Delirium in diseases from inirritability is sometimes preceded by a propensity to surprise. See Cla.s.s I. 1. 5. 11.

M. M. Fomentations of the shaved head for an hour repeatedly. A blister on the head. Rising from bed. Wine and opium, and sometimes venesection in small quant.i.ty by cupping, if the strength of the arterial system will allow it.

2. _Delirium maniacale._ Maniacal delirium. There is another kind of delirium, described in Sect. x.x.xIII. 1. 4. which has the increase of pleasureable or painful sensation for its cause, without any diminution of the other sensorial powers; but as this excites the patient to the exertion of voluntary actions, for the purpose of obtaining the object of his pleasureable ideas, or avoiding the object of his painful ones, such as perpetual prayer, when it is of the religious kind, it belongs to the insanities described in Cla.s.s III. 1. 2. 1, and is more properly termed hallucinatio maniacalis.

3. _Dilirium ebrietatis._ The drunken delirium is in nothing different from the delirium attending fevers except in its cause, as from alcohol, or other poisons. When it is attended with an apoplectic stupor, the pulse is generally low; and venesection I believe sometimes destroys those, who would otherwise have recovered in a few hours.

M. M. Diluting liquids. An emetic.

4. _Somnium._ Dreams const.i.tute the most complete kind of delirium. As in these no external irritations are attended to, and the power of volition is entirely suspended; so that the sensations of pleasure and pain, with their a.s.sociations, alone excite the endless trains of our sleeping ideas; as explained in Sect. XVIII. on Sleep.

5. _Hallucinatio visus._ Deception of sight. These visual hallucinations are perpetual in our dreams; and sometimes precede general delirium in fevers; and sometimes belong to reverie, and to insanity. See Cla.s.s III. 1.

2. 1. and 2. and must be treated accordingly.

Other kinds of visual hallucinations occur by moon-light; when objects are not seen so distinctly as to produce the usual ideas a.s.sociated with them, but appear to us exactly as they are seen. Thus the trunk of a tree appears a flat surface, instead of a cylinder as by day, and we are deceived and alarmed by seeing things as they really are seen. See Berkley on Vision.

6. _Hallucinatio auditus._ Auricular deception frequently occurs in dreams, and sometimes precedes general delirium in fevers; and sometimes belongs to vertigo, and to reverie, and to insanity. See Sect. XX. 7. and Cla.s.s III.

1. 2. 1. and 2.

7. _Rubor a calore._ The blush from heat is occasioned by the increased action of the cutaneous vessels in consequence of the increased sensation of heat. See Cla.s.s I. 1. 2. 1. and 3.

8. _Rubor jucunditatis._ The blush of joy is owing to the increased action of the capillary arteries, along with that of every moving vessel in the body, from the increase of pleasurable sensation.

9. _Priapismus amatorius._ Amatorial priapism. The blood is poured into the cells of the corpora cavernosa much faster than it can be reabsorbed by the vena p.e.n.i.s, owing in this case to the pleasurable sensation of love increasing the arterial action. See Cla.s.s I. 1. 4. 6.

10. _Distentio mamularum._ The teats of female animals, when they give suck, become rigid and erected, in the same manner as in the last article, from the pleasurable sensation of the love of the mother to her offspring.

Whence the teat may properly be called an organ of sense. The nipples of men do the same when rubbed with the hand. See Cla.s.s I. 1. 4. 7.

ORDO II.

_Decreased Sensation._

GENUS I.

_Of the General System._

SPECIES.

1. _Stult.i.tia insensibilis._ Folly from insensibility. The pleasure or pain generated in the system is not sufficient to promote the usual activity either of the sensual or muscular fibres.

2. _Taedium vitae._ Ennui. Irksomeness of life. The pain of laziness has been thought by some philosophers to be that principle of action, which has excited all our industry, and distinguished mankind from the brutes of the field. It is certain that, where the ennui exists, it is relieved by the exertions of our minds or bodies, as all other painful sensations are relieved; but it depends much upon our early habits, whether we become patient of laziness, or inclined to activity, during the remainder of our lives, as other animals do not appear to be affected with this malady; which is perhaps left owing to deficiency of pleasurable sensation, than to the superabundancy of voluntary power, which occasions pain in the muscles by its acc.u.mulation; as appears from the perpetual motions of a squirrel confined in a cage.

3. _Paresis sensitiva._ Weakness of the whole system from insensibility.

ORDO II.

_Decreased Sensation._

GENUS II.

_Of Particular Organs._

SPECIES.

1. _Anorexia._ Want of appet.i.te. Some elderly people, and those debilitated by fermented liquors, are liable to lose their appet.i.te for animal food; which is probably in part owing to the deficiency of gastric acid, as well as to the general decay of the system: elderly people will go on years without animal food; but inebriates soon sink, when their digestion becomes so far impaired. Want of appet.i.te is sometimes produced by the putrid matter from many decaying teeth being perpetually mixed with the saliva, and thence affecting the organ of taste, and greatly injuring the digestion.

M. M. Fine charcoal powder diffused in warm water held in the mouth frequently in a day, as in Cla.s.s I. 2. 4. 12. or solution of alum in water.

Extract the decayed teeth. An emetic. A blister. Chalybeates. Vitriolic acid. Bile of an ox insp.i.s.sated, and made into pills; 20 grains to be taken before dinner and supper. Opium half a grain twice a day.

