
mouth; and he feems to be deftroyed by inflammation or gan- 
grene of the mucous membranes. I have twice feen this dif- 
eafe in patients about fixty. Some other difeafes are erroneouf- 
ly called rheumatic, as hemicrania, and odontalgia. See Seel. 
XXVI. 3. 
M. M. In the three former kinds venefedion repeatedly. Ca- 
thartics. 390 
DISEASES 
Class IV. i. 2. 16. 
thartics. Antimonials. Diluents. Neutral faits. Oil. Warm 
bath. Afterwards the bark. Opium with or without ipecacu- 
anha j 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 ftimulants, as 
wine and water, mucilage, forbeiitia. 
In acute rheumatifm, when the fwelling of the joints firft af- 
fected fubfides, a return of torpor in the part primarily difeafed 
commences previous to an inflammation of the joints fecondari- 
ly affeCted. Hence when the tumor of the joints firft affeCked 
fubfides, half a grain of opium, every night, and Peruvian bark, 
or other bitter medicine, may be given to prevent this return 
of torpor with great advantage ; if the patient has previoufly 
been properly evacuated, and is not now too much inflamed. 
Dr. Fordyce afferts, that when it was the practice to bleed 
largely in acute rheumatifm, a metaftafis frequently took place 
to the interior parts of the body, and deftroyed the patient. And 
adds, that during the laft fifteen years of his practice this has 
rarely happened, as he has entirely left off bleeding in the acute 
rheumatifm. Third differtation on fever by G. Fordyce, M. D. 
London, Johnfon. On this fubject it may be remarked, that as 
rheumatifm like gout is a fecondary difeafe, the inflammation 
of one part being fymptomatic, the feat of torpor exifting in 
fome other part, it may not be fo conftantly neceffary to bleed 
fo copioufly in thofe fecondary inflammatory difeafes, as in thofe 
primary ones, where the inflamed part was previoufly the feat 
of torpor, as in pleurify, peripneumony, and interitis; but in 
rheumatifm, as well as in eryfipelas, I am convinced, that where 
the inflammation of the fyftem is great, repeated venefeCkion is 
not only ufeful; but that thofe, who perilh by either of thofe 
difeafes, perifti for the want of venefeCkion early, where the at- 
tack is violent. And laftly, that even in the gout of young and 
ftrong ftubjeCks, as I know by experience on myfelf, a moderate 
venefeCkion fhortens the fit, and leffens I believe the hazard of 
metaftafis. 
The following is a cafe of fuppurative rheumatifm. Mr. 
F , about fixty, was fuppofed to have the gout in his hand, 
which however fuppurated, and it was then called the fuppura- 
tive rheumatifm. He had lived rather intemperately in refpect 
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 pofture, 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 by Houghs ; 
this Class IV. 1.2. 17. 
OF ASSOCIATION. 
391 
this was a mod diftrefling circumftance to him, and was in vain 
endeavoured to be relieved by fupporting his jaw by (lender 
Heel fprings fixed to his night-cap, and by fprings of elaftic gum. 
The (loughs fpread and feemed to accelerate his death. See 
Clafs 1. i. 3. 2. 
In acute rheumatifm Mr. Kellie averts that he has had great 
fuccefs by putting a tourniquet on the affected limb, fo as to 
comprefs the artery, and then by taking blood from a vein below 
the bandage,as mentioned above in Podagra. Clafs IV. 1. 2. 15. 
17. Eryfipelas. 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 ftrong and full pulfe ; and at other times with weak 
pulfe and great inirritability, as v/hen it precedes or attends 
mortifications. See Clafs II. 1. 3. 2. 
Like the zona ignea above defcribed, it feems to be a fecond- 
ary difeafe, having for its primary part the torpor or inflam- 
mation of fome internal or diftant membrane, as appears from 
its fo frequently attending wounds ; fometimes fpreading from 
iffues over the whole limb, or back, by fympathy with a tendon 
or membrane, which is ftimulated by the peafe in them. In 
its more violent degree I fuppofe that it fympathizes with fome 
extenfive internal membranes, as of the liver, ftomach, or brain. 
Another reafon, which countenances this idea, is, that the in- 
flammation gradually changes its fituation, one part healing as 
another inflames ; as happens in refpeit 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, becaufe the eryfipelas of the face and head is liable to 
affect the memb ranes of the brain ; which were probably in 
thefe cafes the original or primary feat of the difeafe ; and laftly, 
becaufe the fits of eryfipelas, like thofe of the gout, are liable 
to return at certain annual or monthly periods, as further treat- 
ed of in Clafs II. 1. 3. 2. 
Many cafes of eryfipelas from wounds or bruifes are related 
in Default's Surgical Journal, Vol. II. in which poultices are 
faid to do great injury, as well as oily or fatty applications. Sat- 
urnine 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. 
18. Tejlium tumor in gonorrhoea. Mr. Hunter in his Treatife 
on the Venereal Difeafe obferves, that the tumor of the teftes in 
gonorrhoea arifes from their fympathy with the inflammation of 
the urethra ; and that they are not fimilar to the actions arifing 
from the application of venereal matter, whether by abforption 
or 392 
DISEASES 
Class IV. i. 2.19. 
or otherwife ; as they feldom or never fuppurate ; and when 
fuppuration happens, the matter produced is not venereal. Trea- 
tife on Venereal Difeafe, p. 53. 
ip. Tejl'ium tumor tnparotidite. The fympathy between fome 
parts about the throat and the genitals has been treated of in 
Clafs IV. 1. 2. 7. The fwelling of the teftes, when that of 
the parotis fubfides, feems to arife from the aflbciation of fuc- 
ceflive a Ct ion ; as the tenfion of the penis in hydrophobia appears 
to arife from the previous fynchronous aflbciations of the fenfi- 
tivc motions of thefe parts; but the manner of the production 
of both thefe aflbciations is yet very obfcure. In women a 
fwelling of the breafts often fuccceds the decline of the mumps 
by another wonderful fympathy. See Clafs IV. 1. 2. 7. and 
I. 1. 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 feemsm arife from a fympathy of 
fucceflive aCtion, and not of fynchronous aCtion, of the mem- 
branes of the brain with thofe of the parotid glands. Sometimes 
a ftupor comes on inltead of this delirium, which is relieved by 
fomenting the (haved head for an hour or two. See Clafs II. 
T. 3. 4. 
ORDO Class IV. 1. 3.1. 
OF ASSOCIATION. 
393 
ORDO I. 
Increafed Ajfaiate Motions. 
GENUS III. 
Catenated ^ith Voluntary Motions. 
SPECIES. 
I. Deglutitio invita. When any one is told not to fwal- 
low his faliva, and that efpecially if his throat be a little fore, 
he finds a neceffity of immediately fwallowing it; 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 pharynx renders it more fenfible to irritation, and therefore 
occafions it to be more frequently induced to fwallow the fali- 
va. Here the irritation 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 tafte, the objetfs of thofe 
fenfes became perceived ; but not otherwife. Sect. XIX. 6. 
This is a troublefome fymptom in fome fore throats. 
M. M. Mucilage, as fugar and gum arabic. 
Warm water held in the mouth frequently, a fomentation to 
the inflamed throat. 
2. Niflitatio invita. Involuntary winking with the eye-lids, 
and twitchings of the face, are originally induced by an en- 
deavour to relieve fome difagreeable fenfations about inflamed 
eyes, as the dazzling of light; and afterwards thefe motions be- 
come catenated with other motions or fenfations, fo as not to be 
governed by the will. Here the irritation firft produces a vo- 
lition to wink, which by habit becomes ilronger than the anti- 
volition not to wink. 
This fubjecT is rendered difficult from the common accepta- 
tion of the word, volition, including previous deliberation, as 
well as the voluntary exertion, which fucceeds it. In the voli- 
tions here fpoken of there is no time for deliberation or choice 
uf objects, but the voluntary aft immediately fucceeds the fen- 
fation which excites it. 
M. M. Cover the aflecSled parts with a flicking plafter or a 
blifter. Pafe a fine needle and thread through a part of the 
fkin over the mufcle, which moves, and attach the other end of 
Vol. II. C c« the 394 
DISEASES 
Class IV. 1.3.3, 
the thread by a {ticking plafter to a diftant part. An iiTue be- 
hind the ear. To pradtife daily by a looking-glafs to ftop the 
motions with the hand. See the cure of a cafe of the leaping of 
a mufcle of the arm, Se£t. XVII. 1. 8.' See Convulfio debi- 
lis, Clafs III. 1. 1. 5. Frequent electric fparks, or very flight 
(hocks. 
3. Rifus invitus. Involuntary laughter. When the pleafure 
arifing from new combinations of words and ideas, as in puns ; 
or of other circumftances, which are fo trivial, as to induce no 
voluntary exertion to compare or confider their prefent impor- 
tance 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 antithefiftic 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 contrac- 
tion. In this fituation a fcream is begun to relieve this pain of 
ideas too violently exerted, which is (topped again foon, as ex- 
plained in Se£t. XXXIV. 1. 4. and Clafs III. 1. 1. 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 circumftances, as have induc- 
ed them to reftrain it by a counter-volition ; till at length the 
increafed aflbciate motions produce fo much pain as to over- 
come the counter-volition, and the patient burfts out into inde- 
cent laughter, contrary to his will in the common acceptation of 
that word. 
4. Lufus digitorum invitus. An awkward playing with the 
fingers in fpeaking in public. Thefe habits are begun through 
bafhfulnefs, and feem rather at firft defigned to engage the at- 
tention in part, and thus prevent the difagreeable ideas of mau- 
vaife honte ; as timorous boys whiftle, 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 invita. Biting the nails is a de- 
praved habit arifing from fimilar caufes as thofe of the laft arti- 
cle. 
M. M. Dip the fingers in folution of aloes. 
6. Vigdia invita. Watchfulnefs, where the perfon wifhes 
and endeavours to fall afleep, properly belongs to this place, as 
the with or volition to deep prevents the defired effect; be- 
caufe deep confifts in an abolition of volition. See Clafs III- 
1. 2. 3. 
ORDO Class IV. 1.4.r. 
OF ASSOCIATION. 
395 
ORDO I. 
Increafed AJfociate Motions. 
GENUS IV. 
Catenated with External Influences. 
SPECIES. 
i. Vita ovi. Life of an egg. The eggs of fowls were fliewn 
by Mr. J. Hunter to refill the freezing procefs in their living 
(late more powerfully than when they were killed by having the 
yolk and white (hook together. Philqf. Tranf. It may be alli- 
ed, does the heat during the incubation of eggs a£l as a llimulus 
exciting the living principle into adlivity ? Or does it act Am- 
ply 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 wa- 
ter ; not by llimulus, but by its penetrating influence ? Or may 
elementary heat in its uncombined ftate be fuppofed to atl only 
as an influence necelfary to life in its natural quantity ; whence 
torpor and death follow the eduiflion of it from the body ; but 
in its increafed ftate above what is natural, or ufual, that it a6ls 
as a llimulus ; which we have a fenfe to perceive ; and which 
excites many parts of the fyllem into unnatural action ? See 
Clafs IV. i. i. C. 
2. Vita hiemi-dormientium. The torpor of infects, and birds, 
and quadrupeds, during the cold feafon, has been called fleep; 
but I fuppofe it mull differ very much from that ftate of animal 
life, fince not only all voluntary power is fufpended, but fenfa- 
tion and vafcular motion have 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 
water after having experienced many years of torpidity, or ap- 
parent death, in the cabinets of the curious. Here the water as 
well as the heat are required not only as a ftimulus, but as a 
caufa fine qua non of fluidity and motion, and confequent life. 
3. Pullulatio arbor um. The annual revivefcence of the buds 
of trees feems not only to be owing to the influence of the re- 
turning warmth of the fpring, but alfo to be catenated with fo- 
lar gravitation; becaufe feeds and roots and buds, which are 
analogous to the eggs of animals, put forth their fhoots by a lefs 
quantity 396 
DISEASES 
ClASS IV; I. 4. 4 
quantity of heat in fpring, than they had undergone in the lat- 
ter part of autumn, which may however be afcribed to their 
previous torpid ftate, and confequent accumulation of fenforial 
power, or irritability ; as explained in Botanic Garden, Part II. 
Cant. I. 1. 322. note. Other circumftances, which counter 
nance the idea, that vegetation is affefted 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 fhort, 
and in thofe where they are long. And by fome flowers clof- 
ing 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 light. , 
4. Orgafmatis venerei periodus. The venereal orgafm of birds 
and quadrupeds commences or returns about the vernal or au- 
tumnal equinoxes, and thence feems in refped to their great 
periods to be governed by folar influence. But if this orgafm 
be difappointed of its objea, it is faid to recur at about month- 
ly periods, as obferved in mares and bitches, in this refped re- 
fembling the female catamenia. See Sed. XXXVI. 2. 3. and 
Sett. XVI. 13. 
5. Brachii concujjio electrica. The movement of the arm, 
even of a paralytic patient, when an dedric ihodr is pafled 
through it, is owing to the ftimulus of the excefs of dedricity. 
When a piece of zinc and another of fdver, 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 
contad, there is an appearance of light in the eyes, as often as 
the outer edges of thefe metals are brought into contaa or fep- 
arated ; which is another inftance of the ftimulus of the paflage 
of dearie fhocks through the fibres of the organs of fenfe, as 
well as through the muicular fibres. See Sea. XII. 1. 1. But 
in its natural ftate dedricity feems only to ad as an influence 
on animal and vegetable bodies ; of the falutary or injurious ef- 
feas of which we have yet no precife knowledge. 
Yet if regular journals were kept of the variations of atmof- 
pheric elearicity, it is probable fome difeoveries of its influence 
on our fyftem might in time be difeovered. For this purpofe a 
machine on the principle of Mr. Bennet's dearie doubler might 
be applied to the pendulum of a clock, fo as to manifeft, and 
even to record the daily or hourly variations of aerial elearicity. 
Which has already been executed, and applied to the pendu- 
lum of a Dutch wooden clock, by Mr. Bennet, curate of Wirkf- 
worth in Derbyfliire. 
Befides the variations of the degree or kind of atmofpheric 
electricity, fome animals, and fome men, feem to poflefs a great- 
er Class IV. 1.4. 6. 
OF ASSOCIATION. 
397 
er power of accumulating this fluid in themfelves than others. 
Of which a famous hiftory of a Ruffian prince was lately pub- 
liffied; who, during 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 to have been reduced 
to allies. The eledlric concuflion from the gymnotus ele€lricus, 
and torpedo, are other inftances of the power of the animal fyf- 
tem to accumulate electricity, 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 paflage of the 
magnetic fluid might affedt the animal fyftem, and have aflerted 
that the application of a large magnet to an aching tooth has 
quickly effected 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-lhoe magnet, or between the contrary poles of two 
different magnets, that the magnetifm may be accumulated on 
the torpid part. 
6. Oxygenatio fanguinis. The variation of the quantity of 
oxygen gas exifting in the atmofphere muft aifeft all breathing 
animals; in its excels this too muft be efteemed a ftimulus ; 
but in its natural quantity would feem to adt as an influence, 
or caufe, without which animal life cannot exift 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 teft 
of experiment, will meet with public encouragement, and ren- 
der confumption, afthma, cancer, and many difeafes conquera- 
ble, which at prefent prey with unremitted devaluation on all 
orders and ages of mankind. 
7. HumeBatio corporis. Water, and probably the vapour of 
water diflblved or diffufed in the atmofphere, unites by mechan- 
ical attraction with the unorganized cuticle, and foftens and en- 
larges it; as may be feen in the loofe and wrinkled ikin of the 
hands of wafherwomen ; the fame probably occurs to the mu- 
cous membrane of the lungs in moift weather; and by thick- 
ening it increafes the difficulty of refyiration of fome people, 
who are faid to be afthmatical. So far water may be laid to 
act as an influx or influence, but when it is taken up by the 
mouths of the abforbent fyftem, it muft excite thofe mouths into 
action, and then adts as a ftimulus. 
There appears from hence to be four methods by which ani- 
mal bodies are penetrated by external things. 1. By their ftim- 
ulus, which induces the abforbent veflels to imbibe them. 2. By 
mechanical attraction, as when water foftens the cuticle. 3. By 
chemical 398 
DISEASES 
Class IV. i. 4. 7. 
chemical attraction, as when oxygen pafles through the mem- 
branes of the air-veflels of the lungs, and combines with the 
blood. And laftly, by influx without mechanical attraction, 
chemical combination, or animal abforption, as the univerfal 
fluids of heat, gravitation, eleftricity, magnetifm, and perhaps 
of other etherial fluids yet unknown. 
ORDO Class IV. 2. i. 
OF ASSOCIATION, 
399 
ORDO II. 
Decreafed ^JJociate Motion!. 
GENUS I. 
Catenated with irritative Motions. 
As irritative mufcular 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 exerted too weakly, as well as when they are ex- 
erted too ftrongly. Which accounts for thefe ideas being at- 
tended with fenfation in the various kinds of vertigo defcribed 
below. 
There is great difficulty in tracing the immediate caufe of the 
deficiencies of action of fome links of the affociations of irrita- 
tive motions j 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 aflbciated train of actions is exerted with too 
great energy, the fecond link by reverfe fympathy may be affefted 
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 aftion ; and it is poffible this third link may 
in like manner tranfmit its torpor to. a fourth, and thus regain 
its own natural quantity of motion. 
I ffiall endeavour to explain this by an example taken from 
fenfitive aflbciated motions, as the origin of their difturbed ac- 
tions is more eafily detected. This morning 1 faw an elderly 
perfon, who had gradually loft all the teeth in his upper jaw, 
and all of the under except three of the molares ; the laft of 
thefe was now loofe, and occafionally painful; the fangs of 
which were almoft naked, the gums being much wafted both 
within and without the jaw. He is a man of attentive obfer- 
vation, and allured me, that he had again and again noticed, 
that, when a pain commenced in the membranes of ths alveolar 
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 after- 
wards extended to the ear and temple on that fide, the pain in 
the membranes of the upper jaw ceafed. In this cafe the mem- 
branes of the alveolar procefs of the upper jaw became torpid, 
and confequentlv painful, by their '•everfe fympathy with the 
too 400 
DISEASES 
Class IV. 2. 1. 1, 
too violent adions 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 quanti- 
ty of adion, and ceafed to be painful. A great many more nice 
and attentive obfervations are wanted to elucidate thefe curious 
circumftances of aflbeiation, which will be found to be of the 
greateft importance in the cure of many difeafes, and lead us to 
the knowledge of fever. 
SPECIES. 
X. Cutit frigid^ pranforum. Chillnefs after dinner frequent ly 
attends weak people, or thofe who have been exhaufted by exer- 
cife; it arifes from the great expenditure of the fenforial power 
on the organs of digeftion, which are ftimulated into violent 
aeliem by the aliment; and the veflels of the ikin, which are af- 
fociated with them, become in fome meafure torpid by reverfe 
fympathy ; and a confequent chillnefs fucceeds with lefs abforp- 
tion of atmofplreric moillure. See the fubfequent article. 
2. Pallor urina pranforum. The palenefs of urine after a 
full meal is an inltance of reverfe alfociation ; where the fecond- 
ary part of a train of afibciate motions acts with lefs energy in 
confequence of the greater exertions of the primary part. Af- 
ter dinner the abforbent veflels of the itomach and inteftines are 
flimulated into greater action, and drink up the newly taken al- 
iment; while thofe, which are fpread in great number, on the 
neck of the bladder, abforb lefs of the aqueous part of the urine 
than ufual, which is therefore difeharged in a more dilute ftate ; 
and has been termed crude by fome medical writers, but it only 
indicates, that fo great a proportion of the fenforial power is ex- 
pended on digellion and abforption of the aliment, that other 
parts of the fyllem acl for a time with lefs energy. See Clafs IV. 
i. i. 6. 
3. Pallor urina a frigore cutanea. There is a temporary dif- 
charge of pale water, and a diarrhoea, induced by expofing the 
Ikin to the cold air ; as is experienced by boys, who fir ip them- 
fclves before bathing. In this cafe the moutns of the cutaneous 
lymphatics become torpid by the fubduclion of their accuftom- 
td degree of heat, and thofe of the bladder and inteftines be- 
come torpid by direct fympathy ; whence lefs of the thinner part 
of the urinary fecretion, and of the mucus of the inteftines, is 
reabforbed. See Se£l. XXIX. 4. 6. This effect of fuddenly 
cooling the Ikin by the afperfion of cold water has been ufed 
with fuccefs in coftivenefs, and has produced evacuations, when 
other Class IV. 2. 1.4. 
OF ASSOCIATION. 
401 
other means have failed. When young infants are afflicted 
with griping joined with coftivenefs, I have fometimes directed 
them to be taken out of a warm bed, and carried about for a 
few minutes in a cool room, with almoft inftant relief. 
4. Pallor ex xgritudine. When ficknefs of ftomach fir ft oc- 
curs, a palenefs of the Ikin attends it; which is owing to the 
aflbciation or catenation between the capillaries of the ftomach 
and the cutaneous ones ; which at firft act by direct fympathy. 
But in a fliort time there commences an accumulation of the 
fenforial power of aflbciation in the cutaneous capillaries during 
their ftate of inactivity, and then the Ikin begins to glow, and 
fweats break out, from the increafed actions of the cutaneous 
glands or capillaries, which is now in reverfe fympathy with 
thofe of the ftomach. So in continued fevers, when the ftom- 
ach is totally torpid, which is known by the total averfion to 
folid food, the cutaneous capillaries are by reverfe fympathy in 
a perpetual ftate of increafed activity, as appears from the heat 
of the (kin. 
5. Dyfpnoea a balneo frigido. The difficulty of breathing on 
going up to the middle in cold water is owing to the irritative 
aflbciation or catenation of the atftion of the extreme veflels of 
the lungs with thofe of the Ikin. So that when the latter are 
rendered torpid or inactive by the application of fudden cold, 
the former become inactive at the fame time, and retard the 
circulation of the blood through the lungs, for this difficulty of 
breathing cannot be owing to the preflure of the water imped- 
ing the circulation downwards, as it happens equally by a cold 
fhower-bath, and is foon conquered by habitual immerfions. 
The capillaries of the Ikin are rendered torpid by the fubduc- 
tion of the ftimulus of heat, and by the confequent diminutions 
of the fenforial power of irritation. The capillaries of the lungs 
are rendered torpid by the diminution of the fenforial power of 
aflbciation, which is now excited in lefs quantity by the leflen- 
cd actions of the capillaries of the Ikin, with which they are 
catenated. So that at this time both the cutaneous and pulmo- 
nary capillaries are principally actuated, as far as they have any 
action, by the ftimulus of the blood. But in a (hort time the 
fenforial powers of irritation, and of aflbciation, become accu- 
mulated, and very energetic a&ion of both thefe membranes 
fucceeds. Which thus refemble the cold and hot fit of an in- 
termittent fever. 
6. Dy/pepjia a pedibus frigidis. When the feet are long coldj 
as in riding in cold and wet weather, fome people, are very 
liable to indigeftion and confequent heart-burn. The irritative 
motions of the ftomach becomi torpid, and do their office of di- 
Vol. II. D D d geftion 402 
DISEASES 
Class IV. 2.1. 7. 
geftion imperfectly, in confequence of their aflbciation with the 
torpid motions of the veflels of the extremities. Fear, as it pro- 
duces palenefs and torpidity of the (kin, frequently occafions tem- 
porary indigeftion in confequence of this aflbciation of the vef- 
fels of the (kin with thofe of the ftomach ; as riding in very bad 
roads will give flatulency and indigeftion to timorous people. 
A (bort expofure to cold air increafes digeftion, which is then 
owing to the reverfe fympathy between the capillary veflels of 
the (kin, and of the ftomach. Hence when the body is expofed 
to cold air, within certain limits of time and quantity, a reverfe 
fympathy of the ftomach and the (kin firft occurs, and after- 
wards a diredt fympathy. In the former cafe the expendi- 
ture of fenforial power by the (kin being leffened, but not its 
production in the brain ; the fecond link of the aflbciation, viz. 
the ftomach, acquires a greater (hare of it. In the latter cafe, 
by the continuation of the deficient ftimulus of heat, the torpor 
becomes extended to the brain itfelf, or to the trunks of the 
nerves ; and univerfal inactivity follows. 
7. Tuffis a pedibui frigidis. On (landing with the feet in 
thawing fnow, many people are liable to inceffant coughing. 
From the torpidity of the abforbent veflels of the lungs, in con- 
fequence of their irritative aflbeiations with thofe of the (kin, 
they ceafe to abforb the faline part of the fecreted mucus ; and 
a cough is thus induced by the irritation of this faline fecretion; 
which is fimilar to that from the noftrils in frofty weather, but 
differs in refped to its immediate caufe ; the former being from 
aflbciation with a diftant part, and the latter from defeCt of 
the ftimulus of heat on the noftrils themfelves. See Catarrhus 
frigidus, Clafs I. 2. 3. 3. 
8. Tujjis hepatica. The cough of inebriates, which attends 
the enlargement of the liver, or a chronical inflammation of its 
upper membrane, is fuppofed to be produced by the inconveni- 
ence the diaphragm fuffers from the compreflion or heat of the 
liver. It differs however effentially from that attending hepati- 
tis, from its not being accompanied with fever. And is per- 
haps rather owing to irritative aflbciation, or reverfe fympathy, 
between the lungs and the liver. As occurs in (heep, which 
are liable to a perpetual dry cough, when the fluke-worm is prey- 
ing on the fubftance of their livers. See Clafs II. 1. 1. 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. Tuflis arthritica. Gout-cough. I have feen a cough, 
which twice recurred at a few years diftance in the fame per- 
fon, during his fits of the gout, with fuch pertinacity and vio- 
lence Class IV. 2.1.10. 
OF ASSOCIATION. 
403 
lence as to refill venefeClion, opiates, bark, blitters, mucilages, 
and all the ufual methods employed in coughs. It was for a 
time fuppofed to be the hooping-cough, from the violence of the 
aCtion of coughing; it continued two or three weeks, the pa- 
tient never being able to fleep more than a few minutes at once 
during the whole time, and being propped up in bed with pil- 
lows night and day. 
As no fever attended this violent cough, and but little expec- 
toration, and that of a thin and frothy kind, I fufpeCled the 
membrane of the lungs to be rather torpid than inflamed, and 
that the faline part of the mucus not being abforbed ftimulated 
them into perpetual exertion. And laitly, that though the 
lungs are not fenfible to cold and heat, and probably therefore 
lefs mobile, yet, as they are neverthelefs liable to confent with 
the torpor of cold feet, as defcribed in Species 6 of this Genus, 
I fufpeCled this torpor of the lungs to fucceed the gout in the 
feet, or to aft a vicarious part for them. 
io. Vertigo rotatoria. In the vertigo from circumgyration 
the irritative motions of vifion are increafed ; which is evinced 
from the pleafure that children receive on being rocked in a 
cradle, or by fwinging on a rope. For whenever fenfation arif- 
es from the production of irritative motion with lefs energy 
than natural, it is of the difagreeable kind, as from cold or hun- 
ger ; but when it arifes from their production with greater en- 
ergy than natural, if it be confined within certain limits, it is of 
the pleafurable kind, as by warmth or wine. With thefe in- 
creafed irritative motions of vifion, I fuppofe thofe of the ftom- 
ach are performed with greater energy by direCl fympathy ; but 
when the rotatory motions, which produce this agreeable verti- 
go, are continued too long, or are too violent, ficknefs of the 
ftomach follows ; which is owing to the decreafed aClion of that 
organ from its reverfe fympathy with the increafed aCtions 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 afl'oeiation of its due fhare. As mentioned in 
Species 6 of this Genus. 
In the fame manner the undulations of water, or the motions 
of a (hip, at firft give pleafure by increafing the irritative mo- 
tions belonging to the fenfe of vifion ; but produce ficknefs at 
length by expending on one part of the aifociated train of irri- 
tative aClions too much of that fenforial power, which ufual!y 
ferved the whole of it; whence fome other parts of the train ac- 
quire too little of it, and perform their aClions in confequencc too 
feebly, and thence become attended with difagreeable fenfation. 
It 404 
DISEASES 
Class IV. 2. 1.10. 
It muft alfo be obferved, that when the irritative motions arc 
Simulated 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 mo- 
tions thus excited, and thofe which ufed to fucceed them ; 
whence the aflbciation is either diffevered or much weakened, 
and thus the vomiting in fea-ficknefs occurs from the defeat of 
the power of aflbciation, 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 perfect 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 aflbciations of the 
mufcular motions, which were ufed to prefcrve his perpendicu- 
larity, become difordered by their new modes of fucceflive ex- 
ertion ; and he begins to fall. For his feet now touch the floor 
jn manners or directions different from thofe they have been ac- 
cuftomed to ; and in confequence he judges lefs perfectly of the 
fituation of the parts of the floor in refpebt to that of his own 
body, and thus lofes his perpendicular attitude. This may be 
illuilrated by the curious experiment of eroding one finger over 
the next to it, and feeling 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 aflbciated irritative 
motions is increafed in energy, and the fecondary ones are in- 
creafed at firfl. by direct 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 
aflbciation in particular; becaufc in the laft cafe, either pleafur- 
able or painful fenfation has been introduced between the links 
pf a train of irritative motions, and has diflevered, or much en- 
feebled them. 
Dr. Smyth, in his Effay on Swinging in Pulmonary Confump- 
tion, has obferved, that fwinging makes the pulfe flower. Dr. 
Ewart of Bath confirmed this obfervation both on himfelf and 
on Col. Cathcart, who was then hejStic, and that even on Ihip- 
board, where fome degree of vertigo might be fuppofed prcvi- 
oufly to exift. Dr. Currie of Liverpool not only confirmed this 
pbfervation frequently on himfelf, when he was alfo phthifical, 
but found that equitation had a fimilar effect on him, uniform- 
>y Class IV. 2. 1.10. 
OF ASSOCIATION. 
405 
ly retarding his pulfe. This curious circumftancc cannot arife 
from the general effect of exercife, or fatigue, as in thofe cafes 
the pulfe becomes weaker and quicker ; it mull therefore be af- 
cribed to a degree of vertigo, which attends all thofe modes of 
motion, which we are not perpetually accuftomed to. 
Dr. Currie has further obferved, that " in cafes of great de- 
bility tlxe voluntary mufcular exertion requifitc in a fwing pro- 
duces wearinefs, that is, increafes debility; and that in inch in- 
ftances he had frequently noticed, that the diminution of the fre- 
quency of the pulfe did not take place, but the contrary." Thefc 
circumftances may thus be accounted for. 
The links of aflociation, which are effected in the vertigo oc- 
cafioned 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 aflbeiated trains of irritative motions of the ftomach, 
and heart, and arteries, act at firft with greater energy, both by 
direct fympathy, and by the additional fenforial power of fenfa- 
tion. Whence the pulfe of a confumptive patient becomes ftrong- 
er and confequently flower. 
But if this vertigo becomes much greater in degree or dura- 
tion, the firft link of this train of aflbeiated irritative motions 
expends too much of the fenforial power, which was ufually em- 
ployed on the whole train ; and the motions of the ftomach be- 
come in confequcnce exerted with lefs energy. This appears, 
becaufe in this degree of vertigo ficknefs fupervenes, as in fea- 
ficknefs, which has been (hewn to be owing to lefs energetic ac- 
tion of the ftomach. And the motions of the heart and arteries 
then become weaker, and in confequence more frequent, by their 
direct fympathy with the leffened actions of the ftomach. See 
Supplement, I. 12. and Clafs II. 1. 6. 7. The general weak- 
nefs from fatigue is owing to a fimilar caufe, that is, to the too 
great expenditure of fenforial power in the increafed actions of 
one part of the fyftem, and the confequent deficiency of it in 
other parts, or in the whole. 
The abatement of the heat of the fkin in heftic fever by 
fwinging, 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 (kin. Hence 
during moderate fwinging the action of the heart and arteries 
becomes ftronger and flower, and the action of the capillaries, 
which was before too great, as appeared by the heat of the ikin, 
is 406 
DISEASES 
Class IV. 2. 1.11. 
is now leflcned by their reverfe fympathy with that of the heart 
and arteries. See Supplement, I. 8. 
ii. Vertigo vfualis. Vifual vertigo. The vertigo rotatoria 
defcribed above, was induced by the rotation or undulation of 
external objects, and was attended with increafed action of the 
primary link of the aflbciated motions belonging to vifion, and 
with confequent pleafure. The vertigo vifualis is owing to left 
perfect vifion, and is not accompanied with pleafurable fenfa- 
tion. This frequently occurs in ftrokes of the palfy, and is then 
fucceeded by vomiting ; it fometimes precedes 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 
objects are lefs diftinbl, and on that account are not fucceeded 
by their ufual irritative aflbciations of motion ; but excite our 
attention. Whence the objects appear to librate or circulate 
according to the motions of our heads, which is called dizzinefs ; 
and we lofe the means of balancing ourfelves, or preferving our 
perpendicularity, by vifion. So that in this vertigo the motions 
of the aflbciated organs are decreafed by diredt fympathy with 
their primary link of irritation ; as in the preceding cafe of fea- 
ficknefs they are decreafed by reverfe fympathy. 
When vertigo affects people about fifty years of age, their 
fight has generally been fuddenly impaired ; and from their lefs 
accurate vifion they do not foon enough perceive the apparent 
motions of objects ; like a perfon in a room, the walls of which 
are ftained with the uniform figures of lozenges, explained in 
Sedt. XX. i. This is generally afcribed to indigeftion ; but it 
ceafes fpontaneoufly, as the patient acquires the habit of balanc- 
ing himfelf by lefs diftindt objedts. 
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 his bed, and this 
continued eight or ten weeks. As he had many decayed teeth 
in his mouth, and the vertigo was preceded and fometimes ac- 
companied by pains on one fide of his head, the difeafe of a 
tooth was fufpedled to be the caufe. And as his timidity was 
too great to admit the extraction of thofe which were de- 
cayed ; after the trial of cupping repeatedly, fomentations on 
his head, repeated blifters, with valerian, Peruvian bark, mulk, 
opium, and variety of other medicines ; mercurials were ufed, 
both externally and internally, with defign to inflame the mem- 
branes of the teeth, and by that means to prevent the torpor of 
the action of the membranes about the temple, and parietal bone; 
which are catenated with the membranes of the teeth by irrita- 
tive Class IV. 2. 1.12. 
OF ASSOCIATION. 
407 
five aflbciation, but not by fenfitive aflbciation. The event was, 
that as foon as the gums became fore with a flight ptyalifm, the 
pains about the head and vertigo gradually diminiihed,and during 
the forenefs of his gums entirely ceafed ; but I believe recurred 
afterwards, though in lefs degree. 
The idea of inflaming the membranes of the teeth to pro- 
duce increafed fenfation in them, and thus to prevent their 
irritative connexion with thofe of the cranium, was taken from 
the treatment of trifinus, or locked jaw, by endeavouring to in- 
flame the injured tendon ; which is faid to prevent or to remove 
the fpafm of the niufcles of the jaw. See Clafs III. i. i. 13. 
and 15. 
M. M. Emetics. Blifters. Ifluesabout the head. Extrac- 
tion of decayed teeth. Slight falivation. Sorbentia. Incitantia. 
Galvanifm. 
A lady was fuddenly feized with violent vertigo, fo as to pre- 
vent her from walking fafely acrofs the room, this was attended 
with confiderable diminution of fight; and after various evacua- 
tions, and other medicines, had been tried without cure, Mr. 
Volta's galvanic pillar was ufed, confiding of about 30 plates of 
filver, the diameter of about one inch and half, and as many 
zinc plates, with interpofed circles of cloth moiftened with brine. 
A wire connected with each end of this pillar was approached 
repeatedly to her temples, which were previoufly moiftened with 
brine, and 100 galvanic fliocks were daily pafled through the 
optic nerves, which foon appeared to be of great advantage, and 
Ihe foon recovered, both from the vertigo and dimnefs of fight. 
12. Vertigo ebriofa. Vertigo from intoxication is owing to 
the aflbciation 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 irrita- 
tive motions of the retina are produced with lefs energy by re- 
verfe fympathy, and become at the fame time fucceeded by fen- 
fation in confequence of^their decreafed ablion. See Seft. XXL 
3. and XXXV. 1.2. So converfely when the irritative mo- 
tions of vifion are increafed by turning round, or by our unac- 
cuftomed agitation at fea, thofe of the ftomach become inverted 
by reverfe fympathy, and are attended in confequence with difa- 
greeable fenfation. Which decreafed action of the ftomach is 
in confequence of the increafed expenditure of the fenforial 
power on the irritative ideas of vifion, as explained in Vertigo 
rotatoria. 
Whence though a certain quantity of yinous fpirit ftimulates 
the whole fyftem into increafed action, and perhaps even in- 
creafes the fecretionof fenforial power in the brain ; yet as foon 408 
DISEASES 
Class IV. 2. 1. 13. 
as any degree of vertigo is produced, it ?s a proof, that by the 
too great expenditure of fenforial power by the ftomach, and its 
neareft aflociated motions, the morediftant ones, as thofe of vif- 
ion, become imperfectly exerted. From hence may be deduc- 
ed the noceflity of exhibiting wine in fevers with weak pulfe 
in only appropriated quantity ; becaufc if the leaft intoxication 
be induced, fome part of the fyltem mult aft more feebly from 
the unneceflarv expenditure of fenforial power. 
13. Vertigo febriculofa. Vertigo in fevers either proceeds 
from the general deficiency of fenforial power belonging to the 
irritative aflbciations, or to a greater expenditure of it on fome 
links of the trains and tribes of aflociated irritative motions. 
There is however a flighter vertigo attending all people, who 
have been long confined in bed, on their firft riling; owing to 
their having been fo long unufed to the apparent motions of ob- 
jects in their erect pofture, or as they pafs by them, that they 
have loft in part tire habit of balancing themfelves by them. 
14. Vertigo cerebroja. 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 diltrefsful fituations the vital motions, or thofe immediate- 
ly neceflary to life, claim their fhare of fenforial power in the 
firft place, otherwife the patient mult die ; and thofe motions, 
which are lefs neceflary, feel a deficiency of it, as thefe of the 
organs of fenfe and mufcles ; which conftitute vertigo ; and laft- 
ly the voluntary motions, which are (till lefs immediately necef- 
fary to life, are frequently partially deftroyed, as in palfy ; or 
totally, as in apoplexy. 
15. Murmur aurium vertiginofum. 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 frequent- 
ly attends people about 60 years of age ; and like the vifual ver- 
tigo defcribed above is owing to our hearing lefs perfectly from 
the gradual inirritability of the organ on the approach of age ; 
and the difagreeable fenfation of noife attending it is owing to 
the lefs energetic aftion of thefe irritative motions ; which not 
being fufliciently diftinft to excite their ufual aflbeiations become 
fucceeded by cur attention, like the indiftinft view of the ap- 
parent motions of objects mentioned in vertigo vifualis. This 
may be better underftood from confidering the ufe, which 
blind men make of thefe irritative founds, which they have 
taught themfelves to attend to, but which efcape the notice of 
others. The late blind Juftice Fielding walked for the firft 
time into my room, when he once vifited me, and after fpeak- 
ing a few words faid, " This room is about 22 feet long, 18 
wide, Class IV. 2. 1. r6. 
OF ASSOCIATION. 
409 
wide, and 12 high all which he guefled 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 catenation with other irritative 
ideas, as thofe of vifion, becomes dillevfered or difturbed ; and we 
attend to them in Confequence, which I think unravels this in* 
tricate circumltance 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 intoxi- 
cation; for the irritative ideas of found are then more weakly 
excited in confequence 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 ftrokes on the head, fainting fits, and paralytic feiz- 
ures. For in this vertigo from intoxication fo much fenforial 
power in general is expended on the increafed actions of the 
(tomach,and its neareft connections, as the capillaries of the (kin 5 
that there is a deficiency for the purpofcs of the other irritative 
aflociations of motions ufually connected with it. This auditory 
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 vifual vertigo, or by direCt fympathy with it. 
See SeCl. XX. 7. 
M. M. Stimulate the internal ear by ether, or with eflential 
oil diluted with exprefl'ed oil, or with a folution of opium in wine, 
or in water. Or with fait and water. Apply a cupping glafs 
over the ear. See I. 2. 5. 6. Galvanic (hocks through the tem- 
ples. See IV. 2. 1. 11. 
