Zoonomia Volume Ii Part 50

7. The inquisitive reader will excuse my continuing this subject, though perhaps with some repet.i.tions, as it envelopes the very essence of fever.

When the first link of a train of actions is excited by excessive stimulus, or excessive irritability, and thus acts with unusual energy by the increased quant.i.ty of irritation, these increased motions excite a greater quant.i.ty of the sensorial power of a.s.sociation, which causes increased motions in the second link, which is catenated with the first; and then the excessive action of this second link excites also a greater quant.i.ty of the sensorial power of a.s.sociation, which increases the motions of the third link of this chain of a.s.sociation, and thus the increase of the stimulus on the irritative motions, to which the chain of a.s.sociation is catenated, increases the action of the whole chain or circle of a.s.sociated motions.

After a time the irritative motions become torpid by expenditure of the sensorial power of irritation, and then the power of a.s.sociation also becomes less exerted, both because it has been in part exhausted by too great action, and is now less excited by the lessened action of the irritative motions, which used to excite it. These are both instances of direct sympathy, and frequently const.i.tute the cold and hot fit of intermittents.

But though the acc.u.mulation of the sensorial power of irritation during the quiescence of some motion owing to want of stimulus generally induces torpor in the first link of the train of a.s.sociated motions catenated with it; as the capillaries of the lungs become torpid immediately on immersion of the skin into cold water; yet in some situations an o.r.g.a.s.m or excess of action is produced in the first link of the a.s.sociated motions thus catenated with irritative ones; as in the increased action of the stomach, when the skin is for a time exposed to cold air; which may in part be ascribed to the general increase of action of the whole system, owing to the diminished expenditure of sensorial power, but particularly of the parts, which have habitually acted together; as when one arm is paralytic the other is liable to more frequent or almost continual motion; and when one eye becomes blind the other frequently becomes stronger; which is well known to farriers, who are said sometimes to destroy the sight of one eye to strengthen that of the other in diseased horses.

Hence there is sometimes a direct sympathy, and sometimes a reverse one succeeds the torpor occasioned by defect of stimulus, the latter of which is perhaps owing to a certain time being required for the production of an acc.u.mulation of the sensorial power of irritation by the nervous branches of the torpid organ; which acc.u.mulation is now in part or entirely derived to the next link of the a.s.sociation. Thus in going into a coldish bath, as into a river in the summer months, we at first experience a difficulty of breathing from the torpid action of the pulmonary capillaries, owing to the deficient excitement of the sensorial power of a.s.sociation in consequence of the torpor of the cutaneous capillaries. But in a very short time, as in one minute, the sensorial power of irritation becomes acc.u.mulated by the inactivity of the cutaneous capillaries; and as its superabundance becomes now expended on the pulmonary capillaries, the difficult respiration ceases; though the cutaneous capillaries continue torpid by their contact with the cold water, and consequently the sensorial power of a.s.sociation, which used to contribute to actuate the pulmonary capillaries, is less excited.

8. In like manner when there exists an acc.u.mulation of the sensorial power of a.s.sociation, owing to defect of its excitement by some previous irritative or a.s.sociate motions, it is generally accompanied for a certain time by a torpor not only of the link first affected, but of the subsequent parts, or of the whole train of a.s.sociated motions, as in the cold fits of intermittent fevers. Yet after a time an increased action of the next links of a.s.sociated motions succeeds the torpor of the first, as the absorbent vessels of the lungs act more violently in consequence of the deficient action of those of the stomach; and the skin at the commencement of sickness is pale and cold, but in a little time becomes flushed and warm.

Thus we see in a.s.sociate motions, which are rendered torpid by defect of excitement, that sometimes a direct, and sometimes a reverse sympathy succeeds in the subsequent links of the chain. But I believe where a torpor of irritative or of the a.s.sociate motions is caused by a previous too great expenditure or exhaustion of the sensorial powers of irritation or a.s.sociation, no increase of action in the subsequent link ever occurs, or not till after a very long time.

