COMATA. 351 



on constantly increasing, or be absorbed, so as to give relief to 

 the symptoms. I have had frequent occasion to make this ob- 

 servation ; in cases of hydropic diathesis, where I had no doubt 

 that the symptoms in the head proceeded from effusion there, 

 I have seen, that effusion and absorption distinctly alternate with 

 the state of the lower extremities and thorax. The probability, 

 therefore, is, that a case of subsisting effusion will be distinguish- 

 ed by this vicissitude of symptoms. So it is probable also that 

 when the palsy depends upon a plethoric state in the whole or 

 a part of the system, it will suffer some variation according to 

 the state of the evacuations, the passions of the mind, the tem- 

 perature of the air, &c. The same may indeed happen in pure 

 collapse, the cause and nature of which we know less clearly : 

 but it will not be so certain as where we can readily perceive 

 and trace the causes. I am ready therefore, to say 



" 4. That a durable palsy, especially one which, without 

 being to the most violent degree and with very little change, 

 especially affects the sensorium, is to be suspected of being a case 

 of collapse. With regard to the symptoms of affection of the 

 sensorium, we must consider, however, that when the disease has 

 most distinctly begun by compression, it is commonly at the 

 same time accompanied with considerable lowness of the intel- 

 lectual faculties : Now, I say, that when the palsy has begun in 

 this way, there is a gradual restoration of the intellectual facul- 

 ties : and I presume that when the case subsists, it is by the 

 power of collapse. 



" 5. When palsy follows apoplexy, the presumption is in 

 general in favour of compression : but the conclusion must not 

 be considered as absolute, for I think I have proved that there 

 are many apoplexies from collapse ; and, 



" 6. We conclude most certainly, that either apoplexy or 

 palsy depend upon collapse, when the causes evidently are of 

 that kind. Thus, when a gilder is affected with palsy, which 

 we impute to the fumes of mercury, and when painters and 

 others who have been exposed to the fumes of lead, have 

 palsy, it is probably from collapse : when apoplexy or palsy 

 arises from the damp of mines, or from the confined fumes of 

 charcoal, I have no doubt in considering it as depending purely 

 on collapse." 



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