16. Tact us, guftus, olfaEtus •ve^tiginofi. Vertiginous touch, 
talie, and fmell. 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 occurs 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 irritative tangible ideas, are performed 
with lefs energy, in one cafe by reverfe fympathy with the ftom- 
ach, in the other by reverfe fympathy with the nerves of vifion, 
and in confequence become attended with fenfation, and pro- 
duce the fear of falling by other aflociations. 
A vertigo of the fenfe of touch may be produced, if any one 
turns round for a time with his eyes (but, and fnddenly Hops 
Vol. II. E e e without 410 
DISEASES 
Class IV. 2. 1.17. 
without opening them; for he will for a time feem to be ftill 
going forwards; which is difficult to explain. See Seft. XX. 6. 
In the beginning of fome fevers, along with inceflant vomit- 
ing, the patients complain of difagreeable taftes in their mouth, 
and difagreeable odours; which are to be afcribed to the gen- 
eral debility of the great trains, and tribes of aflbciated and irrita- 
tive motions, and to be explained from their direft fympathy 
with the decreafed aftion of a lick ftomach; or from the lefs 
fecretion of fenforial power in the brain. Thefe organs of fenfe 
are conftantly ftimulated into aftion 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 difagreea- 
ble fenfation enfues, as of hunger, or faintnefs, or ficknefs in 
one cafe ; and the ideas of bad taftes or odours in the other. 
This accords with the laws of caufation, Seft. IV. 5. 
*17. Pulfus mollis in vomit io ne. The foftnefs of the pulfe in 
the aft of vomiting is caufed by direft aflbciation between the 
heart and the ftomach ; as explained in Seft. XXV. 17. A great 
flownefs of the pulfation of the heart fometimes attends ficknefs, 
and even with intermiffions of it, as in the exhibition of too great 
a dofe of digitalis. 
i§. Pulfus intermittent a ventricule. When the pulfe firft be- 
gins to intermit, it is common for the patient to bring up a lit- 
tle air from his ftomach ; which if he accomplifties before the 
intermiffion occurs, always prevents it; whence that this debil- 
ity of the heart is owing to the direft aflbciation of its motions 
with thofe of the ftomach is well evinced. See Seft. XXV. 17. 
I this morning faw Mr. , who has long had at times an 
unequal 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 toaft and butter, and 
tea, and to my great furprife his pulfe became immediately per- 
fectly regular, about 100 in a minute, and not weak, by this 
ftimulus on his ftomach. 
A perfon, who for many years had had a frequent intermif- 
fion of his pulfe, and occafional palpitation of his heart, was re- 
lieved from them both for a time by taking about four drops of 
a faturated folution of arfenic three or four times a day for three 
or four days. As this intermiffion of the pulfe is occafioned by 
the direft aflbciation of the motions of the heart with thofe of 
the ftomach, the indication of cure muft be to ftrengthen the ac- 
tion of the ftomach by the bark. Spice. Moderate quantities 
of Class IV. 2. 1.19. 
OF ASSOCIATION. 
411 
of wine. A blifter. Half a grain of opium twice a day. So- 
lution of arfenic ? 
19. Febris inirritativa. Inirritative fever defcribed in Oafs 
I. 2. 1. 1. belongs to this place, as it confifts of difordered trains 
and tribes of aflbciated irritative motions, with leflened actions 
of the aflbciated organs. In this fever the pulfations of the 
heart and arteries are weakened or leflened, not only in the 
cold paroxyfm, as in the irritative fever, but alfo in the 
hot paroxyfm. The capillary arteries or glands have their ac- 
tions neverthelefs increafed after the firft cold fit, as appears by 
the greater production of heat, and the glow of arterial blood in 
the cutaneous veflels ; and laftly, the action of the ftomach is 
much impaired or deftroyed, as appears by the total want of ap- 
petite to folid food. Whence it would feem, that the torpid 
motions of the ftomach, whatever may occafion them, are a 
very frequent caufe of continued fever with weak pulfe ; and 
that thefe torpid motions of the ftomach do not Sufficiently ex- 
cite the fenforial power of affbciation, which contributes in 
health to actuate the heart and arteries along with the irritation 
produced by the ftimulus of the blood-, and hence the aftions 
of thefe organs are weaker. And laftly, that the accumulation 
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 Seft. XXXV. 1. 1. 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 confifts of aflbciat- 
ed trains and tribes of irritative or fenfitive motions, which are 
fometimes mixed with the vertiginous ones, and fometimes Sep- 
arate from them. 
ORDO DISEASES 
Class IV. 2. 2. 
412 
ORDO II. 
Decreafed AJJbciate Motions. 
GENUS II. 
Catenated with Sen/itive Motions. 
In this genus the fenforial power of aflbciation is exerted with 
Jefs energy, and thence the actions produced by it are lefs than 
natural; and pain is produced in confequence, according to the 
fifth law of animal caufation, SeCt. IV. This pain is generally 
attended with coldnefs of the affeCted part, and is feldom fuc- 
ceeded by inflammation of it. This decreafed action of the 
fecondary link of the aflbciated motions, belonging to this ge- 
nus, is owing to the previous exhauftion of fenforial power either 
in the increafed actions of the primary link of the aflbciated mo- 
tions, or by the pain which attends them ; both which are fre- 
quently the confequence of the ftimulus of ibmething external 
to the affefted fibres. 
As pain is produced either by excefs or deleft of the natural 
exertions of the fibres, it is not, confidered feparately, a criteri- 
on 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. 
When great pain exifts without caufing any fibrous motions, 
I conjecture that it contributes to exhauft or expend the gen- 
eral quantity of fenforial power •, becaufe people are fatigued 
by enduring pain, till at length they fleep. Which is contrary 
to what I had perhaps erroneoufly fuppofed in SeCt. XXXV. 
2. 3. If it caufes fibrous motions, it then takes the name of 
fenfation, according to the definition of fenfation in |SeCl. II. 2. 
9. ; and increafed fibrous ablion or inflammation is the confe- 
quence. This circumfiance of the general exhauftion of fenfo- 
rial power by the exiftence of pain will aflift in explaining ma- 
ny of the difeafes of this genus. 
Many of the canals of the body, as the urethra, the bile-duCt, 
the throat, have the motions of their two extremities aflbciated 
bv having been accuftomed to feel pleafurable or painful fenfa- 
tions at the fame time or in fucceflion. This is termed fenfi- 
tive aflbciation, though thofe painful or pleafurable fenfations 
do not caufe the motions, but only attend them; and are thus 
perhaps, ftriClly.fpeaking, only catenated with them. 
SPECIES. Class IV. 2. 2.1. 
OF ASSOCIATION. 
413 
SPECIES. 
I. Torpor gens a dolore dentis. In tooth-ach there is general- 
ly a coldnefs of the cheek, which is fenfible to the hand, and is 
attended in fome degree with the pain of cold. The cheek and 
tooth have frequently been engaged in pleafurable action at the 
fame time during the mafticating of our food ; whence they 
have acquired fenfitive aflbeiations. 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 difeaf- 
ed tooth; whence the membranes of the cheek aflbeiated with 
thofe of the alveolar procefs are deprived of their natural (hare 
of it, and become torpid ; thus they produce lefs fecretions, and 
lefs heat, and ^he pain of cold is the confcquence. This torpor 
of the veflels of the cheek cannot be produced by the activity 
of the fenforial power of fenfation ; for then they would aft 
more violently than natural, or become inflamed. And though 
the pain by exhaufting fo much fenforial power may be a re- 
mote caufe, it is the defeft of the power of aflbeiation, 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 cheek either gradually ceafes along with the pain 
of the difeafed tooth ; or, by the accumulation of fenforial pow- 
er during their ftate of torpor, the capillaries of the cheek aft 
■with greater violence, and produce more fecretions, and heat, 
and confequent tumour, and inflammation. In this ftate the 
pain of the difeafed tooth ceafes ; as the fenforial power of fen- 
fation is now expended on the inflamed veflels of the cheek. It 
is probable that molt other internal membranous inflammations 
begin in a fimilar manner; whence there may feem to be a double 
kind of fenfitive aflbeiation; firft, with decreafed aftion of the 
aflbeiated organ, and then with increafed aftion of it; but the 
latter is in this cafe Amply the confequence of the former ; that 
is, the tumour or inflammation of the cheek is in confequence 
of its previous quiefcence or torpor. 
2. Stranguria a dolore defies. The flrangury, which has its 
origin from pain at the neck of the bladder, confifts of a pain in 
the external extremity of the urethra or of the glands 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, generally with the other end of 
the urethra ; an endeavour and difficulty of making water at- 
tends this pain. 
Its remote caufe is from the internal or external ufe of can- 
tharides, which ftimulatc the neck of the bladder; or from a 
ftone, 414 
DISEASES 
Class IV. 2. 2. 3. 
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 molt feverely in this cafe after having made water. 
The fenfations or fenfitive motions of the glands penis, and 
of the fphintler 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 aflbciation. When there 
is a Hone at the neck of the bladder, which is not fo large or 
rough as to inflame the part, the fphincler of the bladder be- 
comes ftimulated into pain ; but as the glans penis is for the 
purpofes of copulation more fenfitive than the fphinfter of the 
bladder, as foon as it becomes affefled with pain by the aflbcia- 
tion above mentioned, the fenfation at the neck of the bladder 
ceafes ; and then the pain of the glans penis would feem to be 
aflbciated with the irritative motions only of the fphin&er of the 
bladder, and not with the fenfitive ones of it. But a circum- 
ftance 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 with 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 fphinfter of the bladder ; but that as foon as the 
greater pain in a more fenftblepart is produced ; the lefs pain, which 
occafoned it, ceafes; and that this is one of the laws of fenfitive af- 
fociation. See Seft. XXXV. 2. 1. 
A young man had by an accident fwallowed a large fpoonful 
or more of tin&ure of cantharides ; as foon as he began to feel 
the pain of ftrangury, he was advifed to drink large quantities 
of warmilh water : to which, as foon as it could be gotten, fome 
gum arabic was added. In an hour or two he drank by inter- 
vals of a few minutes about two gallons of water, and difcharg- 
ed his urine every four or five minutes. A little blood was 
voided towards the end, but he fuffered no ill confequence. 
M. M. Warm water internally. Clyfters of warm water. 
Fomentation. Opium. Solution of fixed alkali fuperfaturated 
with carbonic acid. A bougie may be ufed to pufti back a ftone 
into the bladder. See Clafs I. 1. 3. 10. 
3. Stranguria convuljiva. The convulfive ftrangury, like that 
before defcribed, is probably occafioned by the torpor or defec- 
tive a£lion of the painful part in confequence of the too great 
expenditure of fenforial power on the primary link of the aflbciat- 
ed motions, as no heat or inflammation attends this violent pain. 
This kind of ftrangury recurs by ftated periods, and fometimes 
arifes to fo great a degree, that convulfion or temporary mad- 
nefs terminates each period of it. It affeds women oftener 
than Class IV. 2. 2.4. 
OF ASSOCIATION. 
415 
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 cathether 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 contract themfelves 
fo far as to exclude the whole of the urine. In fome old peo- 
ple, who have experienced a long retention of urine, rhe blad- 
der never regains the power of completely 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 emp- 
tied the bladder. 
I have believed this pain to originate from fympathy with 
fome diftant part, as from afcarides in the return, 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. Venefeflion. Opium in large quantities. Warm 
bath. Balfams. Bark. Tincture of cantharides. Bougie, and 
the treatment for haemorrhoids. Leeches applied to the fphic- 
ter ani. Aerated alkaline water. Soap and fal foda. Opium 
in clyfters given an hour before the expected return. Smoke 
of tobacco in clyfters. Arfenic. 
4. Dolor termini intejlinalis ductus choledochi. Pain at the in- 
teftinal end of the gall-du6t. When a gall-ftone is protruded 
from the gall-bladder a little way into the end of the gall-duft, 
the pain is felt at the other end of the gall-du<St, which termin- 
ates in the duodenum. For the actions of the two terminations 
of this canal are affociated together from the fame ftreams 
of bile paffing through them in fucceffion, exactly as the two 
terminations of the urethra have their actions affociated, as 
defcribed in Species 2 and 3 of this genus. But as the in- 
teftinal termination of the bile-du6t is made more fenfibie for 
the purpofe of bringing down more bile, when it is ftimulated 
by new fupplies of food from the ftomach, it falls into violent 
pain from affociation ; and then the pain on the region of the 
gall-bladder ceafes, exactly as above explained in the account 
of the pain of the glans penis from a ftone in the fphincter of 
the bladder. 
The common bile-duct opens into the inteftine exaftly at 
what is called the pit of the ftomach ; and hence it has fome- 
times happened, that this pain from affociation with the fenfa- 
tion 416 
DISEASES 
Class IV. 2. 2. 5. 
tion of a gall-ftone at the other end of the bile-duct has been 
miftaken for a pain of the ftomach. 
For the method of cure fee Clafs I. 1.3. 8. to which fhould 
be added the ufe of ftrong electric fhocks patted through the bile- 
du£t from the pit of the ftomach to the back, and from one fide 
to the other. A cafe of the good effect of elecflricity in the 
jaundice is related in Sett. XXX. . 2. And another cafe, 
where it promoted the patfage of a painful gall-ftone, is defcrib- 
cd by Dr. Hall, experienced on himfelf. Tranf. of the Col- 
lege at Philadelphia, Vol. I p. 192. 
Half a pint of warm water two or three times a day is much 
recommended to dilute the infpidated bile. 
5. Dolor pharyngis ab acido gajlrico. The two ends of the 
throat fympathize by fenfitive aflbciation in the fame manner 
as the other canals above mentioned, namely, the urethra and 
the bile-du6l ; hence when too great acidity of undigefted ali- 
ment, or the carbonic acid air, which efcapes in fermentation, 
ftimulates the cardia ventriculi, or lower end of the gula, into 
pain, the pharynx, or upper end of it, is aftedled with greater 
pain, or a difagreeable fenfation of heat. 
6. Pruritus narium a vermibus. The itching of the nofe from 
worms in the intellines is another curious inftance of the fen- 
fitive aflbeiations of the motions of membranes ; efpecially of 
thofe which ccnftitute the canals of the body. Previous to the 
deglutition of agreeable food, as milk in our earlieft infancy, an 
agreeable odour afteefts the membrane, which lines the noftrils; 
and hence an aflbeiation teems to take place between the agreea- 
ble fenfations produced by food in the Itomach and bowels, and 
the agreeable fenfations of the noftrils. The exiftence of afcar- 
ides in the reftum I believe produces this itching of the noftrils 
more than the worms in other parts of the inteflines ; as we have 
already feen, that the terminations of canals fympathize more 
than their other parts, as in the urethra and gall-dufts. See 
Clafs I. 1. 5. 9. IV. 1. 2. 9. 
7. CephaDaSympathetica. Sympathetic head-ach. In cold fits 
of the ague, the head-ach arifes from content with fome torpid 
vifeus, like the pain of the loins. After drunkennefs the head- 
ach is very common, owing to direct fympathy of the mem- 
branes of the bead with thofe of the ftomach ; which is become 
torpid after the too violent ftimulus of the preceding intoxica- 
tion ; and is hence removable by fpirit of wine, or opium, ex- 
hibited in fmaller quantities. In fome conftitutions thefe head- 
achs are induced, when the feet are expofed to much external 
cold ; in this cafe the feet fhould be covered with oiled filk, 
* which Class IV. 2. 2. 8. 
OF ASSOCIATION. 
417 
which prevents the evaporation of the perfpirable inatter, and 
thence diminifties one caufeof 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 folution of arfcnic two or three times a day. See 
Clafs I. 2. 4. 11. A lady once allured me, that when her head- 
ach was coming on, fhe drank three pints (pounds) of hot water, 
as haltily as the could ; which prevented the progrefs of the dif- 
eafe. A folution of arfenic is recommended by Dr. Fowler of 
York. Very ftrong errhines are faid fometimes to cure head- 
achs taken at the times the pain recurs, till a few drops of blood 
iflue from the noftrils. As one grain of tupeth mineral (vitriol- 
ic calx of mercury) mixed with ten grains of fine fugar. Eu- 
phorbium or cayenne pepper mixed with fugar, and ufed with 
caution as an errhine. See the M. M. of the next Species. 
8. Hemicraniafympathetica. Sympathetic pain on one fide of 
the head. This difeafe is attended with cold Ikin, and hence 
whatever may be the remote caufe, the immediate one feems 
to be want of ftiinulus, either of heat or diftention, or of fome 
other unknown ftimulus in the painful part ; or in 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 ren- 
der the neighbouring membranes fenfible, and is frequently the 
caufe of this difeafe. 
Sometimes the ftomach is torpid along with the pained mem- 
brane of the head ; and then ficknefs and inappetency attend 
either as caufes or confequences. The natural cure of hemi- 
crania is the accumulation of fenforial power during the reft or 
ficknefs of the patient. Mrs. is frequently liable to hem- 
icrania 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 aqueou; 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 by fear, 
and from fyncope ; which are all owing to the accumulation of 
fenlorial power during the inactivity of the fvftem. Hence it ap- 
pears, that, though when the fenforial power of volition is much 
exhaufted by fatigue, it can be reftored by eight or ten hours of 
fleep ; yet, when the fenforial power of irritation is exhaufted 
by langue, that it requires two whole folar or lunar days of reft, 
before it can be reftored. 
Vol. II. F f f The 418 
DISEASES 
Class IV. 2. 2. 8. 
The late Dr. Monro aflerted in his lectures, that he cured the 
hemicrania, or megrim, by a ftrong vomit, and a brifk purge 
immediately after it. This method fucceeds belt if opium and 
the bark are given in due quantity after the operation of the 
cathartic ; and with Rill more certainty, if bleeding in fmall 
quantity is premifed, where the pulfe will admit of it. See 
Seft. XXXV. 2. i. 
Mr. Kellie aflerts, that fome kinds of head-achs, efpecially 
thofe which arife from defeat of ftimulation, may be cured by 
compreffing the two fubclavian arteries, as they pafs over the 
firft rib ; which he thinks would produce a preflure on the brain 
fimilar to that, which may be produced by the centrifugal force, 
if a perfon was to lie acrofs a mill-ftone as it revolves. See 
Suppl. I. 15. 7. Would fuch a circulating bed remove any 
kind of head-ach ? 
The pain generally affeas one eye, and fpreads a Ititle way 
on that fide of the nofe, and may fometimes be relieved by prefl- 
ing or cutting the nerve, where it pafles into the bone of the 
orbit above the eye. When it affeas a fmall defined part on 
the parietal bone on one fide, it is generally termed Clavus hyf- 
tericus, and is always I believe owing to a difeafed dens mola- 
ris. The tendons of the mufcles, which ferve the office of 
maftication, have been extended into pain at the fame time that 
the membranous coverings of the roots of the teeth have been 
comprefled into pain, during the biting ot maftication of hard 
bodies. Hence when the membranes, which cover the roots of 
the teeth, become afteaed with pain by a beginning decay, or 
perhaps by the torpor or coldnefs of the dying part of the tooth, 
the tendons and membranous fafcia of the mufcles about the 
fame fide of the head become afteaed with violent pain by their 
fenfitive aflbciations : and as foon as this aflbciated 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 hemicrania, 
viz. that it recurs by periods like thofe of intermittent fevers, as 
explained in the Seaion on Catenation of Motions ; thefe peri- 
ods fometimes correfpond with alternate lunar or folar days 
like tertian agues, and that even when a decaying tooth is evi- 
dently the caufe ; which has been evinced by the cure of the 
difeafe by extraaing the tooth. At other times they obferve 
the monthly lunations, and feem to be induced by the debility, 
which attends menftruation. 
The dens fapientite, or laft tooth of the upper jaw, fre- 
quently decays firft, and gives hemicrania over the eye on the 
fame fide. The firft or fecond grinder in the under-jaw is lia- 
ble Class IV. 2. 2. 8. 
OF ASSOCIATION. 
419 
ble 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 hyftericus, of which an inftru&ive cafe is related in 
Sea. XXXV. 2. I. 
Since the above was firft publifhed I have feen two cafes, 
which were very fimilar, and feem much to confirm the above 
theory of fympathetic hemicrania being perhaps always owing 
to the fympathy of the membranes about the cranium with 
thofe about difeafed teeth. Lord M. and Mr. B. of Edinburgh, 
both of them about the middle of life were afflicted with vio- 
lent hemicrania for about two years ; in the beginning of which 
time they both allured me, that their teeth were perfectly found, 
but on infpeaing their mouths I found all the molares were 
now fo decayed as to have loft their crowns. After having fuf- 
fered pain for fixteen or eighteen months almoft inceffantly in 
different parts of their heads, they had each of them a hemiple- 
gia, from which they gradually recovered, as much as paralytic 
affections generally do recover. All the ftumps of their teeth, 
which were ufelefs, were directed to be extracted ; as the fwal- 
lowing fo much putrid matter from decaying bones feemed to 
injure their digeftion. They were defired not to drink wine or 
ale without its being diluted with twice or thrice its quantity of 
water, to prevent any accefs of torpor from too great previous 
ftimulus, and to take fix grains of rhubarb with three of foap 
made into pills, every night, with fome bitter and very flight 
chalybeate medicines. If the teeth which became torpid in fuc- 
ceffion, could have been difeovered, and extradied, before they 
decayed, and could have been replaced, might not this continu- 
ance of pain, and confequent paralyfis, have been prevented ? or 
might not a moderate falivation have effected this purpofe ? 
M. M. Detect and extract the difeafed tooth. Cut the af- 
fected nerve, or ftimulate the difeafed membrane by acupunc- 
ture. Venefedlion 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 eledlric fhocks through the pained 
membrane, and through the teeth on the fame fide. Apply vit- 
riolic ether externally, and a grain of opium with camphor in- 
ternally, to the cheek on the affeCled fide, where a difeafed tooth 
may be fufpedled. Foment the head with warm vinegar. 
Drink two large fpoonfuls of vinegar. Stimulate the gums of 
the fufpected teeth by oil of cloves, by opium. See Clafs I. i. 
4. 4. Snuff volatile fpirit of vinegar up the noftrils. Laftly, 
in permanent head-achs, as in permanent vertigo, I have feen 
good effect in two cafes by the ufe of mercurial ointment rubbed 
on the fhaved head or about the throat, till a mild falivation com- 
mences. 420 
DISEASES 
Class IV. 2. 2. 9. 
mences, 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 hy- 
drophobia, thofe difeafes may be cured, by difuniting the irrita- 
tive fympathy between thofe parts, which may not poflefs any 
fenfitive fympathy. This idea is well worth our attention. 
Otalgia. Ear-ach is another difeal? occafioned by the fympa- 
thv of the membranes of the ear with thofe which inveft or fur- 
round a decaying tooth, as I have had frequent reafon to be- 
lieve ; and is frequently relieved by filling the ear with tinfture 
of opium. See Clafs I. 2. 4. 
9. Dolor humeri in hepatidide. In the efforts of excluding the 
faeces and urine the mufcles of the (boulders are exerted to com- 
prefs the air in the lungs, that the diaphragm may be prefled 
down. Hence the diftention of the tendons or fibres of thefe 
mufcles is aflbeiated with the diftention of the tendons or fibres 
of the diaphragm ; and when the latter are pained by the en- 
largement or heat of the inflamed liver, the former fympathize 
with them. Sometimes but one fhoulder is affected, fometimes 
both ; it is probable that many other pains, which are termed 
rheumatic, have a fimilar origin, viz. from fenfitive aflbeia- 
tions. 
As no inflammation is produced in confequence of this pain 
of the fhoulder, it feems to be owing to inaftion of the mem- 
branous part from defebl cf the fenforial power of aflbeiation, 
pf which the primary link is the inflamed membrane of the liv- 
er ; which now expends fo much of the fenforial power in gen- 
eral by its increafed action, that the membranes about the fhoul- 
der, which are links of aflbeiation with it, become deprived of 
their ufual fhare, and confequently fall into torpor. 
10. 'Torpor pedum in eruptione variolarum. At the commence- 
ment of the eruption of the fmall-pox, when the face and breaft 
of children are very hot, their extremities are frequently cold, 
□'his I afcribe to fenfitive aflbeiation between the different parts 
pf the fkin ; whence when a part adts too violently, the other 
part is liable to act too weakly ; and the fkin of the face being 
affected firft in the eruption of the fmall-pox, the fkin of the 
feet becomes cold in confequence by reverfe fympathy. 
M. M. Cover the feet with flannel, and expofe the face and 
bofom to cool air, which in a very fhort time both warms the 
feet and cools the face ; and hence what is erroneoufly called a 
rafh, but which is probably a too hafty eruption of the fmall pox, 
difappears; and afterwards fewer and more diftindt eruptions 
of the fmall-pox fupcrvenc. 
11. Tejlium Class IV. 2. 2. 11. 
OF ASSOCIATION. 
421 
11. Tejltum dolor nepbriticus. The pain and retraction of the 
tefticle on the fame fide, when there is a ftone in the ureter, is 
to be afcribed to fenfitive afl'oeiation ; whether the connecting 
caufe be a branch of the fame nerve, or from membranes, which 
have been frequently affected at the fame time. 
12. Dolor digiti minimi fympatbeticus. When any one acci- 
dentally Itrikes his elbow againft any hard body, a tingling pain 
runs down to the little finger end. This is owing to fenlitive 
aflbeiation of motions by means of the fame branch of a nerve, 
as in hemicrania from a decaying tooth the pain is owing to the 
fenfitive afl'oeiation of tendons or membranes. 
13. Dolor braebii in bydrope pedloris. The pain in the left arm 
which attends fome dropfies of the cheft, is explained in Sect. 
XXIX. 5. 2. 10. which refemblcs the pain of the little finger 
from a percufiion of the nerve at the elbow in the preceding ar- 
ticle. A numbnefs of this kind is produced over the whole leg, 
when the crural nerve is much comprefied by fitting for a time 
with one leg crofled over the other. 
Mr. , about fixty, had for two years been afiedted with 
difficulty of reffiiration on any exertion, with pain about the fter- 
num, and of his left arm ; which laft was more confiderable 
than is ufual in dropfy of the cheft ; fome months ago the pain 
of his arm, after walking a mile 01 two, became exceffive, with 
coldnefs and numbnefs ; 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 fome months became dropfical both in 
refpeCt to his cheft and limbs, and was fix or feven times per- 
fectly relieved by one dram of faturated tincture of digitalis, 
taken two or three times a day for a few days in a glafs of pep- 
permint water. He afterwards breathed oxygen gas undiluted, 
in the quantity of fix or eight gallons a day for three or four 
weeks without any effeCt, and funk at length from general de- 
bility. 
In this inftruCtive cafe I imagine the preflure or ftimulus of 
one part of the nerve within the cheft caufed the other part, 
which ferves the arm, to become torpid, and confequently cold 
by fympathy; and that the inflammation was the confcquence 
of the previous 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 are thus produced by fympathy with fome dif- 
tant part. 
14. Diarrhoea a dentitione. The diarrhoea, which frequently 
attends dentition, is the confequence of indigeftion ; the aliment 
acquires 422 
DISEASES 
Class IV. 2. 2. 14. 
acquires chemical changes, and by its acidity a&s as a cathar- 
tic ; and changes the yellow bile into green, which is evac- 
uated along with indigefted parts of the coagulum of milk. 
The indigeftion is owing to the torpor of the ftomach and intef- 
tines caufed by their affociation with the membranes of the 
gums, which are now ftimulated into great exertion with pain ; 
both which contribute to expend the general quantity of fen- 
forial power, which belongs to this membranous affociation; 
and thus the ftomach and inteftines act with lefs than their 
natural energy. This is generally efteemed a favourable fymp- 
tom in difficult dentition, as the pain of the alveolar membranes 
exhaufts the fenforial power without producing convulfions for 
its relief. See Clafs I. i. 4. 5. And the diarrhoea ceafes, as 
the tooth advances. 
ORDO Class IV. 2. 3. i. 
OF ASSOCIATION. 
423 
ORDO II. 
Decreafed AJJbciate Motions. 
GENUS III. 
Catenated with Voluntary Motions. 
SPECIES. 
i. 'Titubatio lingua. Impediment of fpeech is owing to the 
aflbciations of the motions of the organs of fpeech being inter- 
rupted or diflevered by ill-employed fenfation or fenfitive mo- 
tions, as by awe, bafhfulnefs, ambition of fhining, or fear of not 
fucceeding, and the perfon ufes voluntary efforts in vain to re- 
gain the broken aflbciations, as explained in Seft. XVII. i. io. 
and XVII. 2. io. 
The broken aflbciation is generally between the firft confo- 
nant and the fucceeding vowel; as in endeavouring to pronounce 
the word parable, the p is voluntarily repeated again and again, 
but the remainder of the word does not follow, becaufe the af- 
fociation between it and the next vowel is diflevered. 
M. M. The art of curing this defeat is to caufe the ftam- 
merer to repeat the word, which he finds difficult to fpeak, 
eight or ten times without the initial letter, in a ftrong 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 
ihould be pratSlifed for weeks or months upon every word, 
which the ftammerer hefitates in pronouncing. To this fhould 
be added much commerce with mankind, in order to acquire 
a careleflhefs about the opinions of others. 
2. Chorea Sti 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 motion obeys 
the will; but thofe mufcles, whofe motions were affbciated with 
the principal one, do not aft; as their aflbciation is diflevered, 
and thus the arm or leg is drawn outward, or inward, or back- 
ward, inftead of upward or forward, with various gefticulations 
exactly refembling the impediment of fpeech. 
This difeafe is frequently left after the itch has been too haftily 
cured. See convulfio dolorifica, Clafs HL i. i. 6. A girl 
about eighteen, after wearing a mercurial girdle to cure the itch, 
. acquired 424 
DISEASES 
Class IV. 2. 3. 3. 
acquired the Chorea St. Viti in fo univerfal a manner, that her 
fpeech became affected as well as her limbs ; and there was evi- 
dently a difunion of the common trains of ideas ; as the itch 
was ft ill among the younger children of the family, fhe was ad- 
vifed to take her filter as a bedfellow, 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. 
Venefedtion once at the beginning of the difeafe. Electricity. 
Perpetual flow and repeated efforts to move each limb in the 
deiigned direction, as in the titubatio linguae above defcribed. 
3. Rif us. Laughter is a perpetual interruption of voluntary 
exertion by the interpofition of pleafurable fenfation ; which not 
being checked by any important confequences rifes into pain, 
and requires to be relieved or moderated by the frequent repe- 
tition of voluntary exertion. See Sect. XXXIV. 1 4. and 
Clafs III. 1. 1. 4. and IV. 1. 3. 3. 
4. Tremor ex ird. The trembling of the limbs from anger. 
The interruption of the voluntary aflbciations of motions by an- 
ger, originates from too great a part of the fenforial power being 
exerted on 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. 1. 1. 
5. Rubor ex ird. Rednefs from anger. Anger is an excefs 
of averfion,4that is of voluntarily not yet employed. It is excit- 
ed by the pain of offended pride; when it is employed it be- 
comes outrage, cruelty, infanity. The cutaneous capillaries, 
efpecially thofe of the face, are more mobile, that is, more eafi- 
ly excited into increafed action, or more eafdy become torpid, 
from lefs variation of fenforial power, than any other parts of 
the fyftem, which is owing to their being perpetually fubjeft to 
the vicifhtudes of heat and cold, and of cxtenfion and corruga- 
tion. Hence, when an excefs of voluntarity exifts without be- 
ing immediately expended in the actions of the large mufcles, 
the capillary arteries and glands acquire more energetic a£lion, 
and a flufhed fkin is produced, with increafed fecretion of per- 
fpirable matter, and confequent heat, owing to the paufe or in- 
terruption of voluntary action , and thus the actions of thefe 
cutaneous veffels become affociated between the irafeent ideas 
and irafeent mufcular adlions, which are thus for a time inter- 
rupted. 
6. Rubor criminati. The blufhing of accufed people, wheth- 
er guilty or not, appears to be owing to cixcumftances fimilar to 
that Class IV. 2. 3. 7. 
OF ASSOCIATION. 
425 
that of anger ; for in thefe fituations there is always a fuddeil 
voluntarity, or wifh, of clearing their characters 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 aCtions of the capillaries, and the confequent red- 
nefs and heat, become exerted between the voluntary ideas of 
felf-defence, and the mufcular aCtions neceflary for that purpofej 
which laft are thus for a time interrupted or delayed. 
Even in the blufh of modefty or bafhfulnefs there is a felf- 
condemnation for fome fuppofed defeCt or indecorum, and a 
fudden voluntarity, or wifh, of felf-defence; which not being 
expended in actions of the larger mufcles excites the capillaries 
into aCtion; which in thefe fubjeCts are more mobile than in 
others. 
The blufh of young girls on coming into an aflembly room, 
where they expeCt their drefs, and fteps, and manner, to be ex- 
amined, 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. Tarditasparalytica. 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 connection 
diflevered ; and the patient is under the neceffity, by repeated 
efforts, flowly to renew their aflbciations. In this fituation thofe 
words, which have the feweft other words aflbciated with them, 
as the proper names of perfons or places, are the mofl difficult 
to recollect. And in thofe efforts of recollection the word op- 
pofite to the word required is often produced, as hot for cold, 
winter for fummer, which is owing to our aflbciating our ideas 
of things by their oppofites as well as by their fimilitudes, and 
in fome inftances perhaps more frequently, or more forcibly. 
Other paralytic patients are liable to give wrong names to exter- 
nal objects, as ufing the word pigs for fheep, or cows for horfes ; 
in this cafe the aflbciation between the idea of the animal and 
the name of it is diflevered ; but the idea of the clafs or genus of 
the thing remains ; and he takes a name from the firft fpecies 
which prefents itfelf, and fometimes can correCt himfelf, till he 
finds the true one. 
8. Tarditas fenilis. Slownefs of age. The difficulty of aflb- 
ciating ideas increafes with our age ; as may be obferved from 
old people forgetting the bufinefs of the laft hour, unlefs they 
imprefs it ftrongly, or by frequent repetition, though they can 
well recolleCt the tranfaftions of their youth. I faw an elderly 
man, who could reafon with great clearnefs and precifion, and 
' Vol. II. G g g in 426 
DISEASES 
Class IV. 2. 8. 
in accurate language on fubjeCts, which he had been accuftomed 
to think upon ; and yet did not know that he had rung the bell 
by his fire-fide in one minute afterwards; nor could then recol- 
leCt the object 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 muf- 
cular actions, as in learning a new trade or manufacture. The 
trains of movements, which obey volition, are the laft which we 
acquire ; and the firft, which are diflbciated. 
The fymbols moft in ufe, with which we have aflbciated ideas, 
are thofe of vifible and of audible language. It is curious to ob- 
ferve in the inftruCtion of young people, that fome remember 
written language the belt, and others vocal language. The fame 
thing fometimes occurs in aged people, that is, that fome lofe 
the ideas aflbciated with founds fooneft, and others thofe aflb- 
ciated with letters. See recolleCtionis jaCtura, Clafs III. 2. 2. I. 
and Tarditas paralytica above. 
The following curious account of this defeCt of aflbciation of 
ideas with audible but not with vifible fymbols was fent me by 
Dr. Darwin of Shrewfbury. 
" The cafe of an old man lately occurred to me, who was fu- 
peranuated ; his hearing and vifion were perfeCt, but he could 
only call up a train of ideas from the latter. When he was told 
it was nine o'clock, and time for him to eat his breakfaft, he re- 
peated the words diftinCtly but without underftanding them. 
His fervant put a watch into his hand. " Why, William, have 
not I my breakfaft, for it is juft nine o'clock ?" he would fay 
with expreffion, that ffiewed he felt what he faid. 
" On almoft every occafion his fervants converfed with him 
by vifible objects, although his hearing was perfect; and when 
this kind of communication was ufed, he did not appear impair- 
ed in his intellects. This ftate came on from a ftroke of the 
palfy j and till he and his attendants ufed this kind of language 
he was quite childiih." 
ORDO Cmss IV. 2.4. 
OF ASSOCIATION. 
427 
ORDO II. 
Decreafed Affociate Motions. 
GENUS IV. 
Catenated with External Influences. 
As the difeafes, which obey folar or lunar periods, commence 
with torpor or inactivity, 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 influence of the matter of heat, are 
much more generally in this country produced by the defect 
than by the excefs of that fluid. 
The periodic returns of fo 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, tertian, and quartan fevers, muft deny their effeCt 
on the tides, and on the feafons. It has generally been believed, 
that folar and lunar effeCt was exerted on the blood ; which 
was thus rendered more or lefs ftimulant to the fyllem, as de- 
fcribed in SeCt. XXXII. 6. But as the fluid matter of gravita- 
tion permeates and covers all things, like the fluid matter of 
heat; I am induced to believe, that gravitation aCts in its medi- 
um ftate rather as a caufa fine qua non of animal motion like 
heat; which may diforder the fyftem chemically or mechanical- 
ly, when it is diminiffied; but may neverthelefs llimulate it, 
when increafed, into animal exertion. 
Without heat and motion, which fome philofophers ftill 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 counteract the gravitation of bodies to one cen- 
tre ; 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 life cannot exift ; as by their 
means the component particles of matter are enabled to Aide over 
each other with all the various degrees of fluidity and repul- 
fion. 
As the attraction of the moon countervails or diminifhes the 
terrene gravitation of bodies on the furface of the earth ; a tide 
rifes 428 
DISEASES 
Class IV. z, 4. 
rifes on that fide of the earth, which is turned towards the 
moon ; and follows 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 counteracts the gravitation of bodies near its 
furface. For the earth and moon may be confidered as two can- 
non balls of different fizes held together by a chain, and revolv- 
ing once a month round a common centre of gravity between 
them, near the earth's furface ; at the fame time that they per- 
form their annual orbits round the fun. Whence the centrifu- 
gal force of that fide of the earth, which is fartheft from this cen- 
tre 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 fhould be added, 
that this centrifugal force not only contributes to diminifh the 
terrene gravitation of bodies on the earth's furface on that fide 
furtheft from the centre of motion, but alfo to increafe it on that 
fide, ■which is neareft it. 
Another circumftance, which tends to raife the tide on the part 
of the earth's furface, which is moft diftant from the moon, is, 
that the attraction of the moon is lefs on that part of the ocean, 
than it is on the other parts of the earth. Thus the moon may 
be fuppofed to attract the water on the fide of the earth neareft 
it with a power equal to three; and to attrafl the central parts 
of the earth with a power equal to two ; and the water on the 
part of the earth moft diftant from the moon with a power only 
equal to one. Hence on the fide of the earth moft diftant from 
the moon, the moon's attraction is lefs, and the centrifugal force 
round their common centre 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 furfacc of the earth round their common centre of mo- 
tion in fome degree oppofes this effect. 
On thefe accounts, when the moon is in the zenith or nadir, 
the gravitation 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 centre during the 
lunar day is about fix hours and a half after the fouthing, or af- 
ter the northing of the moon. 
Circumftances fimilar to thefe, but in a lefs degree, muft oc- 
cur in refpect 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 al- 
fo at midnight from the greater centrifugal force of that fide of 
the Class IV. 2.4.1. 
OF ASSOCIATION. 
429 
the earth, which is moft diftant from the centre, round which 
the earth moves in her annual orbit, than on the fide neareft 
that centre. Whence it likewife follows, 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 attraction 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 mid- 
night, the gravitation of 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 attraction 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 
particles of bodies to each other, and hence become either the 
efficient caufes of vegetable and animal life, or the caufes with- 
out which life cannot exift, it feems to follow, that when our 
gravitation towards the earth's centre is greateft, the powers of 
life fliould 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 mid- 
night ; or laftly, according to the combination of thefe powers in 
diminifhing or increafing the earth's attraction to bodies on its 
furface. 
The returns or exacerbations of many fevers, both irritative 
and inflammatory, about fix in the evening, and of the periodic 
cough defcribed in SeCt. XXXVI. 3. 9. countenance this theo- 
ry. Tables might be made out to fliew the combined powers 
of the fun and moon in diminifhing 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 fubjeCt. But I am well aware of the difficulty of its appli- 
cation to difeafes, and hope thefe conjectures may induce oth- 
ers to publifh more numerous obfervations, and more conclu- 
five reafonings. 
SPECIES. 
