MEDICINE. 
146 
cnee will come at length to be indisputable, I 
that the brain is the organ or reservoir of 
sensation, and the medium through which 
loco-motion is effected. 
Again, if it be found that at pleasure we 
can deprive any portion of the body both of 
sense and motion, by dividing the nerve sup- 
plying such part, or cutting off its communi- 
cation with the brain, we are likewi e fully 
justified in inferring, that the chord we have 
severed was the instrument by which the 
empire of the will had been exercised over 
the now inert and useless member. 
It is by the aggregation of such observ- 
ances that we arrive at the pathology of 
nervous, as a distinct class of morbid affec- 
tions. When, for example, any particular 
member of the body suddenly refuses to obey 
the command of the will, or, in common lan- 
guage, becomes paralytic, although we may 
not be able to trace the remote cause from 
which this has originated, we know that it 
must have immediately depended upon some 
morbid change, either in the brain itself, or 
at least in the nerve supply ing the organ in- 
disposed. 
This mode of inferring the nature of what 
is not an object of our senses, by comparing 
it with what we actually observe, will be 
found equally satisfactory, in relation to par- 
tial as total interruptions of sense and mo- 
tion ; thus, by a less degree of injury done 
to a nerve, as by lacerating or puncturing, 
instead of dividing it, we snail perceive not 
an entire deprivation of, but merely an im- 
pediment to, the loco-motive faculty ; the 
actions of the member will be in a manner 
refractory ; and convulsive or irregular, in- 
stead of orderly and steady, motion, will fol- 
low the mandates of the will. 
If then, without the interference of an 
experimenter, and without visible injury to 
the animal structure, the movements of an 
organ become improperly accelerated, or 
cease to be exercised in their usual mode; 
if, to instance by example, the heart perform 
two feeble, in place of one full and vigorous 
contraction ; we are authorised to state, that 
the disorder thus constituted is strictly and 
properly a nervous affection ; and our con- 
clusion, as to the fact, will be precisely the 
same, whatever theory we incline to, respect- 
jag the quo modo in which nervous power 
is displayed; whether with Hartley we con- 
ceive it to depend upon vibrations and vi- 
bratiuncles, whether we embrace the doc- 
trine of universally pervading at her, or sub- 
scribe to the untenable positions of the au- 
thor of Zoonomia. 
Depraved perception and interrupted mo- 
tion, are therefore the essences of nervous 
disease: the percipient, however, is to be 
distinguished from the motive faculty ; for we 
have a class of living actions, which, although 
equally under the inlluence of nervous power 
w.th those over which the will presides, are 
nevertheless, in a state of health, incessantly 
carried on without perception or conscious- 
ness; thus, by impeding the functions of 
the nerves of the stomach, we may interrupt 
the function of digestion. Digestion, how- 
ever. is a process performed without design, 
and independantiy of volition; on the other 
hand, the intellect may be impaired by a de- 
rangement in the nervous system, while the 
digestive power shall proceed without the 
smallest hindrance. 
Dr. Cullen’s definition of a nervous dis- 
ease, would therefore have been more accu- 
rate, had he stated it to be an affection of 
either sense or motion, without idiopathic 
pyrexia, or visible disease of parts. I he 
orders of this class (neuroses) are four: 
1. Comata. A diminution of voluntary 
motion, with sleep or impaired senses. 
2. Adynamiag a diminution of the invo- 
luntary motions of either natural or vital 
functions. 
3. Spasmi, morbid motions of muscular 
fibre. 
4. Vesanise, disorders of the judgment or 
intellect without primary pyrexia, or observ- 
able affection of any particular part ot the 
body. 
Order I. Comata. 
Genus I. Apoplexia, apoplexy. 
Symptoms. Abolition of the sentient and 
loco-motive faculties, the sleep in general 
attended with snoring. The respiration, 
motion of the heart, and other involuntary 
actions, remaining. 
Causes. We conclude from the analogy 
above-stated, that there is. some degree of 
pressure on the brain in almost all cases of 
apoplectic stupor; but that effusion of blood 
takes place in the manner described by the 
generality of authors, is exceedingly proble- 
matical ; if the appearances on dissection are 
appealed to in behalf of this theory, it is an- 
swered, that such appearances can alone ap- 
ply to fatal cases of the disease ; and in such, 
an actual rupture of vessels and ellusion ol 
blood will readily be admitted. 
