Chapter V: Preface (4)

In like manner the exertion of the sensorial power less than natural in one part of the system, is liable to produce an increase of the exertion of it in some other part. Thus by the action of vomiting, in which the natural exertion of the motions of the stomach are destroyed or diminished, an increased absorption of the pulmonary and cellular lymphatics is produced, as is known by the increased absorption of the fluid deposited in them in dropsical cases. But these partial quiescences of sensorial power are also sometimes attended with other partial quiescences, which sympathize with them, as cold and pale extremities from hunger. These therefore are to be ascribed to the associations of sympathy explained in Sect. XXXV. and not to the general accumulation of sensorial power.

2. A quantity of stimulus less than natural, applied to fibres previously accustomed to perpetual stimulus, is succeeded by accumulation of sensorial power in the affected organ. The truth of this proposition is evinced, because a stimulus less than natural, if it be somewhat greater than that above mentioned, will excite the organ so circumstanced into violent activity. Thus on a frosty day with wind, the face of a person exposed to the wind is at first pale and shrunk; but on turning the face from the wind, it becomes soon of a glow with warmth and flushing. The glow of the skin in emerging from the cold-bath is owing to the same cause.

It does not appear, that an accumulation of sensorial power above the natural quantity is acquired by those muscles, which are not subject to perpetual stimulus, as the locomotive muscles: these, after the greatest fatigue, only acquire by rest their usual aptitude to motion; whereas the vascular system, as the heart and arteries, after a short quiescence, are thrown into violent action by their natural quantity of stimulus.

Nevertheless by this accumulation of sensorial power during the application of decreased stimulus, and by the exhaustion of it during the action of increased stimulus, it is wisely provided, that the actions of the vascular muscles and organs of sense are not much deranged by small variations of stimulus; as the quantity of sensorial power becomes in some measure inversely as the quantity of stimulus.

3. A quantity of stimulus less than that mentioned above, and continued for some time, induces pain in the affected organ, as the pain of cold in the hands, when they are immersed in snow, is owing to a deficiency of the stimulation of heat. Hunger is a pain from the deficiency of the stimulation of food. Pain in the back at the commencement of ague-fits, and the head-achs which attend feeble people, are pains from defect of stimulus, and are hence relieved by opium, essential oils, spirit of wine.

As the pains, which originate from defect of stimulus, only occur in those parts of the system, which have been previously subjected to perpetual stimulus; and as an accumulation of sensorial power is produced in the quiescent organ along with the pain, as in cold or hunger, there is reason to believe, that the pain is owing to the accumulation of sensorial power. For, in the locomotive muscles, in the retina of the eye, and other organs of senses, no pain occurs from the absence of stimulus, nor any great accumulation of sensorial power beyond their natural quantity, since these organs have not been used to a perpetual supply of it. There is indeed a greater accumulation occurs in the organ of vision after its quiescence, because it is subject to more constant stimulus.

4. A certain quantity of stimulus less than natural induces the moving organ into feebler and more frequent contractions, as mentioned in No. I. 4. of this Section. For each contraction moving through a less space, or with less force, that is, with less expenditure of the spirit of animation, is sooner relaxed, and the spirit of animation derived at each interval into the acting fibres being less, these intervals likewise become shorter. Hence the tremours of the hands of people accustomed to vinous spirit, till they take their usual stimulus; hence the quick pulse in fevers attended with debility, which is greater than in fevers attended with strength; in the latter the pulse seldom beats above 120 times in a minute, in the former it frequently exceeds 140.

It must be observed, that in this and the two following articles the decreased action of the system is probably more frequently occasioned by deficiency in the quantity of sensorial power, than in the quantity of stimulus. Thus those feeble constitutions which have large pupils of their eyes, and all who labour under nervous fevers, seem to owe their want of natural quantity of activity in the system to the deficiency of sensorial power; since, as far as can be seen, they frequently possess the natural quantity of stimulus.

5. A certain quantity of stimulus, less than that above mentioned, inverts the order of successive fibrous contractions; as in vomiting the vermicular motions of the stomach and duodenum are inverted, and their contents ejected, which is probably owing to the exhaustion of the spirit of animation in the acting muscles by a previous excessive stimulus, as by the root of ipecacuanha, and the consequent defect of sensorial power. The same retrograde motions affect the whole intestinal canal in ileus; and the oesophagus in globus hystericus. See this further explained in Sect. XXIX. No. 11. on Retrograde Motions.