I. Somni periodus. The periods of fleeping and of waking 
are fhortened or prolonged by fo many other circumflances in 
animal life, befides the minute difference between diurnal and 
nodurnal 430 
DISEASES 
Class IV. 2. 4. 2. 
no&urnal folar gravitation, that it can fcarcely be afcribed to this 
influence. At the fame time it is curious to obferve, that veget- 
ables in refpedl 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 confulting the calendar of Flora. Bo- 
tanic Garden, Part II. Canto 2. 1. 165. note. 
Some difeafes, which at firft fight might be fuppofed to be in- 
fluenced by folar periods, feem to be induced by the increafing 
fenfibility of the fyftem to pain during our fleeping hours ; as 
explained in Se€t. XVIII. 15. Of thefe are the fits of afthma, 
of fome epilepfies, and of fome haemoptoes; all which difturb 
the patient after fome hours fleep, and are therefore to be af- 
cribed 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, 
fhould be afcribed to the increafed fenfibility in fleep, or to fo- 
lar influence ? 
M. M. When afthmatic or epileptic fits or haemoptoe occur 
after a certain number of hours of fleep, the patient fhould be 
forcibly awakened before the expelled time by an alarm clock, 
and drink a cup of chocolate or lemonade.-Or a grain of opi- 
um fhould be given at going to bed.-In one cafe to prevent 
the too great increafe of fenfibility by fhortening the time of 
fleep ; and in the other by increafing the irritative motions, and 
expending by that means a part of the fenforial power. 
2. Studii inanis periodus. Clafs III. 1. 2. 2. The cataleptic 
fpafm which preceded the reverie and fomnambulation in the 
patient, whofe cafe is related in Sedl. XIX. 2. occurred at ex- 
actly the fame hour, which was about eleven in the morning for 
many weeks ; till thofe periods were difturbed by large dofes of 
opium ; and mult therefore be referred to fome effect of folar 
gravitation. In the cafe of Mafter A. Se<ft. XXXIV. 3. as the 
reverie began early in the morning during fleep, there may be a 
doubt, whether this commenced with torpor of fome organ 
catenated with folar gravitation; or was caufed by the exift- 
ence 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 epi- 
lepfy, afthma, and haemoptoe mentioned in the preceding article. 
3. Hemicrania periodus. Periods of Hemicrania. Clafs IV. 
2. 2. 8. The torpor and confequcnt pain of fome membranes 
on one fide of the head, as over one eye, are frequently occa- 
fioned by a decaying tooth, and are liable to return every day, 
or on alternate days at folar or lunar periods. In this cafe large 
quantities of the bark will frequently cure the difeafe, and ef- 
pecially Class IV. 2. 4.4. 
OF ASSOCIATION. 
431 
pecially if preceded by venefecHon and a brilk cathartic ; but if 
the offending tooth can be detected, the moil certain cure is its 
extraction. Thefe partial head-achs are alfo liable to return at 
the greater lunar periods, as about once 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. Epilepjia dolorifica periodus. Clafs III. I. I. 8. The pain 
which induces after about an hour the violent convulfions or in- 
fanity, which conftitute the painful epilepfy, generally obferve 
folar diurnal periods for four or five weeks, and are probably 
governed by folar and lunar times in refpeft to their greater pe- 
riods ; for I have obferved that the daily paroxyfms, unlefs dif- 
turbed by large dofes of opium, recur at very nearly the fame 
hour, and after a few weeks the patients have recovered to re- 
lapfe again at the interval of a few months. But more obfer- 
vations are wanted upon this fubjeCt, which might be of great 
advantage in preventing the attacks of this difeafe ; as much lefs 
opium given an hour before its expected daily return will pre- 
vent the paroxyfm, than is neceflary to cure it, after it has com- 
menced. 
5. Convulftonis dolorifica 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 fliort time afleep, and are therefore 
perhaps rather to be afcribed to the increafing fenfibility of the 
fyftem during fleep, than to folar diurnal periods, as in Species 
firft and fecond of this Genus. 
6. Eujfis periodica periodus. Periodic cough, Clafs IV. 2. I. 
9. returns at exafl folar periods; that defcribed in Sect. XXXVI. 
3. 9. recurred about feven in the afternoon for feveral weeks, 
till its periods were difturbed by opium, and then it recurred at 
eleven at night for about a week, and was then totally deftroy- 
ed by opium given in very large quantities, after having been 
previoufly for a few days omitted. 
7. Catamenia periodus. Periods of menftruation. The cor- 
refpondence of the periods of the catamenia with thofe of the 
moon was treated of in Sefl. XXXII. 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 commonly been afcribed to fome etfedl of 
the lunar gravitation on the circulating blood, as mentioned in 
Seft. XXXII. 6. But it is more analogous to other animal 
phenomena to fuppofe that the lunar gravitation immediately 
affefls 432 
DISEASES 
Class IV. 2. 4. 8. 
afteCls the folids by its influx or ftimulus. Which we believe 
of the fluid element of heat, in which we are equally inimerfed ; 
and of the eleCtric fluid, which alfo furrounds and pervades us. 
See Sed. XXXVI. 2. 3. 
If the torpor of the uterine veins, which induces the monthly 
periods of the catamenia, be governed by the increafe of terrene 
gravitation ; that is, by the deficiency of the counter-influence 
of folar and lunar gravitation ; why does not it occur molt fre- 
quently 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 difficulty; firft, if the ter- 
rene gravitation be greateft about fix hours after the new moon, it 
muft become lefs and lefs about the fame time every lunar day, till 
the end of the firft quarter, when it will be the leaft ; 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 increafe 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, wheth- 
er 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 
thrown on this fubjeCt; which muft in that refpcCt wait for 
future obfervations. 
Secondly, if the lunar influence produces a very fmall degree 
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 acting 
at the fame time, as explained inSeCf. XII. 3. 3. till at length 
fo great a degree of quiefcence will be induced as to caufe the 
inaction of the veins of the uterus, and confequent venous haem- 
orrhage. See SeCt. XXXII. 6. Clafs I. 2. 1. 11. IV. 1. 4. 4. 
See the introduction to this Genus. 
8. Hamorrhoidis periodus. The periods of the piles depend 
on the torpor of the veins of the retftum, and are believed to re- 
cur nearly at monthly intervals. See Sett. XXVII. 2. and 
Clafs I. 2. 1. 6. 
9. Podagra periodus. 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 
fucceffive 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 di- 
. urnal Class IV. 2. 4. 10. 
OF ASSOCIATION. 
433 
urnal folar periods, or by the increafing fenfibility during Heep, 
as mentioned in the firft fpecies of this genus. 
io. Eryfipelatis periodus. Some kinds of eryfipelas which 
probably originate from the aflbciation of the cutaneous veflels 
with a difeafed liver, occur at monthly periods, like the htemor- 
rhois or piles; and others at annual periods, like the gout; as a 
torpor of fome part I fuppofe always precedes the eryfipelatous 
inflammation, the periods fhould accord with the increafing in- 
fluence of terrene gravitation, as defcribed in the introduction to 
this Genus, and in fpecies the feventh of it. Other periods of 
difeafes referable to folar and lunar influence are mentioned in 
Section XXXVI. and many others will probably be difcovered 
by future obfervation. 
ii. Febrium periodus. Periods of fevers. The commence- 
ment of the cold fits of intermittent fevers, and the daily exa- 
cerbations of other fevers, fo regularly recur at diurnal folar or 
lunar periods, that it is impoflible to deny their connection with 
gravitation ; as explained in SeCt. XXXVI. 3. Not only thefe 
exacerbations of fever, and their remiffions, and the diurnal fo- 
lar and lunar periods ; but the preparatory circumftances, which 
introduce fevers, or which determine their crififes, appear to be 
governed by the parts of monthly lunar periods, and of folar 
annual ones. Thus the variolous fever in the natural fmall- 
pox commences on the 14th day, and in the inoculated finall- 
pox on the feventh day. The fever and eruption in the diftinCt 
kind take up another quarter of a lunation, and the maturation 
another quarter. 
The fever, which 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, it feems 
to acquire fome ftrength, or to lie dormant, till another, or per- 
haps more powerful lunation calls it into action. In the fpring, 
about three or four years ago, a mad dog very much worried one 
fwine confined in a fly, and bit another in the fame fty in a lefs 
degree ; the former became mad, refufed his meat, was much 
convulfed, and died in about four days; this difeafe commenced 
about a month after the bite. The other fwine began to be ill 
about a month after the firft, and died in the fame manner. 
Vol. II. 
H Hh 434 
DISEASES 
Class IV. 3. 1. 1. 
ORDO III. 
Retrograde AJjbciate Motions. 
GENUS I. 
Catenated 'with Irritative Motions. 
Those retrograde affociate motions, the firft links of which 
are catenated with irritative motions, belong to this genus. All 
the retrograde motions are confequent to debility, or inactivity, 
of the organ ; and therefore properly belong to the genera of de- 
creafed actions both in this and the former clafles. 
SPECIES. 
x. Diabetes irritata. When the abforbents of the inteftines 
are ftimulated too ftrongly 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 
action of the cutaneous abforbents, or of the pulmonary ones ? 
May not in fuch cafes oil externally 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 ftimulus ? 
2. Sudor frigidus in ajihmate. The caufe of the paroxyfms of 
humoral afthina is not well underftood ; I fuppofe it to be ow- 
ing to a torpidity or inaction of the abforbents belonging to the 
pulmonary veflels, as happens probably to other vifcera at the 
commencement of intermittent fevers, and to a confequent ac- 
cumulation of fluids in them ; which at length producing great 
irritation or uneafy fenfation caufes the violent efforts to pro- 
duce the absorption of it. The motions of the cutaneous ab- 
forbent veflels 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 conftitution in 
what was called a fit of the afthma; he had about two months 
before had a peripneumony, and had been ever fince fubjedt 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 diffi- 
culty of breathing. He gradually became worfe, and in about 
k . v half Class IV. 3.1. 3. 
OF ASSOCIATION. 
435 
half an hour, the palpitation of his heart and difficult refpiration 
were very alarming ; his whole Ikin was cold and' pale, yet he 
did not ihudder as in cold paroxyfm of fever; his tongue from 
the point to the middle became as cold as his other extremities, 
with cold breath. He feemed to be in the aCt 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 hartlhorn, and recovered in an hour or two 
without any cold fweat. 
There being no cold fweat feems to indicate, that there was 
no accumulation of ferous fluid in the lungs ; and that their 
inactivity, and the coldnefs of the breath, was owing to the 
fympathy of the air-cells with fome diftant part. There was 
no ihuddering produced, becaufe the lungs are not fenlible to 
heat and cold ; as any one may obferve by going from a warm 
room into a frofty air, and the contrary. So the fteam of hot 
tea, which fcalds the mouth, does not affeCt the lungs with the 
fenfation of heat. I was induced to believe that the whole cold 
fit might be'owing to fuppuration in fome part of the cheft; as 
the general difficulty of breathing feemed to be increafed after a 
few days with pulfe of 120, and other figns of empyema. Do 
the cold fweat, and the occurrence of the fits of althma after 
fleep, diltinguilh the humoral althma from the cold paroxyfm of 
intermittents, or that which attends fuppuration, or which pre- 
cedes inflammation ?-I heard a few weeks afterwards, that he 
fpit up much matter at the time he died. 
3. Diabetes a timore. The motions of the abforbent vcflels of 
the neck of the bladder become inverted by their confent with 
thofe of the fkin ; which are become torpid by their reverfe 
fympathy with the painful ideas of fear, as in SeCt. XVI. 8. 1. 
whence there is a great difcharge of pale urine, as in hyfteric 
difeafes. 
The fame happens from anxiety, where the painful fufpcnfe 
is continued, even when the degree of fear is fmall ; as in young 
men about to be examined for a degree a: the univerfities the 
frequency of making water is very obfervable. When this anxi- 
ety is attended with a fleeplefsnight, the quantity of pale urine is 
amazingly great in fome people, and the micturition very fre- 
quent. 
M. M. Opium. Joy. Confolations of friendffiip. 
4. Diarrhoea a timore. The abforbent veflels of the inteftines 
invert their motions by direct confent with the Ikin ; hence 
many liquid llools as well as much pale urine are liable to ac- 
company continued fear, along with coldnefs of the Ikin. The 
immediate caufe of this is the decreafed fenforial power of aflb- 
ciation, 436 
DISEASES 
Class IV. 3. 1.5. 
ciation, which intervenes between the actions of the abforbents 
of the cold fkin, and thofe of the inteftinal abforbents ; the mo- 
tions of the latter become on that account weakened and at 
length retrograde. The remote caufe is the torpor of the vef- 
fels of the |kin catenated with the pain of fear, as explained in 
Sed. XVI. 8. I. 
The capillaries of the fkin confent more generally by direa 
fympathy with thofe of the lower inteftines, and of the bladder; 
but by reverfe fympathy more generally with thofe of the ftom- 
ach and upper inteftines. As appears in fevers, where the hot 
fkin accompanies indigeftion of the ftomach ; and in diarrhoeas 
attended with cold extremities. 
The remote caufe is the torpor of the fkin owing to its reverfe 
fympathy with the painful fenfual motions, or ideas, of fear ; 
which are now aauated with great energy, fo as to deprive the 
fecond link of affociated motions of their due (hare of fenforial 
power. It is alfo probable, that the pain of fear itfelf mav con- 
tribute to exhauft the fenforial power, even when it produces no 
niufcular action. See Clafs IV. 2. 2. 
5. Pallor et tremor a timore. A retrograde action of the ca- 
pillaries of the fkin producing palenefs, and a torpor of the muf- 
cular fibres of the limbs occafioning trembling, are caufed by 
ftheir reverfe affociations with the ideas or imaginations of fear ; 
which are now actuated with violent energy, and accompanied 
with great pain. The caufe of thefe afl'oeiations are explained 
in Sect. XVI. 8. 1. 
Thefe torpid actions 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 actions, as occurs in anger ; where the painful voli- 
tion increafes the actions of the capillaries, exciting a blufh and 
heat of the fkin. Whence we may gain fome knowledge of 
what is meant by depreffing and exciting paffions; the former 
confifting of ideas attended with pain, which pain occafions no 
mufcular actions, like the pain of cold head-ach; the latter be- 
ing attended with volitions, and confequent mufcular exertions. 
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 ; in the former cafe the painful fenfation of fear produces 
no mufcular a&ions, yet it exhaufts or employs fo much fenforial 
power, that the whole fyftem acts more feebly, or becomes 
retrograde ; but fome parts of it more fo than others, according 
to their early aflbeiations defcribed in Seft. XVI. 8. 1. hence 
the tremor of the limbs, palpitation of heart, and even fyncope. 
In anger the painful volition produces violent mufcular actions ; 
but Class IV. 3. 1.6. 
OF ASSOCIATION. 
437 
but if previous to thefe any deliberation occurs, a flufhed coun- 
tenance fometimes, and a red Ikin, are produced by this fupera- 
bundance of volition exerted on the arterial fyitem ; but at oth- 
er times the (kin becomes pale, and the legs tremble, from the 
exhauftion or expenditure of the fenforial power by the painful 
volitions of anger on the organs of fenfe, as by the painful fen- 
fations of fear above mentioned. 
Where the paffion of fear exifts in a great degree, it exhaufts 
or expends fo much fenforial power, either fimply 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 
fkin, but a retrograde motion of the cutaneous abforbents oc- 
curs, and a cold fweat appears upon the whole furface of the 
body, which probably fometimes increafes pulmonary abforp- 
tion ; 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 debilitates the 
conftitution as to occafion a lingering death ; which happens 
much more frequently than is ufually fuppofed ; and thefe vic- 
tims of continued anxiety are faid to die of a broken heart. 
Other kinds of palenefs are defcribed in Clafs I. 2. 2. 2. 
M. M. Opium. Wine. Food. Joy. 
6. Palpitaiio cordis a timore. The palpitation of the heart 
from fear is owing to the w'eak adtion of it, and perhaps fome- 
times to the retrograde exertion of the ventricles and auricles ; 
becaufe it feems to be affected by its affociation with the capil- 
laries, the actions of which, with thofe of the arteries and veins, 
conftitute one great circle of affociate motions. Now when 
the capillaries of the fkin become torpid, coldnefs, and palenefs 
fucceed; and with thefe are affociated the capillaries of the 
lungs, whence difficult refpiraticn ; and with thefe the weak 
and retrograde adtions of the heart. At the fame time the ab- 
forbents of the Ikin, and of the bladder, and of the inteflines, 
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 Rill more violently affected the fyflem, there 
have been inftances where fyncope, and fudden death, or a total 
ftoppage of the circulation have fucceeded : in thefe lait 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 ceafc to act, whence the patient falls down 
and 438 
DISEASES 
Class IV. 3. 1. 7. 
and thofe which conftitute the organs of fenfe, whence fynco- 
pe; but lafily thofe, which perform the vital motions, become 
deprived of fenforial power, and death enfues. See Clafs 1. 2. 
I. 4. and I. 2. I. 10. Similar to this in fome epileptic fits the 
patient firft fuddenly falls down, without even endeavouring to 
fave himfelf by his hands before the convulfive motions come 
on. In this cafe the great exertion of fome fmall part in confe- 
quence of great irritation or fenfation exhaufts the whole fen- 
forial power, which was lodged in the extremities of the lo- 
comotive nerves, for a Ihort time, as in fyncope ; and as 
foon as thefe mufcles are again fupplied, convulfions fuper- 
vene to relieve the painful fenfation. See Clafs III. 1. 1. 7. 
7. Abortio a timore. Women mifcarry much more frequent- 
ly from a fright, than from bodily injury. A torpor or retro- 
grade motion of the capillary arteries of the internal uterus is 
probably the immediate cauie of thefe mifcarriages, owing to 
the allbciation of the actions of thofe veflels with the capillaries 
of the (kin, which are rendered torpid or retrograde by fear. 
By this contraCtion of the uterine arteries, the fine veflels of 
the placenta, which are inferted into them, are detruded, or oth- 
erwife fo affeCted, that the placenta feparates at this time from 
the uterus, and the fetus dies from want of oxygenation. 
A ftrong young woman, in the fifth on fixth month of her preg- 
nancy, who has fince borne many children, went into her cellar 
to draw beer ; one of her fervant boys was hid behind a bar- 
rel, and flarted out to furprife her, believing her to be the 
maid-fervant; fhe began to flood immediately, and mifcarried 
in a few hours. See SeCt. XXXIX. 6. 5. and Clafs I. 2. 1. 14. 
8. Hyjleria a timore. Some delicate ladies are liable to fall 
into hylteric fits from fudden fright. The periftaltic motions 
of the bowels and flomach, and thofe of the cefophagus, make 
a part of the great circle of irritative motions with thofe of the 
fkin, and many other membranes. Hence when the cutaneous 
veflels become torpid from their reverie fympathy with the 
painful ideas of fear; thofe of the bowels, and ftomach, and 
cefophagus, become firft torpid by direft fympathy with thofe 
of the (kin, and then feebly and ineffectually invert the order of 
their motions, which conftitutes a paroxyfm of the hylteric dif- 
eafc. See Clafs I. 3. 1. 10. Thefe hylteric paroxyfms are 
fometimes followed by convulfions, 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. 1. 4. 
Indigeltion from fear, is to be afcribed in the fame manner 
to the torpor of the Itomach, owing to its aflbciation with the 
Ikin. As in Clafs IV. 1. 2. 5. IV. 2. 1. 
OR DO Class IV. 3. 2. 1. 
OF ASSOCIATION. 
439 
ORDO III. 
Retrograde Ajfociate Motions. 
GENUS II. 
Catenated tuith Senfitive Motions. 
SPECIES. 
I. Naufea idealis. Naufea from difguftful ideas, as from 
naufcous Hories, or difguftful fights, or fmells, or taftes, as well 
as vomiting from the fame caufes, conlifts in the retrograde ac- 
tions of the lymphatics of the throat, and of the cefophagus, and 
ftomach; which are aflbciated with the difguftful ideas, or fen- 
fual motions of fight, or hearing, or fmell, or tafte ; for as thefe 
are deareafed motions of the lymphatics, or of the cefophagus, or 
ftomach, they cannot immediately be excited by the fenforial 
power of painful fenfation, as in that cafe they ought to be in- 
creafed motions. So much fenforial power is employed for a 
time on the difguftful idea, or expended in the production of 
inadive pain, which attends it, that the other parts of the aflb- 
ciated chain of aCtion, of which this difguftful idea is now be- 
come a link, are deprived of their accuftomed (hare ; and there- 
fore firft ftop, and then invert their motions. Owing to defi- 
ciency of fenforial power, as explained more at large in SeCt. 
XXXV. 1.3. 
2. Naufea a conceptu. The naufea, which pregnant women 
are fo fubjeU to during the firft part of geftation, is owing to 
the reverfe fympathy between the uterus and ftomach, fo that 
the increafed aCtion of the former, excited by the ftimuhis of 
the growing embryon, which I believe is fometimes attended 
with fenfation, produces decreafed a&ions of the latter with the 
difagreeable fenfation of ficknefs with indigeftion and confe- 
quent 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. Half a grain of opi- 
um twice a day. Recumbent pofture on a fofa. 
3. Vomitio veriiginofa. Sea-ficknefs, the irritative motions of 
vifion, by which we balance ourfelves, and preferve our perpen- 
dicularity, are difturbed by the indiftimftnefs of their objects ; 
which is either owing to the fimilarity of them, or to their dif- 
tance, 440 
DISEASES 
Class IV. 3. 2.4. 
tance, or to their apparent or unufual motions. Hence thefe 
irritative motions of vifion are exerted with greater energy, and 
are in confequence attended with fenfation ; which at firfl is 
agreeable, as when children fwing on a rope ; afterwards the 
irritative motions of the llomach, and of the abforbent veflels, 
which open their mouths into it, become inverted by their af- 
fociations with them by reverfe fympathy. 
For the action of vomiting, as well as the difagreeable fen- 
fation of ficknefs, are Ihewn to be occafioned by defeat of the 
fenforial power ; which in this cafe is owing to the greater ex- 
penditure of it by the fenfe of vifion. On the fame account the 
vomiting, which attends the paflage of a llone through the ure- 
ter, or an inflammation of the bowels, or the commencement of 
fome fevers, is caufed by the increafed expenditure of the fen- 
forial power by the too great action of fome links of the aflbei- 
ations of irritative motions; and there being in confequence a 
deficiency of the quantity required for other links of this great 
catenation. 
It mull be obferved, that the expenditure of fenforial power 
by 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 moll of our lleeping ones ; and by the large diam- 
eters of the two optic nerves, which are nearly the fize of a 
quill, or equal to fome of the principal nerves, which ferve the 
limbs. 
4. Vomitio a calculo in ureterc. The adlion of vomiting in con- 
fequence of the increafed or decreafed actions of the ureter, 
when a flone lodges in it. The natural adlions of the llomach, 
which confill of motions fubjedl to intermitted irritations from 
the fluids, which pafs through it, are afl'oeiated with thofe of the 
ureter ; and become torpid, and confequently retrograde, by in- 
tervals, when the adiions of the ureter become torpid owing to 
previous great llimulus from the llone it contains •, as appears 
from the vomiting exilling when the pain is leaft. When the 
motions of the ureter are thus leflened, the fenforial power of 
aflbeiation, which ought to adluate the llomach along with the 
fenforial power of irritation, ceafes to be excited into action; 
and in confequence the actions of the llomach become lefs en- 
ergetic, and in confequence retrograde. 
For as vomiting is a decreafed adlion of the llomach, as ex- 
plained in Sedl. XXXV. 1. 3. it cannot be fuppofed to be 
produced by the pain of gravel in the ureter alone, as it fhould 
then be an increafed adlion, not a decreafed one. 
The perpetual vomiting in ileus is caufed in like manner by 
the defedlive excitement of the fenforial power of aflbeiation by 
the Class IV. 3. 2. 5. 
OF ASSOCIATION. 
441 
the bowel, which is torpid during the intervals of pain ; and the 
ftomach fympathizes with it. See Enteritis, Clafs II. i. 2. 11. 
Does this fymptom of vomiting indicate, whether the difeafe be 
above or below the valve of the colon ? Does not the fofter 
pulfe in fome kinds of enteritis depend on the fympathy of the 
heart and arteries with the ficknefs of the ftomach ? See Ileus 
and Cholera. 
Hence this ficknefs, as well as the ficknefs in fome fevers, 
cannot be efteemed an effort of nature to diflodge any oftenfive 
material; but like the fea-ficknefs defcribed above, and in Se6t. 
XX. 4. is the confequence of the aflbeiations of irritative or fen- 
fitive motions. See Clafs I. 1. 3. 9. 
5. Vomitio ab injultu paralytica. Paralytic affections generally 
commence with vomiting, the fame frequently happens from a 
violent blow with a ftick on the head ; this curious connection 
of the brain and ftomach has not been explained ; as it refem- 
bles the ficknefs in confequence of vertigo at fea, it would feem 
to arife from a fimilar caufe, viz. from difturbed irritative or 
fenfitive aflbeiations. 
6. Vomitio a titillatione faucium. If the throat be (lightly tick- 
led with a feather, a naufea is produced, that is, an inverted ac- 
tion of the mouths of the lymphatics of the fauces, and by di- 
rect fympathy an inverted action of the ftomach enfues. As 
thefe parts have frequently been ftimulated at the fame time in- 
to pleafurable action by the deglutition of our daily aliment, 
their actions become ftrongly affociated. And as all the food 
wc fwallow, is either moift originally or mixed with our moift 
faliva 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 naulea and vom- 
iting cantiot be caufed by difagreeable fenfation (imply, as then 
they ought to have been increafed exertions, and not decreafed 
ones, as (hewn in Section XXXV. 1.3. But the mouths of the 
lymphatics of the fauces are ftimulated by the dry feather into 
too great aCtion for a time, and become retrograde afterwards 
by the debility confequent to too great previous ftimulus. 
7. Vomit io cutefympathetica. Vomiting is fuccefsfully (topped 
by the application of a blifter on the back in fome fevers, where 
the extremities are cold, and the (kin pale. It was (topped by 
Sydenham by producing a fweat on the (kin by covering the 
head with the bedclothes. See Clafs IV. 1. 1. 3. and Suppl. 
I. 11. 6. 
Vol. IL 
I i i 
ORDO 442 
DISEASES 
Class IV. 3. 3. t. 
ORDO III. 
Retrograde Ajjociate Motions. 
GENUS III. 
Catenated with Voluntary Motions. 
SPECIES. 
i. Ruminatio. In the rumination of horned cattle the food is 
brought up from the firft llomach by the retrograde motions of 
the llomach and oefophagus, which are catenated with the vol- 
untary motions of the abdominal mufcles. 
2. Vomitio voluntaria. Voluntary vomiting. Some human 
fubjeCls have been faid to have obtained this power of volunta- 
ry aClion over the retrograde motions of the flomach and oefoph- 
agus, and thus to have been able to empty their llomach at 
pleafure. See SeCl. XXV. 6. This voluntary acl of empty- 
ing the llomach is poflefled by fome birds, as the pigeon ; who 
has an organ for fecreting milk in its llomach, as Mr. Hunter 
obferved ; and foftens the food for its young by previoully fwal- 
lowing it; and afterwards putting its bill into theirs returns it 
into their mouths. See Se£l. XXXIX. 4. 8. The pelicans ufe 
a llomach, or throat bag, for the purpofe of bringing the filh, 
which they catch in the fea to fhore, and then eject them, and 
eat them at their leifure. See SeCl. XVI. 11. And I am well 
informed of a bitch, who having puppies in a liable at a diftance 
from the houfe, fwallowed the flelh-meat, which was given her, 
in large pieces, and carrying it immediately to her whelps, 
brought it up out of her llomach, and laid it down before them. 
3. EruElatio 'voluntaria. Voluntary eructation. Some, who 
have weak digeftions, and thence have frequently been induced 
to eruCt the quantity of air difeharged from the fermenting ali- 
ment in their llomachs, have gradually obtained a power of vol- 
untary eruClation, and have been able thus to bring up hogf- 
heads of air from their llomachs whenever they pleafed. This 
great quantity of air is to be afcribed to the increafe of the fer- 
mentation of the aliment by drawing off the gas as foon as it is 
produced. See Seel. XXIII. 4. 
ORDO Class IV. 3. 4. 1. 
OF ASSOCIATION 
443 
ORDO III. 
Retrograde Ajjbciate Motions. 
GENUS IV. 
Catenated with External Influences. 
SPECIES. 
I. Catarrhus periodicus. Periodical catarrh is not a very un- 
common difeafe; there is a great difcharge of a thin faline mu- 
cous material from the membranes of the noftrils, and probably 
from the maxillary and frontal linufes, which recur once a day 
at exatt folar periods ; unlefs it be dilturbed by exhibition 
of opium ; and refembles the periodic cough mentioned below. 
See Clafs I. 3. 2. 1. It is probably owing to the retrograde ac- 
tion of the lymphatics of the membranes affected, and produced 
immediately by folar influence. 
2. Tujfls periodica. Periodic cough, called nervous cough, 
and tuffis ferina. It feems to arife from a periodic retrograde 
action of the lymphatics of the membrane, which lines the air- 
cells of the lungs. And the action of coughing, which is vio- 
lent for an hour or longer, is probably excited by the ftimulus 
of the thin fluid thus produced, as well as by the difagreeable 
fenfation attending membranous ii^adiivity ; and refembles pe- 
riodic catarrh not only in its fituation on a mucous membrane, 
but in the difcharge of a thin fluid. As it is partly reftrainable, 
it does not come under the name of convulfion ; 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 cure in 
Sedt. XXXVI. 3. 9. Clafs IV. 2. 4. 6. and feems immediately 
to be induced by folar influence. 
3. Hyfleria a frigore. Hyfteric paroxyfms are occafioned by 
whatever fuddenly debilitates the fyftem, as fear, or cold, and 
perhaps fometimes by external moifture of the air, as all delicate 
people have their days of greater or lets debility, fee Clafs IV. 
3* 1. 8. 
4. Naufea pluvialis. Sicknefs at the commencement of a 
rainy feafon is very common among dogs, who affilt themfelves 
by eating the agroftis canina, or dog's grafs, and thus empty 
their ftomachs. The fame occurs with lefs frequency to cafs, 
who make ufe of the fame expedient. See Setfl. XVI. 11. I 
have known one perfon, who from his early years has always 
been 444 
DISEASES, &c. 
Class IV. 3. 4.4. 
been Tick at the beginning of wet weather, and (till continues fo. 
Is this owing to a fympathy of the mucous membrane of the ftom- 
ach with the mechanical relaxation of the external cuticle by a 
moifter atmofphere, as is feen in the corrugated cuticle of the 
hands of wafher-women ? or does it fympathize with the mu- 
cous membrane of the lungs, which muft be affe&ed along with 
the mucus on its furface by the refpiration of a moifter atmof- 
phere. 
SUPPLEMENT SUPPLEMENT 
TO 
CLASS IV. 
Sympathetic Theory of Fever. 
As fever confifts in the increafe or diminution of direft or 
reverfe aflbciated motions, whatever may have been the remote 
caufe of them, it properly belongs to the fourth clafs of difeaf- 
es; and is introduced at the end of the clafs, that its great dif- 
ficulties might receive elucidation from the preceding parts of 
it. Thefe I (hall endeavour to enumerate under the following 
heads, trufting that the candid reader will difeover in thefe ru- 
diments of the theory of fever a nafeent embryon, an infant 
Hercules, which Time may rear to maturity, and render fervice- 
able 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 aflbciated motions. 
VII. Alternations of cold and hot fits. 
VIII. Orgafin of the capillaries. 
IX. Torpor of the lungs. 
X. Torpor of the brain. 
XI. Torpor of the heart and arteries. 
XII. Torpor of the ftomach and inteftines. 
XIII. Cafe of continued fever explained. 
XIV. Termination of continued fever. 
XV. Inflammation excited in fever. 
XVI. Recapitulation. 
I. Simple Fever. 
i. When a fmall part of the cutaneous capillaries with their 
mucous or perfpirative glands are for a ihort time expofed to a 
colder medium, as when the hands are immerfed in iced water 
for 446 
THEORY OF FEVER. 
Sup. I. I. 2- 
for a minute, thefe capillary veflels and their glands become tor- 
pid or quiefeent, owing to the eduction of the itimulus of heat. 
The Ikin then becomes pale, becaufe no blood pafles through the 
external capillaries ; and appears fhrunk, becaufe their fides are 
collapfed from inactivity, not contracted by fpafm ; the roots 
of the hair are left prominent from the feceding or fubfiding of 
the ikin around them ; and the pain of coldnefs is produced. 
In this fituation, if the ufual degree of warmth be applied, 
thefe veffels regain their activity ; and having now become 
more irritable from an accumulation of the fenforial power of 
irritation during their quiefcence, a greater exertion of them fol- 
lows, with an increafed glow of the Ikin, and another kind of pain, 
which is called the hot-ach ; but no fever, properly fo called, is 
yet produced ; as this effeCt is not univerfal, 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 torpor or quiefcence becomes extended by direft fym- 
pathy to the heart and arteries ; which is known by the weak- 
nefs, and confequent frequency of the pulfe in cold fits of fever. 
This requires to be further explained. The movements of 
the heart and arteries, and the whole of the circulatory veffels, 
are in general excited into aftion by the two fenforial powers of 
irritation, and of aflbeiation. The former is excited by ftimu- 
lus, the latter by the previous aftions of a part of the vital circle 
of motions. In the above fituation the capillaries aft weakly 
from defeCt of irritation, which is caufed by deficient ftimulus 
of heat; but the heart and arteries aft weakly from defeft of 
aflbeiation, which is owing to the weak aftion of the capilla- 
ries ; which does not now excite the fenforial power of aflbeia- 
tion into aftion with fufficient energy. 
After a time, either by the application of warmth, or by the 
increafe of their irritability owing to the accumulation of the 
fenforial power of irritation during their previous quiefcence, the 
capillary veflels and glands aft with greater energy than natural j 
whence the red colour and heat of the ikin. The heart and ar- 
teries acquire a greater flrength of pulfation, and continue the 
frequency of it, owing to the accumulation of the fenforial pow- 
er of aflbeiation during their previous torpor, and their confe- 
quent greater aflbeiability j which is now alfo more ftrongly ex- 
cited by the increafed aftions of the capillaries. And thus a 
fit of Ample fever is produced, which is termed Febris irritati- 
va ; and confifts of a torpor of the cutaneous capillaries with 
their mucous and perfpirable glands, accompanied with a tor- 
por Sup. I. 1. 3. 
THEORY OF FEVER. 
447 
por of the heart and arteries; and afterwards of an increafed 
a€lion of all thefe veflels, by what is termed diretl fympathy. 
This fever, with ftrong pulfe without inflammation, or febris 
irritativa, defcribed iu ClafsI. I. i. i. is frequently feen in ver- 
nal intermittents, 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 remiflion, or approximation to a cold fit; at which time 
a new accumulation of the fenforial power of afl'ociation is pro- 
duced ; which afterwards actuates the heart and arteries with 
unnatural vigour; or unlefs there be fome ftimulus perpetually 
acting on the fyftem, fo as to induce an increafed fecretion of 
fenforial power in the brain, as occurs in flight degrees of intoxi- 
cation. Since without one or other of thefe circumflances in 
continued fevers without inflammation, that is, without the ad- 
ditional fenforial power of fenfation being introduced, it feems 
difficult to account for the production of fo great a quantity of 
fenforial power, as mutt be neceflary to give perpetual increafe 
of action to the whole fanguiferous fyftem. 
3. On the contrary, while the cutaneous capillaries with their 
mucous 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 fe- 
ver ; if the heart and arteries do not acquire any increafe of af- 
fociability, but continue in their ftate 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 pre- 
vious torpor of the capillaries of the fkin, and of the heart and 
arteries by direct fympathy with them ; and afterwards of an 
orgafm or increafed aCtion of. the capillaries of the Ikin, with a 
decreafed adion, or continued torpor, of the heart and arteries 
by reverfe fympathy with them. This orgafm of the cutaneous 
capillaries,-which appears by the blulh and heat of the Ikin, is 
at firft owing to the accumulation of the fenforial power of irri- 
tation during their previous torpid ftate, as in the febris irritata 
above defcribed ; but which is afterwards fupported or continu- 
ed by the reverfe fympathy of thefe capillaries with the torpid 
ftate of the heart and arteries, as will be further explained in ar- 
ticle 8. of this Supplement. 
4. The renovated activity 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 action of the heart and arteries ; for thefe capil- 
laries of the ikin have greater mobility than the heart and arte- 
ries. 448 
THEORY OF FEVER. 
Sup. I. 1. 5. 
Ties, as appears in the fudden blufh of fliame; which may be 
owing to their being more liable to perpetual varieties of a&ivi- 
ty from their expofure to the viciflitudes 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 fkin, 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 recover- 
ed their activity by the reapplication of external warmth ; or 
by their increafed irritability, which is caufed by the accumu- 
lation 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 con- 
tinuing in the bath ; which has indeed proved fatal to fome weak 
and delicate people, and to others after having been much ex- 
haufted by heat and exercife. See Se6t. 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 a minute becomes warm, 
though he remains in the fame medium, owing to the increafe 
of irritability from the accumulation of that fenforial power 
during the ihort time which the chilnefs continued. 
6. Hence fimple fevers are of two kinds ; firft, the febris ir- 
ritativa, or fever with ftrong pulfe ; which confifts of a previous 
torpor of the heart, arteries, and capillaries, and a fucceeding 
orgafm of thofe veflels. Secondly, the febris inirritativa, or fe- 
ver with weak pulfe, which confifts of a previous torpor of the 
heart, arteries, and capillaries; and of a fucceeding orgafm of 
the capillaries, the torpor of the heart and arteries continuing. 
But as the frequency of the pulfe occurs both in the ftate of tor- 
por, and in that of orgafm, of the heart and arteries ; this con- 
ftitutes a criterion to diftinguilh 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 cutane- 
ous or pulmonary capillaries are mentioned, their mucous and 
perfpirative glands are to be underftood as included; but that 
the abforbents belonging to thofe fyftems of veflels, and the 
commencement of the veins, are not always included ; as thefe 
are liable to torpor fcparately, as in anafarca, and petechise ; or 
to orgafm, or increafed action, 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 action of 
thefe Sup. I. 2. 1. 
THEORY OF FEVER. 
449 
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 accumula- 
tion of venous blood in the cutaneous veflels, which would ap- 
pear by its purple colour. 
IL Compound Fever. 
i. When other parts of the fyftem fympathize with this tor- 
por and orgafin of the cutaneous capillaries, and of the heart 
and arteries; the fever-fit becomes more complicated and dan- 
gerous ; and this in proportion to the number and confequence 
of fuch affe&ed parts. Thus if the lungs become affected, as 
in going into very cold water, a Ihortnefs of breath occurs; 
which is owing to the collapfe or inactivity (not to the aCtive 
contraCiion, or fpafm), of the pulmonary capillaries; which, as 
the lungs are not fenfible to cold, are not fubjeCt to painful 
fenfation, and confequent thuddering, like the Ikin. In this cafe 
after a time the pulmonary capillaries, like the cutaneous ones, 
aft with increased energy; the breathing, which was before 
quick, and the air thrown out at each refpiration in lefs quanti- 
ty, and cool to the back of the hand oppofed to it, now becomes 
larger in quantity, and warmer than natural; which however is 
not accompanied with the fenfation of heat in the membrane, 
which lines the air-vefleis of the lungs, as in the Ikin. 
2. One confequence of this increafed heat of the breath is 
the increafed evaporation of the mucus on the tongue and nof- 
trils. A vifeid materal is fecreted by thefe membranes to pre- 
ferve them moift and fupple, for the purpofes of the fenfes of 
tafte and of fmell, which are extended beneath their furfaces ; 
this vifeid mucus, when the aqueous part of it is evaporated by 
the increafed heat of the refpired air, or is abforbed by the too 
great aftion of the mucous abforbents, adheres clofely on thofe 
membranes, and is not without difficulty to be feparated from 
them. This drynefs of the tongue and noftrils is a circumftance 
therefore worthy to be attended to •, as it fhews the increafed 
aftion of the pulmonary capillaries, and the confequent increaf- 
ed heat of the expired air; and may thus indicate, when colder 
air Ihould be admitted to the patient. See Clafs I. i. 3. 1. 
