498 PRACTICE OF PHYSIC. 



be constantly the case, and have referred all cases of delirium lo 

 the state of the circulation in the brain. See, for instance, Boer- 

 haave's 701st aphorism. In the whole tenor of it, notwithstanding 

 his * plurimae causae,' he has chiefly in his view the state of the 

 circulation of the brain, and that, too, confined to increased im- 

 petus, as we may see from the method of cure which he gives 

 in the next aphorism ; for nine out of ten of his remedies are 

 plainly means of diminishing the determination to the brain, 

 and tend only to remove increased impetus in its vessels. It is 

 true, Van Swieten, his commentator, thinks we must go farther, 

 and says, that there are sympathetic deliria, depending upon 

 affections of distant parts of the system, particularly of the 

 stomach, so that the functions of the brain may be affected 

 independently of the circulation. But he had no conception of 

 delirium being cured by the application of powerful stimulants, 

 of which there are cases, I am told, on very good authority ; as 

 that of a gentleman in a fever, who had his delirium removed by 

 the use of wine, and was obliged to drink eight bottles a-day, 

 because, as soon as the effects of the wine were over, he be- 

 came delirious. Now, this is one species of delirium which, I 

 imagine, neither Boerhaave nor Van Swieten ever thought of. In 

 short, the motions of the nervous power can on many occasions 

 be changed without any alteration in the state of the circula- 

 tion ; and it is only in the state of the motions of the nervous 

 fluid that we are to seek for the cause of any change in the state 

 of our intellectual faculties. Some even think that these changes 

 are independent of any change whatever in the circulation of 

 the blood ; and that if they are connected with any changes in 

 our corporeal part, it must be with those of the nervous power. 



" Now, with respect to its depending upon the state of the 

 circulation, I have said that no delirium, perhaps, depends up- 

 on this alone ; for we know, that in violent exercise the impe- 

 tus is greatly increased above what it is in many fevers, and in 

 many cases of exhaustion the impetus is greatly diminished, 

 and yet the intellectual faculties are no ways affected. We are 

 therefore to seek for the cause of such changes in the state 

 of the nervous system alone. 



" But an inequality of the state of the brain may explain de- 

 lirium more particularly, as we may look upon, the whole doc- 



