Zoonomia Volume Ii Part 45

For the method of cure see Cla.s.s I. 1. 3. 8. to which should be added the use of strong electric shocks pa.s.sed through the bile-duct from the pit of the stomach to the back, and from one side to the other. A case of the good effect of electricity in the jaundice is related in Sect. x.x.x. 2. And another case, where it promoted the pa.s.sage of a painful gall-stone, is described by Dr. Hall, experienced on himself. Trans. of the College at Philadelphia, Vol. I. p. 192.

Half a pint of warm water two or three times a day is much recommended to dilute the insp.i.s.sated bile.

5. _Dolor pharyngis ab acido gastrico._ The two ends of the throat sympathize by sensitive a.s.sociation in the same manner as the other ca.n.a.ls above mentioned, namely, the urethra and the bile-duct; hence when too great acidity of undigested aliment, or the carbonic acid air, which escapes in fermentation, stimulates the cardia ventriculi, or lower end of the gula, into pain; the pharinx, or upper end of it, is affected with greater pain, or a disagreeable sensation of heat.

6. _Pruritus narium a vermibus._ The itching of the nose from worms in the intestines is another curious instance of the sensitive a.s.sociations of the motions of membranes; especially of those which const.i.tute the ca.n.a.ls of the body. Previous to the deglut.i.tion of agreeable food, as milk in our earliest infancy, an agreeable odour affects the membrane, which lines the nostrils; and hence an a.s.sociation seems to take place between the agreeable sensations produced by food in the stomach and bowels, and the agreeable sensations of the nostrils. The existence of ascarides in the r.e.c.t.u.m I believe produces this itching of the nostrils more than the worms in other parts of the intestines; as we have already seen, that the terminations of ca.n.a.ls sympathize more than their other parts, as in the urethra and gall-ducts. See Cla.s.s I. 1. 5. 9. IV. 1. 2. 9.

7. _Cephalaea._ Head-ach. In cold fits of the ague, the head-ach arises from consent with some torpid viscus, like the pain of the loins. After drunkenness the head-ach is very common, owing to direct sympathy of the membranes of the head with those of the stomach; which is become torpid after the too violent stimulus of the preceding intoxication; and is hence removeable by spirit of wine, or opium, exhibited in smaller quant.i.ties. In some const.i.tutions these head-achs are induced, when the feet are exposed to much external cold; in this case the feet should be covered with oiled silk, which prevents the evaporation of the perspirable matter, and thence diminishes one cause of external cold.

M. M. Valerian in powder two drams three or four times a day is recommended. The bark. Chalybeates. A grain of opium twice a day for a long time. From five to ten drops of the saturated solution of a.r.s.enic two or three times a day. See Cla.s.s I. 2. 4. 11. A lady once a.s.sured me, that when her head-ach was coming on, she drank three pints (pounds) of hot water, as hastily as she could; which prevented the progress of the disease. A solution of a.r.s.enic is recommended by Dr. Fowler of York. Very strong errhines are said sometimes to cure head-achs taken at the times the pain recurs, till a few drops of blood issue from the nostrils. As one grain of turpeth mineral (vitriolic calx of mercury) mixed with ten grains of fine sugar. Euphorbium or cayan pepper mixed with sugar, and used with caution as an errhine. See the M. M. of the next Species.

8. _Hemicrania._ Pain on one side of the head. This disease is attended with cold skin, and hence whatever may be the remote cause, the immediate one seems to be want of stimulus, either of heat or distention, or of some other unknown stimulus in the painful part; or in those, with which it is a.s.sociated. The membranes in their natural state are only irritable by distention; in their diseased state, they are sensible like muscular fibres. Hence a diseased tooth may render the neighbouring membranes sensible, and is frequently the cause of this disease.

Sometimes the stomach is torpid along with the pained membrane of the head; and then sickness and inappetency attends either as a cause or consequence.