The middle part of the tongue becomes dry fooner, and recov- 
ers its moifture later, than the edges of it ; becaufe the currents 
of refpired air pats moft over the middle part of it. This how- 
ever is not the cafe, when the drynefs of the tongue is owing 
only to the increafed mucous abforption. When however a 
frequent cough attends pulmonary inflammation, the edges of 
Vol. II. K k k the 450 
THEORY OF FEVER. 
Sup. I. 2. 3. 
the tongue are liable to be as much furred as the middle of it ; 
as during the action of coughing the middle of the tongue is de- 
preffed, fo as to form half a cylinder, to give a greater aperture 
for the emiffion of air from the larynx ; and the edges of it be- 
come 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 
affected with torpor, and the external or cutaneous capillaries 
are affected fecondarily, otherfymptoms are produced, which ren- 
der the paroxyfms of fever (till more complicate. Thus if the 
fpleen or pancreas are primarily or fecondarily affected, fo as to 
be rendered torpid or quiefeent, they are liable to become en- 
larged, and to remain fo even after the extinction of the fever- 
fit. Thefe in fome intermittent fevers are perceptible to the 
hand, and are called ague-cakes; their tumour feems to be ow- 
ing to the permanent torpor of the abforbent fyftem, the fecern- 
ing veffels continuing to act fome time afterwards. If the fe- 
cretory veflels of the liver are affected firft with torpor, and af- 
terwards with orgafm, a greater fecretion of 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 vcffels of the kidneys, and the abforbents of the bladder 
act more ftrongly than natural afterwards by their increafed irri- 
tability or affoeiability, 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 urine be in fmall quantity, and no fediment appears in it, af- 
ter the hot fit is over ; it fliews that the fecerning veffels of the 
kidneys and the abforbent veffels of the bladder have not regain- 
ed the whole of their activity, and thence indicates a greater 
tendency to a return of the cold fit. 
4. When the ftomach is affefted with torpor either primari- 
ly ; or fecondarily by its fympathy with the cutaneous capilla- 
ries ; or with fome internal vifeus j ficknefs occurs, with a total 
want of appetite to any thing folid ; vomiting then fupervenes, 
which may often be relieved by a blilter on the ikin, if the Ikin 
be cool and pale ; but not if it be hot and flufhed. The intef- 
tines 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 (tools indicate the inability of the inteftines to perform 
their proper office j as the mucus and gaftric acid, which are 
vomited Sup. I. 2. 
THEORY OF FEVER. 
451 
vomited up, does that of the ftomach; this torpor of the ftom- 
ach is liable to continue after the cold paroxyfm ceafes, and to 
convert intermittent fevers into continued ones by its direct 
fympathy with the heart and arteries. See article io. of this 
Supplement. 
5. If the meninges of the brain fympathize with other torpid 
parts, or are primarily affedted, delirium, ftupor, and perhaps 
hydrocephalus internus, occur, fee Clafs II. 1. 7. 1. and I. 2. 5. 
10; and fometimes the pulfe becomes flow, producing parefis 
inftead of fever. But if the membranes, which cover the muf- 
cles about the head, or of the pericranium, become torpid by 
their fympathy with other torpid parts, or are primarily affeft- 
ed, a head-ach fupervenes ; which however generally ceafes 
with the cold paroxyfm of fever. For as when the fenforial 
power of volition is exhaufted by labour, a few hours, or half a 
folar day, pafied in fleep recruits the fyftem by accumulation of 
this fenforial power ; fo when the fenforial power of irritation is 
exhaufted, one or two folar or lunar days of reft or quiefcence 
of the affected part will generally reftore its action by accumu- 
lation of irritability, and confequent increafe of aflbeiation, 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 accumulation of the fenforial power of irritation 
can take place but flowly ; as to reJi is death / This explains the 
caufe of the duration of fevers with weak pulfe, which con- 
tinue a quarter, or half, or three quarters, or a whole lunation, 
or ftill longer, before fufficient accumulation of irritability can 
be produced to reftore their natural ftrength of aftion. 
6. If the abforbent veflels, which are fpread around the neck 
of the bladder, become torpid by their direft fympathy with the 
abforbents of the fkin in cold fits of fever; the urine, which is 
poured into the bladder in but fmall quantity from the torpid 
kidneys, has neverthelefs none of its aqueous faline part reab- 
forbed; and this faline part ftimulates the bladder to empty it- 
felf frequently, though the urine is in fmall quantity. Which 
is not therefore owing to any fuppofed fpafm of the bladder, for 
the aflion of it in excluding the urine is weak, and as much con- 
trollable by the will as in ordinary micturition. 
7. If the beginnings or abforbent mouths of the venous fyf- 
tem remain torpid, petechia; or vibices are produced in fevers, 
fimilar to thofe which are feen in feurvy without fever. If the 
Ikin was frequently moiftened for an hour, and at the fame 
time expofed to the common air, or to oxygen gas, it might con- 
tribute to turn the black colour of thefe points of extravafated 
blood into fcarlet, and thus by increafing its ftimulus facilitate 
its 452 
THEORY OF FEVER. 
Sup. I. 2. 8. 
its reabforption ? For oxygen gas penetrates moift animal mem- 
branes though not dry ones, as in the lungs during refpiration. 
See Clafs I. 2. 1. 17. 
8. When the fenforial power of fenfation is introduced into 
the arterial fyftem, other kinds of compound fevers are produc- 
ed, which will be fpoken of in their place. 
III. Termination qj the cold Fit. 
i. If all the parts, which were affe&ed with torpor, regain 
their irritability, and aflbciability, the cold paroxyfm of fever 
ceafes; but as fome of the parts affected were previoufly accuf- 
tomed to inceffant action, as the heart and arteries, and others 
only to intermitted action, as the ftomach and inteftines ; and 
as thofe, which are fubjected during health to perpetual action, 
Accumulate fenforial power fafter, when their motions are im- 
peded, than thofe which are fubjected to intermitted action; it 
happens, that fome of the parts, which were affeQed with tor- 
por during the cold fit, recover their irritability or aflbciability 
fooner than others, and more perfectly, or acquire a greater 
quantity of them than natural; as appears by the partial heat 
and fluihings previous to the general hot fit. 
Hence if all the parts, which were previoufly torpid, regain 
their due degree of irritability, or of aflbciability, the difeafe is 
removed, and health reftored. If iome or all of them acquire 
jnore than their natural degree of thefe fenforial powers ; in- 
creafed actions, and confequent 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 irritabili- 
ty, or aflbciability, regain their natural degree of it; the dif- 
eafe is removed, and health reftored. But if fome of thefe parts 
do not regain their natural degree of thefe fenforial powers, the 
actions of thofe parts remain imperfect, 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, per- 
fifts ; and a continued fever is produced. If the torpor of the 
ftomach and inteftines remains, which is known by ficknefs and 
undigefted ftools, the fever is liable to be of confiderable length 
and danger ; the fame if the kidneys and abforbent fyftem re- 
tain fome degree of torpor, as is (hewn by the pale urine in not 
unufual quantity. If part of the abforbent fyftem remains tor- 
pid, as the abforbent veffels of the fpleen, a tumour of that vif- 
cus occurs, which may be felt by the hand ; the fame fome- 
times Sup. I. 3. 3 
THEORY OF FEVER. 
453 
times happens to the liver ; and thefe from their tendency to 
more complete torpor are afterwards liable to give occafion to a 
return of the cold fit. If the cellular abforbents do not com- 
pletely recover their activity, a pale and bloated countenance 
•with fwelled legs marks their want of action. 
3. As the termination of the cold fit is owing to the accumu- 
lation of the fenforial power of irritation and of affociation du- 
ring the previous quiefcence of the fyftem ; and as thofe parts, 
which are in perpetual action during health, are more fubjeft 
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 fen- 
forial power, as that of fenfation, is exerted on the arterial fyf- 
tem, .as in inflammations. The heart and arteries in thefe cafes 
foon recover from their torpor, and are exerted with great vi- 
olence. 
Many other parts of the fyftem fubjett 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 ar- 
teries are previoufly feeble, they cannot much diminifh their 
actions, and certainly cannot reft entirely, for that would be 
death ; and therefore in this cafe their accumulation of the fen- 
forial power of irritation or of affociation is flowly produced, 
and a long fever fupervenes in confequence ; or fudden death, 
as frequently happens, terminates the cold fit. 
Whence it appears, that in fevers with weak pulfe, if the ac- 
tion of the heart, arteries, and capillaries could be diminifhed, 
or flopped for a fhort time without occaGoning the death of the 
patient, as happens in cold bathing, or to perfons apparently 
drowned, that a great accumulation of the fenforial powers of 
irritation or of affociation 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 producing accumula- 
tion 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 ? 
IV. Return 454 
THEORY OF FEVER. 
Sup I. 4.1, 
IV. Return of the cold Fit. 
i. If the increafed adion of the cutaneous and pulmonary 
capillaries, and of the heart and arteries, in febris irritativa, con- 
tinues long and with violence, a proportional expenditure or ex- 
hauftion of fenforial power occurs ; which by its tendency to in- 
duce 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 vifeus ; which after the laft cold 
paroxyfm had not recovered itfelf, as of the fpleen, liver, kid- 
neys, or of the ftomach and inteftines, or abfbrbent veflels, as 
above mentioned. 
3. Other caufes are the deficiency of the natural ftimuli, as 
hunger, thirft, and want of frelh 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 defed of exter- 
nal heat, and of folar or lunar gravitation. Of the latter the 
return of the paroxyfms of continued 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 intcr- 
mittents, whether quotidian, tertian, or quartan, which fo regu- 
larly 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 vifeus is confiderable, 
this will be increafed at the time, when the terrene gravitation 
is greateft, as explained in the introdudion to Clafs IV. 2. 4. 
and may either produce a cold paroxyfm of quotidian fever ; or 
it may not yet be fufficient 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 paroxyfm of tertian fever ; or may ftill become greater, and 
continue fo till the next period of greateft terrene gravitation, and 
then produce a paroxyfm of quartan ague. And laftly, the pe- 
riodical times of thefe paroxyfms may exceed, or fall Ihort of, 
the time of greateft diurnal terrene gravitation 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 excited in Fever. 
i. A curious obfervation is related by Dr. Fordyce in his 
Trad Sup. I. 5. 2. 
THEORY OF FEVER. 
455 
Traft on Simple fever, page 168. He aflerts, that thole 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 fub- 
jedl to palenefs of their (kins, 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. Analo- 
gous to this, an obferving friend of mine allured me, that once 
having fat up to a very late hour with three or four very inge- 
nious and humorous companions, and drunk a confiderable 
quantity of wine; both contrary to his ufual habits of life ; and 
being obliged to rife early, and to ride a long journey on the 
next day; he expelled to have found himfelf weak and foon 
fatigued; but on the contrary he performed his journey with 
unufual eafe and alacrity ; and frequently laughed, as he rode, 
at the wit of the preceding evening. In both thefe cafes a de- 
gree of pain or pleafure actuated the fyftem; and thus a fenfo- 
rial power, that of fenfation, was fuperadded to that of irrita- 
tion, or volition. See Se<T. 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 actions of the cutaneous veflels, which are more 
liable to be excited by this ftimulus. When this additional fen- 
forial power of fenfation exifts to a greater degree, the pulfe, 
which was before full, now becomes hard, owing to the inflam- 
mation of the vafa vaforum, or coats of the arteries. In thefe cafes 
whether there is any topical inflammation or not, the fever ceaf- 
es to intermit; but neverthelefs there are daily remiflions and 
exacerbations of it; which recur for the moft part about fix in 
the evening, when the folar gravitation is the leaft, as mention- 
ed in Sed. XXXVI. 3. 7. 
3. Thus the introduction of another fenforial power, that of 
fenfation, converts an intermittent fever into a continued one. 
If it be attended with ftrong pulfe, it is termedjfebris fenfitiva ir- 
ritata, or pyrexia, or inflammation ; if with a weak pulfe, is is 
termed febris fenfitiva inirritata, or typhus gravior, or malignant 
fever. The feat of the inflammation is in the glandular or capil- 
lary fyftem, as it confifts in the fecretion of new fluids, or new 
fibres, which form new veflels, as they harden, like the filk of 
the filk-worm. See Art. 15. of this Supplement. 
VI. Circles of irritative Ajfociate Motions. 
I. There are fome aflbciate motions, which are perpetually 
proceeding 456 
THEORY OF FEVER. 
Sup. I. 6. 2. 
proceeding in our waking hours, and are catenated by their firft 
link, or in fome fubfequent parts of the chain, with the ftimuli 
or the influence of external things; which we {hall here enu- 
merate, 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 affociated with them ; which, when 
the chain is difturbed or interrupted, excite the fenforial power 
of fenfation, and proceed in confufion. Thus if the irritative 
ideas of fight are difturbed, the paralaftic motions of objects, 
which in general are unperceived, becomes fenfible to us ; and 
the locomotive mufcles aflbeiated with them, which ought to 
preferve the body ereft, flagger from this decreafe or interrup- 
tion of the fenforial power of afibciation ; and vertigo is pro- 
duced. 
When the irritative fenfual motions, or ideas, belonging to 
one fenfe are increafed or diminifhed, the irritative fenfual mo- 
tions, or ideas, of the other fenfes are liable to become difturbed 
by their general catenations; whence occur noifes in the ears, 
bad tafles in the mouth, bad odours, and numbnefs or tingling 
of the limbs, as a greater or lefs number of fenfes are affefted. 
Thefe conllitute concomitant circles of difturbed irritative ideas; 
or make a part of the great circle of irritative ideas, or motions 
of the organs of fenfe ; and whemthus difturbed occafion many 
kinds of hallucination of our other fenfes, or attend on the ver- 
tigo of vifion. 
2. Another great circle of irritative afTociated motions con- 
fifts of thofe of the alimentary canal; which are catenated with 
ftimuli or with influences external to the fyflem, but continue 
to be exerted in our fleeping as well as in our waking hours. 
When thefe aflbciations of motion are difturbed by the too great 
or too fmall ftimulus of the food taken into the ftomach, or by 
the too great excefs or deprivation of heat, or by indigeftible 
fubftances, or by torpor or orgafm occafioned by their aflbeia- 
tion with other parts, various difeafes are induced under the 
names of apepfia, hypochondriafis, hyfteria, diarrhoea, cholera, 
ileus, nephritis, fever. 
3. A third circle of irritative aflbeiate motions confiftsof thofe 
of the abforbent fyflem; which may be divided into two, the 
lafteals, and the lymphatics. When the ftomach and inteflines 
are recently filled with food and fluid, the lafteal fyflem is 
ftimulated into great aftion ; at the fame time the cellular, cuta^- 
neous, and pulmonary lymphatics aft with lefs energy; becaufe 
lefs fluid is then wanted from thofe branches, and becaufe more 
fenforial power is expended by the lafteal branch. On this ac- 
count thefe two fyftems of abforbents are liable to aft by re- 
verfc Sup. I. 6. 4. 
THEORY OF FEVER* 
457 
verfe fympathy ; hence pale urine is made after a full dinner, as 
lefs of the aqueous part of it is imbibed by the urinary lym- 
phatics ; and hence the water in anafarca of the lungs and limbs 
is fpeedily abforbed, when the actions of the laiieals of the 
ftomach or inteftines are weakened or inverted by the exhibition 
of thofe drugs, which produce naufea, or by violent vomiting, 
or violent cathartics. 
Hence in diabetes the lafteal fyftem a£ts ftrongly, at the fame 
time that the urinary lymphatics invert their motions, and tranf- 
mit the chyle into the bladder ; and irt diarrhoea from crapula, 
or too great a quantity of food, and fluid taken at a time, 
the ladteals aQ ftrongly, and abforb chyle or fluids from the 
ftomach and upper inteftines ; while the lymphatics of the low- 
er inteftines revert their motions, and tranfmit this over-repletion 
into the lower inteftines, and thus produce diarrhoea ; which 
accounts for the fpeedy operation of fome cathartic drugs, when 
much fluid is taken along with them. 
4. Other circles of irritative aflbciate motions of great impor- 
tance are thofe of the fecreting 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 oth- 
ers ; fome of which a6l by direct and others by reverfe fympa- 
thy with each other. Thus when the gaftric glands act moft 
powerfully, as when the ftomach is filled with food, the kidneys 
act with lefs energy ; as is fhewn by the fmall fecretion of 
urine for the firft hour or two after dinner; which reverfe fym- 
pathy is occafioned by the greater expenditure of fe'nforial pow- 
er on the gaftric glands, and to the newly abforbed fluids not 
yet being fufficiently animalized, or otherwife prepared, to ftim- 
ulate the fecretory veflels of the kidneys. 
But thofe very extenfive glands, which fecrete the perfpira- 
ble matter of the (kin and lungs, with the mucus, which lubri- 
cates all the internal cells and cavities of the body, claim our 
particular attention. Thefe glands, as well as all the others, 
proceed from the capillary veflels 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 pulmo- 
nary capillaries, are aflbeiated by diretft fympathy ; as appears 
from immerfion in the cold bath, which is therefore attended 
with a temporary difficult refpiration; while thofe from the ca- 
pillaries of the ftomach and heart and arteries are more gener- 
ally aflbeiated by reverfe fympathy with thofe of the cutaneous 
capillaries ; as appears in fevers with weak pulfe and indigeftion, 
and at the fame time with hot and dry fkin. 
The difturbed actions of this circle of the aflbciate motions of 
Vol. IT. L l I tn? 458 
THEORY OF FEVER. 
Sup. I. 6. 5. 
the fecerning fyftem, when the fenforial power of fenfation is 
added to that of irirtation, frequently produces inflammation, 
which confifts in the fecretion of new fluids or new veflels. 
Neverthelefs, if thefe difturbed actions be of the torpid kind, 
the pain, which attends them, is feldom productive of inflam- 
mation, as in hemicrania ; but is liable to excite voluntary ac- 
tions, and thus to expend much fenforial power, as in the fhud- 
dering in cold fits of fever, or in convulfions; or laftly the pain 
itfelf, which attends torpid actions, is liable to expend or ex- 
hauft much fenforial power without producing any increafed 
actions ; whence the low puife, and cold extremities, which ufu- 
ally attend hemicrania ; and hence when inert, or inactive fen- 
fation attends one link of aflbeiated action, the fucceeding link 
is generally rendered torpid, as a coldnefs of the cheek attends 
tooth-ach. 
5. A fifth important circle of irritative motions is that of the 
fanguiferous fyftem, in which the capillary veflels are to be in- 
cluded, which unite the arterial and venous fyftems, both pul- 
monary and aortal. The difturbed action of this fyftem of the 
heart and arteries, and capillaries, corftitutes Ample fever; to 
which may be added, that the fecerning and abforbent veflels 
appending to the capillaries, and the bibulous mouths of the 
veins, are in tome meafure at the fame time generally affebled. 
6. Now, though the links of each of thefe circles of irritative 
motions are more ftriblly aflbeiated together, yet are they in 
greater or lefs degree aflbeiated or catenated with each other by 
direbt or reverie fympathy. Thus the ficknefs, or inverted irri- 
tative motions of the ftomach, are aflbeiated or catenated with 
the difturbed irritative ideas, or fenfual motions, in vertigo ; as 
in fea-ficknefs. This ficknefs of the ftomach is alfo aflbeiated 
or catenated with the torpor of the heart and arteries by direbb 
fympathy, and with the capillaries and abforbents by reverfe 
fvmpathy ; and are thus all of them liable occafionally to be dif- 
turbed, when one of them is difeafed ; and conftitute the great 
variety of the kinds or fymptoms of fevers. 
VII. Alternation of the cold and hot Fits. 
i. When any caufe occurs, which diminiflies to a certain de- 
gree the fupply of fenforial power in refpebt to the whole fyf- 
tem; as fuppofe a temporary inexertion of the brain ; what 
happens ? Firft, thofe motions are exerted with lefs energy, 
which are not immediately neceflary to life, as the locomotive 
mufcles; and thofe ideas, which are generally excited by voli- 
tion ; at the fame time this deficiency of voluntary motion is 
different Sup. I. 7. 2. 
THEORY OF FEVER. 
459 
different from that which occurs in fleep ; as in that the move- 
ments of the arterial fyftem are increafed in energy though not 
in frequency. Next, the motions of the alimentary canal be- 
come performed with lefs energy, or ceafe altogether ; and a 
total want of appetite to folid food occurs, or ficknefs or a diar- 
rhoea occafioned by the indigefted aliment. Then the abibrbent 
veffels ceafe to aft with their due energy; whence third, and 
pale urine, though in fmall quantities. Fourthly, the fecerning 
veflels become affefted by the general diminution of fenforial 
power; whence all the fecreted fluids are produced in lefs 
quantity. And laftly, the fanguiferous canals feel the general 
torpor; the pulfations of the heart and arteries become feeble, 
and confequently quick; and the capillaries of the ikin become 
inactive, acquire lefs blood from the arteries, and are confe- 
quently paler and fhrunk. 
In this laft circumftance of the torpor of the fanguiferous 
fyftem confifts inirritative fever ; as all the others are rather ac- 
cidental or concomitant fymptoms, and not eflential ones; as 
fewer or more of them may be prefent, or may exift with a 
greater or lefs degree of inactivity. 
2. Now as the capillaries of the Ikin are expofed to greater 
varieties of heat and cold, than the heart and arteries, they are 
fuppofed 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 fanguiferous fyftem ; and as the ikin 
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 firft perceived by, the cold- 
nefs 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 or- 
gans fooneft, and in greateft quantity, during their quiefcence, 
which were moft perpetually in aftion during health ; hence 
thofe parts of the fyftem fooneft recover from torpor in inter- 
mittent fever, and fooneft fall into the contrary extreme of in- 
creafed activity; as the fanguiferous fyftem of the heart and ar- 
teries and capillaries. But of thefe the capillaries feem firft to 
acquire a renovation of their aCtion, as the heat of the Ikin be- 
comes 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 quanti- 
ty carried away into the atmofphere, or diffufed amongft other 
bodies in a given time; as more heat pafles through water, 
which boils vehemently, than when it boils gently, though the 
rife 460 
THEORY OF FEVER. 
Sup. I. 7. 4. 
rife of the thermometer in both cafes continues the fame. This 
faft may be known by boiling an egg in water, the white of 
which coagulates in much lefs time* if the water boils vehement- 
ly, 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 re- 
new their actions fooner than the heart and arteries after im- 
merfion in the cold bath, is, that their torpor was occafioned by 
defeat of irritation : whereas that of the heart and arteries was 
occafioned by defect of afibciation ; which deleft of affociation 
was owing to the decreafed aft ions cf the capillaries, and is now 
again excited by their renewed aclion ; which excitement mult 
therefore be fubfequent to that increafed aftion of the capilla- 
ries ; and in confequence the increafed aftion of the heart and 
arteries at the commencement of the hot fit of fome fevers is 
fubfequent to the increafed aftion of the cutaneous capillaries. 
There is, however, in this cafe an accumulation of the fenforial 
power of-afibciation in the heart and arteries, which mull con- 
tribute to increafe their orgafm in the hot fit, as well as the in- 
creafed excitement of it by the increafed adlion of the capillaries. 
4. Now this increafed action of the fyftem, during the hot 
fit, by exhaufting the fenforial powers of irritation and afibcia- 
tion, contributes to induce a renewal of the cold paroxyfm ; as 
the accumulation of thofe fenforial powers in the cold fit pro- 
duces the increafed actions of the hot fit; which two Rates of 
the fyftem reciprocally induce each other by a kind of libration, 
or a plus and minus, of the fenforial powers of irritation and 
afibciation. 
If the exhauftion of fenforial power during the hot fit of fe- 
ver only reduces the quantity of irritability and aflbeiability to 
its natural ftandard, the fever is cured, not being liable to re- 
turn. If the quantity of thefe fenforial powers be reduced only 
fo much, as pot to produce a fecond cold fit during the prefent 
quantity of external ftimuli or influences ; yet it may be fo far 
reduced, that a very fmall fubtradlion of ftimulus, or of influ- 
ence, may again induce a cold fit; fuch as the coldnefs of the 
night-air, or the diminution of folar or lunar gravitation, as in 
intermittent fevers. 
r. Another caufe of the renovation of the cold fits of fever 
is from fome parts of the fyftem not having completely recov- 
ered from the former cold paroxyfm ; as happens to the fplecn, 
liver, or other internal vifeus; which fometimes remains tumid, 
and either occafions a return of the cold fit by direft fympathy 
with other parts of the body, or by its own want of adtion cauf- 
es a diminution of the general quantity of heat, and thus facili- 
tates Sup. I. 8. 1. 
THEORY OF FEVER. 
461 
tates the renovation of the torpor of the whole fyftem, and gives 
caufe to intermittent fevers catenated with lunar or folar influ- 
ence. 
VIII. Orgafm of the Capillaries. 
As the remaining torpor of fome lefs eflential part of the fyf- 
tem, as of the fpleen, when the hot fit ceafes, produces after 
one, two, or three days a return of cold fit by direfl: fympathy 
with the cutaneous capillaries^ when joined with fome other 
caufe of torpor, as the defeat of folar or lunar influences, or the 
expofure to cold or hunger, and thus gives origin to intermit- 
tent fever ; fo the remaining torpor of fome more eflential parts 
of the fyftem, as of the ftomach and inteftines, is probably the 
caufe of the immediate recurrence of the cold paroxyfm, at the 
time the hot one ceafes, by their direct fympathy with the cu- 
taneous capillaries, without the affiftance of any other caufe of 
torpor ; and thus produces remittent fever. And laftly the re- 
maining torpor of fome ftill more eflential parts of the fyftem, 
as the heart and arteries, after the hot fit ought to ceafe, is lia- 
ble by reverfe fympathy with the cutaneous capillaries to con- 
tinue their orgafm, and thus to render a fever continual, which 
would otherwife remit or intermit. 
Many difficulties here occur, which we ffiall endeavour to 
throw fome light upon, and leave to future inveftigation; ob- 
ferving only that difficulties were to be expected, otherwife fe- 
vers would long fince have been underftood, as they have em- 
ployed the unremitted attention of the phyficians of all ages of 
the world. 
i. Why do the fame parts of fucceffive trains of aftion fome- 
times affect each other by direct, and fometimes by reverfe fym- 
pathy ?-ift, When any irritative motion ceafes, or becomes 
torpid, which was before in perpetual action ; it is either de- 
prived of its ufual ftimulus, and thence the fenforial power of 
irritation is not excited ; or it has been previoully too much ftim- 
ulated, 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 room. 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 firft chill in going into frofty air, or into the 
bath at Buxton, which is about eighty degrees of heat. Or, 
laftly, 462 
THEORY OF FEVER. 
Sup. I. 8. 2. 
laftly, this accumulation of the fenforial power of irritation fo 
far abounds, that it increafes the action of the next link of the 
aflociated train or tribe of motions ; thus on expofing the (kin 
to cold air, as in walking out in a frofty morning, the actions 
of the ftomach are increafed, and digelbon (lengthened. 
But where the torpor of fome irritative motion is owing to 
the previous exhauftion of the fenforial power of irritation by 
too great ftimulus, the reftoration of it occurs either not at all, 
or much more flowly than in the former inftances; thus after 
intoxication the ftomachps very flow in recovering its due quan- 
tity of the fenforial power of irritation, and never (hews any ac- 
cumulation of it. 
2. When an aflbeiate motion, as defcribed in the introduc- 
tion to Clafs IV. i. i. afls with lefs energy, the fenforial pow- 
er of aflbeiation is either not fufficiently excited by the preced- 
ing fibrous motions; or it has been expended or exhausted by 
the too violent actions of the preceding fibrous motions. In the 
former cafe there occurs an accumulation of the fenforial power 
of aflbeiation; exactly as, where the ufual ftimulus is with- 
drawm, there occurs an accumulation of the fenforial power of 
irritation. Thus when the actions of the capillaries of the fkin 
are diminifhed by immerfion in cold water, the capillaries of the 
lungs are rendered torpid by the want of the excitement of the 
fenforial power of aflbeiation, owing to the leflened actions of the 
previous fibrous motions, namely, of thofe of the fkin. Never- 
thelefs as foon as the capillaries of the Ikin regain their increafed 
activity by the accumulation of the fenforial power of irrita- 
tion, thefe capillaries of the lungs aft with greater energy alfo 
owing to their accumulated fenforial power of aflbeiation. Thefe 
are inftances of direft fympathy, and conftitute the cold and 
hot paroxyftns of intermittent fever; or the firft paroxyfm of a 
continued one. 
3. When the firft link of a train of aflociated motions, which 
is fubjeft to perpetual afiion, becomes a confiderable time tor- 
pid for want of being excited by the previous exertions of the 
irritative motions, with which it is catenated ; the fenforial 
power of aflbeiation becomes accumulated in fo great a degree 
as to affeft the fecond link of the train of aflociated motions, 
and to excite it into ftronger aflion. Thus when the ftomach 
is rendered torpid by contagious matter fwallowed into it mixed 
with the faliva, the heart and arteries aft more feebly; becaufe 
the fenforial power of aflbeiation, which ufed to be excited by 
the fibrous motions of the ftomach, is not now excited ; and in 
confequence the motions of the heart and arteries aft only by 
the Sup. I. 8. 4. 
THEORY OF FEVER. 
463 
the fenforial power of irritation, which is excited by the ftimu- 
lus of the blood. 
But during this torpor of the ftomach, and lefs action of the 
heart and arteries, fo great an accumulation of the fenforial 
powers of irritation and of aflbciation occurs, that it adds to the 
action of the next link of this vital circle of actions, that is, to 
that of the cutaneous capillaries. Whence in this fituation the 
torpor of the ftomach occafions a diminifhed action of the heart 
and arteries by direct fympathy, and may be faid to occafion an 
increafed one of the cutaneous capillaries by reverfe fympathy ; 
which conftitute continued fever with weak pulfe. 
Nor is this increafed action of the capillaries in confequence 
of the decreafed action of the heart and arteries, as in fevers 
with weak pulfe, a fingle fa £1 in the animal economy ; though 
it exifls in this cafe in the greateft degree or duration, becaufe 
the heart and arteries are perpetually in greater action than any 
other part of the fyftem. But a fimilar circumitance occurs, 
when the ftomach is rendered inactive by defective excitement 
of the fenforial power of aflbciation, as in fea-ficknefs, or in 
nephritis. In thefe cafes the fenforial power of aflbciation be- 
comes much accumulated in the ftomach, and feems by its fu- 
perabundance to excite the abforbent fyftem, which is fo nearly 
connected with it, into great increafe of adlion ; as is known by 
the great quantity frequently in thefe fituations rejected by vom- 
it, which could not otherways be fupplied. It is probable the 
increafe of digeftion by walking in frofty air, with many other 
animal fads, may by future obfervations be found to be depend- 
ent on this principle, as well as the increafed action of the ca- 
pillaries in continued fevers with weak pulfe. 
Whereas in continued fever with ftrong pulfe, which may 
perhaps occur fometimes on the firft day even of the plague, the 
ftomach with the heart and arteries and the capillaries a£l by 
direct fympathy; that is, the ftomach is excited into ftronger 
action by increafed irritation owing to the ftimulus of conta- 
gious matter ; thefe ftronger irritative motions of the ftomach 
excite a greater quantity cf the fenforial power of aflbciation, 
which then actuates the heart and arteries with greater energy, 
as thefe are catenated with the ftomach •, and in the fame man- 
ner the increafed aftions of the heart and arteries excite a great- 
er quantity of the fenforial power of aflbciation, which actuates 
the cutaneous capillaries with increafe of energy. See Clafs 
IV. i. i. 
4. I (hall dwrell a little longer on this intricate fubjecl. The 
commencement of fever-fits is known by the inactivity of the 
cutaneous capillaries, which inactivity is obfervable by the pale- 
nefs 464 
THEORY OF FEVER, 
Sup. I. 8. 5* 
nefs and coldnefs of the fkin, and alfo by the pain of coldnefs, 
which attends it. There is neverthelefs in moft cafes, except 
thofe which are owing to expofure to external cold, a torpor of 
tire capillaries of forne internal vifcus preceding this inactivity 
of the cutaneous capillaries ; which is known by the tumour or 
hardnefs of the vifcus, or by an aching pain of it. The capilla- 
ries of the lungs are at the fame time rendered inactive or tor- 
pid, 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 affeCted with the pain either of coldnefs or 
of torpor. 
One caufe of this fynchronous or fucceffive inactivity of the 
cutaneous capillaries, in confequence of the previous torpor of 
fome internal vifcus, may be owing to the deficiency of heat; 
which muft occur, when any part becomes inaCtive ; becaule 
the fecretions of that part ceafe or are lefl'ened, and the quantity 
of heat of it in confequence. But the principal caufe of it I 
fuppofe to be owing to the defeCt of the fenforial power of af- 
fociation ; which power of aflbeiation is excited by fome pre- 
vious or concomitant motions of the parts of every great circle 
of aClions. This appears on going into the cold bath, becaufe 
the ihortnefs of breath inftantly occurs, fooner than one can con- 
ceive the diminution of the heat of the Ikin could affect the lungs 
by the want of its ftimulus ; but not fooner than rhe defedl of the 
fenforial power of aflbeiation could aifeeft them ; becaufe this 
mult ceafe to be excited into action on the inftant that the cu- 
taneous capillaries ceafe to act; whence in the firft moment of 
contact of the cold water the cutaneous capillaries ceafe to a£t 
from defefl of irritation; which is caufedby defeft of the ftim- 
ulus of heat; and in the fecond moment the capillaries of the 
lungs ceafe to a<T from the defect of aflbeiation ; which is cauf- 
ed by the defect of the motions of the cutaneous capillaries. 
Thus the univerfal torpor in the cold paroxyfm of fever is an ex- 
ample of direft fympathy, though occafioned in part by defeat 
of irritation, and in part by defeft of aflbeiation. 
5. Thus in walking out in a frofty morning the Ikin is cool- 
ed bv the contaft of the cold air, whence the aftions of its ca- 
pillaries are diminifhed for want of their ufual ftimulus of heat 
to excite a fufficient quantity of the fenforial power of irritation. 
Hence there is at firft a faving of the fenforial power of irrita- 
tion for the purpofe of actuating the other parts of the fyftem 
with greater energy. Secondly, the fenforial power of aflbeia- 
tion, which ufed to be excited by the motions of the cutaneous 
capillaries, is now not fo powerfully excited ; and in confequence 
the parts, which conftitute the next links of the circles of aflb- 
ciated Sup. I. 8. 6. 
THEORY OF FEVER. 
465 
ciated motions, are for a time actuated with lefs energy, and a 
temporary general chillnefs fucceeds ; which is fo far fimilar to 
the cold fit of intermittent fever. 
In this fituation there is a curious circumfiance occurs, which 
merits peculiar attention : after a fhort time, though the exter- 
nal ikin continues cool by its expofure to the cold air, and the 
actions of its capillaries are confequently diminifhed, yet the ca- 
pillaries of the ftomach act with greater energy; as is known 
by increafed digcftion and confequent hunger. This is to be 
afcribed to the accumulation of the fenforial power of irritation, 
which now excites by its fuperabundance, or overflowing, as it 
were, the ftomach into increafed action ; though it is at the fame 
time excited lefs powerfully than ufual by the fenforial power of 
aflbciation. Thus the accumulation of the fenforial power of 
irritation in the veflels of the fkin increafes in this cafe the ac- 
tion of the ftomach, in the fame manner as an accumulation of 
the fenforial power of aflbciation in the heart and arteries in fe- 
vers with weak pulfe increafes the action 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 irritation occurs ; and in confequence the actions of 
the ftomach become lefs than natural by the defeat of the fen- 
forial power of aflbciation ; which has ceafed to be excited by 
the want of action of the cutaneous capillaries. Whence con- 
tinued coldnefs of the feet is accompanied with indigeftion and 
heartburn. See Clafs IV. 2. 1.6. 
6. Similar to this when the actions of the ftomach are ren- 
dered 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 
direct action, as is evinced by the exhibition of digitalis in ana- 
farca. In this fituation I fuppofe the emetic drug ftimulatesthe 
mufcular fibres of the ftomach into too great action ; and that 
in confequence a great torpor foon fucceeds ; and that this in- 
aftion of the mufcular parts of the ftomach is not followed by 
much accumulation of the fenforial power of irritation ; be- 
caufe that fenforial power is in great meafure exhaufted by the 
previous exceflive ftimulus. But the lymphatics of the ftom- 
ach have their actions leflened by defeat of fenforial power 
of aflbciation, which is not now excited into action, owing to 
the leflened motions of the mufcular parts of it, with which the 
lymphatics are aflbciated. The fenforial power of aflbciation 
becomes therefore accumulated in theft lymphatics of the ftom- 
Vol. II. M m m ach, 466 
THEORY OF FEVER. 
Sup. I. 8. 7. 
ach, becaufe it is not excited into action ; exactly as the power 
of irritation becomes accumulated in the hand, when immerfed 
in fnow ; and this accumulated fenforial power of aflbciation 
excites the lymphatics of the lungs and of other parts, which are 
molt nearly aflbciated with thofe of the ftomach, into more en- 
ergetic actions. Thus the mufcular fibres of the llomach act 
with the lymphatics of that organ in direct fympathy ; and the 
lymphatics of the ftomach add in reverfe fympathy with thofe of 
the lungs and of other parts of the body ; the former of which is 
caufed by defect of the excitement of the fenforial power of af- 
fociation, and the latter by the accumulation of it. 
Befidesthe efficient caufe, as above explained, the final caufe, 
or convenience, of thefe organic actions are worthy our atten- 
tion. In this cafe of an acrid drug fwallowed into the ftomach 
the reverted actions of the mufcular fibres of the ftomach tend 
to eject its enemy ; the reverted actions of its lymphatics pour 
a great quantity of fluids into the ftomach for the purpofe of di- 
luting or wafhing off the noxious drug ; and the increafed ac- 
tions of the other lymphatics fupply 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 
fubjedt, though perhaps with fome repetitions, as it envelopes 
the very effence of fever. When the firft link of a train of ac- 
tions is excited by exceflive ftimulus, or exceflive irritability, and 
thus adts with unufual energy by the increafed quantity of irri- 
tation, thefe increafed motions excite a greater quantity of the 
fenforial power of aflbciation, which caufes increafed motions 
in the fecond link, which is catenated with the firft ; and then 
the exceflive action of this fecond link excites alfo a greater 
quantity of the fenforial power of aflbciation, which increafes 
the motions of the third link of this chain of aflbciation, and 
thus the increafe of the ftimulus on the irritative motions, to 
which the chain of aflbciation is catenated, increafes the adtion 
of the whole chain or circle of aflbciated motions. 
After a time the irritative motions become torpid by expendi- 
ture of the fenforial power of irritation, and then the power of 
aflbciation alfo becomes lefs exerted, both becaufe it has been in 
part cxhaufted by too great action, and is now lefs excited by 
the leffened adtion of the irritative motions, which ufed to ex- 
cite it. Thefe are both inftances of diredt fympathy, and fre- 
quently conftitute the cold and hot fit of intermittents. 
But though the accumulation of the fenforial power of irri- 
tation during the quiescence of fome motion owing to want of 
ftimulus generally induces torpor in the firft link of the train of 
aflbciated Su?. I. 8. 8. 
THEORY OF FEVER. 
467 
afibciated motions catenated with it; as the capillaries of the 
lungs become torpid immediately on immerlion of the fkin into 
cold water; yet in fome fituations an orgafm or excefs of action 
is produced in the firft link of the afibciated motions thus cate- 
nated with irritative ones ; as in the increafed aClion of the 
ftomach, when the fkin is for a time expofed to cold air ; which 
may in parr be afcribed to the general increafe of ailion of the 
whole fyftem, owing to the diminilhd expenditure of fenforial 
power, but particularly of the parts, which have habitually aCt- 
ed together ; as when one arm is paralytic the other is liable to 
more frequent or almoft continual motion; and when one eye 
becomes blind the other frequently becomes ftronger; which is 
well known to farriers, who are faid fometimes to deftroy the 
fight of one eye to ftrengthen that of the other in difeafed horfes. 
Hence there is fometimes a direft fympathy, and fometimes 
a reverfe one fucceeds the torpor occafioned by defeCt of ftimu- 
lus, the latter of which is perhaps owing to a certain time be- 
ing required for the production of an accumulation of the fen- 
forial power of irritation by the nervous branches of the tor- 
pid organ ; which accumulation is now in part or entirely de- 
rived to the next link of the aflbciation. Thus in going into a 
coldifh bath, as into a river in the fummer months, we at firft 
experience a difficulty of breathing from the torpid aCtion 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 min- 
ute, the fenforial power of irritation becomes accumulated by 
the inactivity of the cutaneous capillaries ; and as its fuperabun- 
dance becomes now expended on the pulmonary capillaries, the 
difficult refpiration ceafes •, though the cutaneous capillaries con- 
tinue torpid by their contaCt with the cold water, and confe- 
quently the fenforial power of aflbciation, which ufed to con- 
tribute to actuate the-pulmonary capillaries, is lefs excited. 