Thus when the stomach becomes torpid by previous violent exertion, and consequent exhaustion of the sensorial power of irritation, as after intoxication with wine or opium, or after the exhibition of some violent emetic drug, the torpor is communicated to the heart and arteries, as in continued fevers with weak pulse. But where the torpor of the stomach is produced from defective a.s.sociation, as in sea-sickness; or in the sickness which occurs, when a stone stimulates the ureter; no torpor is then communicated to the heart and arteries. For in the former case there is no acc.u.mulation of sensorial power in the stomach, which was previously exhausted by too great stimulus; but in the latter case the acc.u.mulation of sensorial power in the stomach during its torpor is evinced by this circ.u.mstance; that in sea-sickness the patients eat and drink voraciously at intervals; and the pulse is generally not affected by the sickness occasioned by a stone in the ureter. For the action of the stomach is then lessened, and in consequence becomes retrograde, not owing to the exhaustion of the sensorial power of irritation, but to the want of excitement of the sensorial power of a.s.sociation; which is caused by the defective action of the ureter, which becomes occasionally torpid by the great stimulus of the stone it contains; or which is caused by the great exhaustion of sensorial power by the pain; which affects the ureter without exciting inflammation, or increased action of it.

9. Thus though the stomach after the great stimulus of intoxication from excess of wine or opium will continue many hours without acc.u.mulation of sensorial power, as appears from the patient's experiencing no appet.i.te at the intervals of sickness; yet after long abstinence from food, at length not only the exhausted quant.i.ty of sensorial power is renewed, but an acc.u.mulation of it at length occurs, and hunger returns. In this situation the stomach is generally about a whole day before it regains its usual powers of digestion; but if it has been still more violently stimulated, and its actions further impaired, a still more permanent torpor along with a continued fever with weak pulse is liable to occur; and a fourth part, or a half, or three fourths, or a whole lunar period pa.s.ses, before it recovers its due irritability and consequent action.

In similar manner, after a person has been confined in a very warm room for some hours, the cutaneous capillaries, with their secretory and absorbent vessels, become exhausted of their sensorial power of irritation by the too great violent exertions occasioned by the unusual stimulus of heat; and in coming into a colder atmosphere an inactivity of the cutaneous vessels exists at first for some time without acc.u.mulation of sensorial power; as is shewn by the continuance of the pain of cold and the paleness; but after a time both the pain of cold and paleness vanish, which now indicates an acc.u.mulation of the sensorial power of irritation, as less degrees of heat stimulate the system into due action.

In the same manner, after any one has been some time in the summer suns.h.i.+ne, on coming into a dark cell he continues much longer before he can clearly distinguish objects, than if his eyes had only been previously exposed to the light of a cloudy day in winter; because the sensorial power of irritation, and consequent sensation, had in the first case been previously much expended or exhausted; and therefore required a much longer time before it could be produced in the brain, or derived to the optic nerves, in such quant.i.ty as to restore the deficiency, and to cause an acc.u.mulation of it; whereas in the latter case no deficiency had occurred.

10. Thus the acc.u.mulation or deficiency of sensorial power in a torpid organ, which had previously been accustomed to perpetual action, depends on the manner in which it becomes torpid; that is, whether by great previous stimulus, or great previous excitement of the power of a.s.sociation; or by defect of its accustomed stimulus, or of its accustomed excitement of the power of a.s.sociation. In the former case the sensorial power is in an exhausted state, and therefore is not likely to become so soon acc.u.mulated, as after drunkenness, or exposure to great heat, or to great light; in the latter a great acc.u.mulation of sensorial power occurs, as after exposure to cold, or hunger, or darkness.

Hence when the stomach continues torpid by previous violent stimulus, as in the exhibition of digitalis, no acc.u.mulation of sensorial power of irritation supervenes; and in consequence the motions of the heart and arteries, which are a.s.sociated with those of the stomach, become weak, and slow, and intermittent, from the defect of the excitement of the sensorial power of a.s.sociation. But what follows? as the actions of the heart and arteries are lessened by the deficient action of the sensorial power of a.s.sociation, and not by previous increased excitement of it; a great acc.u.mulation of the sensorial power of a.s.sociation occurs, which is exerted on the pulmonary and cutaneous absorbents by reverse sympathy, and produces a great absorption of the fluid effused into the cellular membrane in anasarca, with dry skin; const.i.tuting one kind of atrophy.

