10. _Maeror._ Grief.
11. _Taedium vitae._ Irksomeness of life.
12. _Desiderium pulchritudinis._ Loss of beauty.
13. _Paupertatis timor._ Fear of poverty.
14. _Lethi timor._ ---- of death.
15. _Orci timor._ ---- of h.e.l.l.
16. _Satyriasis._ l.u.s.t.
17. _Ira._ Anger.
18. _Rabies._ Rage.
19. _Citta._ Depraved appet.i.te.
20. _Cacositia._ Aversion to food.
21. _Syphilis imaginaria._ Imaginary pox.
22. _Psora imaginaria._ ---- itch.
23. _Tabes imaginaria._ ---- tabes.
24. _Sympathia aliena._ Pity.
25. _Educatio heroica._ Heroic education.
ORDO II.
_Decreased Volition._
GENUS I.
_With decreased Actions of the Muscles._
SPECIES.
1. _La.s.situdo._ Fatigue.
2. _Vacillatio senilis._ See-saw of old age.
3. _Tremor senilis._ Tremor of old age.
4. _Brachiorum paralysis._ Palsy of the arms.
5. _Raucedo paralytica._ Paralytic hoa.r.s.eness.
6. _Vesicae urinariae paralysis._ Palsy of the bladder.
7. _Recti paralysis._ Palsy of the r.e.c.t.u.m.
8. _Paresis voluntaria._ Voluntary debility.
9. _Catalepsis._ Catalepsy.
10. _Hemiplegia._ Palsy of one side.
11. _Paraplegia._ Palsy of the lower limbs.
12. _Somnus._ Sleep.
13. _Incubus._ Night-mare.
14. _Lethargus._ Lethargy.
15. _Syncope epileptica._ Epileptic fainting.
16. _Apoplexia._ Apoplexy.
17. _Mors a frigore._ Death from cold.
GENUS II.
_With decreased Actions of the Organs of Sense._
SPECIES.
1. _Recollectionis jactura._ Loss of recollection.
2. _Stult.i.tia voluntaria._ Voluntary folly.
3. _Credulitas._ Credulity.
CLa.s.s III.
DISEASES OF VOLITION.
ORDO I.
_Increased Volition._
GENUS I.
_Increased Actions of the Muscles._
We now step forward to consider the diseases of volition, that superior faculty of the sensorium, which gives us the power of reason, and by its facility of action distinguishes mankind from brute animals; which has effected all that is great in the world, and superimposed the works of art on the situations of nature.
Pain is introduced into the system either by excess or defect of the action of the part. (Sect. IV. 5.) Both which circ.u.mstances seem to originate from the acc.u.mulation of sensorial power in the affected organ. Thus when the skin is exposed to great cold, the activity of the cutaneous vessels is diminished, and in consequence an acc.u.mulation of sensorial power obtains in them, because they are usually excited into incessant motion by the stimulus of heat, as explained in Sect. XII. 5. 2. Contrarywise, when the vessels of the skin are exposed to great heat, an excess of sensorial power is also produced in them, which is derived thither by the increase of stimulus above what is natural.
This accounts for the relief which is received in all kinds of pain by any violent exertions of our muscles or organs of sense; which may thus be in part ascribed to the exhaustion of the sensorial power by such exertions.
But this relief is in many cases so instantaneous, that it seems nevertheless probable, that it is also in part owing to the different manner of progression of the two sensorial powers of sensation and volition; one of them commencing at some extremity of the sensorium, and being propagated towards the central parts of it; and the other commencing in the central parts of the sensorium, and being propagated towards the extremities of it; as mentioned in Sect. XI. 2. 1.
These violent voluntary exertions of our muscles or ideas to relieve the sensation of pain const.i.tute convulsions and madness; and are distinguished from the muscular actions owing to increased sensation, as in sneezing, or coughing, or parturition, or ejectio feminis, because they do not contribute to dislodge the cause, but only to prevent the sensation of it.