8. In like manner when there exifts an accumulation of the 
fenforial power of aflbciation, owing to defeCt of its excitement 
by fome previous irritative or aflbciate motions, it is generally 
accompanied for a certain time by a torpor not only of the link 
firft affeCted, but of the fubfequent parts, or of. the whole train 
of afibciated motions, as in the cold fits of intermittent fevers. 
Yet after a time an increafed aCtion of the next links of aflbci- 
ated motions fucceeds the torpor of the firft, as the abforbent 
veflels of the lungs aCl more violently in confequence of the de- 
ficient aCtion of thofe of the ftomach ; and the fkin at the com- 
mencement of ficknefs is pale and cold, but in a little time be- 
comes flufhed and warm. 
Thus 468 
THEORY OF FEVER. 
Sup. 1.8.9. 
Thus we fee in aflbciate motions, which are rendered torpid 
by defeat of excitement, that fometimes a direft, and fometimes 
a reverfe fympathy fucceeds in the fubfequent links of the chain. 
But I believe where a torpor of irritative or of the aflbciate mo- 
tions is caufcd by a previous too great expenditure or exhauftion 
of the fenforial powers of irritation or aflbciation, no increafe 
of aftion in the fubfequent link ever occurs, or not till after a 
very long time. 
Thus when the ftomach becomes torpid by previous violent 
exertion, 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 communi- 
cated to the heart and arteries, as in continued fevers with 
weak pulfe. But where the torpor of the ftomach is produced 
from defective aflbciation, as in fea-ficknefs ; or in the ficknefs 
which occurs, when a ftone ftimulates the ureter; 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 exhaufted by too great ftimulus ; 
but in the latter cafe the accumulation of fenforial power in the 
ftomach during its torpor is evinced by this circumftance ; that 
in fea-ficknefs the patients eat and drink voracioufly at inter- 
vals ; and the pulfe is generally not affefted by the ficknefs oc- 
cafioned by a ftone in the ureter. For the aftion of the ftom- 
ach is then leflened, and in confequence becomes retrograde, 
notowing to the exhauftion of the fenforial power of irritation,but 
to the want of excitement of the fenforial power of aflbciation ; 
which is caufcd by the defective aftion of the ureter, which be- 
comes occafionally torpid by the great ftimulus of the ftone it 
contains; or which is caufed by the great exhauftion of fenfori- 
al power by the pain ; which affefts the ureter without exciting 
inflammation, or increafed aftion of it. 
9. Thus though the ftomach after the great ftimulus of in- 
toxication from excefs of wine or opium will continue many 
hours without accumulation of fenforial power, as appears from 
the patient's experiencing no appetite at the intervals of fick- 
nefs ; yet after long abftinpnce from food, at length not only 
the exhaufted quantity of fenforial power is renewed, but an ac- 
cumulation of it at length occurs, and hunger returns. In this fitu- 
ation the ftomach is generally about a whole day before it regains 
its ufual powers of digeftion; but if it has been ftillmore violently 
ftimtilated, and its aftions further impaired, a ftill more perma- 
nent 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 Sup. I. 8. 10. 
THEORY OF FEVER. 
469 
whole lunar period paffes, before it recovers its due irritability 
and confequent action. 
In fimilar manner, after a perfon has been confined in a very 
warm room for fome hours, the cutaneous capillaries, with their 
fecretory and abforbent veflcls, become exhaufted of their fenfo- 
rial power of irritation by the too great violent exertions occa- 
fioned by the unufual ftimulus of heat; and in coming into a 
colder atmofphere an inactivity of the cutaneous veflels exifts at 
firft for fome time without accumulation of fenforial power ; as 
is (hewn by the continuance of the pain of cold and the palc- 
nefs ; but after a time both the pain of cold and palenefs van- 
id), which now indicates an accumulation of the fenforial pow- 
er of irritation, as lefs degrees of heat ftimulate the fyftem into 
due action. 
In the fame manner, after any one has been fome time in the 
fummer funfhine, on coming into a dark cell he continues much 
longer before he can clearly diftinguilh objeds, 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 firft cafe been previoufly much expended 
or exhaufted; and therefore required a much longer time be- 
fore it could be produced in the brain, or derived to the optic 
nerves, in fuch quantity as to reftore the deficiency, and to caufe 
an accumulation of it; whereas in the latter cafe no deficiency 
had occurred. 
io. Thus the accumulation or deficiency of fenforial power 
in a torpid organ, which had previoufly been accuftomed to per- 
petual action, depends on the manner in which it becomes tor- 
pid ; that is, whether by great previous ftimulus, or great previ- 
ous excitement of the power of affociation ; or by defeat of its 
accustomed ftimulus, or of its accuftomed excitement of the 
power of affociation. In the former cafe the fenforial power is in 
an exhaufted ftate, and therefore is not likely to become fo foon 
accumulated, as after drunkennefs, or expofure to great heat, or 
to great light; in the latter a great accumulation of fenforial 
power occurs, as after expofure to cold, or hunger, or darknefs. 
Hence when the ftomach continues torpid by previous vio- 
lent ftimulus, 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 affociated with 
thofe of the ftomach, become weak, and flow, and intermittent, 
from the defeat of the excitement of the fenforial power of aflb- 
ciation. But what follows ? as the addons of the heart and ar- 
teries are lefl'ened by the deficient addon of the fenforial power 
of aflbeiation, and not by previous increafed excitement of it; 
a 470 
THEORY GF FEVER. 
Sup. I. 8. 11. 
a great accumulation of the fenforial power of aflbciation oc- 
curs, which is exerted on the pulmonary and cutaneous abforb- 
ents by reverfe fympathy, and produces a great abforption of 
the fluid eftufed into the cellular membrane in anafarca, with 
dry fkin ; conftituting one kind of atrophy. 
But if at the fame time the fecerning veflels of the ftomach 
are Simulated into lb violent activity as to induce great confe- 
quent torpor, as probably happens when contagious matter is 
{wallowed into the ftomach with our faliva, thole of the heart 
and arteries act feebly from the deficient excitement of the pow- 
er of aflbciation ; and then the cutaneous and pulmonary fe- 
cerning veflels act with greater force than natural, owing to the 
accumulation of the fenforial power of aflbciation ; and unnatur- 
al heat of the fkin, and of the breath fucceed j but without 
frequency of pulfe, conftituting the parefis irritativa of Clafs I. 
2. 1.2. And laftly, if a paucity of blood attends this parefis or 
fome other caufe inducing a frequency of pulfe, the ft bris inirri- 
tativa, or fever with weak pulfe, is produced. 
But on the contrary when the ftomach has previoufly been 
rendered torpid by defect of ftimulus, as by hunger, if food be 
too haftily fupplied, not only great exertion of the ftomach it- 
felf fucceeds, but fever with ftrong pulfe is induced in confe- 
quence ; that is, the heart and arteries are excited into more en- 
ergetic abtion by the excefs of the power of aflbciation, which 
catenates their motions with thofe of the ftomach. For the re- 
dundancy of fenforial power of irritation, which was accu- 
mulated during the inactivity of the ftomach, and is now called 
into action by ftimulus, actuates that organ with increafed en- 
ergy, and excites by thefe increafed motions the fenforial power 
of aflbciation ; which has alfo been accumulated during the in- 
activity of the heart and arteries ; and thus thefe organs aifo are 
now excited into greater abtion. 
So after the fkin 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 torpid from direbt fympathy with it, when we come in- 
to air of a moderate temperature; whence catarrhs, coughs, 
and fevers. But if this torpor be occafioned by defebt of ftim- 
lus, 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 circu- 
lation. 
11. It may be afked, Why is there a great and conftant accu- 
mulation of the fenforial power of aflbciation, owing to the tor- 
por of the ftomach and heart and arteries, in continued fever 
with Sup. I. 8. 12. 
THEORY OF FEVER. 
471 
with weak pulfe ; which is exerted on the cutaneous and pul- 
monary capillaries, fo as to excite them into increased action 
for many weeks, and yet no fuch exuberance of fenforial power 
produces fever in winter-flecping animals, or in chlorolis, or 
apepfia, or hyfteria ? 
In winter-lleeping animals I fuppofe the whole nervous fyf- 
tem is torpid, or paralyfed, as in the deep of frozen people ; 
and that the ftomach is torpid in confequence of the inactivity 
of quiefcence of the brain ; and that all other parts of the body, 
and the cutaneous capillaries with the reft, labour under a fim- 
ilar torpor. 
In chlorofis, I imagine, the actions of the heart and arteries, 
as well as thofe of the cutaneous and pulmonary capillaries, fuf- 
fer along with thofe of the ftomach 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 defe<ft of the excitation of the fenforial power 
of aflbciation ; yet as this torpor occurs in fo fmall a degree as not 
to excite a fhuddering or cold fit, no obfervable confequenccs arc 
in general occafioned by the confequent accumulation of fcnfori- 
al power. Sometimes indeed in chlorofis there does occur 
a frequent pulfe and hot (kin; in which circumftances I fup- 
pofe the heart and arteries are become in fome degree torpid by 
direCt fympathy with the torpid liver; and that hence not on- 
ly the pulfe becomes frequent, but the capillaries of the fkin act 
more violently by reverfe fympathy with the heart and arteries, 
owing to the accumulation of the fenforial power of aflbciation 
in them during their torpid ftate, as occurs in irritative fever. 
See Article 11. of this Supplement. 
In apepfia chronica the actions of the ftomach are not fo far 
impaired or deftroyed as totally to prevent the excitation of the 
fenforial power of aflbciation, which therefore contributes fome- 
thing towards the actions of the heart and arteries, though lefs 
than natural, as a weak pulfe always I believe attends this dif- 
eafe. 
There is a torpor of the ftomach, and of the upper part of 
the alimentary canal in hyfteria, as is evident from the retro- 
grade actions of the duodenum, ftomach, and cefophagus, which 
conftitute the globus hyftericus, or fenfation of a globe riling in- 
to the throat. But as thefe retrograde aCtions are lefs than thofe, 
which induce ficknefs or vomiting, and are not occafioned by 
previous exhauftion of the fenforial power of in Station, they do 
not fo totally prevent the excitement of the fenforial power of 
aflbciation, as to leflen the motion of the lieart and arteries fo 
much as to induce fever; yet in'this cafe, as in apepfia, and in 
cholorofis, 472 
THEORY OF FEVER. 
SuPk I. 8. 12. 
chlorofis, the pulfations of the heart and arteries are weaker than 
natural, and are fometimes attended with occasionally increafed 
action of the capillaries ; as appears from the flufhings of the 
face, and hot fkin, which generally form an evening febricula in 
difeafes attended with weak digeftion. 
12. The increafed action, or orgafm, of the cutaneous, pul- 
monary, and cellular capillaries, with thfeir fecerning and abforb- 
ent veffels, in thofe fevers which are attended with deficiency 
of vital action, exhaufts the patient both by the additional ex- 
penditure of fenforial power on thofe organs of fecretion, and 
by the too great abforption of the mucus and fat of the body ; 
whence great debility and great emaciation. Hence one great 
indication of cure of continued fever with arterial debility is to 
diminiffi the too great action 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. Currie of Liverpool 
(Philof. Tranf. for 1792), for half an hour, twice a day, or at 
thofe times when the Ikin feels dryell 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 aflion 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 aftion 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 accu- 
rate language to be called a cold bath ; but the degree of cold- 
nefs, where the patient is fenfible, fhould in fome meafure be 
governed by his fenfations; as it is probable, that the degree of 
coldnefs, which is molt grateful to him, will alfo be of the great- 
eft benefit to him. See Clafs III. 2. 1. 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 cutane- 
ous abforbents •, which is diffipated fafter by the increafed ac- 
tion of the fecerning capillaries, than the ftomach can furnilh, 
and occafions great thirft at the intervals of the ficknefs. 
IX. Torpor of the Lungs. 
i. The lungs in many cafes of contagion may firft be affect- 
ed with torpor, and the (kin become cold by fympathy; in the 
fame Sup. I. 9. 2. 
THEORY OF FEVER. 
473 
fame manner as a cold ikin on going into the cold bath induces 
difficulty of breathing. Or the ftomach may become affiedred 
with torpor by its fympathy with the lungs, as in the experi- 
ments of Mr. Watt with hydrocarbonate gas ; a few refpira- 
tions of which induced ficknefs, and even fyncope. When the 
ftomach or (kin is thus affefted fecondarily by aflbciation, an 
accumulation of fenforial power occurs much fooner, than when 
thefe parts become torpid in confequence of previous excefs of 
ftimulus ; and hence they fooner recover their accuftomed ac- 
tion, and the fever ceafes. The particles of contagious matter 
thus received by refpiration fomewhat refemble in their effects 
the acid gafes from burning fulphur, or from charcoal; which, 
if they do not inftantly deftroy, induce a fever, and the patient 
flowly recovers. 
2. I was fome years ago ftooping down to look, which way 
the water oozed from a moral's, as a labourer opened it with a 
fpade, to dete£l the fource of the fpring, and inhaled a vapour, 
which occafioned an inftant fenfe of fuffocation. Immediately 
recoiling I believe I inhaled it but once ; yet a few hours after- 
wards in the Cool of the evening, when I returned home rather 
fatigued and hungry, a Ihivering and cold fit occurred, which 
was followed by a hot one; and the whole difeafe began and 
terminated in about twelve hours without return. In this cafe 
the power of fear, or of imagination, was not concerned ; as I 
neither thought of the bad air of a morafs before I perceived 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, and hunger, 
was propagated by direft fympathy to the reft of the fyftem. 
An orgafm or increafed action of the whole fyftem was then 
induced by the accumulation 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 tor- 
por of the capillaries of the air-veflels of the lungs be fo fud- 
denly produced by great ftimulation ?-It appears probable, that 
it might, becaufe great exertion of irritative motions may be in- 
ftantly produced without our perceiving them ; that is, without 
their being attended by fenfation, both in the lungs and ftom- 
ach ; and the organs may become torpid by the great expendi- 
ture of the fenforial power of irritation in an inftant of time ; 
as paralyfis frequently inftantly follows too great an exertion of 
voluntary power. 
3. When the capillaries of the lungs a<£l 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 mid- 
Vol. II. N n n die THEORY OF FEVER. 
Suf. I. I®. 1. 
474 
die part of it; not only cooler air might be admitted more free- 
ly into a fick room to counterad this orgafm of the pulmonary 
capillaries ; but perhaps the patient might breathe with advan- 
tage 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 capillaries, which may 
be known by the correfpondent chillnefs of the fkin ; and by a 
tickling cough, which fometimes attends cold paroxyfms of fe- 
ver, and is then owing to the deficient abforption of the pulmo- 
nary mucus, the faline parts of which ftimulate the bronchise, 
or air-veflels ; a mixture of one part of oxygen gas with 10 or 
20 parts of atmofpheric air might probably be breathed with 
great advantage. 
X. Torpor of the Braith 
As the inactivity or torpor of the abforbent veflels 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 vef- 
fels of the brain, which are fuppofed to produce the fenforial 
power, may conftitute the immediate caufe of fome fevers with 
arterial debility. And alfo that the increafed aClion of thefe fe- 
cerning veflels may fometimes conftitute the immediate caufe of 
fevers with arterial ftrength. 
It is neverthelpfs probable, that the torpor or orgafm of the 
fanguiferous, abforbent, or fecerning veflels of the brain, may 
frequently exift as a fecondary effect, owing to their aflbciation 
with other organs, as the ftomach 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 eledric fhocks pafled frequently through it in all direc- 
tions be ufed with advantage ? Might not fomentations of 94 
or 96 degrees of heat on the head for an hour at a time, and fre- 
quently repeated, ftimulate the brain into adion ; as in the re- 
vival of winter-fleeping animals by warmth ? Ether externally 
might be frequently applied, and a blifter on the fliaved head. 
Where the fecerning veflels of the brain aCt with too great 
energy, as in fome inflammatory fevers, might it not be dimin- 
iflied by laying the patient horizontally on a mill-ftone, and 
whirling him, till ileep fhould be produced, as the brain be- 
come? Sup. I. 11. 1. 
THEORY OF FEVER. 
475 
comes compreffed by the centrifugal force ? See Article 15. of 
this Supplement. 
XI. Torpor of the Heart and Arteries. 
i. It was (hewn in Clafs IV. i. i. 6. in IV. 2. 1. 2. and in 
Suppl. I. 6. 3. that a reverie fympathy generally exifts between 
the ladteal and lymphatic branches of the abforbent fyftem. 
Hence, when the motions of the abforbents of the ftomach are 
rendered torpid or retrograde in fevers with arterial debility, 
thofe of the ikin, lungs, and cellular membrane, adt with in- 
creafed energy. But the actions of the mufcular fibres of the 
heart and arteries are at the fame time affociated with thofe of 
the mufcular fibres of the ftomach by diredt fympathy. Both 
thefe actions occur during the operation of powerful emetics, 
as fquill, or digitalis ; while t?he motions of the ftomach con- 
tinue torpid or retrograde, the cellular and cutaneous abforbents 
act with greater energy, and the puliations of the heart and ar- 
teries become weaker, and fometimes flower. 
2. The increafed adtion of the ftomach after a meal, and of 
the heart and arteries at the fame time from the ftimulus of the 
new fupply of chyle, feems originally to have produced, and to 
have eltablilhed this diredt fympathy between them. As the 
increafed adtion of the abforbents of the ftomach after a meal 
has been ufually attended with diminifhed adtion of the other 
branches of the abforbent fyftem, as mentioned in Clafs IV. 
j. 1. 6. and has thus eftablilhcd a reverie fympathy between 
them. 
2. Befides the reverfe fympathy of the abforbent veflels and the 
mufcles of the ftomach, and of the heart and arteries, with thofe 
of the Ikin, lungs, and cellular membrane-, thereexifts a fimilar 
reverfe fympathy between the fecerning veflels or glands of the 
former of thefe organs with thofe of the latter ; that is the mu- 
cous glands of the heart and arteries adt generally by direct fym- 
pathy with thofe of the ftomach; and the mucous glands of 
the cellular membrane of the lungs, and of the Ikin, adt by re- 
verfe fympathy with them both. 
Hence when the ftomach is torpid, as in ficknefs, this torpor 
fometimes only affedts the abforbent veflels of it; and then the 
abforbents of the cellular membrane and the Ikin only adt with 
increafed energy by reverie fympathy. If the torpor aftedts the 
mufcular fibres of the ftomach, thofe of the heart and arteries 
adt by direct 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 affects the glands of the ftomach, the cu- 
taneous 476 
THEORY OF FEVER. 
Sup. I. 11. 3. 
taneous and pulmonary glands aft with greater energy by their 
reverfe fympathy with thofe of the ftomach, and of the heart 
and arteries ; and great heat is produced along with increafed 
perfphation both from the Ikin and lungs. 
3. There is fome difficulty in explaining, why the aftionsof 
the extcnfive fyftem of capillary glands, which exift on every 
other membrane and cell in the body for the purpofe of fecreting 
mucus and perfpirable matter, fhould fo generally aft by reverfe 
fympathy with thofe of the ftomach and upper part of the in- 
teftines. It was (hewn in Clafs IV. 1. 1.6. that when the ftom- 
ach was filled with folid and fluid aliment, the abforbents of the 
cellular membrane, and of the bladder, and of the Ikin, afted 
with lefs energy; as the fluids, they were ufed to abforb and 
tranfmit into the circulation, were now lefs wanted; and that 
hence by habit a reverfe fympathy obtained between thefe 
branches of the abforbents of the alimentary canal, and thofe of 
the other parts of the body. 
Now, as at this time lefs fluid was abforbed by the cutane- 
ous and cellular lymphatics, it would happen, that lefs would 
be fecreted by their correfpondent fecerning veflels, or capillary 
glands ; and that hence by habit, thefe fecerning veflels would 
acquire a reverfe fympathy of aftion with the fecerning veflels 
of the alimentary canal. 
Thus when the abforption of the tears by the punfta lacry- 
malia is much increafed by the ftimulus of fnuff; or of an af- 
fefting idea, on the nafal dufts, as explained in Seft. XVI. 8. 
2. a great increafe of the fecretion of tears from the lacrymal 
glands is produced by the direft fympathy of the aftion of thefe 
glands with thofe of their correfpondent abforbents ; and that 
though in this cafe they are placed at fo great a diftance from 
each other. 
4. A difficult queftion here occurs ; why does it happen, that 
in fevers with weak pulfe the contraftions of the heart and ar- 
teries become at the fame time more frequent; which alfo fome- 
times occurs in chlorofis, and in fome hyfteric and hypochon- 
driac difcafes, 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 irritativa, defcribed in Clafs I. 2. 1. 2. 
which may be termed a fever with flow pulfe ? this frequency 
of pulfe cannot 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 dy- 
ing in the flaughter-howe from deficiency of blood the puife be- 
comes frequent in extreme ; may not the frequency of pulfe in 
fevers Sup, I. 11. 5. 
THEORY OF FEVER. 
477 
fevers with arterial debility be in general owing to paucity of 
blood ? as explained in Seft. XXXII. 2. 3. and its flownefs in 
parefis irritativa be caufed by the debility being accompanied 
with due quantity of blood ? or may not the former circum- 
ftance fometimes depend on a concomitant affection of the brain 
approaching to Heep ? or to the unufual facility of the paflage 
of the blood through the pulmonary and aortal capillaries ? in 
which circumftance the heart may completely empty itfelf at 
each pulfation, though its contractions 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 haemoptoe ; in thefe cafes the incrcafed 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. 
5. In refpeft to the fympathies of aftion, which produce or 
conftitute fever with debility, the fyftem may be divided into 
certain provinces, which are eflentient or oppolite to each oth- 
er. Firft, the lafteals or abforbent veflels of the ftomach, and 
upper part of the inteftines; fecondly, the lymphatics or all the 
other branches of the abforbent veflels, which arife from the 
ikin, mucous membranes, cellular membranes, and the various 
glands. Thefe two divifions aft by reverfe fympathy with each 
other in the hot fits of fever with debility, though by direft 
fympathy in the cold ones. The third divifion confifts of the 
fecerning veflels of the ftomach and upper inteftines ; and the 
fourth of the fecerning veflels of all the other parts of the body, 
as the capillary glands of the Ikin, lungs, and cellular membrane, 
and the various other glands belonging to the fanguiferous fyf- 
tem. Many of thefe frequently, but the capillaries always, aft 
by reverfe fympathy with thofe of the third divifion above men- 
tioned in the hot fits of fever with debility, though by dircft 
fympathy with them in the cold fits. Fifthly, the mufcular fi- 
bres of the ftomach, and upper inteftines ; and fixthly, the muf- 
cular fibres of the heart and arteries. The aftions of thefe 
two laft divifions of moving fibres aft by direft fympathy with 
each other, both in the cold and hot fits of fevers with debility. 
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 aflefted I believe to be 
the ftomach, and that it has become torpid by previous violent 
exertion, as by fwallowing contagious matter mixed with faliva, 
and not by defect of ftimulus, as from cold or hunger. The 
aftions of this important organ, which fympathizes with almoft 
every 478 
THEORY OF FEVER. 
Sup. I. 11. 6. 
every part of the body, being thus much diminifhed or nearly 
deftroyed, the fenforial power of aflbciation is not excited ; 
which in health contributes to move the heart and arteries, and 
all the reft of the fyftem ; whence an univerfal torpor occurs. 
When the hot fit approaches, the ftomach in fevers with 
ftrong pulfe regains its activity by the accumulation of the fen- 
forial power either of irritation, if it was the part firft afl'e^led, 
or of aflbciation if it was affefted in fympathy with fome other 
torpid part, as the fpleen or liver j which accumulation is pro- 
duced during its torpor. At the fame time all the other parts 
of the fyftem acquire greater energy of action by the accumula- 
tion of the fenforial power of aflbciation, which was produced, 
during their inactivity in the cold fit. 
But in fevers with weak pulfe the ftomach, in which the fen- 
forial power of irritation had been previoufly exhaufted by vio- 
lent attion, acquires no fuch quick accumulation of fenforial 
power, but remains in a ftate of torpor after the hot fit com- 
mences. The heart and arteries remain alfo in a ftate of tor- 
por, becaufe there continues to be no excitement of their power 
of aflbciation owing to the torpid motions of the ftomach ; but 
hence it happens, that there exifts at this time a great accumu- 
lation of the power of aflbciation in the lefs aClive fibres of the 
heart and arteries; which, as it is not excited and expended by 
them, incrcafes the aflbeiability of the next link of the aifociated 
chain of motions, which confifts of the capillaries or other 
glands; and that in fo great a degree as to actuate them with 
unnatural energy, and thus to produce a perpetual hot fit of fe- 
ver. Becaufe the aflbeiability of the capillaries is fo much in- 
creafed by the accumulation of this power, owing to the ieflen- 
ed activity of the heart and arteries, as to over-balance the lef- 
fened excitement of it by the weaker movements of the heart 
and arteries. 
6. When the accumulation of the fenforial power of irrita- 
tion caufed by defect of ftimulus is greater in the firft link of a 
train of actions, to which aflbeiated motions are catenated, than 
the deficiency of the excitement of the fenforial power of aflbeia- 
tiou in the next link, what happens ?-the fuperabundance of the 
unemployed fenforial power of the firft link is derived to the 
fecond ; the aflbeiability of which thus becomes fo greatly in- 
creafed, that it a£ts more violently than natural, though the ex- 
citement of its power of aflbciation by the lefl'ened action of the 
firft link is lefs than natural. So that in this fituation the with- 
drawing of an accuftomed ftimulus in fome parts of the fyftem 
will decrease the irritative motions of that part, and at the fame 
time Sup. I. i 1. 6. 
THEORY OF FEVER. 
479 
time occafion an increafe of the aflbciate motion of another part) 
which is catenated with it. 
This circumitance neverthelefs can only occur in thofe parts 
of the fyftem, whofe natural actions are perpetual, and the ac- 
cumulation of fenforial power on that account very great, 
when their activity is much leflened by the deduction of their 
ufual ftimulus ; and are therefore only to be found in the fan- 
guiferous 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 hydrogene 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 in- 
ftance in which a lowered atmofphere did not at the moment 
quicken the pulfe, while it weakened the action of the heart 
and arteries." Confiderations on Factitious Airs, by Thomas 
Beddoes and James Watt, Part III. p. 67. Johnfon, London. 
By the afliftance of this new fa£t the curious circumitance of 
the quick production of warmth of the fkin on covering the 
head under the bed-clothes, which every one mult at fome time 
have experienced, receives a more fatisfabtory explanation, than 
that which is given in Clafs IV. 1. 1. 2. which was printed 
before this part of Dr. Beddoes's Confiderations was publifhed. 
For if the blood be deprived of its accuftomed quantity of ox- 
ygen, as in covering the head in bed, and thus breathing an air 
rendered impure by repeated refpiration, or by breathing a fac- 
titious air with lefs proportion of oxygen, which in common ref- 
piration pafles through the moift membranes of the lungs, and 
mixes with the blood, the pulfations of the heart and arteries 
become weaker, and confequently quicker, by the defeat of the 
ftimulus of oxygen. And as thefe veflelsare fubject to perpet- 
ual motion, the accumulation of the fenforial power of irrita- 
tion becomes fo great by their leflened activity, that it excites 
the veflels next connected, the cutaneous capillaries for inftance, 
into more energetic adlions, fo as to produce increafed heat of 
the fkin, and greater perfpiration. 
How exactly this refembles a continued fever with weak and 
quick pulfe !-in the latter the action of the heart and arteries 
are leflened by defeCt of the excitement of the fenforial power of 
aflbeiation, owing to the torpor or leflened adlions of the ftom- 
,ach; hence the accumulation of the fenforial power of affbeia- 
tion in this cafe, as the accumulation of that of irritation in the 
former, becomes fo abundant as to excite into increafed action 
the parts moft nearly connected, as the cutaneous capillaries. 
hi refpebt to the circumitance mentioned by Sydenham, that 
covering 480 
THEORY OF FEVER. 
Sup. T. n. 7, 
covering the head in bed in a fhort time relieved the pertina- 
cious ficknefs of the patient, it mult be obferved, that when the 
action of the heart and arteries becomes weakened by the want 
of the due ftimulus of the proper quantity of oxygen in the 
blood, an accumulation of the fenforial power of irritation oc- 
curs in the fibres of the heart and arteries, which then is ex- 
pended on thofe of the capillary glands, increafmg their actions 
and confequent fecretions and heat. And then the ftomach is 
thrown into ftronger acftion, both by the greater excitement of 
its natural quantity of the fenforial power of adbciation by the 
increafed actions of the capillaries, and alfo by fome increafe of 
aflbciability, as it had been previoufly a long time in a Hate of 
torpor, or lefs activity than natural, as evinced by its perpetual 
ficknefs. 
In a manner fomewhat fimilar to this, is the rednefs of the 
fkin produced in angry people by the fuperabundance of the un- 
employed fenforial power of volition, as explained in Clafs IV. 
2. 3. 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 actions of the whole moving fyftem, and cures 
thofe difeafes. 
7. As the orgafm of the capillaries in fevers with weak pulfe 
is immediately caufed by the torpid actions of the heart and ar- 
teries, as above explained, this fupplies us with another indica- 
tion of cure in fuch fevers, and that is to ftimulate thele organs. 
This may probably 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 colour of it, and thus increafe its ftimu- 
lus, and the fame may be fuppofed of other faits, neutral or me- 
talic ? As rubia tinfloria, madder, colours the bones of young 
animals, it mud pafs into the blood with its colouring matter 
at lead unchanged, and perhaps many other medicines may 
likewife afteft the blood, and thus aft by ftimulating the heart 
and arteries, as well as by ftimulating the ftomach ; which cir- 
cumftance deferves further attention. 
Another way of immediately ftimulating the heart and arte- 
ries would be by transfufing new blood into them. Is it poflible 
that any other fluid befides blood, as chyle, or milk, or water, 
could, if managed with great art, be introduced fafely or advan- 
tageoufly into the vein of a living animal ? 
A third method of exciting the heart and arteries immediate- 
ly is bv increafing the natural ftimulus of the blood, and is well 
worthy experiment in all fevers with weak pulfe ; and that con- 
fifts Sup. I. 12. Ik 
THEORY OF FEVER. 
481 
fills in fupplying the blood with a greater proportion of oxygen } 
which may be done by refpiration, if the patient was to breathe 
either oxygen gas 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. Prieftley, and uniting with the bloody 
might render it more ftimulant, and thus excite the heart and 
arteries into greater action ! May not fome eafier method of 
exhibiting oxygen gas by refpiration be difcovercd, as by ufing 
very fmall quantities of hyper-oxygenated marine acid gas very 
much diluted with atmofpheric air ? 
XIL Torpor of the Stomach and upper Intejlines* 
I. The principal circumftance, which fupports the increafed 
action of the capillaries in continued fever with weak pulfe, is 
their reverfe fympathy with thofe of the ftomach and upper in* 
teftines, or with thofe of the heart and arteries. The torpor of 
the ftomach and upper inteftines is apparent in continued fevers 
from the total want of appetite' for folid food, befide the fick* 
nefs with which fevers generally 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 ficknefsi 
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 ladteal abforbents are a different 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 
weaknefs of the pulfe. When the actions of the abforbents of 
the ftomach are diminiflied by the exhibition of fmall dofes of 
digitalis, or become retrograde by larger ones, the heart and ar- 
teries act more feebly by direct fympathy ; but the cellular, cu- 
taneous, and pulmonary abforbents are excited into greater ac- 
tion. Whence in anafarca the fluids in the cellular membrane 
throughout the whole body are abforbed during the ficknefs, 
and frequently a great quantity of atmofpheric moifture at the 
fame time ; as appears by the very great difcharge of urine, 
which fometimes happens in thefe cafes ; and in ileus the pro- 
digious evacuations by vomiting, which are often a hundred 
fold greater than the quantity fwallowed, evince the great action 
of all the other abforbents during the ficknefs of the ftomach. 
3. But when the ftomach is rendered permanently lick by 
an emetic drug, as by digitalis, it is not probable, that much ac- 
cumulation of fenforial power is foon produced in this organ 5 
Vol. II. O 00 becaufe 482 
THEORY OF FEVER. 
Sup. I. 12. 4. 
becaufe its ufual quantity of fenforial power is previoufly ex- 
haufted by the great ftimulus of the foxglove; and hence it 
feems probable, that the great accumulation of fenforial power, 
which now caufes the increafed action of the abforbents, is pro- 
duced in confequence of the inactivity of the heart and arteries; 
which inactivity is induced by deficient excitement of the fen- 
forial power of affbciation between thofe organs and the ftom- 
ach, and not by any previous exhauftion of their natural quan- 
tity of fenforial power ; whereas in ileus, where the torpor of 
the ftomach, and confequent ficknefs, is induced by reverfe 
fympathy with an inflamed inteftine, that is, by diifevered or 
defective aflbciation ; the accumulation of fenforial power, 
which in that difeafe fo violently aCtuates the cellular, pulmo- 
nary, and cutaneous abforbents, is apparently produced by the 
torpor of the ftomach and lafteals, and the confequent accumu- 
lation of the fenforial power of aflbciation in them owing to 
their leflened aftion in ficknefs. 
4. This accounts for the dry fkin in fevers with weak pulfe, 
where 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 reverfe fympathy with thofe of the ftomach, or with thofe of 
the heart and arteries ; that is by the expenditure of that fenfo- 
rial power of aflbciation, which is accumulated in confequence 
of the torpor of the ftomach and heart and arteries, or of either 
of them ; this alfo explains the fudden abforption 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 
tongue and noftrils. 
5. Befides the reverfe fympathy, with which the abforbent 
veflels of the ftomach and upper inteftines aft in refpeft 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 fecretory veflels of the ftomach, and thofe of the 
Ikin. Which may neverthelefs be occafioned by the accumula- 
tion of fenforial power by the torpor of the heart and arteries, 
which is induced by direft fympathy with the ftomach ; thus 
when the torpor of the ftomach remains in a fever-fit, which 
might otherwife have intermitted, the torpor of the heart and 
arteries remains alfo by direft fympathy, and the increafed cu- 
taneous capillary aftion, and confequent heat, are produced 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 capilla- 
ries of the ftomach and the cutaneous capillaries, appears by the 
chillnefs Sup. I. 12. 7. 
THEORY OF FEVER. 
483 
chillnefs of fome people after dinner ; and contrariwife by the 
digeftion being ftrengthened, when the Ikin is expofed to cold 
air for a fhort time ; as mentioned in Clafs IV. i. 1.4. and IV. 
2. 1. 1. and from the heat and glow on the Ikin, which attends 
the action of vomiting ; for though when ficknefs firft com- 
mences, the Ikin is pale and cold ; as it then partakes of the gen- 
eral torpor, which induces the ficknefs ; yet after the vomiting 
has continued fome minutes, fo that an accumulation of fenfo- 
rial power exifts in the capillaries of the ftomach, and of the 
Ikin, owing to their diminilhed action ; a glow of the Ikin fuc- 
ceeds, with fweat, as well as with increafed abforption. 
7. Neverthelefs in fome circumftances the ftomach and the 
heart and arteries feem to aft by direft fympathy with the cu- 
taneous capillaries, as in the flulhing of the face and glow of the 
ikin of fome people after dinner ; and as in fevers with ftrong 
pulfe. In thefe cafes there appears to be an increafed produc- 
tion of fenforial power, either of fenfation, as in the bluih of 
fliame ; or of volition, as in the bluih of anger; or of irritation, 
as in the flulhed face after dinner above mentioned. 
This increafed aftion of the capillaries of the ikin along with 
the increafed aftions of the ftomach and heart is perhaps to be ef- 
teemed a fynchronous incrafe of aftion, rather than a fympathy 
between thole organs. Thus the flulhing of the face after din- 
ner may be owing to the fecretion of fenforial power in the brain 
being increafed by the aflbciation of that organ with the ftom- 
ach, in a greater proportion than the increafed expenditure of 
it, or may be owing alfo to the ftimulus of new chyle received 
into the blood. 
8. When the ftomach and the heart and arteries are render- 
ed torpid in fevers, not only the cutaneous, cellular, and pulmo- 
nary abforbents are excited to aft with greater energy j but alfo 
their correfpondent capillaries and fecerning veflels or glands, 
cfpecially perhaps thofe of the ikin, are induced into more ener- 
getic aftion. Whence greater heat, a greater fecretion of per- 
fpirable matter, and of mucus ; and a greater abforption of them 
both, and of aerial moifture. Thefe reverfe fympathies coin- 
cide with other animal fafts, as in eruption of fmall-pox on the 
face and neck the feet become cold, while the face and neck are 
much flulhed ; and in the hemiplegia, when one arm and leg be- 
come difobedient to volition, the patient is perpetually moving 
the other. Which are well accounted for by the accumulation 
of fenforial power in one part of an aflbeiated feries of aftions, 
when lefs of it is expended by another part of it; and by a defi- 
ciency of fenforial power in the fecond link of aflbciation, when 
too much of it is expended bv the firft. 
9. This 484 
THEORY OF FEVER. 
Sup. I. 12. 9, 
9. This doftrine of reverfe fympathy enables us to account 
for that difficult problem, why in continued fevers the increafed 
action of the cutaneous, cellular, and pulmonary capillaries pro- 
ceeds without interruption pr return of cold fit; though per- 
haps with fome exacerbations and remiffions j 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 weak- 
er than natural. 
To this ffiould be added the dire<ft 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 fee- 
ble pulfe is reduced to curious fimplicity. 
The direft 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 drunk 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 to vomit, ar the fame time that the aftions 
pf the abforbent fyftem are known to be much increafed by the 
hafty abforption of the ferous fluid in anafarca, the pulfations of 
the heart become flow and intermittent to an alarming degree. 
See Clafs IV- 2. 1. 17. and 18. 
10. It would affift us much in the knowledge and cure of fe- 
vers, if we could always determine, which part of the fyftem 
was primarily affefted ; and whether the torpor of it was from 
previous excefs or defeft of ftimulus ; which the induftry of fu- 
ture obfervers muft difeover. Thus if the ftomach be affefted 
primarily, and that by previous excefs of ftimulus, as when cer- 
tain 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 ftimulus, before any 
accumulation of it can occur. But if it be affefted with torpor 
fecondarily, by fympathy with fome diftant part-, as with the 
torpid capillaries of the fkin, that is by defeftive excitement of 
the fenforial power of affcciation ; or if it be affefted by defeft 
of ftimulus of food or of heat ; it fooner acquires fo much ac- 
cumulation of fenforial power, as to be enabled to accommodate 
itfelf to its leffened ftimulus by increafe of its irritability. 
Thus in the hemicrania the torpor generally commences in a 
difeafed tooth, and the membranes about the temple, and alfo 
thofc of the ftomach become torpid by direft fynchronous fym- 
pathy ; and pain of the head, and ficknefs fupervene-, but no 
fever or quicknefs of pulfe. In this cafe the torpor of the ftom- 
ach Sup. I. 12. 10. 
THEORY OF FEVER. 
485 
ach is owing to defeat of the fenforial power of aflbeiation, 
which is caufed by the too feeble actions of the membranes fur- 
rounding the difeafed tooth, and thus the train of fympathy ceaf- 
es here without aftefting 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 fen- 
forial power of irritation, and the heart and arteries aft feebly 
from defeft of the excitement of the power of aflbeiation. In 
the former cafe the torpor of the ftomach is conquered by 
accumulation of the power of aflbeiation 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 af- 
fefted fecondarily by fympathy with the torpid cutaneous ca- 
pillaries, or with fome internal torpid vifeus, and on this ac- 
count an accumulation of fenforial power arifes in a few hours 
fuflicient to reftore the natural irritability of this organ ; and 
hence the hot fit fucceeds, and the fever intermits. Or if this 
accumulation of fenforial power becomes exceflive and per- 
manent, the continued fever with ftrong pulfe is produced, or 
febris irritativa. 
