590 PRACTICE OF PHYSIC. 



has been agreed upon among physicians as a symptom of particu- 

 lar irritation in the brain, and very frequently of an inflammatory 

 state of it. Another symptom is a constant waking, which is a 

 stronger mark of the same condition; or, when not only constant 

 waking, but a constant restlessness and inquietude takes place 

 at the same time, when the patient frequently changes his pos- 

 ture, and can find no ease, which must be owing either to pain 

 or uneasiness, the latter generally depending upon what we 

 more strictly call anxiety. (Physiology, p. 59.) . And we find 

 that there is no cause of uneasiness so powerful in producing 

 anxiety and restlessness, as an irritation applied in a particular 

 manner to the brain. Uneasiness arises from the mind as well 

 as from the body, and we join to this delirium. We have 

 distinguished Delirium into two kinds, the placid and furi- 

 ous ; the latter, when it is with more emotion and restlessness, 

 and particularly when it is to the degree of a remarkable im- 

 patience to get out of bed, &c. when it may be considered as a 

 certain mark of a considerable irritation applied to the brain. 



" We may add every degree of convulsive and spasmodic mo- 

 tions. These, for the reasons I have given, may be reckoned 

 under the head of debility, since, if they were not from debility, 

 they would seldom take place ; but I must add, that they are also 

 marks of irritation, particularly as applied to the nervous sys- 

 tem ; and when they appear in the vital functions, as in the ac- 

 tion of the heart, producing a very frequent, small, and con- 

 tracted, or hard pulse, they are owing to some peculiar cause of 

 debility and irritation joined together. I have explained how 

 the weaker action of the heart gives a small and frequent pulse; 

 but I am to add now, that when a stimulus is applied to the 

 heart, and occasions a frequent contraction, so that it is imper- 

 fectly evacuated, it must also give a small pulse ; or, when it is 

 more or less applied to the arterial system, it gives a contracted 

 hard pulse ; and where the symptoms of irritation are not very 

 clear and evident, but are however taking place in the system 

 in an obscure manner, I know of no more certain means of 

 judging than from this small, frequent, hard, and contracted 

 pulse. 



" Lastly, Irritation may appear in the excretions, but I can 

 mention it only in one particular instance, in the case of the 