The natural cure of hemicrania is the acc.u.mulation of sensorial power during the rest or sickness of the patient. Mrs. ---- is frequently liable to hemicrania with sickness, which is probably owing to a diseased tooth; the paroxysm occurs irregularly, but always after some previous fatigue, or other cause of debility. She lies in bed, sick, and without taking any solid food, and very little of fluids, and those of the aqueous kind, and, after about 48 or 50 hours, rises free from complaint. Similar to this is the recovery from cold paroxysms of fever, from the torpor occasioned by fear, and from syncope; which are all owing to the acc.u.mulation of sensorial power during the inactivity of the system. Hence it appears, that, though when the sensorial power of volition is much exhausted by fatigue, it can be restored by eight or ten hours of sleep; yet, when the sensorial power of irritation is exhausted by fatigue, that it requires two whole solar or lunar days of rest, before it can be restored.

The late Dr. Monro a.s.serted in his lectures, that he cured the hemicrania, or megrim, by a strong vomit, and a brisk purge immediately after it. This method succeeds best if opium and the bark are given in due quant.i.ty after the operation of the cathartic; and with still more certainty, if bleeding in small quant.i.ty is premised, where the pulse will admit of it. See Sect.

x.x.xV. 2. 1.

The pain generally affects one eye, and spreads a little way on that side of the nose, and may sometimes be relieved by pressing or cutting the nerve, where it pa.s.ses into the bone of the orbit above the eye. When it affects a small defined part on the parietal bone on one side, it is generally termed Clavus hystericus, and is always I believe owing to a diseased dens molaris. The tendons of the muscles, which serve the office of mastication, have been extended into pain at the same time, that the membranous coverings of the roots of the teeth have been compressed into pain, during the biting or mastication of hard bodies. Hence when the membranes, which cover the roots of the teeth, become affected with pain by a beginning decay, or perhaps by the torpor or coldness of the dying part of the tooth, the tendons and membranous fascia of the muscles about the same side of the head become affected with violent pain by their sensitive a.s.sociations: and as soon as this a.s.sociated pain takes place, the pain of the tooth entirely ceases, as explained in the second species of this genus.

A remarkable circ.u.mstance attends this kind of hemicrania, viz. that it recurs by periods like those of intermittent fevers, as explained in the Section on Catenation of Motions; these periods sometimes correspond with alternate lunar or solar days like tertian agues, and that even when a decaying tooth is evidently the cause; which has been evinced by the cure of the disease by extracting the tooth. At other times they observe the monthly lunations, and seem to be induced by the debility, which attends menstruation.

The dens sapientiae, or last tooth of the upper jaw, frequently decays first, and gives hemicrania over the eye on the same side. The first or second grinder in the under-jaw is liable to give violent pain about the middle of the parietal bone, or side of the head, on the same side, which is generally called the Clavus hystericus, of which an instructive case is related in Sect. x.x.xV. 2. 1.

M. M. Detect and extract the diseased tooth. Cut the affected nerve, or stimulate the diseased membrane by acu-puncture. Venesection to six ounces by the lancet or by leeches. A strong emetic and a subsequent cathartic; and then an opiate and the bark. Pa.s.s small electric shocks through the pained membrane, and through the teeth on the same side. Apply vitriolic ether externally, and a grain of opium with camphor internally, to the cheek on the affected side, where a diseased tooth may be suspected. Foment the head with warm vinegar. Drink two large spoonfuls of vinegar. Stimulate the gums of the suspected teeth by oil of cloves, by opium. See Cla.s.s I. 1.

4. 4. Snuff volatile spirit of vinegar up the nostrils. Lastly, in permanent head-achs, as in permanent vertigo, I have seen good effect by the use of mercurial ointment rubbed on the shaved head or about the throat, till a mild salivation commences, which by inflaming the membranes of the teeth may prevent their irritative sympathy with those of the cranium. Thus by inflaming the tendon, which is the cause of locked jaw, and probably by inflaming the wound, which is the cause of hydrophobia, those diseases may be cured, by disuniting the irritative sympathy between those parts, which may not possess any sensitive sympathy. This idea is well worth our attention.