In continued fevers the ftomach is frequently I fuppofe af- 
fefted with torpor by previous excefs of ftimulus, and confe- 
quent exhauftion of fenforial power, as when contagious matter 
is fwallowed with the faliva, and it is then much flower in pro- 
ducing an accumulation of fenforial power fuflicient to reftore its 
healthy irritability ; which is a frequent eaufe of continued fe- 
ver with weak pulfe or febris inirritativa. Which conflfts, after 
the cold fit is over, in a more frequent and more feeble aftion 
of the heart and arteries, owing to their direft fympathy with 
the mufcular fibres of the torpid ftomach ; together with an in- 
creafed aftion of the capillaries, glands, and abforbents of the 
jkin, and cellulular membrane, owing to their reverfe fympathy 
with the torpid capillaries, glands, and abforbents of the ftom- 
uch, 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 irrita- 
tion by the ftimulus of contagious matter fwallowed with the 
faliva. 2. The whole fyftem becomes torpid from defeft of 
the excitement of the fenforial power of aflbeiation 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 aftion, or orgafm, 
owing to accumulation of fenforial power of aflbeiation during 
their 486 
THEORY OF FEVER. 
Sup. I. 12. 11. 
their previous torpor, this is the hot fit. 4. The ftomach and 
upper inteftines have not acquired their natural quantity of fen- 
forial power of irritation, which was previoufly exhaufted by vi- 
olent action in confequence of the ftimulus of contagious 
matter, and the heart and arteries remain torpid from defi- 
cient excitement of the fenforial power of affbciation, owing 
to the too feeble actions of the ftomach. 5. The accumulation 
of fenforial power of affbciation in confequence of the torpor of 
the heart and arteries occafions a perpetual orgafm, or increafed 
action of the capillaries. 
11. From hence it may be deduced firft, that when the tor- 
por of the ftomach firft occurs, either as a primary effeCt, or as 
a fecondary link of fome aflbciate train or circle of motions, a 
general torpor of the fyftem fometimes accompanies it, which 
conftitutes the cold fit of fever ; at other times no fuch general 
torpor occurs,-as during the operation of a weak emetic, or dur- 
ing fea-ficknefs. 
Secondly. After a time it generally happens, that a torpor 
of the ftomach ceafes, and its actions are renewed with increafc 
of vigour by accumulation of fenforial power during its quief- 
cence ; as after the operation of a weak emetic, or at the inter- 
vals of fea-ficknefs, or after the paroxyfm of an intermittent 
fever. 
Thirdly. The ftomach is fometimes much flower in recov- 
ering 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 defi- 
cient excitement of the power of affbciation by the too weak 
actions of the ftomach ; and to an orgafm of the capillaries of 
the other parts of the fyftem, in confequence of the accumula- 
tion of fenforial power occafioned by the inactivity of the heart 
and arteries. 
Fourthly. The torpor of the ftomach is fometimes fo com- 
plete, that probably the origin of its nerves is likewife affeCted, 
and then no accumulation of fenforial power occurs. In this 
cafe the patient dies for want of nourifhment; either in three 
or four weeks, of the inirritative fever ; or without quick pulfe, 
by what we have called parefis irritativa. Or he continues ma- 
ny years in a ftate of total debility. When this torpor fudden- 
ly commences, the patient generally fuffers epileptic fits or 
temporary infanity from the difagreeable fenfation of fo great a 
torpor of the ftomach ; 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. 1. 1. 
7. and Suppl. I. 14. 3. 
Fifthly. Sup. I. 12. 11. 
THEORY OF FEVER. 
487 
Fifthly. When this torpor of the ftomach is lefs in degree 
or extent, and yet without recovering its natural irritability by 
accumulation of fenforial power, as it does after the cold fit 
of intermittent fever, or after the operation of mild emetics, or 
during fyncope ; a permanent defect of its activity, and of that 
of the upper inteftines, remains, which conftitutes apepfia, car- 
dialgia, hypochondrialis, and hyfteria. See Clafs I. 3. 1. 3. and 
I. 2.4. 5. 
Sixthly. If the torpor of the ftomach be induced by direft 
fympathy, as in confequence of a previous torpor of the liver, or 
fpleen, or Ikin, an accumulation of fenforial power will fooner 
be produced in the ftomach; becaufe there has been no previ- 
ous expenditure of it, the prefent torpor of the ftomach arifing 
from defeft of aflbciation. Hence fome fevers perfeftly inter- 
mit, the ftomach recovering its complete aftion after the torpor 
and confequent orgafm, which conftitute the paroxyfm of fever, 
are terminated. 
Seventhly. If the torpor of the ftomach be owing to defeft 
of irritation, as to the want of food, an accumulation of fenfo- 
rial power foon occurs with an increafe of digeftion, 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 ftomach be induced by defeft 
of pleafurable fenfation, as when ficknefs is caufed by the fug- 
geftion of naufeous ideas; an accumulation of fenforial power 
foon occurs, and the ficknefs ceafes with the return of hunger; 
for in this cafe the inactivity of the ftomach is occafioned by the 
fubduftion of agreeable fenfation, which afts as a fubduftion of 
ftimulus, and not by exhaufting the natural quantity of fenfori- 
al power in the fibres or nerves of the ftomach. 
Ninthly. If the torpor of the ftomach be induced by a two- 
fold caufe, as in fea-ficknefs. See vertigo rotatoria. Clafs IV. 
2. 1. 10. in which the firft link of aflbciation afts too ftrongly, 
and in confequence expends more than ufual of the fenforial 
power of irritation ; and fecondly in which fenfation is produc- 
ed between the links of aflbciation, and diflevers or enfeebles 
them; the accumulation of fenforial power foon occurs in the 
ftomach ; as no previous expenditure of it in that organ has oc- 
curred. Whence in fea-ficknefs the perfons take food with ea- 
gernefs at times, when the vertigo ceafes for a few minutes. 
Tenthly. If the gaftric torpor be induced by previous vio- 
lent exertion, as after intoxication, or after contagious matter 
has been fwallowed, or fome poifons, as digitalis, or arfenic; 
an accumulation of fenforial power very flowly facceeds; 
whence 488 
THEORY OF FEVER. 
Sup. I. 12. 12. 
whence long ficknefs, or continued fever, becaufe the quantity 
of fenforial power already wafted mult firft be renewed, before 
an accumulation of it can be produced. 
12. This leads us to a fecond indication of cure in continued 
fevers, which conlifts in ftrengthening the adlions of the ftom- 
ach; as the firft indication confifted in decreafing the actions 
of the cutaneous capillaries and abforbents. The actions of the 
ftomach may fometimes be increafed by exhibiting a mild emet- 
ic 5 as an accumulation of fenforial power in the fibres of the 
ftomach is produced during their retrograde adlions. BefideS 
the evacuation of any noxious material from the ftomach, and 
duodenum, and from the abforbents, which open their mouths 
on their internal furfaces, by their retrograde motion. 
It is probable, that when mild emetics are given, as ipecacu- 
anha, or antimonium tartarizatum, or infufion of camomile, 
they are rejected by an inverted motion of the ftomach and 
oefophagus in confcquence of difagreeable fenfation, as duft is 
excluded from the eye ; and thefe atftions having by previous 
habit been found effectual, and that hence there is no exhauftion 
of the fenforial power of irritation. But where ftrong emetics 
are adminiftered, as digitalis, or contagious matter, the previous 
exhauftion of the fenforial power of irritation feems to be a 
Caufe of the continued retrograde actions and ficknefs of the 
ftomach. An emetic of the former kind may therefore ftrength- 
en the power of the ftomach immediately after its operation by 
the accumulation of fenforial power of irritation during its ac- 
tion. See Clafs IV. i. i. 
Another method of decreafing the action of the ftomach for 
a time, and thence of increafing it afterwards, is by the accumu- 
lation of the fenforial power of irritation during its torpor ; is 
by giving ice, iced water, iced creams, or iced wine. This ac- 
counts for the pleafure, which many people in fevers with weak 
pulfe exprefs on drinking cold beverage of any kind. 
A fecond method of exciting the ftomach into action, and of 
decreafing that of the capillaries in confcquence, is by the ftimu* 
lus of wine, opium, bark, metallic faits of antimony, fteel, cop- 
per, arfenic, given in fmall repeated quantities ; which fo long 
as they render the pulfe flower are certainly of fervice, and may 
be given warm or cold, as moft agreeable to the patient. For it 
is poflible, that the capillaries of the ftomach may a<ft too vio- 
lently, 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. Het fomentation on the region of the ftomach 
might be of moft eflential fervice by its ftimulus, as heat pene- 
trates Sui*. I. 12. 12. 
THEORY OF FEVER. 
489 
trates the fyftem not by the abforbent veffels, but by external 
influence ; whence the ufe of hot fomentation to the head in tor- 
por of the brain ; and the ufe of hot bath in cafes of general de- 
bility, which has been much too frequently neglected from a pop- 
ular error occafioned by the unmeaning application of the word 
relaxation to animal power. If the fluid of heat could be di- 
rected to pafs through particular parts of the body with as lit- 
tle diffufion of its influence, as that of electricity in the (hocks 
from the coated jar, it might be employed with (till greater ad- 
vantage. 
Fourthly. The ufe of repeated fmall electric (hocks through 
the region of the ftomach might be of fervice in fevers with 
weak pulfe, and well deferves a trial; twenty or thirty fmall 
(hocks twice a day for a week or two would be a promifing ex- 
periment. 
Fifthly. A blifter on the back, or (ides, or on the pit of the 
ftomach, repeated in fucceflion, by ftimulating the (kin frequent- 
ly ftrengthens the action of the ftomach by exciting the fenfo- 
rial power of aflbciation ; thi; efpecially in thofe fevers where 
the (kin of the extremities, as of the hands or nofe or ears, foon- 
er becomes cold, when expofed to the air, than ufual. 
Sixthly. The action of the ftomach may be increafed by pre- 
venting too great expenditure of fenforial power in the link 
of previous motion with which it is catenated, efpecially if the 
action of that link be greater than natural. Thus as the 
capillaries of the (kin act too violently in fevers with weak 
pulfe, if thefe are expofed to cold air or cold water, the fenfori- 
al power, which previoufly occafioned their orgafm, becomes 
accumulated, and tends to increafe the action of the ftomach; 
thus in thofe fevers with weak pulfe and hot (kin, if the ftomach 
be ftimulated by repeated fmall dofes of bark and wine or opi- 
um, and be further excited at the fame time by accumulation of 
fenforial power occafioned by rendering the capillaries torpid by 
cold air or water, this twofold application is frequently attended 
with vifible good effect. 
By thus ftimulating the torpid ftomach into greater action, 
the motions of the heart and arteries will likewife be increafed 
by the greater excitement of the power of aflbciation. And the 
capillaries of the (kin will ceafe to act fo violently, from their 
not poffefling fo great a fuperfluity of fenforial power as during 
the greater quiefcence of the ftomach and of the heart and arte- 
ries. Which is in fome circumftances fimilar to the curious 
phenomenon mentioned in Clafs IV. 2. 2. 10.; where, by cov- 
ering the chill feet with flannel at the eruption of the fmall-pox, 
the points of the flannel ftimulate the (kin of the-feet into greater 
Vol. II. Ppp adion, 490 
THEORY OF FEVER. 
Sup. I. 13. 
action, and the quantity of heat, which they poflefs, is alfo con- 
fined, or infulated, and further increafes by its ftimulus the ac- 
tivity of the cutaneous veflels of the feet; and by that circum- 
ftance abates the too great aeftion of the capillaries of the face, 
and the confequent heat of it. 
XIII. Cafe of continued Fever. 
The following cafe of continued fever which I frequently faw 
during its progrefs, as it is lefs complicate than ufual, may il- 
luftrate this doctrine. Mafter S. D. an active boy about eight 
years of age, had been in the fnow for many days, and fat in the 
clafiical fchool with wet feet; he had alfo about a fortnight at- 
tended a writing fchool, where many children of the lower or- 
der were inftrudted. He was feized on February the 8th, 17951 
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 blifter, which check- 
ed the ficknefs only for a few hours ; his fkin became perpetu- 
ally hot, and dry ; and his tongue white and furred ; his pulfe 
when afleep about 104 in a minute, and when awake about 
112. 
Fourth day of the difeafe. He has had another blifter, the 
pain of his head is gone, but the ficknefs continues by intervals; 
he refufes to take any folid food, and will drink nothing but milk, 
or milk and water, cold. He has two or three very liquid ftools 
every day, which are fometimes green, but generally of a dark- 
ilh yellow, with great flatulency both upwards and downwards 
at thofe times. An antimonial powder was once given, but in- 
ftantly rejected; a fpoonful of decoction of bark was alfo ex- 
hibited with the fame event. His legs are bathed, and his 
hands and face are moiftened twice a day for half an hour in 
warmiflr water, which is neverthelefs much colder than his 
fkin. 
Taghth day. His fkin continues hot and dry without any ob- 
fervable remiffions, with liquid ftools and much flatulency and 
ficknefs; his water when obferved was of a ftraw colour. He 
has alked for cider, and drinks nearly a bottle a day mixed 
with cold water, and takes three drops of laudanum twice a 
day. 
Twelfth day. He continues much the fame, takes no milk, 
drinks only cider and water, Ikin hot and dry, tongue hot and 
furred, with liquid ftools, and ficknefs always at the fame time ; 
Heeps much. 
Sixteenth day. Was apparently more torpid, and once rath- 
er Sup. I. 13. 
THEORY OF FEVER. 
491 
er delirious ; pulfe 112. Takes only capillaire and water ; fleeps 
much. 
Twentieth day. Pulfe 100, ikin dry but lefs hot, liquid (tools 
not fo frequent, he is emaciated to a great degree, he has eaten 
half a tea-cup full of cullard to day, drinks only capillaire and 
water, has thrice taken two large fpoonfuls of decoftion of bark 
with three drops of laudanum, refufes to have his legs bathed, 
and will now take nothing 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 playthings, and takes 
wine fyllabub. 
Twenty-eighth day. He daily grows ftronger, eats eggs, 
and bread and butter, and fleeps immediately after his food, can 
creep on his hands and knees, but cannot (land erc<ft. 
Thirty-fecond day. He cannot yet ftand alone fafely, but 
feems hourly to improve in ftrength of body, and activity of 
mind. 
In this cafe the remote caufe of his fever could not be well 
afeertained, as it might be from having his feet cold for many 
fuccelfive days, or from contagion ; but the latter feems more 
probable, bccaufe his younger brother became ill of a fimilar fe- 
ver about three weeks afterwards, and probably received the in- 
fection from him. The difeafe commenced with great torpor 
of the llomach, which was {hewn by his total averlion to folid 
food, and perpetual ficknefs ; the watery ftools, which were 
fometimes green, or of a darkifh yellow, were owing to the ac- 
rimony, or acidity of the contents of the bowels; which is well 
as the flatulency were occafioned by indigeftion. This torpor 
of the llomach continued throughout the whole fever, and when 
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 vefl'els, which conllitute the ftomach, into the 
greateft irritative motion like arfenic ; 'which might not be per- 
ceived) and yet might render that organ paralytic or inirritable in a 
moment of time ; as animals fometimes die by one fingle exertioi^ 
and confequent paralyfis, without a fecond ftruggle ; as by 
lightning, or being fhot through the back part of the brain; of 
both which I have feen inftances. I had once an opportunity 
of infpedling 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 prefl'ed or bent near them; I have alfo feen two horfes (hot 
through the cerebellum, who never once drew in their legs after 
they 492 
THEORY OF FEVER. 
Sup. I. 13. 
they hr ft ftretched them out, but died inftantaneoufly ; in a fim-> 
ilar manner the lungs feem to be rendered inftantly inanimate 
by the fumes of burning fulphur. 
The lungs may be fometimes primarily affected with conta- 
gious matter floating in the atmoiphere as well as the ftomach, 
as mentioned in article 9. of this Supplement. But probably 
this may occur much lefs frequently, becaufe the oxygene of the 
atmofphere does not appear to be taken into the blood by ani- 
mal abforption, as the faliva in the ftomach, but pafles through 
the moift membranes into the blood, like the ethereal fluids of 
electricity or heat, or by chemical attraction, and in confequence 
the contagious matter may be left behind ; except it may fome- 
times be ab:orbed along with the mucus ; of which however in 
this cafe 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 inirritat- 
ed fevers ; but no fymptom of this appeared here, as the toniils 
were at no time of the fever inflamed, though they were in this 
child previoufly uncommonly large. 
The pain of the forehead does not feem to have been of the 
internal parts of the head, becaufe the nerves, which ferve the 
ftomach, are not derived from the anterior part of the brain ; 
but it feems to have been owing to a torpor of the external mem- 
branes about the forehead from their direct fympathy with thole 
of the ftomach; that is, from the deficient excitement of the 
fenforial power of aflbeiation ; and feemed in fome meafure to 
be relieved by the emetics and blifters. 
The pulfations of the heart were weaker and in confequence 
quicker than natural, owing to their dired fympathy with the 
torpid periftaltic motions of the ftomach ; that is to the deficient 
excitement of the fenforial power of aflbeiation. 
The action of the cutaneous capillaries and abforbents were 
ftronger than natural, as appeared by the perpetual heat and 
dryneis of the fkin ; which was owing to their reverie fympathy 
with the heart and arteries. This weaker and quicker ablion of 
the heart and arteries, and the ftronger action of the cutaneous 
capillaries and abforbents, continued throughout die difeafe, 
and may be faid to have conftituted the fever, of which the tor- 
por of the ftomach was the remote caufe. 
His tongue was not very much furred or very dry, nor his 
breath very hot; which (hewed, that there was no great increafe 
of the action of the mucous abforbents, nor of the pulmonary 
capillaries, and yet fufheient to produce great emaciation. His 
mine was nearly natural both in quantity and colour; which 
(hewed. Sup. I. 14. 1. 
THEORY OF FEVER. 
493 
Ihewed, that there was no increafe of aCtion either of the kid- 
neys, or of the urinary abforbents. 
The bathing his legs and hands and face for half an hour 
twice a day feemed to refrelh him, and fometimes made his 
pulfe flower, and thence 1 fuppofe ftronger. This feems to 
have been caufed by the water, though fubtepid, being much 
below the heat of his (kin, and confequently 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 tinCture of opium 
from about the eighth day to the twenty-fourth, and for the 
three preceding days took along with it two large fpoonfuls of 
an infulion of bark in equal parts of wine and water. The for- 
mer of thefe by its ftimulus feemed to decreafe his languor for 
a time, and the latter to ftrengthcn his returning power of di- 
geftion. 
The daily exacerbations or remiflions were obfcure, and not 
well attended to ; but he appeared to be worfe on the four- 
teenth or fifteenth days, as his pulfe was then quickeft, and his 
inattention greateft ; and he began to get better on the twen- 
tieth or twenty-firft days of his difcafe ; for the pulfe then be- 
came lefs frequent, and his Ikin cooler, and he took rather more 
food : thefe circumftances feemed to obferve the quarter periods 
of lunation. 
XIV. Termination of continued Fever. 
I. When the ftomach is primarily affected with torpor not 
by defeat of ftimulus, but in confequence of the previous ex- 
hauftion of its fenforial power ; and not fecondarily by its affo- 
ciation with other torpid parts ; it feems to be the general caufe 
of the weak pulfations of the heart and arteries, and the confe- 
quent increafed action of the capillaries, which conftitute con- 
tinued fever with weak pulfe. In this fituation if the patient 
recovers, it is owing to the renovation of life in the torpid ftom- 
ach, as happens to the whole fyftem in winter-fleeping animals. 
If he perithes, it is owing to the exhauftion of the body for 
want of nouriftiment occafioned by indigeftion ; which is haft- 
cned by the increafed actions of the capillaries and abforbents. 
2. When the ftomach is primarily affeCled by defed of ftim- 
ulus, as by cold or hunger; or fecondarily by defeat of the pow- 
er of affociation, as in intermittent fevers ; or laftly in confe- 
quence of the introduction of the fenforial power of fenfation, 
as in inflammatory difeafes ; the actions of the heart and arte- 
ries are not aliminifhed, as when the ftomach is primarily af- 
fected 494 
THEORY OF FEVER. 
Sup. I. 14. 3. 
fefied with torpor by its previous exhauftion of fenforial pow- 
er, but become greatly increafed, producing irritative or inflam- 
matory fever. Where this fever is continued, though with 
fome remiftions and exacerbations, the exceflive adlion is at 
length to much leffened by expenditure of fenforial power, as to 
gradually terminate in health ; or it becomes totally exhaufted, 
and death fucceeds the deitru&ion of the irritability and affocia- 
bility of the fyftem. 
3. There is alfo another termination of the difeafes in con- 
fequence of great torpor of the ftomach, which are not always 
termed fevers; one of thefe is attended with fo great and uni- 
verfal torpor, that the patient dies in the firft cold fit; that is, 
within twelve hours or lefs of the firft feizure; this is common- 
ly termed hidden death. But the quicknefs of the pulfe, and 
the coldnefs with fhuddering, and with fick ftomach, diftinguifh- 
ed a cafe, which I lately faw, from the fudden deaths occafion- 
cd by apoplexy, or ruptured blood-veflels. 
In hemicrania I believe the ftomach is always affected fec- 
ondarily, as no quicknefs of pulfe generally attends it, and as 
the ftomach recovers its aftivity in about two whole days. But 
in the following cafe, which I faw laft week, I fuppofe the 
ftomach fuddenly became 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 much indifpofed after it ; flie 
was feized with ficknefs, and cold fliuddering, with very quick 
pulfe, which was fucceeded by a violent hot fit ; during the 
next cold paroxyfm (he had a convulfion fit; and after that 
fymptoms of infanity, fo as to ftrike and bite the attendants, 
and to fpeak furious language ; the fame circumftances occur- 
red during a third fit, in which I believe a ftrait waiftcoat was 
put on, and fome blood taken from her ; during all this time 
her ftomach would receive no nutriment, except once or twice 
a little wine and water. On the feventh day of the difeafe, 
when I faw her, the extremities were cold, the pulfe not to be 
counted, and fhe was unable to fwallow, or to fpeak; a clyfter 
was ufed with turpentine and muik and opium, with warm fo- 
mentations, but Ihe did not recover from that cold fit. 
In this cafe the convulfion fit and the infanity feem to have 
been violent efforts to relieve 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 not many be faved in thefe fevers with weak pulfe 
for Sup. I. 15. 1. 
THEORY OF FEVER. 
495 
for a few weeks by the introduction of blood into a vein, once 
in two or three days ; which might thus give further time for 
the recovery of the torpid ftomach ? Which feems to require 
fome weeks to acquire its former habits of aCtion, like the muf- 
cles of paralytic patients, who have all their habits of voluntary 
afl'oeiations to form afrefh, as in infancy. 
If this experiment be again tried on the human fubjeCl, it 
fhould be fo contrived, that the blood in palling from the well 
perfon to the fick one fhould not be expofed to the air ; it fbould 
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 fmall crow-quill. Fix one of 
thefe filver funnels by its wide end to one end of the gut of a 
chicken frefh 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 
water-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 
gutful into a cup, in order to afeertain the quantity by weight. 
Then introduce the other end of the other funnel into a fimilar 
vein in the arm of the fick perfon upwards towards the (boul- 
der ; and by Aiding one finger, and then another reciprocally, 
along the chicken's gut, fo as to comprefs it, from the arm of 
the well perfon to the arm of the fick one, the blood may be 
meafured, and thus the exa£l quantity known which is given 
and received. See Clafs I. 2. 3. 25. 
XV. Inflammation excited in Fever. 
i. When the actions of any part of the fyftem of capillaries 
are excited to a certain degree, fenfation is produced, along 
with a greater quantity of heat, as mentioned in the fifth article 
of this fupplement. When this incTeafed capillary action be- 
comes 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 veflels are con- 
ftrufled ; it is then termed inflammation : if this exifts in the 
capillary veflels of the cellular membrane or Ikin only, with fee- 
ble pullations of the heart and arteries, the febris fenfitiva inir- 
ritata, or malignant fever, occurs; if the coats of the arteries 
are 496 
THEORY OF FEVER. 
Sup. 1.15.1. 
are alio inflamed, the febris fenfitiva irritata, or inflammatory 
fever, exifts. 
In all thefe fevers the part inflamed is called a phlegmon, and 
by its violent actions excites fo much pain, that is, fo much of 
the fenforial power of fenfation, as to produce more violent ac- 
tions, and inflammation, throughout the whole fyftem. 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 con- 
tinue, though with exacerbations and remilfions ; which feem 
to be governed by folar or lunar influence. 
2. In this fituation there generally, I fuppofe, exifts an in- 
creafed activity of the fecerning veffels of the brain, and confe- 
quently an increafed production of fenforial power; in lefs vio- 
lent quantity of this difeafe however the increafe of the action 
of the heart and arteries may be owing fimply to the accumula- 
tion of fenforial power of aflbeiation in the ftomach, when that 
organ is affected by fympathy with fome inflamed part. In the 
fame manner as the capillaries are violently and permanently ac- 
tuated by the accumulation of the fenforial power of aflbeiation 
in the heart and arteries, when the ftomach is affected primari- 
ly by contagious matter, and the heart and arteries fecondarily. 
Thus I fufpebl, that in the diftind; fmall-pox the ftomach is af- 
fected fecondarily by fympathy with the infected tonfils or 
inoculated arm ; but that in the confluent fmall-pox the ftom- 
ach is affected primarily, as well as the tonfils, by contagious 
matter mixed with the faliva, and fwallowed. 
3. In inflammatory fevers with great arterial a£tion, as the 
ftomach is not always aflebted with torpor, and as there is a di- 
rect fympathy between the ftomach and heart, fome people have 
believed, that naufeating dofes of fome emetic drug, as of anti- 
monium tartarizatum, have been adminiftered with advantage, 
abating by direct fympathy the actions of the heart. This the- 
ory is not ill-founded, and. the ufe of digitalis, given in fmall 
dofes, as from half a dram to a dram of the faturated tincture, 
two or three times a day, as well as other lefs violent emetic 
drugs, would be worth the attention of hofpital phyficians. 
In three cafes of what I believed to be inflammatory rheu- 
matifm, two of them attended with pain of the fide, and diffi- 
cult refpiration, and the other with fwelled joints, after repeated 
venefebiions and moderate cathartics, and mild dofes of anti- 
monials, without fuccefs, the tincTure of digitalis given in the 
fmall dofe of ten drops every fix hours, appeared to abate the 
quicknefs and hardnefs of the pulfe in two or three or four 
days, without inducing any degree of fleknefs. 
Sicknefs Sup. 1.15. 4. 
THEORY OF FEVER. 
497 
Sicknefs might alfo be produced probably with advantage by 
whirling the patient in a chair fufpended from the ceiling by 
two parallel cords ; which after being revolved fifty or a hun- 
dred times in one direction, would return with great circular 
velocity, and produce vertigo, fimilar I fuppofe to fea-ficknefs. 
And laftly the ficknefs produced by refpiring an atmofphere 
mixed with one tenth of carbonated hydrogen, difcovered by 
Mr. Watt, and pubhfhed by Dr. Beddoes, would be well wor- 
thy exaft 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 veflels, they muff return to the 
heart with lefs ftimulus, than when they are heated above the 
natural degree of ninety-eight. For this purpofe 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 Oafs III. 2. 1. 12. and 
Suppl. I. 8. 
5. The lancet however with repeated mild cathartics is the 
great agent in deftroying this enormous excitement of the fyf- 
tem, fo long as the ftrength of the patient will admit of evacua- 
tions. Blitters over the painful part, where the phlegmon or 
topical inflammation is fituated, after great evacuation, is of ev- 
ident 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 
excitement of the fyftem in inflammatory difeafes, might not 
the fhaved head be covered with large bladders of cold water, in 
which ice or fait had been recently diflblved ; and changed as 
often as neceflary, till the brain is rendered in fome degree tor- 
pid 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 wifhed to try, 
which cannot be done in private practice, and which I there- 
fore recommend to fome hofpital phyfician ; and that is, to en- 
deavour to ft ill the violent actions of the heart and arteries, after 
due evacuations by venefe&ion and cathartics, by gently com- 
prefling the brain. This might be done by fufpending a bed, 
fo as to whirl the patient round with his head moft diftant from 
the centre of motion, as if he lay acrofs a mill-ftone, as defcrib- 
ed in Sect. XVIII. 20. For this purpofe a perpendicular (haft 
armed with iron gudgeons might have one end pafs into the 
floor, and the other into a beam in the ceiling, with an horizon- 
tal arm, to which a fmall bed might be readily fufpended. 
Vol. II. 498 
THEORY OF FEVER. 
Sup. 1.16. 
By thus whirling the patient with increafing velocity fleep 
might be produced, and probably the violence of the aClions of 
the heart and arteries might be diminifhed in inflammatory fe- 
vers ; 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 compreflion, or by the bladder- 
cap of cold water above defcribed, the lives of thoufands might 
probably be faved by thus extinguifhing the exacerbations of fe- 
brile paroxyfms, or preventing the returns of them. 
In fevers with weak pulfe fleep, or a degree of llupor, thus 
produced, 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 centre of motion, fo 
as to force the blood from the brain into the other parts of the 
body, might be difcovered by cautious experiment without 
danger, and might probably add to our ability of curing fever. 
Mr. Kelly, in his obfervations on compreflion, Edinb. 1797, 
aflerts, that by comprefling the two fubclavian arteries, as they 
pafs over the firlt rib, more blood will comprefs the brain, and 
produce a kind of apopleCtic ftate fimilar to that, which may 
occur by the centrifugal force, if the patient was whirled round 
as above defcribed. And adds, that by this compreflion of the 
two fubclavian arteries a greater quantity of blood will be cir- 
culated through the head, whence the patient foon complains of 
drowfinefs and vertigo ; and that hence different fpecies of 
head-achs are foon removed, efpecially thofe which depend on 
defect of ftimulation. 
XVI. Recapitulation, 
t. The fenforial power caufes the contraction of the fibres, 
and is excited into aClion by four different circumflances, by the 
ftimulus of external bodies, by pain or pleafure, by defire or 
averfion, or by the previous motions of other contraCling fibres. 
In the firft fituation it is called die 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 affociation. 
Many parts of the body are excited into perpetual aClion, as 
the fanguiferous veffels confifling of the heart, arteries, and 
veins; others into nearly perpetual aClion, as the conglomerate 
and capillary glands ; and others into aClions (till fomewhat 
lefs frequent, as the alimentary canal, and the laCteal and 
lymphatic abforbents with their conglobate glands : all thefe arc 
principally Sup. I. 16. 2. 
THEORY OF FEVER. 
499 
principally actuated by the fenforial powers of irritation, and of 
aflbciation ; but in fome degree or at fome times by thofe of 
fenfation, and even of volition. There are three kinds of ftim- 
ulus, which may eafily be occafionally diminilhed, that of heat 
on the (kin, of food in the ftomach, 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 perpetu- 
al action by ftimulus, become torpid or lefs active from decreafe 
of that ftimulus ; there firft occurs a decreafe of the activity of 
the parts next catenated with them ; thus going into cold water, 
produces a torpor of the capillary veflels 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 actions 
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 defeat of ftimu- 
lus, as the cutaneous veflels for inftance when expofed to cold 
air; and a flmilar accumulation of the fenforial power of aflb- 
ciation occurs in the parts which were catenated with the for- 
mer, as the veflels of the lungs in the example above mentioned. 
Whence, if the fubdu&ion of ftimulus has not been too great, 
fo as to impair the health of the part, the activity of the irrita- 
tive motions returns, even though the ftimulus continues lefs 
than ufual $ and thofe of the aflbciate motions become confid- 
erably increafed, becaufe thefe latter are now excited by the pre- 
vious fibrous motions, which now act as ftrong or ftronger than 
formerly, and have alfo acquired an accumulation of the fenfo- 
rial power of aflbciation. 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 pf a frofty morning of about 30 degrees of heat. 
But if the parts thus pofl'efled of the accumulated fenforial 
powers of irritation and of aflbciation be expofed again to their 
natural quantity of ftimulus, a great excels of activity fuper- 
venes j becaufe the fibres, which poflefs accumulated irritation, 
are now excited by their ufual quantity of ftimulus ; and thofe 
which poflefs accumulated aflbciation, are now excited by double 
or treble the quantity of the preceding irritative fibrous mo- 
tions, with wffiich they are catenated; this conftitutes the hot 
fit of fever. 
Another important circumftance occurs, when the parts, 
which are torpid from decreafed ftimulus, do not accumulate a 
quantity 500 
THEORY OF FEVER. 
Sup. I. 16. 3. 
quantity of fenforial power fufficient for the purpofe of renew- 
ing their own natural quantity of action ; 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 irri- 
tation contributes to actuate the affociate motions next catenated 
with them. Thus, when a perfon breathes air with lefs oxy- 
gene than natural, as by covering his head in bed, and thus re- 
fpiring the fame atmofphere repeatedly, the heart and arteries 
become lefs active by defeat of the ftimulus of oxygene ; and 
then the accumulation of fenforial power of irritation becomes 
inftantly very great, as thefe organs are fubjeft to perpetual and 
energetic action. This accumulation neverthelefs is not fo great 
as to renew their own activity under this defeat of ftimulus, but 
yet is in fufficient abundance to increafe the aflbeiability of the 
next link of catenation, that is, to acuate the capillaries of the 
Ikin with great and perpetual increafe of energy. This refem- 
bles continued fever with weak pulfe ; in which the accumula- 
tion of the fenforial power caufed by the leflened motions of the 
heart and arteries, actuates the capillaries with increafe of energy. 
3. When the accumulation of the fenforial power of aflbei- 
ation, which is caufed as above explained by deficient excite- 
ment owing to the leflened quantity of aOion of the irritative 
fibrous motions, with which the aflbeiate train is catenated, is 
not in quantity fufficient to renew the natural actions of the firft 
link of an aflbeiate train of motions ; it is neverthelefs fre- 
quently fo abundant as to acuate the next link of the aflbeiated 
train with unnatural energy by increafing its aflbeiability ; and 
that in a ftill greater degree if that fecond link of the aflbeiated 
train wras previoufly in a torpid ftate, that is, had previoufly ac- 
quired fome accumulation of the fenforial power of aflbeiation. 
This important circumftance of the animal economy is worthy 
our moft accurate attention. Thus if the heart and arteries are 
deprived of their due quantity of the ftimulus of oxygene in the 
blood, a weak and quick pulfe enfues, with an accumulation of 
the fenforial power of irritation ; next follows an increafe of the 
action of the capillaries by the fuperabundance of this accumu- 
lated power of irritation ; but there alfo exifts an accumulation 
of the power of aflbeiation in thefe aiding capillaries, which is 
not now excited by the deficient actions of the heart and arte- 
ries ; but which by its abundance contributes to actuate the 
next link of aflbeiation, which is the fick ftomach in the cafe 
related from Sydenham in Clafs IV. 1. 1. 2. and explained in 
this Supplement I. 4. And as this fick ftomach was in a pre- 
yious ftate of torpor, it might at the fame time poflefs an accu- 
mulation of fome fenforial power, which, if it was of aflbeiation, 
would Sup. I. 16. 4. 
THEORY OF FEVER. 
501 
would be thus more powerfully excited by the increafed actions 
of the capillaries; which exifted in confequence of the weak 
a&ion of the heart and arteries. This alfo refembles in fome 
refpefts the continued fevers with weak pulfe, and with increaf- 
ed activity of the capillaries. 
4. When a torpor of fome irritative motions occurs from a 
previous exhauftion of the fenforial power of irritation by the 
ablion of fome very great ftimulus, it is long before any accu- 
mulation 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 aflbciation in the firft 
link of the aflbciate train of motions, which is catenated with 
thefe torpid irritative ones; which accumulation is owing to de- 
ficient excitement of that fenforial power in the firft link of the 
aflbciate train. This firft link therefore exifts alfo in a lefs ac- 
tive or torpid ftate, but the accumulation of the fenforial power 
of aflbciation by its fuperabundance contributes to a&uate the 
fecond link of the aflbciate train with unnatural quantity of mo- 
tion ; and that though its own natural quantity of the power 
of aflbciation is not excited by the deficient a&ion of preceding 
fibrous motions. 
When this happens to the ftomach, as after its irritative mo- 
tions have been much exerted from the unnatural ftimulus of 
wine, or opium, or of contagious matter mixed with the faliva, 
a torpor or inactivity 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 has been previoufly ex- 
pended, is firft reftored. Then the heart and arteries, which are 
next in catenation, become lefs aCrive from the want of fuffi- 
cient excitement of the fenforial power of aflbciation, which 
previoufly contributed to actuate them. This fenforial power 
of aflbciation therefore becomes accumulated, and by its fuper- 
abundance contributes to actuate the link next in aflbciation, 
which has thus acquired fo great a degree of aflbciability, as to 
overbalance the lefs quantity of the excitement of it by the tor- 
pid aCiion of the previous or firft aflbciate link. This happens 
to the capillaries, when the heart and arteries are affeCled as 
above by the torpor of the ftomach, when it is occafioned by 
previous great expenditure of its fenforial power, and thus con- 
ftitutes 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 accumu- 
lation of fenforial power occurs ; as when the ficin is long ex- 
pofed 502 
THEORY OF FEVER. 
Sup. I. 16. 6. 
pofed to cold and damp air. In that cafe the link in catenation, 
that is, the firft of the aflbciate train, is rendered torpid by de- 
feat of excitement of its ufual quantity of the fenforial power of 
affociation, and from there being no accumulation of the fenfori- 
al power of irritation to increafe its affociability, and thus to con- 
tribute to adnate it by overbalancing the defed of the excite- 
ment of its affociation. 
Thus on riding long and flowly on a cold and damp day, 
the exhalation of the vapour, which is impinged on the fkin, as 
the traveller proceeds, carries away his warmth fafter, than it is 
generated within the fyltem ; and thus the capillaries of the fkin 
have their adions fo much impaired after a time, that no accu- 
mulation of the fenforial power of irritation occurs ; and then 
the flomach, the motions of which are catenated with thofe of 
the capillaries, ceafes to ad from the deficient excitement of the 
power of affociation; and indigeftion and flatulency fucceed, 
inftead of the increafed digeftion and hunger, which occur, 
when the cutaneous capillaries are expofed to a lefs degree of 
cold, and for a fhorter time. In which latter fituation the accu- 
mulation of the fenforial power of irritation increafes by its fu- 
perabundance the affociability of the fibres of the ftomach, fo 
as to overbalance the defed of the excitement of their aifocia- 
tion. 
6. The ftomach is affeded fecondarily in fevers with ftrong 
pulfe, as in thofe with weak pulfe it is affeded primarily. To 
illuftrate this dodrine I fhall relate the following cafe of Mr. 
Y . He was a young man rather intemperate in the ufe 
of wine or beer, and was feized with a cold fit, and with a con- 
fequent hot one with ftrong pulfe \ on examining his hypochon- 
drium an oblong tumour was diftindly felt on the left fide of 
the ftomach, which extended fix or eight inches downward, and 
was believed to be a tumour of the fpleen, which thus occafioned 
by its torpor the cold fit and ccnfequent hot fit of fever with 
ftrong pulfe. This fever continued, though with remiflions, 
for two or three weeks; and the patient repeatedly loft blood, 
ufed cathartics with calomel and fenna,and had frequent antimo- 
nial and faline medicines. And after he was much weakened 
by evacuations, the peruvian bark and fmall dofes of fteel re- 
moved 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 con- 
tinued fomewhat longer to pour their fluids into the cells of it. 
Phen the inactivity of this vifeus afl'e£led the whole fyftem with 
torpor by the deficient excitement of the fenforial powef of aflb- 
ciation, Sup. I. 16. 6. 
THEORY OF FEVER. 
503 
ciation, which contributes along with the irritation caufed by 
their fpecific ftimuli to actuate the whole fanguiferous, fecern- 
ing, and abforbent veflels; and along with thefe the ftomach, 
which poffefles perhaps greater mobility, or promptitude co tor- 
por or to orgafm, than any other part. And after a time ail thefe 
parts recover their actions by the accumulation of their fenfori- 
al power of affociation. But the fpleen not recovering its ac- 
tion from the accumulation of its power of irritation, as appear- 
ed from the continuance of the tumour, Rill affects the ftomach 
by its defective irritative motions cealing to excite the affocia- 
tion, which ought to contribute to actuate it. 