I must observe, also, that something similar happens in the production of our ideas, or sensual motions, when they are too weakly excited; when any one is thinking intensely about one thing, and carelessly conversing about another, he is liable to use the word of a contrary meaning to that which he designed, as cold weather for hot weather, summer for winter.

6. A certain quantity of stimulus, less than that above mentioned, is succeeded by paralysis, first of the voluntary and sensitive motions, and afterwards of those of irritation, and of association, which constitutes death.

VI. _Cure of increased Exertion._

1. The cure, which nature has provided for the increased exertion of any part of the system, consists in the consequent expenditure of the sensorial power. But as a greater torpor follows this exhaustion of sensorial power, as explained in the next paragraph, and a greater exertion succeeds this torpor, the constitution frequently sinks under these increasing librations between exertion and quiescence; till at length complete quiescence, that is, death, closes the scene.

For, during the great exertion of the system in the hot fit of fever, an increase of stimulus is produced from the greater momentum of the blood, the greater distention of the heart and arteries, and the increased production of heat, by the violent actions of the system occasioned by this augmentation of stimulus, the sensorial power becomes diminished in a few hours much beneath its natural quantity, the vessels at length cease to obey even these great degrees of stimulus, as shewn in Sect. XL. 9. 1. and a torpor of the whole or of a part of the system ensues.

Now as this second cold fit commences with a greater deficiency of sensorial power, it is also attended with a greater deficiency of stimulus than in the preceding cold fit, that is, with less momentum of blood, less distention of the heart. On this account the second cold fit becomes more violent and of longer duration than the first; and as a greater accumulation of sensorial power must be produced before the system of vessels will again obey the diminished stimulus, it follows, that the second hot fit of fever will be more violent than the former one. And that unless some other causes counteract either the violent exertions in the hot fit, or the great torpor in the cold fit, life will at length be extinguished by the expenditure of the whole of the sensorial power. And from hence it appears, that the true means of curing fevers must be such as decrease the action of the system in the hot fit, and increase it in the cold fit; that is, such as prevent the too great diminution of sensorial power in the hot fit, and the too great accumulation of it in the cold one.

2. Where the exertion of the sensorial powers is much increased, as in the hot fits of fever or inflammation, the following are the usual means of relieving it. Decrease the irritations by blood-letting, and other evacuations; by cold water taken into the stomach, or injected as an enema, or used externally; by cold air breathed into the lungs, and diffused over the skin; with food of less stimulus than the patient has been accustomed to.

3. As a cold fit, or paroxysm of inactivity of some parts of the system, generally precedes the hot fit, or paroxysm of exertion, by which the sensorial power becomes accumulated, this cold paroxysm should be prevented by stimulant medicines and diet, as wine, opium, bark, warmth, cheerfulness, anger, surprise.

4. Excite into greater action some other part of the system, by which means the spirit of animation may be in part expended, and thence the inordinate actions of the diseased part may be lessened. Hence when a part of the skin acts violently, as of the face in the eruption of the small-pox, if the feet be cold they should be covered. Hence the use of a blister applied near a topical inflammation. Hence opium and warm bath relieve pains both from excess and defect of stimulus.

5. First increase the general stimulation above its natural quantity, which may in some degree exhaust the spirit of animation, and then decrease the stimulation beneath its natural quantity. Hence after sudorific medicines and warm air, the application of refrigerants may have greater effect, if they could be administered without danger of producing too great torpor of some part of the system; as frequently happens to people in health from coming out of a warm room into the cold air, by which a topical inflammation in consequence of torpor of the mucous membrane of the nostril is produced, and is termed a cold in the head.

VII. _Cure of decreased Exertion._

1. Where the exertion of the sensorial powers is much decreased, as in the cold fits of fever, a gradual accumulation of the spirit of animation takes place; as occurs in all cases where inactivity or torpor of a part of the system exists; this accumulation of sensorial power increases, till stimuli less than natural are sufficient to throw it into action, then the cold fit ceases; and from the action of the natural stimuli a hot one succeeds with increased activity of the whole system.