In two cases of parturition, both of young women with their first child, I have seen general convulsions occur from excess of voluntary exertion, as above described, instead of the actions of particular muscles, which ought to have been excited by sensation for the exclusion of the fetus. They both became insensible, and died after some hours; from one of them the fetus was extracted in vain. I have heard also of general convulsions being excited instead of the actions of the musculi acceleratores in the ejectio feminis, which terminated fatally. See Cla.s.s III. 1. 1. 7.
These violent exertions are most frequently excited in consequence of those pains, which originate from defect of the action of the part. See Sect.
x.x.xIV. 1. and 2. The pains from excess and defect of the action of the part are distinguishable from each other by the former being attended with increase of heat in the pained part, or of the whole body; while the latter not only exist without increase of heat in the pained part, but are generally attended with coldness of the extremities of the body.
As soon as these violent actions of our muscular or sensual fibres for the purpose of relieving pain cease to be exerted, the pain recurs; whence the reciprocal contraction and relaxation of the muscles in convulsion, and the intervals of madness. Otherwise these violent exertions continue, till so great a part of the sensorial power is exhausted, that no more of it is excitable by the faculty of volition; and a temporary apoplexy succeeds, with snoring as in profound sleep; which so generally terminates epileptic fits.
When these voluntary exertions become so connected with certain disagreeable sensations, or with irritations, that the effort of the will cannot restrain them, they can no longer in common language be termed voluntary; but nevertheless belong to this cla.s.s, as they are produced by excess of volition, and may still not improperly be called depraved voluntary actions. See Sect. x.x.xIV. 1. where many motions in common language termed involuntary are shewn to depend on excess of volition.
When these exertions from excess of volition, which in common language are termed involuntary motions, either of mind or body, are perpetually exerted in weak const.i.tutions, the pulse becomes quick; which is occasioned by the too great expenditure of the sensorial power in these unceasing modes of activity. In the same manner as in very weak people in fevers, the pulse sometimes increases in frequency to 140 strokes in a minute, when the patients stand up or endeavour to walk; and subsides to 110, when they lie down again in their beds. Whence it appears, that when a very quick pulse accompanies convulsion or insanity, it simply indicates the weakness of the patient; that is, that the expenditure of sensorial power is too great for the supply of it. But if the strength of the patient is not previously exhausted, the exertions of the muscles are attended with temporary increase of circulation, the reciprocal swellings and elongations of their bellies push forwards the arterial blood, and promote the absorption of the venous blood; whence a temporary increase of secretion and of heat, and a stronger pulse.
SPECIES.
1. _Jact.i.tatio._ Restlessness. There is one kind of restlessness attending fevers, which consists in a frequent change of posture to relieve the uneasiness of the pressure of one part of the body upon another, when the sensibility of the system, or of some parts of it, is increased by inflammation, as in the lumbago; which may sometimes be distinguished in its early stage by the incessant desire of the patient to turn himself in bed. But there is another restlessness, which approaches towards writhing or contortions of the body, which is a voluntary effort to relieve pain; and may be esteemed a slighter kind of convulsion, not totally unrestrainable by opposite or counteracting volitions.
M. M. A blister. Opium. Warm bath.
2. _Tremor febrilis._ Reciprocal convulsions of the subcutaneous muscles, originating from the pain of the sense of heat, owing to defect of its usual stimulus, and consequent acc.u.mulation of sensorial power in it. The actual deficiency of heat may exist in one part of the body, and the pain of cold be felt most vividly in some other part a.s.sociated with it by sensitive sympathy. So a chillness down the back is first attended to in ague-fits, though the disease perhaps commences with the torpor and consequent coldness of some internal viscus. But in whatever part of the system the defect of heat exists, or the sensation of it, the convulsions of the subcutaneous muscles exerted to relieve it are very general; and, if the pain is still greater, a chattering of the teeth is added, the more suddenly to exhaust the sensorial power, and because the teeth are very sensible to cold.
These convulsive motions are nevertheless restrainable by violent voluntary counteraction; 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 interval of pleasure preceding each moment of pain in this as in the latter.
M. M. See I. 2. 2. 1.