But if at the same time the secerning vessels of the stomach are stimulated into so violent activity as to induce great consequent torpor, as probably happens when contagious matter is swallowed into the stomach with our saliva, those of the heart and arteries act feebly from the deficient excitement of the power of a.s.sociation; and then the cutaneous and pulmonary secerning vessels act with greater force than natural, owing to the acc.u.mulation of the sensorial power of a.s.sociation; and unnatural heat of the skin, and of the breath succeed; but without frequency of pulse, const.i.tuting the paresis irritativa of Cla.s.s I. 2. 1. 2. And lastly, if a paucity of blood attends this paresis, or some other cause inducing a frequency of pulse, the febris inirritativa, or fever with weak pulse, is produced.

But on the contrary when the stomach has previously been rendered torpid by defect of stimulus, as by hunger, if food be too hastily supplied, not only great exertion of the stomach itself succeeds, but fever with strong pulse is induced in consequence; that is, the heart and arteries are excited into more energetic action by the excess of the power of a.s.sociation, which catenates their motions with those of the stomach. For the redundancy of sensorial power of irritation, which was acc.u.mulated during the inactivity of the stomach, and is now called into action by stimulus, actuates that organ with increased energy, and excites by these increased motions the sensorial power of a.s.sociation; which has also been acc.u.mulated during the inactivity of the heart and arteries; and thus these organs also are now excited into greater action.

So after the skin has been exposed some hours to greater heat than natural in the warm room, other parts, as the membranes of the nostrils, or of the lungs, or of the stomach, are liable to become torpid from direct sympathy with it, when we come into air of a moderate temperature; whence catarrhs, coughs, and fevers. But if this torpor be occasioned by defect of stimulus, as after being exposed to frosty air, the acc.u.mulation of sensorial power is exerted, and a glow of the skin follows, with increased digestion, full respiration, and more vigorous circulation.

11. It may be asked, Why is there a great and constant acc.u.mulation of the sensorial power of a.s.sociation, owing to the torpor of the stomach and heart and arteries, in continued fever with weak pulse; which is exerted on the cutaneous and pulmonary capillaries, so as to excite them into increased action for many weeks, and yet no such exuberance of sensorial power produces fever in winter-sleeping animals, or in chlorosis, or apepsia, or hysteria?

In winter-sleeping animals I suppose the whole nervous system is torpid, or paralysed, as in the sleep of frozen people; and that the stomach is torpid in consequence of the inactivity or quiescence of the brain; and that all other parts of the body, and the cutaneous capillaries with the rest, labour under a similar torpor.

In chlorosis, I imagine, the actions of the heart and arteries, as well as those of the cutaneous and pulmonary capillaries, suffer along with those of the stomach from the deficient stimulus of the pale blood; and that though the liver is probably the seat of the original torpor in this disease, with which all other parts sympathize from defect of the excitation of the sensorial power of a.s.sociation; yet as this torpor occurs in so small a degree as not to excite a shuddering or cold fit, no observable consequences are in general occasioned by the consequent acc.u.mulation of sensorial power. Sometimes indeed in chlorosis there does occur a frequent pulse and hot skin; in which circ.u.mstances I suppose the heart and arteries are become in some degree torpid by direct sympathy with the torpid liver; and that hence not only the pulse becomes frequent, but the capillaries of the skin act more violently by reverse sympathy with the heart and arteries, owing to the acc.u.mulation of the sensorial power of a.s.sociation in them during their torpid state, as occurs in irritative fever. See Article 11 of this Supplement.

In apepsia chronica the actions of the stomach are not so far impaired or destroyed as totally to prevent the excitation of the sensorial power of a.s.sociation, which therefore contributes something towards the actions of the heart and arteries, though less than natural, as a weak pulse always I believe attends this disease.