So in fainting fits, or syncope, there is a temporary deficiency of sensorial exertion, and a consequent quiescence of a great part of the system. This quiescence continues, till the sensorial power becomes again accumulated in the torpid organs; and then the usual diurnal stimuli excite the revivescent parts again into action; but as this kind of quiescence continues but a short time compared to the cold paroxysm of an ague, and less affects the circulatory system, a less superabundancy of exertion succeeds in the organs previously torpid, and a less excess of arterial activity. See Sect. XXXIV. 1. 6.

2. In the diseases occasioned by a defect of sensorial exertion, as in cold fits of ague, hysteric complaint, and nervous fever, the following means are those commonly used. 1. Increase the stimulation above its natural quantity for some weeks, till a new habit of more energetic contraction of the fibres is established. This is to be done by wine, opium, bark, steel, given at exact periods, and in appropriate quantities; for if these medicines be given in such quantity, as to induce the least degree of intoxication, a debility succeeds from the useless exhaustion of spirit of animation in consequence of too great exertion of the muscles or organs of sense. To these irritative stimuli should be added the sensitive ones of cheerful ideas, hope, affection.

3. Change the kinds of stimulus. The habits acquired by the constitution depend on such nice circumstances, that when one kind of stimulus ceases to excite the sensorial power into the quantity of exertion necessary to health, it is often sufficient to change the stimulus for another apparently similar in quantity and quality. Thus when wine ceases to stimulate the constitution, opium in appropriate doses supplies the defect; and the contrary. This is also observed in the effects of cathartic medicines, when one loses its power, another, apparently less efficacious, will succeed. Hence a change of diet, drink, and stimulating medicines, is often advantageous in diseases of debility.

4. Stimulate the organs, whose motions are associated with the torpid parts of the system. The actions of the minute vessels of the various parts of the external skin are not only associated with each other, but are strongly associated with those of some of the internal membranes, and particularly of the stomach. Hence when the exertion of the stomach is less than natural, and indigestion and heartburn succeed, nothing so certainly removes these symptoms as the stimulus of a blister on the back. The coldness of the extremities, as of the nose, ears, or fingers, are hence the best indication for the successful application of blisters.

5. Decrease the stimulus for a time. By lessening the quantity of heat for a minute or two by going into the cold bath, a great accumulation of sensorial power is produced; for not only the minute vessels of the whole external skin for a time become inactive, as appears by their paleness; but the minute vessels of the lungs lose much of their activity also by concert with those of the skin, as appears from the difficulty of breathing at first going into cold water. On emerging from the bath the sensorial power is thrown into great exertion by the stimulus of the common degree of the warmth of the atmosphere, and a great production of animal heat is the consequence. The longer a person continues in the cold bath the greater must be the present inertion of a great part of the system, and in consequence a greater accumulation of sensorial power. Whence M. Pomè recommends some melancholy patients to be kept from two to six hours in spring-water, and in baths still colder.

6. Decrease the stimulus for a time below the natural, and then increase it above natural. The effect of this process, improperly used, is seen in giving much food, or applying much warmth, to those who have been previously exposed to great hunger, or to great cold. The accumulated sensorial power is thrown into so violent exertion, that inflammations and mortifications supervene, and death closes the catastrophe. In many diseases this method is the most successful; hence the bark in agues produces more certain effect after the previous exhibition of emetics. In diseases attended with violent pain, opium has double the effect, if venesection and a cathartic have been previously used. On this seems to have been founded the successful practice of Sydenham, who used venesection and a cathartic in chlorosis before the exhibition of the bark, steel, and opiates.

7. Prevent any unnecessary expenditure of sensorial power. Hence in fevers with debility, a decumbent posture is preferred, with silence, little light, and such a quantity of heat as may prevent any chill sensation, or any coldness of the extremities. The pulse of patients in fevers with debility increases in frequency above ten pulsations in a minute on their rising out of bed. For the expenditure of sensorial power to preserve an erect posture of the body adds to the general deficiency of it, and thus affects the circulation.