_Otalgia._ Ear-ach is another disease occasioned by the sympathy of the membranes of the ear with those which invest or surround a decaying tooth, as I have had frequent reason to believe; and is frequently relieved by filling the ear with tincture of opium. See Cla.s.s I. 2. 4.

9. _Dolor humeri in hepat.i.tide._ In the efforts of excluding the faeces and urine the muscles of the shoulders are exerted to compress the air in the lungs, that the diaphragm may be pressed down. Hence the distention of the tendons or fibres of these muscles is a.s.sociated with the distention of the tendons or fibres of the diaphragm; and when the latter are pained by the enlargement or heat of the inflamed liver, the former sympathize with them.

Sometimes but one shoulder is affected, sometimes both; it is probable that many other pains, which are termed rheumatic, have a similar origin, viz.

from sensitive a.s.sociations.

As no inflammation is produced in consequence of this pain of the shoulder, it seems to be owing to inaction of the membranous part from defect of the sensorial power of a.s.sociation, of which the primary link is the inflamed membrane of the liver; which now expends so much of the sensorial power in general by its increased action, that the membranes about the shoulder, which are links of a.s.sociation with it, become deprived of their usual share, and consequently fall into torpor.

10. _Torpor pedum in eruptione variolarum._ At the commencement of the eruption of the small-pox, when the face and breast of children are very hot, their extremities are frequently cold. This I ascribe to sensitive a.s.sociation between the different parts of the skin; whence when a part acts too violently, the other part is liable to act too weakly; and the skin of the face being affected first in the eruption of the small-pox, the skin of the feet becomes cold in consequence by reverse sympathy.

M. M. Cover the feet with flannel, and expose the face and bosom to cool air, which in a very short time both warms the feet and cools the face; and hence what is erroneously called a rash, but which is probably a too hasty eruption of the small-pox, disappears; and afterwards fewer and more distinct eruptions of the small-pox supervene.

11. _Testium dolor nephriticus._ The pain and retraction of the t.e.s.t.i.c.l.e on the same side, when there is a stone in the ureter, is to be ascribed to sensitive a.s.sociation; whether the connecting cause be a branch of the same nerve, or from membranes, which have been frequently affected at the same time.

12. _Dolor digiti minimi sympatheticus._ When any one accidentally strikes his elbow against any hard body, a tingling pain runs down to the little finger end. This is owing to sensitive a.s.sociation of motions by means of the same branch of a nerve, as in hemicrania from a decaying tooth the pain is owing to the sensitive a.s.sociation of tendons or membranes.

13. _Dolor brachii in hydrope pectoris._ The pain in the left arm which attends some dropsies of the chest, is explained in Sect. XXIX. 5. 2. 10.

which resembles the pain of the little finger from a percussion of the nerve at the elbow in the preceding article. A numbness of this kind is produced over the whole leg, when the crural nerve is much compressed by sitting for a time with one leg crossed over the other.

Mr. ----, about sixty, had for two years been affected with difficulty of respiration on any exertion, with pain about the sternum, and of his left arm; which last was more considerable than is usual in dropsy of the chest; some months ago the pain of his arm, after walking a mile or two, became excessive, with coldness and numbness; and on the next day the back of the hand, and a part of the arm swelled, and became inflamed, which relieved the pain; and was taken for the gout, and continued several days. He after some months became dropsical both in respect to his chest and limbs, and was six or seven times perfectly relieved by one dram of saturated tincture of digitalis, taken two or three times a day for a few days in a gla.s.s of peppermint water. He afterwards breathed oxygen gas undiluted, in the quant.i.ty of six or eight gallons a day for three or four weeks without any effect, and sunk at length from general debility.

In this instructive case I imagine the pressure or stimulus of one part of the nerve within the chest caused the other part, which serves the arm, to become torpid, and consequently cold by sympathy; and that the inflammation was the consequence of the previous torpor and coldness of the arm, in the same manner as the swelling and inflammation of the cheek in tooth-ach, in the first species of this genus; and that many rheumatic inflammations are thus produced by sympathy with some distant part.