There is a torpor of the stomach, and of the upper part of the alimentary ca.n.a.l in hysteria, as is evident from the retrograde actions of the duodenum, stomach, and oesophagus, which const.i.tute the globus hystericus, or sensation of a globe rising into the throat. But as these retrograde actions are less than those, which induce sickness or vomiting, and are not occasioned by previous exhaustion of the sensorial power of irritation, they do not so totally prevent the excitement of the sensorial power of a.s.sociation, as to lessen the motion of the heart and arteries so much as to induce fever; yet in this case, as in apepsia, and in chlorosis, the pulsations of the heart and arteries are weaker than natural, and are sometimes attended with occasionally increased action of the capillaries; as appears from the flus.h.i.+ngs of the face, and hot skin, which generally form an evening febricula in diseases attended with weak digestion.

12. The increased action, or o.r.g.a.s.m, of the cutaneous, pulmonary, and cellular capillaries, with their secerning and absorbent vessels, in those fevers which are attended with deficiency of vital action, exhausts the patient both by the additional expenditure of sensorial power on those organs of secretion, and by the too great absorption 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 diminish the too great action of the capillaries; which is to be done by frequent ablutions, or bathing the whole skin in tepid or in cold water, as recommended by Dr. Currie of Liverpool (Philos. Trans. for 1792), for half an hour, twice a day, or at those times when the skin feels dryest and hottest. Much cool air should also be admitted, when the breath of the patient feels hot to one's hand; or when the tongue, especially its middle part, is dry, and covered with a crust of indurated mucus; as these indicate the increased action of the pulmonary capillaries; in the same manner as the dry and hot skin indicates the o.r.g.a.s.m of the cutaneous capillaries; and the emaciation of the body that of the cellular ones.

For this purpose of abating the action of the capillaries by frequent ablution or fomentation, water of any degree of heat beneath that of the body will be of service, and ought in accurate language to be called a cold bath; but the degree of coldness, where the patient is sensible, should in some measure be governed by his sensations; as it is probable, that the degree of coldness, which is most grateful to him, will also be of the greatest benefit to him. See Cla.s.s III. 2. 1. 12. and Article 15 of this Supplement.

Another great use of frequent ablutions, or fomentations, or baths, in fevers, where the stomach is in some degree torpid, is to supply the system with aqueous fluid by means of the cutaneous absorbents; which is dissipated faster by the increased action of the secerning capillaries, than the stomach can furnish, and occasions great thirst at the intervals of the sickness.

IX. _Torpor of the Lungs._

1. The lungs in many cases of contagion may first be affected with torpor, and the skin become cold by sympathy; in the same manner as a cold skin on going into the cold bath induces difficulty of breathing. Or the stomach may become affected with torpor by its sympathy with the lungs, as in the experiments of Mr. Watt with hydro-carbonate gas; a few respirations of which induced sickness, and even syncope. When the stomach or skin is thus affected secondarily by a.s.sociation, an acc.u.mulation of sensorial power occurs much sooner, than when these parts become torpid in consequence of previous excess of stimulus; and hence they sooner recover their accustomed action, and the fever ceases. The particles of contagious matter thus received by respiration somewhat resemble in their effects the acid gases from burning sulphur, or from charcoal; which, if they do not instantly destroy, induce a fever, and the patient slowly recovers.

2. I was some years ago stooping down to look, which way the water oozed from a mora.s.s, as a labourer opened it with a spade, to detect the source of the spring, and inhaled a vapour, which occasioned an instant sense of suffocation. Immediately recoiling I believe I inhaled it but once; yet a few hours afterwards in the cool of the evening, when I returned home rather fatigued and hungry, a s.h.i.+vering and cold fit occurred, which was followed by a hot one; and the whole disease began and terminated in about twelve hours without return. In this case the power of fear, or of imagination, was not concerned; as I neither thought of the bad air of a mora.s.s before I perceived it; nor expected a fever-fit, till it occurred.

