VESANIJE. 537 



some consider it as an affection of respiration, others believe 

 it to be one of the head. 



" I try to reconcile them in this manner. Comatous affec- 

 tions, if very entire, affect respiration, and give stertor as a 

 mark of it. If, therefore, a congestion of the head is not con- 

 siderable enough to overcome all sense, it may be so much as to 

 affect the breathing, to prevent the easy and full dilatation of the 

 thorax; and the sense of that is imputed to what otherwise pre- 

 vents the dilatation, a weight somewhat pressing; the thorax. 

 Whatever difficulty there may be in this, it is pretty certain 

 that ephialtes depends upon congestion. It occurs in most 

 cases from a supine posture, which prevents the blood from 

 passing into the jugular veins : and if this is not always the 

 case, something analogous may be presumed in other instances. 

 Hence the cure." 



ON HEADACH. 



(From the Clinical Lectures.) 



" Headach, as a disease, is obscure ; as a symptom, difficult. 

 It may be allowed to be generally symptomatic; but I presume 

 it may also be primary ; and much confusion has arisen in the 

 attempts to distinguish between them. Sauvages has treated 

 the subject in every respect improperly. He has enumerated 

 as species of Headach what are evidently only symptoms of 

 other diseases, or affections not peculiar to the head. From 

 the species of primary headach, are to be rejected, 



" 1. All those pains depending on topical affections of the ex- 

 ternal parts, which may occur in other parts of the body, and 

 the seat of which in the head changes neither their nature nor 

 their indications. Thus, the Cephalaea syphilitica is not a dis- 

 ease different from a pain of the shins from the same cause. 

 Upon the same grounds I reject the Cephalaea ab acrimonia, the 

 Hemicrania ocularis, odontalgica, sinus, purulenta, ab insectis. 



" 2. All those that are manifestly symptomatic, as the Ce- 

 phalalgia catamenialis, haemorrhoidalis, stomachica, febrilis, 

 pulsatilis, intermittens, gravidarum, inflammatoria, catarrhalis, 