14. _Diarrhoea a dent.i.tione._ The diarrhoea, which frequently attends dent.i.tion, is the consequence of indigestion; the aliment acquires chemical changes, and by its acidity acts as a cathartic; and changes the yellow bile into green, which is evacuated along with indigested parts of the coagulum of milk. The indigestion is owing to the torpor of the stomach and intestines caused by their a.s.sociation with the membranes of the gums, which are now stimulated into great exertion with pain; both which contribute to expend the general quant.i.ty of sensorial power, which belongs to this membranous a.s.sociation; and thus the stomach and intestines act with less than their natural energy. This is generally esteemed a favourable symptom in difficult dent.i.tion, as the pain of the alveolar membranes exhausts the sensorial power without producing convulsions for its relief. See Cla.s.s I. 1. 4. 5. And the diarrhoea ceases, as the tooth advances.

ORDO II.

_Decreased a.s.sociate Motions._

GENUS III.

_Catenated with Voluntary Motions._

SPECIES.

1. _t.i.tubatio linguae._ Impediment of speech is owing to the a.s.sociations of the motions of the organs of speech being interrupted or dissevered by ill-employed sensation or sensitive motions, as by awe, bashfulness, ambition of s.h.i.+ning, or fear of not succeeding, and the person uses voluntary efforts in vain to regain the broken a.s.sociations, as explained in Sect. XVII. 1. 10. and XVII. 2. 10.

The broken a.s.sociation is generally between the first consonant and the succeeding vowel; as in endeavouring to p.r.o.nounce the word parable, the p is voluntarily repeated again and again, but the remainder of the word does not follow, because the a.s.sociation between it and the next vowel is dissevered.

M. M. The art of curing this defect is to cause the stammerer to repeat the word, which he finds difficult to speak, eight or ten times without the initial letter, in a strong voice, or with an aspirate before it, as arable, or harable; and at length to speak it very softly with the initial letter p, parable. This should be practised for weeks or months upon every word, which the stammerer hesitates in p.r.o.nouncing. To this should be added much commerce with mankind, in order to acquire a carelessness about the opinions of others.

2. _Ch.o.r.ea St. Viti._ In the St. Vitus's dance the patient can at any time lie still in bed, which shews the motions not to be convulsive; and he can at different times voluntarily exert every muscle of his body; which evinces, that they are not paralytic. In this disease the princ.i.p.al muscle in any designed motion obeys the will; but those muscles, whose motions were a.s.sociated with the princ.i.p.al one, do not act; as their a.s.sociation is dissevered, and thus the arm or leg is drawn outward, or inward, or backward, instead of upward or forward, with various gesticulations exactly resembling the impediment of speech.

This disease is frequently left after the itch has been too hastily cured.

See Convulsio dolorifica, Cla.s.s III. 1. 1. 6. A girl about eighteen, after wearing a mercurial girdle to cure the itch, acquired the Ch.o.r.ea St. Viti in so universal a manner, that her speech became affected as well as her limbs; and there was evidently a disunion of the common trains of ideas; as the itch was still among the younger children of the family, she was advised to take her sister as a bedfellow, and thus received the itch again; and the dance of St. Vitus gradually ceased. See Cla.s.s II. 1. 5. 6.

M. M. Give the patient the itch again. Calomel a grain every night, or sublimate a quarter of a grain twice a day for a fortnight. Steel. Bark.

Warm-bath. Cold-bath. Opium. Venesection once at the beginning of the disease. Electricity. Perpetual slow and repeated efforts to move each limb in the designed direction, as in the t.i.tubatio linguae above described.

3. _Risus._ Laughter is a perpetual interruption of voluntary exertion by the interposition of pleasurable sensation; which not being checked by any important consequences rises into pain, and requires to be relieved or moderated by the frequent repet.i.tion of voluntary exertion. See Sect.

x.x.xIV. 1. 4. and Cla.s.s III. 1. 1. 4. and IV. 1. 3. 3.