In this case the torpor commenced in the lungs, and after a few hours, by the addition of fatigue, and cold, and hunger, was propagated by direct sympathy to the rest of the system. An o.r.g.a.s.m or increased action of the whole system was then induced by the acc.u.mulation of sensorial power of irritation in the lungs, and of a.s.sociation in the other organs; and when these subsided, the disease ceased. It may be asked, could a torpor of the capillaries of the air-vessels of the lungs be so suddenly produced by great stimulation?--It appears probable, that it might, because great exertion of irritative motions may be instantly produced without our perceiving them; that is, without their being attended by sensation, both in the lungs and stomach; and the organs may become torpid by the great expenditure of the sensorial power of irritation in an instant of time; as paralysis frequently instantly follows too great an exertion of voluntary power.

3. When the capillaries of the lungs act too violently, as in some continued fevers; which is known by the heat of the breath, and by the dryness of the tongue, especially of the middle part of it; not only cooler air might be admitted more freely into a sick room to counteract this o.r.g.a.s.m of the pulmonary capillaries; but perhaps the patient might breathe with advantage a mixture of carbonic acid gas, or of hydrogene gas, or of azote with atmospheric air. And on the contrary, when there exists an evident torpor of the pulmonary capillaries, which may be known by the correspondent chilness of the skin; and by a tickling cough, which sometimes attends cold paroxysms of fever, and is then owing to the deficient absorption of the pulmonary mucus, the saline parts of which stimulate the bronchiae, or air-vessels; a mixture of one part of oxygen gas with 10 or 20 parts of atmospheric air might probably be breathed with great advantage.

X. _Torpor of the Brain._

As the inactivity or torpor of the absorbent vessels of the brain is the cause of hydrocephalus internus; and as the deficiency of venous absorption in the brain, or torpor of the extremities of its veins, is believed frequently to be the cause of apoplexies; so there is reason to conclude, that the torpor of the secerning vessels of the brain, which are supposed to produce the sensorial power, may const.i.tute the immediate cause of some fevers with arterial debility. And also that the increased action of these secerning vessels may sometimes const.i.tute the immediate cause of fevers with arterial strength.

It is nevertheless probable, that the torpor or o.r.g.a.s.m of the sanguiferous, absorbent, or secerning vessels of the brain may frequently exist as a secondary effect, owing to their a.s.sociation with other organs, as the stomach or lungs; and may thus be produced like the torpor of the heart and arteries in inirritative fevers, or like the o.r.g.a.s.m of those organs in irritative fevers, or inflammatory ones.

Where there exists a torpor of the brain, might not very slight electric shocks pa.s.sed frequently through it in all directions be used with advantage? Might not fomentations of 94 or 96 degrees of heat on the head for an hour at a time, and frequently repeated, stimulate the brain into action; as in the revival of winter-sleeping animals by warmth? Ether externally might be frequently applied, and a blister on the shaved head.

Where the secerning vessels of the brain act with too great energy, as in some inflammatory fevers, might it not be diminished by laying the patient horizontally on a mill-stone, and whirling him, till sleep should be produced, as the brain becomes compressed by the centrifugal force? See Article 15 of this Supplement.

XI. _Torpor of the Heart and Arteries._

1. It was shewn in Cla.s.s IV. 1. 1. 6. in IV. 2. 1. 2. and in Suppl. I. 6.

3. that a reverse sympathy generally exists between the lacteal and lymphatic branches of the absorbent system. Hence, when the motions of the absorbents of the stomach are rendered torpid or retrograde in fevers with arterial debility, those of the skin, lungs, and cellular membrane, act with increased energy. But the actions of the muscular fibres of the heart and arteries are at the same time a.s.sociated with those of the muscular fibres of the stomach by direct sympathy. Both these actions occur during the operation of powerful emetics, as squill, or digitalis; while the motions of the stomach continue torpid or retrograde, the cellular and cutaneous absorbents act with greater energy, and the pulsations of the heart and arteries become weaker, and sometimes slower.