Hence the ftomach continues torpid in refpedl to its motions, 
but accumulates its power of affociation; which is not excited 
into action by the defective motions of the fpleen; this accu- 
mulation of the fenforial power of affociation now by its fuper- 
abundance actuates the next link of affociate motions, which 
confifts of the heart and arteries, into greater energy of action 
than natural, and thus caufes fever with ftrong puife; which, 
as it was fuppofed to be moft frequently excited by increafe of 
irritation, is called irritative fever or fynocha. 
Similar to this in the fmall-pox, which is given by inocula- 
tion, the ftomach is affected fecondarily, when the fever com- 
mences ; and hence in this fmall-pox the pulfations of the heart 
and arteries are frequently ftronger than natural, but never 
weaker, for the reafons above given. Whereas in that fmall-pox, 
which is caufed by the ftomach being primarily affected, by the 
contagious matter being fwallowed with the faliva, whether the 
tonfils are at the fame time afledted 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 ftomach is affected fecond- 
arily, whereas in the natural fmall-pox it is frequently affedt- 
ed primarily by fwallowing the contagious matter mixed with 
faliva. 
In the mealies I fuppofe the contagious matter to be diffolved 
in the air, and therefore not liable to be mixed with the faliva ; 
whereas the variolous matter is probably only diffufed in the air, 
and thence more readily mixed with the faliva in the mouth dur- 
ing 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 neceflary to acquire the mealies. The 
contagion of the mealies affects the membranes of the noftrils, 
and the fecretion of tears in confequence, but never I fufpecl 
the ftomach primarily, but always fecondarily ; whence the pul- 
fation 504 
THEORY OF FEVER. 
Sup. I. 16. 7* 
fation of the heart and arteries is always ftronger than natural, 
fo as to bear the lancet at any period of the difeafe. 
The great mildnefs fometimes, and fatality at other times, of 
the fcarlet fever may depend on the fame circumftance ; that is, 
on the ftomach being primarily or fecondarily affected by the 
contagious matter, obferving that the tonfils may be affected at 
the fame time with the ftomach. Should this prove to be the 
cafe, which future obfervations muft determine, what certain ad- 
vantage muft arife from the inoculation of this difeafe ! When 
it is received by the ficin primarily 1 fuppofe no fore throat at- 
tends it, nor fever with weak pulfe ; when it is received by the 
ftomach primarily, the tonfils are affected at the fame time, and 
the torpor of the ftomach produces inirritative fever, and the 
mortification of the tonfils fucceeds. 
We may hence conclude, that when the torpor of the ftom- 
ach 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 cat- 
enation or affociation with other torpid parts, as in the com- 
mencement of intermittent fevers, and inoculated fmall-pox, that 
the fubfequent action of the heart and arteries is generally in- 
creafed, producing irritative fever. Which is owing to the ac- 
cumulation of the fenforial power of irritation in one cafe, and 
of affociation in the other, contributing to actuate the next link 
of the catenated or affociated motions. But when the torpor of 
the ftomach is induced by previous exhauftion of its fenforial 
powers of irritation or of affociation by continued violent action, 
as by the ftimulus of digitalis, or of contagious matter, or after 
intoxication from wine or opium, a weaker action of the heart 
and arteries fucceeds, becaufe there is no accumulation of fen- 
forial power, and a deficient excitement of affociation. And 
finally, as this weak action of the heart and arteries is not in- 
duced by exhauftion of fenforial power, but by defedl of the ex- 
citement of affociation, the accumulation of this power of affo- 
ciation increafes the action of the capillaries, and thus induces 
inirritative fever. 
7. When any part of the fyftem aefts very violently in fevers, 
the fenforial power of fenfation is excited, which increafes the 
affions of the moving fyftem : whereas the pain, which arifes 
from decreafed irritative motions, as in hemicrania, feems to ex- 
hauft a quantity of fenforial power, without producing or in- 
creafing any fibrous aflions. 
When the ftomach is primarily afle6led,as in inirritative fevers 
from contagion, and in fuch a manner as to occafion pain, the 
action of the capillaries feems to be increafed by this additional 
fenforial Sup. I. 16. 7. 
THEORY OF FEVER. 
505 
fenforial power of fenfation, whence extenfive inflammation of 
mortification ; but when the ftomach and confequently the heart 
and arteries continue their torpidity of action ; as in confluent 
fmall-pox, and fatal fcarlatina ; this conftitutes fenfitive inirri- 
tative fever, or typhus gravior. 
But when the ftomach is fecondarily affected, if the fenforial 
power of fenfation is excited, as in pleurify or peripneumony, 
the ailions of the heart and arteries are violently increafed, and 
of all the moving fyftem along with them. Thus the peripneu- 
mony is generally induced by the patient refpiring very cold air, 
and this cfpecially after being long confined to warm air, or af- 
ter being much fatigued and heated by exceflive labour or exer- 
cife. For we can cover the fkin with more clothes, when we 
feel ourfelves cold ; but the lungs 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 proportion to the previous ex- 
penditure of fenforial power by heat or exercife* 
This torpor of the lungs affects the fkin with (Ruddering, and 
the ftomach is alfo fecondarily aftetfted ; next follows the violent 
action of the lungs from the accumulation of the power of irri- 
tation, and an inflammation of them follows this violent action. 
While the ftomach recovers its activity by the increafe of the 
excitement of the fenforial power of aflbciation, and along with 
it the heart and arteries, and the whole moving fyftem. Hence 
this inflammation occurs during the hot fit of fever, and no cold 
fit fucceeds, becaufe the excefs of the fenforial power of fenfa- 
tion prevents a fucceeding torpor. 
Thefe new motions of certain parts of the fyftem produce in- 
creafed 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 pro- 
ducing fimilar actions and effects, with or without fever, as in 
the fmall-pox and meafles, or in the itch and venereal difeafe. 
If any of thefe contagious matters afleft the ftomach with tor- 
por either by their ftimulus immediately applied, or by its fyma 
pathy with the parts firft difeafed, a fever is produced with fick- 
nefs and want of appetite ; as in fmall-pox, and fcarlatina. If 
the ftomach is not affected by contagious matter, no fever fuc- 
ceeds, as in itch, tinea, fyphilis. 
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 oxy- 
gene, and thence to become fome kinds of animal acids. As 
Vol. II. R r r the 506 
THEORY OF FEVER. 
Sup. I. 16. 8. 
the preparations of mercury cure venereal ulcers ; as a quarter 
of a grain of fublimate diflblved in wine, and given thrice a 
day ; this effect feems to be produced either by its {Emulating 
the abforbents in the ulcer to abforb the venereal matter before 
it has acquired oxygene ; or by afterwards uniting with it chem- 
ically, and again depriving it of its acquired acidity. On either 
fuppofition it might probably be given with advantage in fmall- 
pox, and in all infectious difeafes, both previous to their com- 
mencement, and during their whole progrefs. 
8. The cold fits of intermittent fevers are caufed by the tor- 
por of fome part owing to deficient irritation, and of the other 
parts of the fyftem from deficient afibciation. The hot fits are 
owing firft to the accumulation of irritation in the part prima- 
rily afi'ecTed, if it recovers its aClion, which does not always hap- 
pen ; and fecondly to the accumulation of afibciation in the oth- 
er parts of the fyftem, which during health are fubjeCt to per- 
petual a&ion; and laftly alfo to the greater excitement of the 
power of afibciation, when the part primarily afi'eCtcd recovers 
its irritability, and adds with greater energy than natural. 
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 aClion. The thirft in the cold fit is 
owing to the deficient abforption from the fkin, cellular mem- 
brane, and bladder; the thirft in the hot fit is owing to the too 
great diftipation of the aqueous part of the blood. The urine 
is pale and in fmall quantity in the cold fit from deficient fecre- 
tion of it, and from deficient abforption of its aqueous parts ; it 
is high coloured, and fometimes dcpofits a fediment, in the hot 
fit from the greater fecretion of it in the kidneys, and the great- 
er abforption of its aqueous and falinc part in the bladder. The 
drynefs and fcurf on the tongue and noftrils are 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 appear in confequence of the declenfion of the hot fit, 
owing to the abforbent veflels of the Ikin lofing their increafed 
a&ion fooner than the fecerning ones ; and to the evaporation 
leflening as the fkin becomes colder. The returns of the par- 
oxyfms are principally owing to the torpor of fome lefs efl'cntial 
part of the fyftem remaining after the termination of the laft fit; 
and are alfo dependent on folar or lunar diurnal periods. 
The torpor of the part, which induces ths cold paroxyfm, is 
owing to deficient irritation occafioned either by the fubdu&ion 
of the natural ftimuli of food, or water, or pure air, or by de- 
ficiency of external influences, as of heat, or of folar or lunar 
gravitation. Or fecondly, in confequence of the exhauftion of 
fenforial Sup. I. 16. 9. 
THEORY OF FEVER. 
507 
fenforial power by great previous exertions of fome parts of the 
fyftem, as of the limbs by 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 me- 
chanic injury, as by a compreflion of the nerves of the part, or 
of their origin in the brain ; as the fitting long with one leg 
eroded over the other occafions numbnefs, and as a torpor of 
the ftomach with vomiting frequently precedes paralytic ftrokes 
of the limbs. 
As deep is produced, either by defeat of ftimulus, or by pre- 
vious exhauftion of fenforial power; fo the accumulation of the 
fenforial power of volition in thofe mufcles and organs of fenfe, 
which are generally obedient to it, awakens the deeping perfon ; 
when it has increased the quantity of voluntarily fo much as to 
overbalance the defect of ftimulus in one cafe, and the exhauf- 
tion of fenforial power in the other; which latter requires a 
much longer time of deep than the former. So the cold par- 
oxyfm of fever is produced either by defeat of ftimulus, or by 
previous exhauftion of the fenforial power of fome part of the 
fyftem ; and the accumulation of the fenforial power of irrita- 
tion in that part renews the action of it, when it has increafed 
its irritability fo much as to overbalance the defebt of ftimulus in 
one cafe, and the exhauftion 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 fyftem from defeat of irritation, the remainder of it 
becomes torpid owing to defebt of excitement of the fenforial 
power of adbeiation by the leffened adtion of the part firft affect- 
ed. This torpor of the general fyftem remains, till the accumu- 
lation of the fenforial power of adbeiation has increafed the af- 
fociability fo much as to overbalance the defect of the ex- 
citement of adbeiation; then the torpor ceafes, and if the firft 
affected part has recovered its activity, the other parts are all 
thrown into excefs of action by their increafed adbeiability, and 
the hot fit of fever is produced. 
9. In the continued fevers with ftrong pulfe the ftomach is 
affebted fecondarily, ami thus a<fts feebly from deficient excite- 
ment of the power of adbeiation ; but the accumulation of the 
power of adbeiation thus produced in an organ fubjebt to per- 
petual and energetic action, is fo great as to affebt the next link 
of the afibciate train, which confifts of the heart and arteries ; 
thefe therefore are exerted perpetually with increafe of abtion. 
In continued fevers with weak pulfe the torpid ftomach is af- 
fected 508 
THEORY OF FEVER. 
Sup. I. 16. 9. 
fedted primarily by previous exhauftion of its irritability by ftim- 
ulus, as of contagious matter fwallowed into it. The heart and 
arteries aft 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 fubjedl to perpetual and energetic mo- 
tion, is fo great, as to affe<ft the next link of the aflbciate train ; 
■which confifts of the capillaries of the fkin or other glands ; thefe 
therefore are exerted perpetually with great increafe of action. 
The continued fevers with flrong pulfe terminate by the re- 
duction or exhaullion of the fenforial power by violent aClion 
of the whole fyftem ; which is followed either by return of 
health with the natural quantity of irritability, and of aflbciabil- 
ity, or by a total deltruCtion of them both, and confequent 
death. 
In continued fevers with weak pulfe the flomach remains 
torpid during the whole courfe of the fever ; and at length by 
the recovery of its irritability and fenfibility effects the cure of 
jt. Which generally happens about the firft, fecond, or third 
quarter of the lunar period, counted from the commencement 
of the difeafe, or continues a whole lunation, and fometimes 
more ; which gave rife to what are termed critical days. See 
SeCt. XXXVI. 4. on this fubjedl. If the flomach does not re- 
cover from ifs torpor, the patient becomes emaciated, and dies 
exhaufted by the continuance of the increafed aClion of the ca- 
pillaries and abforbents, and the want of nourifhment. 
The cure of continued fever with weak pulfe confifts firft in 
■weakening the undue aClion of the capillaries of the fkin by ab- 
lution with cold water from 32 to 80 degrees of heat; or by ex- 
pofing them to cool air. Secondly by invigorating the actions 
of the flomach, by deertafing them for a time, and thence ac- 
cumulating the power of irritation, as by an emetic, or by iced 
■water, or iced wipe. Or by increafe of flimulus, as by bark, 
wine, opium, and food, in fmall quantities frequently repeated. 
Or by renewing the aflion of the flomach by flight eledlric 
fhocks. Or by fomenting it frequently with water heated to 96 
or 100 degrees. Or laflly by exciting its power of aflbciation 
with other parts of the fyftem, as by a blifter ; which fucceeds 
belt vi hen the extremities arc cool; or by fwinging, as in verti- 
go rotatoria. 
If by the flimulus of the Peruvian bark on the fibres of the 
flomach, they regain their due acSlion, the heart and arteries alio 
regain their due ablion ; as their fenforial power of aflbciation 
is now excited, and expended as ufual. And as there is then 
no accumulation of fenforial power in the heart and arteries, the 
capillaries Sup. I. 16. 10. 
THEORY OF FEVER. 
509 
capillaries ceafe to aft with too great energy, and the fever is 
cured. 
Thirdly. If the heart and arteries could be themfelves Sim- 
ulated into greater aftion, although the ftomach remained tor- 
pid, 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 podioly be only 
different modes of aftion of the fpirit of animation,) and thus 
the too great action of the capillaries might be prevented and 
the fever ceafe. This new mode of cure might poffibly be ac- 
compliffied, if the patient was to breathe a gallon or two of pure 
or diluted oxygene gas frequently in a day ; which by palling 
through the moift membranes of the lungs and uniting wi h the 
blood might render it more ftimulant, and thus excite the heart 
and arteries into greater aftion. 
Fourthly". Greater energy might probably be given to the 
whole fyftem, and particularly to thole parts which aft too fee- 
bly in fevers, as the ftomach and the heart and arteries, if the 
aftion of the fecerning veffels of the brain could be increafed in 
energy ; this is probably one effeft*of all thofe drugs, which 
when given in large quantity induce intoxication, as wine and 
opium. And when given with great caution in fmall quanti- 
ties uniformly repeated, as from three drops to rive of the tinc- 
ture of opium, but not more, every fix hours, I believe they fup- 
ply an efficacious medicine in fevers with great arterial debility; 
and the more fo, if the Peruvian bark be exhibited alternately 
every fix hours along with them. There are other means of ex- 
citing the veffels of the brain into aftion; as firft by decreafmg 
the Itimulus of heat by temporary cold fomentation ; fecondly, 
increafmg the Itimulus of heat by long continued warm fomen- 
tation ; thirdly, by eleftricity, as very fmall fhocks paffed through 
it in all directions ; and laftly by blifters on the head. All thofe 
require to be ufed with great caution, and efpecially where there 
exilts an evident ftupor, as the removing of that is I believe fre- 
quently injurious. See ftupor, Clafs 1. 2. 5. 10. 
'Fhe cure of fever with ftrong pulfe confifts in the repeated 
ufe of venefeftion, gentle cathartics, diluents ; medicines pro- 
ducing ficknefs, as antimonials, digitalis ; or the refpiration of 
carbonated hydrogen ; or by refpiration of atmofpheric air low- 
ered by a mixture of hydrogen, azote, or carbonic acid gas, or 
by compreffing the brain by whirling in a decumbent pofture, 
as if lying acrofs a horizontal mill-ftone. See the former parts 
pf this fupplement for the methods of cure both of fevers with 
lliong and weak pulfe. 
io. When any difficulty occurs in determining the weak 
pulfe 510 
THEORY OF FEVER. 
Sup. I. 16. to. 
pulfe from the ftrong one, it may generally be aflafted by count- 
ing its frequency. 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 
feldoms exceeds 118 or 120 in a minute ; and the weak pulfe 
is generally not much below 130, and often much above that 
number ; except where a patient has naturally a pulfe flower 
than ufual in his healthy ftate. 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 pulfations in a minute, which does not 1 believe occur in the 
ftrong pulfe, when the patient has refted himfelf after the exer- 
tion of riling. 
I (hall here infert a remark on the general ufe of ftimulating 
materials, whether medicinal or culinary, to counteract or pre- 
vent debility. When a ftimulating material is exhibited, as the 
Peruvian bark, or opium, or wine ; it fhould be continued but 
a certain time, as half a lunation, or a whole lunation. If the 
whole fyftem be ftimulated into increafed exertion, as by wine 
or opium, there appears to be a temporary increafed fecretion of 
fenforial power in the brain, fo long as this ftimulus affects the 
fyftem. If a part only of the fyftem be ftimulated, as by the 
exhibition of fpiccs, efl'ential oils, or bitter medicines, or metal- 
lic ones, then the ftimulated organ has derived to it a greater 
quantity of fenforial power, or a greater fecretion of it is pro- 
duced in that part of the brain, where the ftimulated nerves 
arife. Which is probably owing to the fympathy of the ftimu- 
Fated extremity of every nerve, or its organ of fenfe, with the 
other extremity of it in the brain, in the fame manner as when 
the excretory du eft of a gland is ftimulated, a greater fecretion 
is produced in the body of it, as when the dufts of the lacrymal 
glands in the eyes, or of the falivary glands in the mouth are 
ftimulated by duft or acrid materials. 
Now if a ftimulating medicine be given at certain intervals of 
time, as the Peruvian bark or wine in fevers, the increafed ac- 
tion of a part or of the whole fyftem foon becomes a link of 
the aflbeiated circle of diurnal actions, and may be faid to be- 
come habitual. 
'Fhe quantity of the ftimulating medicine may then be dimin- 
ifhed, and yet the increafed activity of the fyftem will continue \ 
becaufe the increafed exertions are now produced partly by the 
fenforial power of aflbeiation, as they are become a part of the 
diurnal circle of aeftions. And finally the ftimulating medicine 
may be totally omitted, and yet the increafed activity of the fyf- 
tem continue for the fame reafon. 
On Sup. I. 17. 
THEORY OF FEVER. 
511 
On this circumflance depends the power of the bitter medi- 
cines, as the bark, and other (Emulating materials, as beer and 
wine, in preventing the returns of the cold paroxyfmsof fevers, 
and in flrengthening the fyltem, which increafe of irritability, 
that is of (Irength, continues after the ufe of the medicine is 
withdrawn. 
But on the contrary, if the (Emulating material be continued 
much longer than one lunation, the whole fyftem, or the (Emu- 
lated organ alone, is excited into too forcible aftion by the two 
fenforial powers of irritation, and of affociation ; and confe- 
quently in procefs of time lofes in foine degree both its irrita- 
bility and its allbciability ; and inactivity or torpor fucceeds ; 
which conftitutes weaknefs, as is feen in all thofe, who accuf- 
tom themfelves to dram-drinking. 
Hence wine or opium, or Peruvian bark, may be continued 
twice or four times a day for half a lunation, or for a whole 
one with advantage in difeafes of debility, for the purpofe of 
gaining both diurnal and monthly affociations of activity. But 
(hould not be much longer continued ; as a confequent debility 
will then be liable to fucceed. 
XVII. Conclujion. 
Thus have I given an outline of what may be termed the 
fympathetic theory of fevers, to diftinguiih it from the mechan- 
ic theory of Boerhaave, the fpafmodic theory of Hoffman and 
of Cullen, and the putrid theory of Pringle. What I have 
thus delivered, I beg to be confidered rather as obfervations and 
conjectures, than as things explained and demonftrated ; to be 
confidered as a foundation and a fcaffolding, which may enable 
future induftry to erect a folid and a beautiful edifice, eminent 
both for its fimplicity and utility, as well as for the permanency 
of its materials,-which may not moulder, like the ftructures 
already erected, into the fand of which they were compofed ; 
but which may (land unimpaired, like the Newtonian philofo- 
phy, a rock amid the wafte of ages 1 
END OF THE SECOND PART 
LINES, LINES, 
TO BE FLACED AT THE END OF 
Z O O N O M I A. 
BE A FRIEND. 
J AM QUE OPUS EXEGI. 
The work is done !-nor Folly's active rage, 
Nor Envy's felf, fhall blot the golden page ; 
Time fhall admire, his mellowing touch employ, 
And mend the immortal tablet, not deftroy. 
ZOONOMIzE auctori 
S. P. D. 
AMICUS. 
CURRUS TRIUMPHALIS MEDICINE. 
Currus it Hygcias, Medicus movet arma triumphans, 
Undique vida fugit lurida turma mail. 
Laurea dum Phcebi viridis tua tempora cingit, 
Nec mortale fonans Fama coronat opus ; 
Poft equitat trepidans, repetitque Seneftus in aurem, 
Voce canens ftridula, " fis memor ipfe mori !" INDEX 
TO THE 
CLASSES OF PART SECOND* 
A A. 
BORTION, i. 2. 1. 14. 
from fear, iv. 3. 
1. 7. 
not from epilepfy, 
iii. 1. 1. 7. 
not from hepati- 
tis, ii. 1.2. 12. 
Abforption of folids, i. 2. 2. 14. 
of matter, ii. 1. 6. 2. 
and 6. 
cellular, iv. 1. 1.6. 
from the lungs, iv 3.1. 
5. Suppl. i. 8 6. 
Abftinence of young ladies, ii. 2. 
Accumulation of feces, ii. 2. 2. 7. 
Acupun&ure, iii. 1. 1. 8. 
Adipfia, ii. 2. 2. 2. 
^Egritudo ventriculi, i. 2. 4. 4. 
See Sicknefs. 
Agripnia. See Vigilia. 
Ague cakes, Suppl. i. 2, 3. 
Alum in ulcers of the mouth, ii. j. 
3. 1. ii. 1. 6. 16. 
Ambition, iii. 1. 2. 9. 
Amaurofis, i. 2. 5. 5. 
Anafarca of the lungs, i. 2. 3. 16. 
Aneurifma, i. 2. 1. 18. 
Anger, iii. 1. 17. 
tremor of, iv. 2. 3.4. 
blulh of, iv. 2. 3. 5. 
Angina. See l onfilhtis. 
pedoris. See Aflhma 
painful. 
Anhelitus, ii. 1. 1.4. 
Anhelatio fpafmodica, i. 3.3. 3. 
Annulus repens, ii. 1. 5. 10. 
Anorexia, ii. 2. 2. 1. 
maniacalis, Suppl.i-14. 3. 
epileptica, ii. 2. 2. i- iii. 
. ii-7- 
Apepfia, 1. 3. 1.3. Suppl. i. 8. u. 
Aphtha, ii. 1. 3. 17. 
Apoplexy, iii. 2. 1. 16. 
Appetite defective, ii. 2. 2. 1. 
depraved, iii 1. 2. 19. 
from abflinence,ii. 2.2. t. 
Vol. II. Ssf 
Appetite deftroyed, iii. i- 2. 20. 
from epilepfy, ii. 2. 2. i> 
Arm, pain of iv 2. 2 13. 
palfy of, iii. 2.1.4 
Arfenic in tooth-ach, i. 2. 4.12. 
in head-ach, i. 2. 4. 11. 
Arthrocele, ii 1. 4. 17. 
Arthropuolis, ii. 1. 4- 18. 
Arthritis. See Gout. 
Afcarides, i. t. 4. 12. iv. r. 2. 9. 
iv. 2, 2. 6. 
Afcites, i. 2. 3. *3. 
Aflbciations affected four ways, iv. 
1. 1. G 
how produced, iv. 1. 
1. H. 
diftinft from catena^ 
tions iv 1. 1. A. 
Aflbciations, three kinds of, iv. 1. 
1. B. 
tertian, iv 1. r. K. 
of the fauces and pu- 
bis, iv. 1 2. 7. 
fenfitive, a law of, iv. 
2. 2. 2.t 
fenfitive, iv. 2. 1. 
accumulates, Suppl. i. 
8 3. i. 11.4 
Aflhma humoral, ii. 1. 1. 8. i. 3. 
2 8 
of infants, i. t. 3.4. 
convulfive, iii. 1 1. 10. 
painful, iii. 1. 1. n. 
Auditus acrior, i. 1. 5. 2. 
imminutus, i. 2. 5. 6. 
Azote, Suppl. i. 9. 3 i 11. 4. 
fceptiC, ii. 1. 6. 6. 
B. 
Bandages, ill effect of, ii. 1. 1. 12. 
promote abforption, i. 1. 
3- J3- . 
in gout, iv. 1. 2. 15. 
in rheumatilm, iv. 1. 2. 
16 
in hemicrania, iv. 2 2.8. 
in epilepfia, iii. 1. 1. 7. 
Bath, 514 
INDEX TO THE CLASSES.-Part II. 
Bath, cold, i. 2. 2. j. Suppl. r. 
14. 3; 
warm, i. 1. 2. 3. 
Beauty, iii. 1 2 4. 
lofs of, iii. 1-2. 12. 
Bile-du^t, pain of, iv. 2. 2. 4. 
Bile cryftallized, i. 1.3. 8. 
Bitter tafie, i. 1. 3. 1. 
not from bile, i. 1.3.1. 
Bleeding. See Haemorrhage. 
Bladder, diftention of, ii. 2. 2. 6. 
fione of, i. 1.3. xq. 
catarrh of, ii. 1.4. ri. 
Blindnefs, i. 2. 5. 5. 
Blufh of anger, iv. 2. 3. 5. Suppl. 
i. 12. 7. 
of guilt, iv. 2. 3.6. Suppl. i. 
12. 7. 
Bones, innutrition of, i. 2. 2. 14. 
caries of, ii. 1. 4. 19. 
Borborigmus, i. 3. 1. 9. 
Bougies, ii. 14. it. 
Bowels, gurgling of, i. 3. 1. 9. 
Brachiorum paralyfis, iii. 2. 1.4, 
Brain fiimulated, Suppl. i. 16. 9. 
Bronchocele, i. 2. 3. 20. 
Broth, i. 2. 4. 8. 
Burns, i. 1. 3. 13. 
Butterflies, experiment on, i. 1. 
2. 3. 
Buxton bath feels warm, Suppl. i. 
16. 
C. 
Cacofitia, iii. 1. 2, 20. 
Calculi produftio, i. 1. 3. 9. ii. 1. 
2. 14. 
renis, i. 1. 3. 9. iv. 2. 3. 3. 
velicae, i. 1.3. 10. iv. 2. 2. 2. 
Callico fiiirts, i. 1.2. 3. 
Callus, i. 2. 2. 12. 
Canities. See Hair grey. 
Calor febrilis, i. 1. 2. 1. 
Calves fed on gruel, i. 1. 2. 5. 
hydatides of, i. 2. 5. 4. 
Cancer, ii. 1. 4- 16. ii. 1. 6. 13. 
Cantharides, large dofeof, iv. 2.2. 2. 
Carbonic acid gas, Suppl. i. 9. 3. 
Cardialgia, i. 2. 4. 5. 
Carcinoma, ii. 1. 4. 16. ii. 1.6. 13. 
Caries oflium, ii. 1. 4. 19. 
Cataraft, i. 2. 2. 13. 
Catarrh, warm, i. 1. 2. 7. 
cold, i. 2. 3. 3. 
lymphatic, i. 3. 2. 1. 
fenhtive, ii. 1. 3. 5- 
epidemic, ii. 1.3.6. 
of dogs and horfes, ii. 1. 
3- 6. 
from cold (kin, iv. 1. 1. 5. 
periodic, iv. 3. 4. 1. 
Catamenia, i. 2. x. 10. iv. 2. 4. 7. 
Catalepfis, iii. 2. 1. 9. 
Cats, mumps of, ii. 1. 3. 4. 
Cephalaea fympathetica, iv. 2. 2. 7. 
idiopathica, i. 2. 4. it. 
fomniofa, i. 2. 4. n. 
Cefarian operation, i. 2. 2. 14. 
Charcoal tooth-powder, i. 2. 4.12. 
Cheek, torpor of, iv. 2. 2. 1. 
Chicken-pox, ii. i. 3. 15. 
Chin-cough, ii- 1. 3. 8. 
Child-bed fever, ii- 1. 6. 16. 
Children, new-born, ii. 1. 1. 12. 
gripes and purging of, i. 
1 2. 5- 
Chlorofis, i. 2. 3. 10. Suppl. 18 11. 
Chorea St. Viti, iv. 2. 3. 2. 
Citta, iii- •. 2. 19. 
Clamor, iii. i. 1. 3. 
Clavicular animals, ii. 1. 2. 6. 
Clavus hyftericus, iv. 2. 2. 8. 
Claudicatio coxaria, i. 2 2. 17. 
Cold in the head. See Catarrh. 
Cold air in fevers, iii. 2. x- 12. iv. 
2. 4. ii. 
effects of, iii. 2 1. 17. 
how to be ufed, iv. 1. 1. 4. 
death from, iii. 2. 1. 17. 
Colic, flatulent, i 2. 4 7. 
from lead, i. 2. 4 8. 
hyfteric, i. 2. 4. 7. iii. 1.1. 8. 
Compaflion, iii- 1. 2. 24. 
Confumption, ii. x. 6. 7. 
Convullion, iii 1. 1. 5. 
weak, iii. r. 1. 5. 
from bad air, iii. /. r- 5. 
painful, iii- 1. 1. 6. iv. 
2. 4. 5. 
Confirmation, i. 1. 5. 12. 
Conftipation, i. 1. 3. 5. ii. 2. x. 7. 
Contagious matter of two kinds, ii. 
i- 3 
is oxygenated, 
•i- i- 5- 
produces fever, 
how, Suppl. i. 
16. 7. 
deftroycd by ni- 
trous vapour, 
ii 1. 3- 
defiroyedby ful- 
phurous va- 
pour, ii. 1. 3. 
Cornea to perforate, i. 1. 3. 14. 
fears of feen on milk, i. 1. 
3- 
Corpulency, i. 2. 3. 17, 
Coryza. See Catarrh. 
Cofiivenefs, i. 1. 3. 5. ii. 2. 1. 7. 
Cough of drunkards, ii. x. 1. 5. 
hooping, ii. 1.3.8. 
hepatic, iv. 2. 1. 8, 
gouty, iv. 2. 1. 9. 
Cough INDEX TO THE CLASSES.-Part II. 
515 
Cough periodic, iv. 2. 4 6. iv. 3. 
4-2- : . 
from cold feet, iv. 2. 1. 7. 
Cows, peftilence of, ii. 1. 3. 13. 
bloody urine of, ii. 1.3. 13. 
fwelled by clover; ii. 1. 7. 
Cow-pox, ii. 1. 3.9. 
Crab-lice, i. 1.4. 14. 
Cramp, iii. 1. i- 13. 
painful, iii. 1. 1. 14. 
in diarrhoea, iv. 1. 2. 10. 
Crapula ventriculi, ii. 1. 1. 7. 
Credulity, iii. 2. 2. 4. 
Crines novi, i. 1. 2. 15. 
Croup, i. 1. 3 4 ii i - 2.4. ii. 1. 3.3. 
Crulta iaCtea, ii. 1. 5. 12. 
Cutis arida, i. 1.3. 6. 
Cynanche. See Tonfillitis. 
parotidaaa. See Parotitis. 
D. 
Darknsfs in fevers, i. 2. 5. 3. 
Deafnefs, two kinds of, i. 2. 5.6. 
Debility, three kinds of, i. 2. 1. 
Debility and llrength metaphors, i. 
2. 1. 
Deculfation of nerves, iii. 2, t. 10. 
Deglutition, ii. 1. 1. 1. 
involuntary, iv. r. 3.1. 
Delirium febrile, ii. 1. 7. 1. 
of drunkennels, ii. 1. 7. 3. 
maniacal, ii. 1.7.2. 
in parotitis, iv. 2. 1, 19. 
Dentition, i- 1. 4. 5. 
Dentium dolor a ftridore, iv. 1.2.3. 
Defcent of the uterus, i. j. 4. 8. 
Diabetes, i. 3. 2. 6. 
foul tongue in, i. 1. 3 1. 
irritative, iv. 3. 1, 1. 
from fear, iv. 3. 13. 
Diarrhoea warm, i. 1. 2. 5 
of infants, i 1. 2. 5. 
lymphatic, i- 3. 2. 4. 
cny liferbus, i. 3. 2. 5. 
cold, i. 2. 3 6. 
rheumatic, iv. 2. 1. 16. 
from fear, iv. 3. 1. 4. 
from toothing, iv. 2. 2.14. 
in fevers, Suppl. i 2 4. 
cure of, iv. i 1. F. 
Bigeftionincreafedby cold,iv.t.1.4. 
decreafed by cold, iv. 1. 2. 
5- 1 
Digitalis in rheumatifm, iv. 1. 2. 16. 
Diluents, ufe of, ii- 1. 1. 1. 
Diftention of the nipples, ii. 1. 7. 
10. iv. 1. 2 7. 
Diuretics ufelefs in dropfy, i. 1.3-7. 
Dizzinefs. See Vertigo. 
Dogs, catarrh of, ii. 1.3 6. 
Dolor digiti fympathet. iv. 2.2. 12. 
ductus choledochi, iv. 2.2.4. 
Dolor humeri in hepatidite, iv. 2. 2. 
9- . . 
phary ngis ab acido, iv. 2. 2. 5. 
tedium nephriticus, iv. 2. 2. 
11. 
urens, i. 1. 5. jo. 
Dracunculus, i. 1. 4. 13. 
Dreams, ii. 1.7.4- 
Dropfy of the brain, i. 2. 3. 12. 
of the belly, i. 2. 3. 13. 
• of the che/t, 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. 
Dy/menorrhagia, i. 2. 1. 12. 
Dyfpepfia, i. 3. 1. 3. 
a frigore, iv. 2. 1. 6. 
Dyfpnoea from cold bath,iv. 2.1.5. 
rheumatica, iv. 2. 1. jS. 
Dyfuria infenfitiva, ii. 2. 2. 6. 
paralytica, iii. 2. 1. 6. 
E. 
Ears, difcharge behind, i. 1. 2. 9. 
noife in them, iv. 2. 1. 15. 
Ear-ach, iv. 2. 2. 8. 
Ebrietas, i. 1. 1. 2. 
Education, iii. 2. 1. 8. iii. 1.2 24. 
iii. 1. 2. 11. 
heroic, iii. 1. 2. 25. 
Egg boiled for enflamed eyes, ii. r. 
4. 1. 
boiled fooneft, Suppl. i. 7. 
life of, iv. 1. 4 1. 
Electric Chocks, iv. 1.4 5. 
in paralyfis, iii. 2.1. 10. 
in fcrofula, i. 2. 3. 21. 
in hoarfenefs, iii. 2. 1. 5. 
Electrized zinc and filver, i. 2. 5. 
5. iv. 2. i. ti. 
Empyema, ii- 1. 6 4. 
Ennui, iii. 1. 2 11. iii. 2. 1. 8. 
Enteralgia rheumatica, iv. 1. 2. 16. 
Enteritis, ii. I. 2. n, 
fuperficialis, ii 1. 3. 20. 
Epilepfy, iii. I- 1. 7. iv. 3 1. 6 
painful, iii. 1. i- 8. iv. 2. 
4- 4. 
terminates with deep, iii. 
1. 1. 
in parturition, iii. 1. 1. 7. 
with digettion, ii. 2. 2. 1. 
Epiftaxis. See Haemorrhagia. 
Epoulofis. See Cicatrix. 
Erotomania, iii. 1. 2. 4. 
EruCtation, voluntary, iv. 3. 3. 3. 
Eruption of fmall-pox, iv. 2. 1. u. 
iv. 2. 2. 10. 
Erylipelas, iv. 1, 2. 17. ii. 1 3 2. 
iv. 2. 4. io. 
Erylipelas 516 
INDEX TO THE CLASSES.-Part II. 
Eryfipelas feldom fuppurates, why, 
ii 1. 3; 2 
Efuries, i 2. 4 2. 
Ether, to purify, i- 2. 5 6. 
Evil, i 2 3. 21. 
Expectoration, warm, i. 1. 2. 8. 
folid, i. 1. 3. 4. 
cold, i. 2 3 4. 
Exfudation behind the ears, i. 1. 
2> 9- 
Eyes, blue under the, i. 2. 2. 2- ii. 
1. 4. 4. 
Eye-wing, ii. 1. 4. 2. 
Eye lids, red, ii. 1 4 3. 
Eyelid inverted, cure of, ii- I-1- 8. 
coloured with antimony, ii. 
.1 4. 3. 
Excoriations, iii. 2. 1. to. 
F. 
Face, pimpled, ii. 1 4. 6. 
red after meals, Suppl. i. 12. 
7 
fluflied after dinner, iv 1.1. f. 
Fat people why fhort breathed, ii. 
1.14. 
how to reduce, i. 2. 3.17. 
Fear, fyncope from, i 2. 1 4. 
aboition from, iv 1. 3 7. 
produces abforption, ii. 1.6.4. 
palenefs in, iv. 1 3 5. 
of death, iii. 1 2 14. 
of hell iii. 1 2 15. 
of poverty, iii. 1 2 13 
Feet cold produces heartburn. 
Suppl. i. 8. 5. 
fetid, i 1. 2. 14 
cold in fmall-pox, iv. 2. 2. 
10. 
Fevers, five kinds, ii. 1. 2. Suppl. 
i. 1 2. 
irritative, i. 1.x.1. iv. 1. 1. 
8. 
inirritative, i 2. 1. 1. iv. 2. 
1. 19. suppl. i. 1. 2. 
fenfitive, ii 1. 5 1. 
fenfitive irritated, ii. 1. 2.1. 
fenhtive inirritated, ii. 13. 
I. 
intermit, why, Suppl. i. 
continue, why, Suppl. i. 
periods of, iv 2 4 11. 
fimple, Suppl i x. 
compound, ouppl i- 2. 
termination of cold fit, 
Suppl- i- 3. 
return of cold fit, Suppl. i. 3. 
fenfation in, Suppl i 5. 
ci rcles of motions in, Suppl. 
i. 6. 
cold and hot fits, Suppl.i.7. 
continued, Suppl i. 8. 
Fevers, torpor of lungs in, Suppl. u 
9- I- 
not determinable in cold 
fit, i. ». 1.1. 
frequency of pulfe in, i. i. 
i- i. 
not an effort to cure, i. x. 
•• 3 
from enclofed matter, ii. 
x. 6. 2. 
from aerated matter, ii. x. 
. 6. 6- 
from contagious matter, ii. 
i. 6. ii. 
from contagious fanies, ii. 
I. 6. 15- 
puerperal, ii. i. 6. 16. 
torpor of the ftomach in. 
Suppl- i- ia. 
cafe of, Suppl. i. 13 
terin; nation of, Suppl i. 14. 
inflammation excited in, 
Suppl i 15. 
returns of, Suppl i. 4. 
when cold air in, Suppl. i. 
2. 2 
fympathetic, theory of, 
Suppl i. 
duration of explained, 
Mippl i. 2. 5. 
Fingers, playing with, iv. 1. 3. 4. 
pain of, iv 2. 2. 12. 
Fire, animal, iv. 1 4. 5. 
Filh live longer with injured brain, 
i. 2. 5. io. 
Fiftuia in ano, ii. 1.4. xo. 
lacrymalis, ii. 1 4- 9. 
in urethra, ii. 1.4- 11. 
Flannel ihirt in diarrhoea, iv. 1.1. 3. 
injurious in fummer, 
i. 12. 3. 
Fluor albus warm, i. x. 2. 11. 
cold, i. 2. 3. 7. 
Frigus febrile, i. 2 2. 1. 
chronicum, i. 2. 2. 2. 
lethale, iii. 2. 1. 17. 
G. 
Galvanifm, i. 2. 5. 5. iv. 2. 1. 11. 
Gall-ftone, i. 1. 3 8. 
Gangrene, ii. 1. 6. 17. 
Gargles, ii. 1. 3. 3. 
Gaflritis, ii. 1. 2. 10. 
Gallritis fuperficialis, ii. 1. 3. 19. 
Genu tumor albus, i. 2. 3. 19. 
Gleet. See Gonorrhoea. 
Globus hyltericus, i. 3. 1. 7. 