All the strength we possess is ultimately derived from the food, which we are able to digest; whence a total debility of the system frequently follows the want of appet.i.te, and of the power of digestion. Some young ladies I have observed to fall into this general debility, so as but just to be able to walk about; which I have sometimes ascribed to their voluntary fasting, when they believed themselves too plump; and who have thus lost both their health and beauty by too great abstinence, which could never be restored.

I have seen other cases of what may be termed anorexia epileptica, in which a total loss of appet.i.te, and of the power of digestion, suddenly occurred along with epileptic fits. Miss B. a girl about eighteen, apparently very healthy, and rather plump, was seized with fits, which were at first called hysterical; they occurred at the end of menstruation, and returned very frequently with total loss of appet.i.te. She was relieved by venesection, blisters, and opiates; her strength diminished, and after some returns of the fits, she took to her bed, and has survived 15 or 20 years; she has in general eaten half a potato a day, and seldom speaks, but retains her senses, and had many years occasional returns of convulsion. I have seen two similar cases, where the anorexia, or want of appet.i.te, was in less degree; and but just so much food could be digested, as supplied them with sufficient strength to keep from the bed or sofa for half the day. As well as I can recollect, all these patients were attended with weak pulse, and cold pale skin; and received benefit by opium, from a quarter of a grain to a grain four times a day. See Cla.s.s III. 1. 1. 7. and III. 1. 2. 1. and III. 1. 2. 20.

2. _Adipsia._ Want of thirst. Several of the inferior people, as farmers wives, have a habit of not drinking with their dinner at all, or only take a spoonful or two of ale after it. I have frequently observed these to labour under bad digestion, and debility in consequence; which I have ascribed to the too great stimulus of solid food undiluted, destroying in process of time the irritability of the stomach.

3. _Impotentia_ (agenesia). Impotency much seldomer happens to the male s.e.x than sterility to the female s.e.x. Sometimes a temporary impotence occurs from bashfulness, or the interference of some voluntary exertion in the production of an effect, which should be performed alone by pleasurable sensation.

One, who was soon to be married to a lady of superior condition to his own, expressed fear of not succeeding on the wedding night; he was advised to take a grain of opium before he went to bed, and to accustom himself to sleep with a woman previously, but not to enjoy her, to take off his bashfulness; which succeeded to his wish.

M. M. Chalybeates. Opium. Bark. Tincture of cantharides.

4. _Sterilitas._ Barrenness. One of the ancient medical writers a.s.serts, that the female s.e.x become pregnant with most certainty at or near the time of menstruation. This is not improbable, since these monthly periods seem to referable the monthly venereal o.r.g.a.s.m of some female quadrupeds, which become pregnant at those times only; and hence the computation of pregnancy is not often erroneous, though taken from the last menstruation. See Section x.x.xVI. 2. 3.

M. M. Opium a grain every night. Chalybeates in very small doses. Bark.

Sea-bathing.

5. _Insensibilitas artuum._ As in some paralytic limbs. A great insensibility sometimes accompanies the torpor of the skin in cold fits of agues. Some parts have retained the sense of heat, but not the sense of touch. See Sect. XVI. 6.

M. M. Friction with flannel. A blister. Warmth.

6. _Dysuria insensitiva._ Insensibility of the bladder. A difficulty or total inability to make water attends some fevers with great debility, owing to the insensibility or inirritability of the bladder. This is a dangerous but not always a fatal symptom.

M. M. Draw off the water with a catheter. a.s.sist the patient in the exclusion of it by compressing the lower parts of the abdomen with the hands. Wine two ounces, Peruvian bark one dram in decoction, every three hours alternately. Balsam of copaiva. Oil of almonds, with as much camphor as can be dissolved in it, applied as a liniment rubbed on the region of the bladder and perinaeum, and repeated every four hours, was used in this disease with success by Mr. Latham. Med. Comment. 1791, p. 213.

7. _Acc.u.mulatio alvina._ An acc.u.mulation of feces in the r.e.c.t.u.m, occasioned by the torpor, or insensibility, of that bowel. But as liquids pa.s.s by these acc.u.mulations, it differs from the constipatio alvi, which is owing to too great absorption of the alimentary ca.n.a.l.

Old milk, and especially when boiled, is liable to induce this kind of costiveness in some grown persons; which is probably owing to their not possessing sufficient gastric acid to curdle and digest it; for as both these processes require gastric acid, it follows, that a greater quant.i.ty of it is necessary, than in the digestion of other aliments, which do not previously require being curdled. This ill digested milk not sufficiently stimulating the r.e.c.t.u.m, remains till it becomes a too solid ma.s.s. On this account milk seldom agrees with those, who are subject to piles, by inducing costiveness and large stools.

M. M. Extract the hardened scybala by means of a marrow-spoon; or by a piece of wire, or of whale-bone bent into a bow, and introduced. Injections of oil. Castor oil, or oil of almonds, taken by the mouth. A large clyster of smoak of tobacco. Six grains of rhubarb taken every night for many months. Aloes. An endeavour to establish a habit of evacuation at a certain hour daily. See Cla.s.s I. 1. 3. 5.

ORDO III.

_Retrograde Sensitive Motions._