2. The increased action of the stomach after a meal, and of the heart and arteries at the same time from the stimulus of the new supply of chyle, seems originally to have produced, and to have established, this direct sympathy between them. As the increased action of the absorbents of the stomach after a meal has been usually attended with diminished action of the other branches of the absorbent system, as mentioned in Cla.s.s IV. 1. 1.

6. and has thus established a reverse sympathy between them.

2. Besides the reverse sympathy of the absorbent vessels and the muscles of the stomach, and of the heart and arteries, with those of the skin, lungs, and cellular membrane; there exists a similar reverse sympathy between the secerning vessels or glands of the former of these organs with those of the latter; that is the mucous glands of the heart and arteries act generally by direct sympathy with those of the stomach; and the mucous glands of the cellular membrane of the lungs, and of the skin, act by reverse sympathy with them both.

Hence when the stomach is torpid, as in sickness, this torpor sometimes only affects the absorbent vessels of it; and then the absorbents of the cellular membrane and the skin only act with increased energy by reverse sympathy. If the torpor affects the muscular fibres of the stomach, those of the heart and arteries act by direct sympathy with it, and a weak pulse is produced, as in the exhibition of digitalis, but without increase of heat. But if the torpor also affects the glands of the stomach, the cutaneous and pulmonary glands act with greater energy by their reverse sympathy with those of the stomach, and of the heart and arteries; and great heat is produced along with increased perspiration both from the skin and lungs.

3. There is some difficulty in explaining, why the actions of the extensive system of capillary glands, which exist on every other membrane and cell in the body for the purpose of secreting mucus and perspirable matter, should so generally act by reverse sympathy with those of the stomach and upper part of the intestines. It was shewn in Cla.s.s IV. 1. 1. 6. that when the stomach was filled with solid and fluid aliment, the absorbents of the cellular membrane, and of the bladder, and of the skin acted with less energy; as the fluids they were used to absorb and transmit into the circulation, were now less wanted; and that hence by habit a reverse sympathy obtained between these branches of the absorbents of the alimentary ca.n.a.l, and those of the other parts of the body.

Now, as at this time less fluid was absorbed by the cutaneous and cellular lymphatics, it would happen, that less would be secreted by their correspondent secerning vessels, or capillary glands; and that hence by habit, these secerning vessels would acquire a reverse sympathy of action with the secerning vessels of the alimentary ca.n.a.l.

Thus when the absorption of the tears by the puncta lacrymalia is much increased by the stimulus of snuff; or of an affecting idea, on the nasal dusts, as explained in Sect. XVI. 8. 2. a great increase of the secretion of tears from the lacrymal glands is produced by the direct sympathy of the action of these glands with those of their correspondent absorbents; and that though in this case they are placed at so great a distance from each other.

4. A difficult question here occurs; why does it happen, that in fevers with weak pulse the contractions of the heart and arteries become at the same time more frequent; which also sometimes occurs in chlorosis, and in some hysteric and hypochondriac diseases, and in some insanities; yet at other times the weak pulse becomes at the same time slow, as in the exhibition of digitalis, and in paresis irritativa, described in Cla.s.s I.

2. 1. 2. which may be termed a fever with slow pulse? this frequency of pulse can not depend on heat, because it sometimes exists without heat, as towards the end of some fevers with debility.

Now as apoplexies, which are sometimes ascribed to fulness of blood, are attended with slow pulse; and as in animals dying in the slaughter house from deficiency of blood the pulse becomes frequent in extreme; may not the frequency of pulse in fevers with arterial debility be in general owing to paucity of blood? as explained in Sect. x.x.xII. 2. 3. and its slowness in paresis irritativa be caused by the debility being accompanied with due quant.i.ty of blood? or may not the former circ.u.mstance sometimes depend on a concomitant affection of the brain approaching to sleep? or to the unusual facility of the pa.s.sage of the blood through the pulmonary and aortal capillaries? in which circ.u.mstance the heart may completely empty itself at each pulsation, though its contractions may be weak. While the latter depends on the difficulty of the pa.s.sage of the blood through the pulmonary or aortal capillaries, as in the cold fits of intermittents, and in some palpitations of the heart, and in some kinds of haemoptoe? in these cases the increased resistance prevents the heart from emptying itself, and in consequence a new diastole sooner occurs, and thus the number of pulsations becomes greater in a given time.

