COMATA. 



353 



than those from the medulla spinalis. When palsy is attended 

 with disorder of the intellectual powers, or of those senses which 

 depend on the brain, viz. sight, smell, taste, and hearing (for 

 touch, I imagine, may be produced by nerves arising from any 

 part of the body, certainly it may from nerves arising from the 

 medulla spinalis), then I say the prognosis is unfavourable. 



" Haller has observed, that sense requires less force in the 

 impelling powers than motion does: hence we may consider 

 these palsies as less dangerous when motion is lost than when 

 sense is. * 



" The loss of heat in a part, I consider as a more dangerous 

 symptom than that of sense ; for as the heat depends on a mo- 

 tion of the heart, &c. it is a proof that the heart and arteries do 

 not receive the nervous power more than the muscles affected ; 

 and consequently the disease is more universal. But as every 

 body does not admit that the nervous influence is the cause of 

 the contraction of the heart and arteries ; and some suppose with 

 Haller, a vis insita contractilis ; to such this prognostic sign 

 will appear unjust ; but, however, experience confirms it. And 

 even on their doctrine it may be owing to the loss of motion in 

 the affected muscle, which therefore does not assist to propel the 

 bloott with sufficient force to the heart, so that thereby the cir- 

 culation is rendered languid, and the disease more dangerous. 



" It is for the same reason that the loss of nourishment and 

 the decay of the part affords an unfavourable prognosis. 



" When the muscles continue contracted I consider it as fa- 

 vourable, because it is a proof that they still retain some degree 

 of irritability. 



" In general I would form a more favourable prognosis when 

 the nerves are permeable. And here we may observe, that me- 

 dicines which have no effect when applied to the hand, yet sti- 

 mulate often farther up, as does also electricity."" 



MCLI. From what has been said MCXLIV., it will be ob- 

 vious that the hemiplegia may be prevented by all the several 



* It is surprising that, when the nerves that go off together in a bundle from the sen- 

 rium are the cause of both sensation and motion in a muscle, yet the one should be de- 

 stroyed and the other remain entire ; this affords a proof that these nerves are distinct 

 even in the sensoiiam See Clinical Lectures by Dr. W. Cullen, Lond. 1797, p. 194. 



VOL. II. Z 