4. _Tremor ex ira._ The trembling of the limbs from anger. The interruption of the voluntary a.s.sociations of motions by anger, originates from too great a part of the sensorial power being exerted on the organs of sense; whence the muscles, which ought to support the body upright, are deprived of their due quant.i.ty, and tremble from debility. See Cla.s.s III. 2. 1. 1.

5. _Rubor ex ira._ Redness from anger. Anger is an excess of aversion, that is of voluntarity not yet employed. It is excited by the pain of offended pride; when it is employed it becomes outrage, cruelty, insanity. The cutaneous capillaries, especially those of the face, are more mobile, that is, more easily excited into increased action, or more easily become torpid, from less variation of sensorial power, than any other parts of the system, which is owing to their being perpetually subject to the vicissitudes of heat and cold, and of extension and corrugation. Hence, when an excess of voluntarity exists without being immediately expended in the actions of the large muscles, the capillary arteries and glands acquire more energetic action, and a flushed skin is produced, with increased secretion of perspirable matter, and consequent heat, owing to the pause or interruption of voluntary action; and thus the actions of these cutaneous vessels become a.s.sociated between the irascent ideas and irascent muscular actions, which are thus for a time interrupted.

6. _Rubor criminati._ The blus.h.i.+ng of accused people, whether guilty or not, appears to be owing to circ.u.mstances similar to that of anger; for in these situations there is always a sudden voluntarity, or wish, of clearing their characters arises in the mind of the accused person; which, before an opportunity is given for it to be expended on the large muscles, influences the capillary arteries and glands, as in the preceding article. Whence the increased actions of the capillaries, and the consequent redness and heat, become exerted between the voluntary ideas of self-defence, and the muscular actions necessary for that purpose; which last are thus for a time interrupted or delayed.

Even in the blush of modesty or bashfulness there is a self-condemnation for some supposed defect or indecorum, and a sudden voluntarity, or wish, of self-defence; which not being expended in actions of the larger muscles excites the capillaries into action; which in these subjects are more mobile than in others.

The blush of young girls on coming into an a.s.sembly room, where they expect their dress, and steps, and manner to be examined, as in dancing a minuet, may have another origin; and may be considered as a hot fit of returning confidence, after a previous cold fit of fear.

7. _Tarditas paralytica._ By a stroke of the palsy or apoplexy it frequently happens, that those ideas, which were a.s.sociated in trains, whose first link was a voluntary idea, have their connection dissevered; and the patient is under the necessity by repeated efforts slowly to renew their a.s.sociations. In this situation those words, which have the fewest other words a.s.sociated with them, as the proper names of persons or places, are the most difficult to recollect. And in those efforts of recollection the word opposite to the word required is often produced, as hot for cold, winter for summer, which is owing to our a.s.sociating our ideas of things by their opposites as well as by their similitudes, and in some instances perhaps more frequently, or more forcibly. Other paralytic patients are liable to give wrong names to external objects, as using the word pigs for sheep, or cows for horses; in this case the a.s.sociation between the idea of the animal and the name of it is dissevered; but the idea of the cla.s.s or genus of the thing remains; and he takes a name from the first of the species, which presents itself, and sometimes can correct himself, till he finds the true one.

8. _Tarditas senilis._ Slowness of age. The difficulty of a.s.sociating ideas increases with our age; as may be observed from old people forgetting the business of the last hour, unless they impress it strongly, or by frequent repet.i.tion, though they can well recollect the transactions of their youth.

I saw an elderly man, who could reason with great clearness and precision and in accurate language on subjects, which he had been accustomed to think upon; and yet did not know, that he had rang the bell by his fire-side in one minute afterwards; nor could then recollect the object he had wanted, when his servant came.

Similar to this is the difficulty which old people experience in learning new bodily movements, that is, in a.s.sociating new muscular actions, as in learning a new trade or manufactury. The trains of movements, which obey volition, are the last which we acquire; and the first, which are disa.s.sociated.