8. The longer in time and the greater in degree the quiescence or inertion of an organ has been, so that it still retains life or excitability, the less stimulus should at first be applied to it. The quantity of stimulation is a matter of great nicety to determine, where the torpor or quiescence of the fibres has been experienced in a great degree, or for a considerable time, as in cold fits of the ague, in continued fevers with great debility, or in people famished at sea, or perishing with cold. In the two last cases, very minute quantities of food should be first supplied, and very few additional degrees of heat. In the two former cases, but little stimulus of wine or medicine, above what they had been lately accustomed to, should be exhibited, and this at frequent and stated intervals, so that the effect of one quantity may be observed before the exhibition of another.

If these circumstances are not attended to, as the sensorial power becomes accumulated in the quiescent fibres, an inordinate exertion takes place by the increase of stimulus acting on the accumulated quantity of sensorial power, and either the paralysis, or death of the contractile fibres ensues, from the total expenditure of the sensorial power in the affected organ, owing to this increase of exertion, like the debility after intoxication. Or, secondly, the violent exertions above mentioned produce painful sensation, which becomes a new stimulus, and by thus producing inflammation, and increasing the activity of the fibres already too great, sooner exhausts the whole of the sensorial power in the acting organ, and mortification, that is, the death of the part, supervenes.

Hence there have been many instances of people, whose limbs have been long benumbed by exposure to cold, who have lost them by mortification on their being too hastily brought to the fire; and of others, who were nearly famished at sea, who have died soon after having taken not more than an usual meal of food. I have heard of two well-attested instances of patients in the cold fit of ague, who have died from the exhibition of gin and vinegar, by the inflammation which ensued. And in many fevers attended with debility, the unlimited use of wine, and the wanton application of blisters, I believe, has destroyed numbers by the debility consequent to too great stimulation, that is, by the exhaustion of the sensorial power by its inordinate exertion.

Wherever the least degree of intoxication exists, a proportional debility is the consequence; but there is a golden rule by which the necessary and useful quantity of stimulus in fevers with debility may be ascertained. When wine or beer are exhibited either alone or diluted with water, if the pulse becomes slower the stimulus is of a proper quantity; and should be repeated every two or three hours, or when the pulse again becomes quicker.

In the chronical debility brought on by drinking spirituous or fermented liquors, there is another golden rule by which I have successfully directed the quantity of spirit which they may safely lessen, for there is no other means by which they can recover their health. It should be premised, that where the power of digestion in these patients is totally destroyed, there is not much reason to expect a return to healthful vigour.

I have directed several of these patients to omit one fourth part of the quantity of vinous spirit they have been lately accustomed to, and if in a fortnight their appetite increases, they are advised to omit another fourth part; but if they perceive that their digestion becomes impaired from the want of this quantity of spirituous potation, they are advised to continue as they are, and rather bear the ills they have, than risk the encounter of greater. At the same time flesh-meat with or without spice is recommended, with Peruvian bark and steel in small quantities between their meals, and half a grain of opium or a grain, with five or eight grains of rhubarb at night.

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SECT. XIII.

OF VEGETABLE ANIMATION.

I. 1. _Vegetables are irritable; mimosa, dionæa muscipula. Vegetable
secretions._ 2. _Vegetable buds are inferior animals, are liable to
greater or less irritability._ II. _Stamens and pistils of plants shew
marks of sensibility._ III. _Vegetables possess some degree of
volition._ IV. _Motions of plants are associated like those of
animals._ V. 1. _Vegetable structure like that of animals, their
anthers and stigmas are living creatures. Male-flowers of Vallisneria._
2. _Whether vegetables, possess ideas? They have organs of sense as of
touch and smell, and ideas of external things?_

I. 1. The fibres of the vegetable world, as well as those of the animal, are excitable into a variety of motion by irritations of external objects. This appears particularly in the mimosa or sensitive plant, whose leaves contract on the slightest injury; the dionæa muscipula, which was lately brought over from the marshes of America, presents us with another curious instance of vegetable irritability; its leaves are armed with spines on their upper edge, and are spread on the ground around the stem; when an insect creeps on any of them in its passage to the flower or seed, the leaf shuts up like a steel rat-trap, and destroys its enemy. See Botanic Garden,