5. In respect to the sympathies of action, which produce or const.i.tute fever with debility, the system may be divided into certain provinces, which are a.s.sentient or opposite to each other. First, the lacteals or absorbent vessels of the stomach, and upper part of the intestines; secondly, the lymphatics or all the other branches of the absorbent vessels, which arise from the skin, mucous membranes, cellular membranes, and the various glands. These two divisions act by reverse sympathy with each other in the hot fits of fever with debility, though by direct sympathy in the cold ones. The third division consists of the secerning vessels of the stomach and upper intestines; and the fourth of the secerning vessels of all the other parts of the body, as the capillary glands of the skin, lungs, and cellular membrane, and the various other glands belonging to the sanguiferous system. Many of these frequently, but the capillaries always, act by reverse sympathy with those of the third division above mentioned in the hot fits of fever with debility, though by direct sympathy with them in the cold fits. Fifthly, the muscular fibres of the stomach, and upper intestines; and sixthly, the muscular fibres of the heart and arteries. The actions of these two last divisions of moving fibres act by direct sympathy with each other, both in the cold and hot fits of fevers with debility.

The efficient cause of those apparent sympathies in fevers with weak pulse may be thus understood. In the cold paroxysm of fever with weak pulse the part first affected I believe to be the stomach, and that it has become torpid by previous violent exertion, as by swallowing contagious matter mixed with saliva, and not by defect of stimulus, as from cold or hunger.

The actions of this important organ, which sympathizes with almost every part of the body, being thus much diminished or nearly destroyed, the sensorial power of a.s.sociation is not excited; which in health contributes to move the heart and arteries, and all the rest of the system; whence an universal torpor occurs.

When the hot fit approaches, the stomach in fevers with strong pulse regains its activity by the acc.u.mulation of the sensorial power of either irritation, if it was the part first affected, or of a.s.sociation if it was affected in sympathy with some other torpid part, as the spleen or liver; which acc.u.mulation is produced during its torpor. At the same time all the other parts of the system acquire greater energy of action by the acc.u.mulation of the sensorial power of a.s.sociation, which was produced, during their inactivity in the cold fit.

But in fevers with weak pulse the stomach, whose sensorial power of irritation had been previously exhausted by violent action, acquires no such quick acc.u.mulation of sensorial power, but remains in a state of torpor after the hot fit commences. The heart and arteries remain also in a state of torpor, because there continues to be no excitement of their power of a.s.sociation owing to the torpid motions of the stomach; but hence it happens, that there exists at this time a great acc.u.mulation of the power of a.s.sociation in the less active fibres of the heart and arteries; which, as it is not excited and expended by them, increases the a.s.sociability of the next link of the a.s.sociated chain of motions, which consists of the capillaries or other glands; and that in so great a degree as to actuate them with unnatural energy, and thus to produce a perpetual hot fit of fever. Because the a.s.sociability of the capillaries is so much increased by the acc.u.mulation of this power, owing to the lessened activity of the heart and arteries, as to over-balance the lessened excitement of it by the weaker movements of the heart and arteries.

6. When the acc.u.mulation of the sensorial power of irritation caused by defect of stimulus is greater in the first link of a train of actions, to which a.s.sociated motions are catenated, than the deficiency of the excitement of the sensorial power of a.s.sociation in the next link, what happens?--the superabundance of the unemployed sensorial power of the first link is derived to the second; the a.s.sociability of which thus becomes so greatly increased, that it acts more violently than natural, though the excitement of its power of a.s.sociation by the lessened action of the first link is less than natural. So that in this situation the withdrawing of an accustomed stimulus in some parts of the system will decrease the irritative motions of that part, and at the same time occasion an increase of the a.s.sociate motion of another part, which is catenated with it.