Gonorrhoea warm, i. i 2. io. 
cold, i. 2. 3. 8- 
venereal, ii- 1. 4. 1. 
Gout, iv. 1. 2 15. iv. 2.4. 9. 
of the liver, ii. 1. 1. 7. 
Gout, INDEX TO THE CLASSES.-Part IT. 
517 
Gout, cafes of, iv. 1. 2. 15. 
cough, iv. 2. 1. 9. 
of the ftomach, i. 2. 4. 6. 
haemorrhage in, i. 1. 1. 4. 
Grace defined, iii. 1. 2 4. 
Gravel diftinguifhed from faits, i. 
1. 3. 9 
Gravitation, iv. 2. 4. 
Green-ficknefs. See Chlorofis. 
Grief, iii x. 2. 10. 
Gripes of children, i. 1, 2. 5. iv. 2. 
«• 3- 
Guftus acrior, i. 1. 5. 4. 
imminutus, i. 2, 5. 8, 
Gum, red, i. 1. 2. 3. ii. 1. 3. 12. 
Gutta rolea, ii. 1. 4. 6. iv. 1.2. 13. 
and 14. 
ferena, i. 2. 5. 5. 
H. 
Haemorrhage arterial, i. 1. 1. 3. 
of the lungs, i. 1. 1. 
4- 
of the nofe, i. 1. 1. 
5- 
venous, i 2. 1.5. 
of the rehtum, i. 2.1. 
6. 
of the kidnies, i. 2. t. 
7- 
of the liver, i. 2.1.8. 
Haemoptoe arterial, i.i. 1. 4. 
venous, i. 2. 1. 9. 
Haemorrhois cruenta, i. 2. 1. 6. iv. 
2. 4. 8. 
alba, i. 1. 2. 12. 
Hair, grey, i. 2. 2. 11. 
new, i. 1. 2. 15. 
white by uterine preflure, i. 
2. 2. n. 
Hallucination of fight, ii. 1. 7. 5. 
of hearing, ii. 1. 7. 
6. 
maniacal, iii. 1. 2. 1. 
Hallucinatio ftudiofa, iii. 1. 2. 2. 
Harrogate water, faftitious, i. 1 4. 
Head-ach. See Hemicrania and 
Cephalaea. 
Hearing, acuter, i. 1. 5. 2. 
diminilhed, i. 2. 5. 6. 
Heart-burn, i. 2. 4. 5. 
Heart ftimulated, Suppl. i. 11. 7. i. 
16. 9. 
Heat, animal, i. 1. 2. 1. i, 1. 2. 3. 
fenfe of acuter, i. 1. 5. 6. 
elemental, iv. 2.4. 
hedtic leflened by fwinging, 
iv. 2. 1. 10. 
not perceived by the lungs, 
iii. 1. 1. 10. 
Heat, not eftimated by thermome- 
ters, Suppl i. 7 
of the breath, Suppl. i. 2. 3. 
Hemicrania idiopathica, i 2. 4. 12. 
fympathetica, iv 2 2. 
8. iv. 2. 4. 3- suppl. 
i- »4 3 ' 
relieved by mercury, 
iv 2 2 8. 
Hemiplegia, iii 2 1. 10. 
Hepa'is tumor, i. 2. 3. g. 
Hepatitis, ii 1. 2 12. 
chronica, ii. 1. 4. 12. 
Herpes, ii. 1-5 8. 
nephritica, iv. 1. 2. u. 
Hiccough, ii 1. i.6.iv 1 1.7. 
Hip-joint injured, i. 2 2. 17. 
Hoarfenefs, ii 1. 3. 5. iii. 2. 1. 4. 
Hordeolum, ii 144. 
Hooping-cough, ii 1.3. 8. 
Hories, broken wind of, i. 2. 4. 9. 
catarrh of, ii 1.3. 6. 
Humeftation ot the body, iv. x. 4. 
7 
Hunger, i 2. 4 2. 
Hydatides in calves, i. 2. 5. 4. 
Hydrocele, i. 2 3. n. 
Hydrocephalus inter, i. 2. 3. 12. i. 
2. 5. 4. iii. 2. 1. 
10. 
from inflammation, 
i. 2. 3. 12. 
Hydrogene gas, Suppl. i 9. 3. j. 
ii- 4 
in fevers, Suppl. 
i.i 1. 6. i- 16 9. 
Hydrothorax, i. 2. 3. 14- cafe of, iv. 
2 2. 13. 
Hydro-carbonate gas, Suppl. i. g. 
1. Suppl i. 15 3. 
Hydrops ovarii, i. 2. 3. 15. 
Hydrophobia, i 3. 1. 11. iii. 1. x. 
15. iv. 1. 2 7. iv. 2. 4 11. 
Hypochondriafis, i. 2. 4. 10. 
Hylieralgia frigida, i. 2. 4. 17. 
Hyfleria, i. 3. 1. io. Suppl. i. 1. 8. 
11. 
from fear, iv. 3. 1. 8. 
from cold, iv. 3. 3 3. 
convulfionsin, iii. 1. 
I- 5- 
laughter in, iii. 1.1-5. 
Hyfteritis, ii- j. 2. 16. 
I. 
Jaftitatio, iii. r- 1. 1. 
Jaundice, i. 1.3. 8. i. 2. 4. 19. 
Rterus, i. 1. 3. 8. i. 2. 4. 19. 
Ileus, i. 3 1. 6. ii. 1.2. 11. 
Impotentia, ii- 2. 2. 3. 
Indigeftion, i. 3. 1. 3. 
Indigeftion, 518 
INDEX TO THE CLASSES.-Part II. 
Indigeftion. See Anorexia and A- 
pepfia. 
from cold feet.iv. 2. 1, 
6. Sup. i. 8. 5. 
Incubus, iii 2. 1.13. 
Infants, green ftools of, i. 1. 2. 5. 
new born, ii. 1. i. 13. 
Inflammation of the eye, ii. 1. 2. 2. 
fuperficial, ii. 1.4 1. 
of the brain, ii. 1. 2. 
3- 
of the lungs, ii. 1. 2. 
4- 
fuperficial, ii. 1. 3. 7. 
of the pleura, ii. 1. 2. 
5- 
of the diaphragm, ii. 
1. 2. 6. 
of the heart, ii. 1. 2. 7. 
of the peritoneum, ii. 
1. 2. 8. 
of the mefentery, ii. 
1. 2. 9. 
of the ftomach, ii 1. 
2. lO. 
fuper- 
ficial, ii- i. 3. 19. 
of the bowels, ii. 1.2. 
ji. 
fuper- 
ficial, ii. 1. 3- 20. 
of the liver, ii. 1. 2. 
12. 
chronical, ii. 1.4. 12. 
of the fpleen, ii. x. 2. 
13. Sup- i. 16. 6. 
of the kidnies, ii. I. 
2. 14. 
of the bladder, ii. 1. 
2. 15. 
of the womb, ii. 1.2. 
4 16, 
of the tonfils, ii. 1. 3. 
3- . . 
of the parotis, 11.1. 3. 
4- 
Inirritability of lafteals, i. 2. 3. 26. 
of lymphatics, i. 2. 3. 
27- 
of the gall-bladder, i. 
2. 4 19- 
of the kidney, i. 2.4. 
20. 
of the fpleen, Sup. i. 
16. 6. 
viciflitudes of, i. b b 
Innutrition of bones, i. 2. 2. 14. 
Inoculation, ii. 1. 3. 9. 
Infanity, quick pulfe in, iii. b I. 
from partiuition, iii. I. 2. 
from paralyfis, iii. I. 2. 
Infanity, with fever, iii. I. a. 
cure of, iii. 1. 2. 
confinement in, iii. 1. 2. 
cures other difeafes, i. 2. 3. 
16. 
Infenfibility, ii. 2. 1. 1. 
Introfufception of the inteftine, i. 
3 i- 6- 
Ira, iii. 1. 2. 17. 
Ifchias, ii. 1. 2. 18. i. 2. 4. 15. 
I (Tues, ufeof, i. 1. 2. 9. iii. 1. 1. n. 
Itch, ii. 1. 5. 6. 
Itching, i. 1. 5. 9. 
of the nofe, iv. 2. 2. 6. 
K. 
Kanguroo, i. 2. 2. 14. 
L. 
Labour, difficult, i. 2. 2. 14. 
Lachrymarum fluxus fym. iv. 1. 2. 
I. 
Lamenefs of the hip, i. 2. 2, 17. 
Laflitude, iii. 2. I. 1. 
Laughter, iv. 2. 3. 3. iii. I. I. 4. iv. 
l-3-3« 
See Rifus. 
Lead, pernicious, i. 2. 4. 8. 
Leg, one fhorter, i. 2. 2. 17. 
Lepra, ii. b 5- 3. 
Lethargus, iii. 2. 1. 14. 
Lethi timer, iii- 1. 2. 14. 
Lice, i. 1. 4- 15. 
Lientery, i. 2. 3. 6. 
Life of an egg. iv. 1. 4. 1. 
of winier-fleepers, iv. 1. 4. 2. 
Light debilitates in fevers, i. 2. 5. 
3- 
Lingua arida, i. 1.3. 1. iv. 2. 4. n 
Liver, torpor of, i. 2. 2. 6. 
tumor of, i. 2. 3. 9. 
inHamed, ii. 1. 2, 12. 
Lochia nimia, i. 2. 
Locked jaw, iii. 1. I. 13. 
Love, fentimental, iii 1. 2. 4. 
Lues venerea, ii. 1. 5- 8. 
imaginaria, iii. 1. 2. 21. 
Lumbago, ii. I. 2. 17. iii. I. 1. 1. 
cold, i. 2. 4. 16. 
Lumbricus, i- I. 4. 10. 
Lunar influence on the folids, i. 2. 
1. 11. 
Lungs, adhefions of, ii. I. 2. 5, 
wot fenfible to heat, iii. 1.1. 
10. 
Lufus digitorum invitus, iv. 1.3.4. 
M. 
Maculae vultus, i. 2. 1. 9. 
Madnefs, mutable, iii. 1. 2. 1. 
Magnetic fluid, iv. 1. 4. 5. 
Mammarum INDEX TO THE CLASSES.-Part II. 
519 
Mammarum tumor, iv. 2. 1. 19. 
Mammularum tenfio, iv. 2. 1.6. i. 
1 -4- 7- ... 
Mania mutabilis, iii- 1. 2. 1. 
Matter, variolous, ii. 1. 3. 9. 
contagious, ii. 1. 3. ii. 1. 6. 
11. 
enclofed, ii. 1. 6. 11. 
oxygenated, ii. 1. 6. 6. 
fanious, ii. 1. 6. 15. 
Meades, ii. 1. 3. io- Suppi. i. 16. 6. 
Membranes, what, iv. 1. 2. 
Menorrhagia, i. 2.1. 11. 
Mercury crude, as aclyfter, i. 3. 1. 
6. 
in colic from lead, i. 2. 4. 
8. 
in all contagions, Suppl. i. 
16. 7. 
in vertigo, iv. 1. 2. 11. 
Miliaria, ii. 1. 3. 12. 
Milk new, for children, i. 1. 2 5. 
old, induces coftivenefs, ii. 2. 
2. 7. 
Milk-cruft, ii. 1. 5. 12. 
Mifcarriage. See Abortion. 
Maeror, iii. 1. 2. 10. 
Mobility, iv. 1. 2. 
of the (kin, Suppl. 1. 7. 
Mallities oflium, i. 2. 2. 14. 
Moon, effect of, iv. 2. 4. 
Morbilli. See Kubeola. 
Mortification, ii. 1. 6. 17. iii. 2. 1. 
10. 
Morpiones, i. 1.4.14. 
Mucusdiminiftied, i. 2. 2. 4. 
of the throat cold, i. 2 . 3. 1. 
of the bowels, i. 2. 3. 6. i. 
1. 2. 12. 
of the lungs, i. 1.3. 4. 
forms ftones, i. 1. 3. 9. 
diftinguifhed from pus, ii. 1. 
6. 6. 
Mumps, ii. 1.3 4. 
Murmur aurium, iv. 2. 1. 15. 
Mufc'ae volitantes, i. 2. 5. 3. 
/ _ N. 
Nails, bitingof, iv. 1. 3. 5. 
Nares aridi, i. 1. 3. 3. 
Naufea, dry, i. 2. 4. 3. 
humid, i. 3. 2. 3. 
ideal, iv. 3. 2. 1. 
from conception, iv. 3. 2. 
2. 
Navel-ftring of infants, ii- 11. 12. 
cut too foon, ii. 1. 1. 
12. 
Neck tl ickens at puberty, iv. 1. 2. 
7- 
Neck-fwing, i. 2. 2. 16. 
Necrnfis odium, :i. 1. 4 19 
Nephritis, ii. i. 2. 14. i. 1. 3. g- iii. 
2. 1. 14.' 
Nerves decollate, iii. 2. 1. 10. 
Nictitation irritative, i. 1. 4- !• 
fenfitive, ii. 1. 1. 9. 
involuntary, iv. 1. 3. 2. 
Night-mare, iii. 2. 1.13. 
Nipples, tenfion of, i. 1. 4. 7. iv. 2« 
1. 6. 
want of, ii. 1. 1. 13- 
Noftalgia, iii 1. 2. 6. 
Noftrils, dry, i. 1. 3. 3. 
O. 
Obefitas, i. 2. 3. 17. 
Odontalgia, i. 2. 4 13. 
Odontitis, ii. 1. 4. 7. 
CEfophagi fcirrhus, i. 2. 3. 25. 
OlfaCtus acrior, i. 1. J. 3. 
imminutus, i. 2. 5. 7. 
Oil deftroys infeCts, i i»4- 14- 
eflential of animals, i. 1. 2.14. 
why injurious in erylipelas, ii. 
1.32. 
Opthalmy, internal, ii. 1. 2. 2. 
fuperficial, ii. 1. 4- 
Opium in catarrh, i. 2. 3. 3. 
in diaphragmitis, ii. 1. 2. 6. 
Orci timor, iii. 1. 2. 15. 
Ofcitatio, ii. 1. 1. 10. 
Oflium innutritio, i. 2. 2. 14. 
Otalgia, i. 2. 4. 13. iv. 2. 2. 8. 
Otitis, ii. 1.4. 8. 
Otopuofis, ii. 1. 4. 8. 
Ovary, dropfy of, i. 2. 3. 15. 
exfeCtion of, i. 2. 3. 1$. 
Oxygen gas. Suppl. i. 9. 3. 
in fevers, Suppl. i. 11 • 7* 
i. 16 9. 
Oxygenation of blood, iv. 1. 4. 6. 
P. 
Pain exhaufts fenforial power, iv. 
2. 2. 
greater prevents lefs, iv. 2. 2. 
2. 
nervous, i. 2. 4. 
of the little finger, fymptom, 
iv. 2. 2. 12. 
of arm in hydrothorax, iv. 2. 
2.13. 
of the bile duCt, iv. 2. 2. 4. 
of the (boulder, iv. 2. 2. 9. 
of the pharinx, iv. 2. 2. 5. 
of the teftis, iv. 2.2. 11. 
fmarting, i 1.5 10. 
of the fide, i. 2. 4. 14 iv. 1. 2. 
16. 
of menftruation, i. 2. 1. 12. 
ufe of, iii. 1. 1. 11. i 1. 2. 9. 
of the uterus, i. 2. 4. 17. 
Paint, white, dangerous, ii. 1. 4. 6. 
Palate, 520 
INDEX TO THE CLASSES.-ParY IL 
Palate, defeat of, i. 2. 2. 20. 
Palenefs, i. 2. 2. 2. 
from fear, iv. 3. 1. 5. 
from licknefs, iv. 2. 1.4. 
of urine after dinner, iv. 
2. 1. 2. 
from cold (kin, iv 2 1.1* 
Palpitation of heart, i. 3. 3. 2. i. 2. 
1. 10. 
from fear, iv. 3. 1.6. 
relieved by arfenic, iV. 
2 1. 8. 
Pancreas, torpor of, i. 2. 2. 7. 
Pandiculatio, ii. 1. 1. 10. 
Panting, ii. 1. 1. 4 ' 3- 3 3- 
Paracenteiis at the navel, i. 2. 3. 13. 
Paralyfis, iii 1. 10. 
of the bladder, iii. 2. 1.6. 
of the re turn, iii. 2.1. 7. 
of the hands, iii 2. 1. 4. 
cure of, iii. 2. 1.4. 
Paraplegia, iii. 2. 1. 11. 
Pareiis inirritativa, i. 2. 1. 2. Suppl. 
i. 8. 10. 
fenlltiva, i. 2. 1. 3. 
voluntar'a, iij. 2. 1. 8. 
Paronychia, internal, ii. 1. 2. 19. 
fuperficial, ii. 1.4.$. 
Parotitis, ii. 1. 3 4. 
Parturition, ii 1. I. 13 ii i- 2. 16. 
more fatal in high life, 
ii 1. 1. 13. 
with convullion, iii. I. 
1. iii 1. i- 7. 
difficult, i. 2. 2. 14. 
Paffions deprclling and exciting, iv. 
3- i-5- 
Paupertatis timor, iii. 1. 2. 13. 
Pediculus, i 1.4 15. 
Pemphigus, ii. 1. 3.14. 
Penetration of animal bodies, iv. 1. 
4. 7. 
Peripneumony, ii- I- 2. 4> 
tracheal, ii. 1. 2. 4. 
fuperficial, ii. 1.3 7. 
inirritated, ii-1.2.4. 
Peritonitis, ii. 1. 2. 8. 
Perfpiration not an excrement, i. 1. 
2. 14 
greateff in the hot fit, 
i I- * 3- 
fetid, i. 1. 2. 14. 
Pertuffis, ii. 1. 3 8. 
Heftis, ii. 1. 3. 13 
Pctechise, i- 2. 1. 17. 
cure of, Suppl. i. 2. 7. 
Pharynx, pain of, iv. 2. 2. 5. 
Phofphorus, ii 2 2. 3. 
Phrenitis, ii. 1. 2. 3. 
Phthifis, pulmonary, ii. 1. 6 7. 
Files, bleeding, 1. 2. 1. 6. 
white, i. 1. 2. 12. 
Pimples on the face, ii. i. 4. 6. 
Pins fwallowed, ii. 1. 1. 7. 
Placenta, ii. 1. 1. 12. ii. 1. 2. 16. 
Plague, ii 1.3.13. 
Plalfers, why moift, i. 1. 3. 6. 
Pleurify, ii. 1. 2. 5. 
Pleurodyne chronica, i. 2. 4. 14. 
rheumatica.iv. 1. 2. 16. 
Podagra, iv 1.2 15 iv. 2. 4. 9. 
Polypus of the lungs, i. 1 3. 4. 
of the nofe from worms, 
iv. 1. 2. 9. 
Pregnancy, ii. t. 1. 12. 
Priapilmus, i. 1. 4. 6. ii. 1. 7. 9. 
Proctalgia, i. 2. 4 18. 
Prolapfus ani, i. 1.4. 9. 
Pruritus, i. 1. 5. 9. 
narium a vermibus, iv.a. 
2. 6. 
Pfora, ii. 1. 5. 6. 
imaginaria, iii. 1. 2.22. 
Pterigion, ii. 1. 4. 2. 
Ptyalifmus. See Salivatio. 
Pubis and throat fympathize, iv. 2. 
'• 7' 
Puerperal fever, i. 2. 4. 9. ii. 1. 6. 
16. 
infanity, iii. 1. 2. 1. 
Pulchritudinis deliderium, iii. 1. 2. 
12. 
Pullulation of trees, iv. 1.4 3. 
Pulle full, why, i. 1. 1. 1. 
ftrong, how determined, i. 1. 
1. 1. Suppl. i. 16. 10. 
foft in vomiting, iv. 2. 1. 17. 
intermittent, iv. 2. 1. 18. 
quick from paucity of blood. 
Suppl. i. 11. 4- 
quick fometimes in fleep, iii. 
2. 1. 12. 
quick in weak people, iii. 1.1. 
iii. 2. 1. Suppl. i. 11.4. 
flower by twinging, iv. 2. 1. 
10. 
quick in chlorofis, i. 2. 3. 10. 
Punfta: mucofae vultus, i. 2. 2. 9. 
Purging. See Diarrhoea. 
Pus diminifhed, i. 2. 2 3. 
diftinguiflied from mucus, ii. 1. 
6. 6. 
R. 
Ratiocinatio verbofa,iii. 2. 2. 3. 
Rabies, iii. 1. 2. 18. 
Rachitis, i. 2. 2. 15. 
Raucedo catarrhal, ii. 1. 3. 5. 
paralytic, iii. 2. 1.5. 
Reafoning, faife iii. 2. 2. 3. 
Recollection, lofs of, iii. 2. 2. 1. 
Retti paralyfis, iii. 2. 1. 7. 
feirrhus, i. 2. 3. 23. 
Red-gum, ii. 1. 3. 12. i. 1. 2. 3. 
Rednefs INDEX TO THE CtASSES.-PARr II. 
521 
Rednefs from heat, ii. 1. 7. 7. 
of joy, ii. 1.7.8. 
after dinner, iv. 1. 1. 1. 
of anger, iv. 2. 3. 5. 
of guilt, iv. 2. 3. 6. 
of modefty, iv. z. 3. 6. 
Refpiration, ii. 1. 1. 2. 
quick in exercife, ii. 
1. 1. 3. 
in foftnefs of bones, i. 
2. 2. 14. 
Reftleflnefs, iii. 1. 1. 1. 
Retroverfio uteri, i. 2. 1. 14. 
Reverie, iii. 1. 2. 2. iv. 2. 4. 2. 
Rhaphania, iii. 1. 1.6. 
Rheumatifm, iv. 1. 2. 16. 
of the joints, iv.x. 2.16. 
of the bowels, iv. 1. 
2. 16. 
of the pleura, iv. 1. 
2. 16. 
fuppurating, iv. 1.2. 
16. 
from fympathy, iv. 2. 
2. 13. 
chronical, i. 1. 3.12. 
iii. 1. 1.6. 
venefedtion in, iv. 1. 
2. 16. 
Rickets, i. 2. 2. 15. 
Ring-worm, ii. 1. 5. 10. 
Rifus, iii. 1. 1. 4. iv. 2. 3. 3. 
fardonicus, iv. 1. 2. 4. 
invitus, iv. 1. 3. 3. 
Rubeola, ii. 1. 3. 10. 
Rubor a calore, ii. 1. 7. 7. 
jucunditatis, ii. 1. 7. 8. 
pranforum, iv. 1. 1. 1. 
Ruflus, i. 3. 1. 2. 
Ruminatio, i. 3. x. 1. iv. 3. 3. 1. 
S. 
Sailing in phthifis, ii. 1. 6. 7. 
Salivation warm, i. 1. 2.6. 
lymphatic, i. 3. 2. 2. 
fympathetic, iv. 1. 2. 5. 
in low fevers, i. 1. 2. 6. 
Salt of urine, i. 1. 2. 4. i. 1. 3. 9. 
Satyr iafis, iii. 1. 2. 16. 
Scabies. See Pfora. 
Scald-head, ii. 1.5. 11. 
Scarlatina, ii. 1. 3. 11. 
Sciatica frigida, i. 2. 4. 15. 
Scirrhus, i. 2. 3. 22. 
fuppurans, ii. 1.4. 14. 
of the rectum, i. 2. 3. 23. 
of the urethra, i. 2. 3. 24. 
of the cefophagus, i. 2. 3. 
.25- 
Scorbutus, i. 2. 1. 15. 
fuppurans, ii. 1. 4. 14. 
Scrofula, i. 3. 21. 
Vol, If. Txt 
Scrofula, fuppurating, ii. i. 4. 13. 
produces infanity, iii. 1. 2. 
Scurf of the head, i. 1. 3. 6. 
of the tongue, i. 1. 3. 1. 
Scurvy, i. 2. 1. 15. 
fuppurating, ii. 1. 4. 14. 
Sea-air in phthifis, ii. 1.6. 7. 
Sea-ficknefs, iv. 2. 1. 10. Suppl. i. 
8. 3. 
Seat, defcent of, i. 1.4. 9. 
Seed, ejection of, ii- 1. 1. 11. 
See-faw of old people, iii. 2. 1. 2. 
Senfation inert, Suppl. i. 6. 4. 
Senfitive alTociation, law of, iv. 2. 
2 2. 
Setons, ii. 1. 6. 
Shingles, ii. 1. 5. 9. 
Shoulder, pain of, iv. 2. 2. 9. 
Shrieking, iii. 1. 1. 3. 
Sicknefs, i. 2.4. 4 i 3. 2. 3. 
cured by a blifter, iv. 1. 
»• 3- 
by warm (kin, iv. 1. 2. 2. 
Suppl. i. 11. 4. 
by whirling, i. i.*i. 4. 
by fwinging, Suppl. i- 15. 
3- 
by hydrocarbonate gas, 
Suppl. i. 15. 3. 
See Naufea. 
Sight acuter, i. 1.5. 1. 
impaired, i. 2. 5. 2. 
Side, chronical pain of, i. 2. 4, 14. 
Sighing and fobbing, iii. 1. 2. 10. 
Sitis calida, i. 2 4. 1. 
frigida, i. 2. 4. 1. 
defeftus, ii. 2. 2. 2. 
Skin pale in old age, i. 2. 2. 2. 
from cold, i- 2. 2. 2. 
Skin dry, i. 1. 3. 6 
yellowifh, i. 2. 2. 2. 
blui/h and fhrunk, i. 2. 1. 1. 
reddifh, ii. 1. 3. 1. 
cold after meals, iv. 2. x. 1. 
Sleep, iii. 2. 1.12. 
interrupted, i. 2. 1. 3. 
periods in, iv. 2. 4. 1. 
with quick pulfe, iii. 2. 1.12. 
difturbed by digeftion, iii. 2. 
Sleep-walkers, iii. 1. 1. 9. 
Small-pox, ii. 1. 3. 9. 
why diftindtand conflu- 
ent, Sup. i. 15. i.i t6 8. 
fecondary fever of, ii. 
1.6, 12. 
eruption of, iv. 1.2. 12. 
Smarting, i. 1. 5. to. 
Smell acuter, i. 1.5. 3. 
impaired, i- 2. 5. 7. 
Sneezing, ii. 1.i. 3. iv. 1. 2. 2. 
Snow in fcrofula, i. 2. 3. 21. 
Snow 522 
INDEX TO THE CLASSES.-Part II. 
Snow in paralyfis, iii. 2. 1.4. 
Snuff in hydrocephalus, i. 2. 3. 12. 
Softnefs of bones, i. 2. 2. 14. 
Somnambulifm, iii- 1. 1. 9. 
Somnium, ii. 1. 7. 4. 
Somnus, iii. 2. i. 12. iv. 2.4, 1. 
interruptus, i 2. 1. 3. 
Spafmof diaphragm, iii. 1. 1. ri. 
of the heart, iii. j. 1. 11. 
Spine diltorted, i. 2. 2. 16. 
protuberant, i- 2. 2. 18. 
bifid, i. 2. 2. 19. 
Spitting blood, i. 1. 1. 4. i- 2. 1. 9. 
Spleen fwelled, i. 2. 3. 18. Suppl. 
i. 16. 6. 
Splenitis, ii. 2. 2. 13. 
Spots on the face, i. 2. 2. 9. 
feen on bed-clothes, i. 2. 5. 3. 
Squinting, i-2 5.4. 
in hydrocephalus, i. 2. 
5- 4. 
Stammering, iv. 2. 3. 1. 
Stays tight, injurious, ii. 1. 1. 12. 
Sterility, ii. 2. 2. 4. 
Sternutatio, ii. 1. 1. 3. iv. 1. 2. 2. 
a lumine, iv. 2. 1. 2. 
Stimulants, their twofold effect, ii. 
1. 2. 6. 
injure weak people, i. 
1.2. 3. 
except the for- 
bentia, i. 1. 
2- 3- 
Stocks for children dangerous, ii. 
2. 2. 17. 
Stomach, torpor of, i. 2. 1 2. Suppl. 
i. 12. i. 8. io. i. 16. 6. 
inflammation of, ii. 1, 2. 
10 ii 1. 3. ,9. 
its affociation, iv. r. 1. 
caufe of fever, Suppl. i. 
8. 8- 
Stones in the bladder- See Calculi, 
in horfes, i. 1. 3. 5. i. 1. 3. 
10. 
Strabifmus, i. 2 5. 4. 
Strangury, ii. 1. 1. 12, iv. 2. 2. 2. 
convulfive, iv. 2 2. 3. 
Strength and debility metaphors,!. 
2 1. 
Stridor dentium, iii 1. 1. 12. 
Studium inane, iii. 1. 2. 2. iv. 2. 4. 
2. 
Stultitia inirritabilis, i. 2. 5. 1. 
infenfibilis, ii. 2. 1. i- 
voluntaria, iii. 2. 2. 2. 
Stupor, i 2. 5. io- Suppl. i. 15. 
Stye, ii. 1. 4. 4 
Spbfultus tendinum, iii. 1. 1.5. 
Sudor. See Sweats. 
Suggeftion, flow, iv. 2. 3. 8. 
Superannuation, iv 2. 3. 8. 
Surprife, i. i. 5. 12. 
Sweats, warm, i. 1. 2- 3. 
cold, i. 2. 3. 2. 
lymphatic, i. 3. 2. 7. 
afthmatic, i. 3. 2. 8, iv. 3. 
1. 2. 
covered in bed, iv. 1. 1. 2. 
Suppl i. u. 6. 
of the brows, i. 1. 2. 3. 
in fever fits, why, i. 1.2.5. 
from exercife, i. 1. 2. 3. 
from heat, i. 1. 2. 3. 
from medicines, i. 1. 2. 3. 
Sweaty hands cured, i. 3 2. 7. 
Swinging, ii. 1. 6 7. 
makes the pulfe flower, 
iv. 2. 1. 10. 
Swing centrifugal, Suppl. i. 15. 
and 3. 
Symbols of ideas, iv. 2.3.8. 
Sympathy direft and reverfe, iv. r. 
1 F. 
with others, iii. 1. 2. 24. 
of various parts, Suppl. 
i. 11. 5- 
reverfe of lafteals and 
lymphatics, Suppl. i. 
U- 5« 
of capillaries, Suppl. j. 
11. 5. 
direft of flomach and 
heart, Sup. i. 11. 5. 
how to deftroy, iv. 2. 2. 
8 
• of throat and pubis, iv. 
c . 2-,-7- 
Syncope, 1. 2. 1.4 
epileptic, iii. 2. I. 15- 
Syngultus, ii. 1.1.6. 
nephriticHS, iv. j. 1. 7. 
Syphilis, ii. 1. 5. 2. 
Syphilis imaginaria, iii. 1. 2.21. 
Syphon capillary of cloth, ii. 13. I. 
T. 
Taftus acrior, i. 5. 5. 
imminutus, 1. 2. 5. 6. 
Taedium vitae, ii. 2. 1. 2. iii. 1. 2.11. 
iii. 2. 1. 8. 
Taenia, i. 1.4. 11. 
Tape-worm, 1. 4. 1. 1. 
Tapping at the navel, i. 2. 3. 13. 
Tarditas fenilis, iv. 2. 3. 8. 
paralytica, iv. 2. 3. 7. 
Tarfitis, ii. 1 • 4. 3. 
Tafte. See Guftus. 
bitter, not from bile, i. 1. 
3- i- 
Tears fympathetic, iv. 1. 2. 1.iii. 1, 
1. to. « 
Teeth, to preferve, i. 1. 4. 5. 
fall out whole, ii. 1. 4. 7. 
Tenefnius, INDEX TO THE CLASSES.-Part II. 
523 
Tenefmus, ii. 1. 1. 11. 
calculofus, iv. 1. 2. 8. 
Teftium dolor nephriticus, iv. 2. 2. 
n. 
tumor in gonnorrhoea, iv. 
1. 2. 18. 
tumor in parotide, iv. 1. 
2. 19. 
Tetanus trifmus, iii. 1. 1. 13. 
dolorificus, iii. 1. 1. 14. 
Third. See Sitis and Adipfia. 
Thread-worm, i. 1. 4. 12. 
Throat fwelled, i. 2. 3. 20. 
thickens at puberty, iv. 2. 
' l7- ,. 
grown up, 1. 2. 3. 25. 
Thrulh, ii. 1. 3. 17. 
Tic doloureux, i. 2. 4. 12. 
Tickling, i. 1. 5. 8. 
Timor orci, iii. 1. 2. 15* 
lethi, iii- 1. 2. 14. 
paupertatis, iii. 1. 2. 13. 
Tinea, ii. 1. 5. n. 
Tinnitus aurium, iv. 1. 1. 15. 
Titillatio, i- 1. 5. 8. 
Titubatio linguae, iv. 2. 3. 1. 
Tobacco, fmoke of in piles, i. 2. 1. 
6. 
Tongue dry, i. 1. 3. 1. Suppl. i. 2. 
coloured mucus, i. 1. 3.1. 
Tonfillitis, ii. 1. 3. 3. 
Tonlils fwelled from bad teeth, i. 
2. 3. 21. ii. 1. 3. 3. 
Tooth-ach, i. 2. 4. 12. ii. 1. 4. 7. 
Tooth-edge, iv. 1. 2. 3, 
Toothing, i. 1.4. 5. 
Tooth-powder, i. 1. 4. 5. 
Torpor of the liver, i. 1. 2. 6. 
of the pancreas, i. 2. 2. 7. 
of the lungs, Suppl. 1.9. 
of the ftomach, Suppl. i. 10. 
of the heart, Suppi. i. 10. 
Touch. See 1 adtus. 
deceived three ways, i. 2. 
5. 9. iv. 2. 1. io. 
Transfufion of blood, i. 2. 3. 25. 
Suppl. i. 14- 4- 
Tranllation of matter, i. 3. 2. 9. 
of milk, i. 3 2.'io. 
of urine, i. 3. 2.11. 
Tranfparency of cornea, i. 1. 4. 1. 
of cryftalline, i. 2. 2. 
*3- 
of air before rain, i. 
Tremor of old age, iii. 2. 1. 3. 
of fever, iii. 1. 1. 2. 
of anger, iv. 3. 1,4. 
of fear, iv. 1 2. 5. 
Tricks of the face, iii. 1. 1.5, iv. 1. 
3 2 
Trifmus, iii. 1. 1. 13. 
Trifmus, dolorificus, i. 2. 4. 12. 
Twitchings of the face, iv. r. 3. 2. 
Tullis ebriorum, ii. 1. 1. 5. 
convulfiva, ii. 1. 3. 8. 
hepatica, iv. 2. 1. 8. 
arthritica, iv. 2. 1.9. 
periodica, iv. 3. 4. 2. 
a pedibus frigidis, iv. 2. 1. 7; 
Tympany, i. 2. 4. 9. 
Typhus, i. 2. 1. 1. ii. 1. 3. 1. 
U. 
Ulcers, healing of, i. 1.3. 13. 
of the cornea, i. 1.3. 14. 
from burns, i. 1. 3. 13. 
fcrofulous, ii. 1. 4. 13. 
of the throat, ii. 1. 3. 3. ii. 
*• 3- Ir- 
of the legs, ii. 1. 4.14. 
Unguium morfiuncula, iv- 1. 3. 5. 
Urethra, fcirrhus of, i. 2. 3, 24. 
fiftula of, ii. 1. 4. 11. 
Urine, copious, coloured, i. 1.2. 4. 
copious, pale, i. 2. 3. 5. 
diminilhed, coloured,!. 1.3. 
,.7'. . 
diminilhed, pale, i. 2. 2.5. 
its mucus, faits, Pruliian 
blue, i. 1. 2. 4. 
why lefs and coloured in 
dropfies, i. 1. 3. 7. 
tranllation of, i. 3. 2. ir. 
difficulty of, iii. 2. 1. 6. 
not fecreted, i. 2. 2. 8. 
pale after meals, iv. 2. 1. 2. 
pale from cold Ikin, iv. 2, j. 
3; 
fediment in fevers, Suppl. i. 
2- 3- 
pale in fevers, Suppl. i. 2.3. 
and 5. 
Urticaria, ii. 1. 3, 16. 
Uteri defcenfus, i. 1. 4. 8. 
retroverlio, i. 2. 1. 14. 
V. 
Varix, i. 2. 1. 19. 
Vacillatio fenilis, iii. 2. 1. 2. 
Varicella, ii. 1. 3. 15. 
Variola, ii 1. 3. 9. 
eruption of, iv. 2. 1. 12. 
Vaforumcapil. retrogreffio, i. 3.3.1. 
Venereal orgafm, iv. 1. 4 4. 
dileafe, ii. 1. 5. 2. 
imaginary, iii. 1. 2. 21. 
Ventriculi aegritudo, i. 2. 4. 4. 
veficatorio fan- 
ata, iv. 1. 1. 
w ■ 3* 
Vermes, 1. 1.4 10. 
Vertigo rotatory, iv. 2.1. 10. 
of fight, iv. 2. j. 11. 
Vertigo 524 
INDEX TO THE CLASSES.-Part II. 
Vertigo inebriate, iv. 2. 1. 12. 
of fever, iv. 2. 1. 13. 
from the brain, iv. 2. 1.14, 
©f the ears, iv. 2. 1.15. 
of the touch, tafte and 
fmell, iv. 2. 1. 16. 
with vomiting, iv. 2. 3. 2. 
produces flow pulfe, iv. 2. 
1. 1 o. 
of blind men, iv. 2. 1. 10. 
ufe of mercurials in it, iv. 
2. 1.11. 
Vibices, i. 2,1. 16. Suppl. i. 2 7. 
Vigilia, iii. 1. 2 3. iv. 1. 3. 6. 
Vinegar in petechiae, i. 2. 1. 17. 
in fcarlet fever, ii. 1. 3.11. 
Vifion acuter, i- 1. 5 1. 
diminifhed, i. 2. 5. 2. 
expends much fenlorial pow- 
er, i. 2. 5. 3. 
Vita ovi, iv. 1. 4.1. 
hiemi-dormientium, iv. 1.4. 
2. 
Vitus's dance, iv. 2. 3. 2. 
Volition, three degrees of, iii. 2. 1. 
12. 
lelfens fever, iii. 2. 1. 12. 
S.uppl. i. 11. 6. 
produces fever, iii. 2.1.12. 
without deliberation, iii. 
1. 1. iv. 1. 3. 2. 
Vomica, ii. 1. 6. 3. 
Vomitus, i. 3. 1. 4. 
Vomendi conamen inane, i. 3- 1. 8. 
Vomiting Hopped, iv. 1. 1. 3. iv. 1. 
1. F. 
voluntary, iv. 3. 3 2. 
how acquired, iv. 1. 1. 
2. F. 
vertiginous, iv. 3. 2. 3. 
from Hone in ureter, iv. 
3-»4. 
Vomiting from paralytic (Iroke, iv. 
3- 2- 5- 
from tickling the throat, 
iv. 3. 2. 6. 
fympathifes with the 
fkin, iv. 3. 2*. 
in haemaptoe, i. 1. 1. 4. 
from defect of aflbciation, 
iv. 2. 1. 10. 
Vulnerum cicatrix, i. 1. 3. 13. 
W. 
Watchfulnefs, iii. 1. 2. 3. iv. 3. 2. 5. 
Water-qualm, i. 3. 1. 3. 
Weaknefs, three kinds of, i. 2. 1. 
Whirling-chair, Suppl. i. 15. 3. 
Whirling-bed, Suppl. i. 15. 7. L 2. 
S-.5- 
White fwelling of the knee, i. 2. 3. 
!Q. 
Whitlow, fuperficial, ii. 1. 4. 5. 
internal, ii. 1. 2. 19. 
Wine in fevers, ii. 1.3. i.iv. 2.1.12. 
Winking, ii. 1. 1. 8. i. 1. 4.1. iv. 3. 
2. 2. 
Winter-fleeping animals, iv. 1.4.2. 
Womb, defcent of, i. 1. 4. 8. 
retroverfion of, i. 2. 1.14. 
inflammation of, ii. 1.8.16. 
Worms, i. 1. 4. 10. 
mucus counterfeits, i. 1. 
. 3- 4* 
in fheep, i. 1. 4. 10. 
Wounds, healing of, i. 1.3. 13. 
Y. 
Yawning, ii. 1. 1.9. 
Yaws, ii. 1. 5. 5. 
Z. 
Zona ignea, ii. 1. 5. 9. iv. 1. 2. n, 
ii. 1. 2. 14,