Epilepsv, palsy, and apoplexy, were con- 
tended by Brown to originate from the mere 
irregularity of nervous power consequent 
upon debility or deficient excitement ; and 
to be occasioned without either an unusual 
impetus of circulation to the vessels of the 
brain, or impeded return of blood from this 
organ. We believe, however, that although 
the cause of apoplexy often is in one sense 
mere deficiency of excitement directed to 
tire sentient organization, the immediate oc- 
casion of the apoplectic symptoms is for the 
most part the state of the vessels ol the 
brain. 
Apoplexy, for the sake of illustration, may 
be divided into sthenic and asthenic. If a 
vigorous and plethoric man, sitting down to 
his dinner and his glass, suddenly, during 
the excitement of conviviality, of mirth, and 
of alcohol, fall on the floor with deprivation 
of sense and apoplectic stertor, it must be 
evident that the fit has been induced by a 
greater flow of arterial blood into the vessels 
of the brain, than the veins of this organ could, 
in due time, convey away. The apoplexy 
has been induced in the manner yf a sthenic 
di-ease. 
If, on the other hand, a debauched and de- 
bilitated individual be the subject of an apo- 
plectic attack, at the time when the excite- 
ment of intoxication shall have been succeed- 
ed by the condition ot indirect debility, the 
disease will here have been brought about in 
a different manner ; the impetus in the vessels 
ot the brain shall have partaken of the gene- 
ral diminution of power throughout the whole 
system ; sluggish vascular action shall have 
caused congestion ; which congestion, in union 
witii the deficient excitement on which it had 
depended, shall have induced that sudden 
1 
suspension of the sentient faculty which co re- 
stitutes the apoplectic paroxysm. 
Apoplexy often immediately succeeds to 
a full meal : what more natural than, under 
such circumstances, to attribute the fit to a 
distended stomach pressing upon the aorta 
or large descending blood-vessel, and conse- 
quent determination of the vital fluid in an 
inordinate measure to the head? Such con- 
clusion, however, will not bear the scrutiny 
of strict enquiry. Upon this principle, the 
apoplectic stertor and insensibility ought to 
be induced with most readiness, as in oneor- 
dynia or night-mare, while the body is in a 
recumbent posture, and the stomach is most 
distended from the extrication of gas which 
takes place in consequence of the weak- 
ened digestive power; in place of this, how- 
ever, the fall is immediate ; the attack is made- 
while the body is in an erect position, and 
often before the stomach has become in a very- 
great degree distended ; the lit fhen arises, in 
this last case, from that degree of excitement 
which the digestive powers have called off to. 
their aid, leaving the brain in a condition of 
insufficient energy, properly to propel the 
vital fluid through its own vessels ; congestion 
of blood is the consequence, and this last the 
proximate or immediate cause of the fit. 
M. M. The strictest attention to the man- 
ner in which the disorder has been brought 
on. If the disease is sthenic, and the phy- 
sicians are called in while the paroxysm still 
continues, immediate and copious bleedr 
ing from the arm, the jugular veins, or the 
temporal artery. Every ligature about the 
patient’s body, especially about the neck, 
to be loosened immediately. Press hard with 
the thumb and fore-finger upon the carotid, 
arteries, taking care to avoid the jugular 
veins. Place the head of the patient high on 
his pillow, or seat him erect in a chair.. 
Preserve the apartment cool. Cold water 
may in some cases be applied vigorously to 
the forehead and temples. Afterwards saline 
purges, and subacid drinks. Enemas. Care- 
ful preservation from irregular and violent 
excitations, either of body or mind. In the 
asthenic, and by far the most usual form, of 
the complaint, bleeding with much less freedom 
and only during the paroxysm; in general,; 
it is not at all proper. It is better to opera 
the temporal artery, if convenient, than to 
bleed from the arm or jugulars. The ap-3 
plication of cupping-glasses still prefer- 
able ; apply blisters to the neck. When 
the power of deglutition has returned, cor- 
dials and stimulants. Opium and wine in 
very small doses. Volatile alkali. Sprinkle 
vinegar about the room. To prevent the 
returns of the fits ; tonics, particularly bit- 
ters, as Colombo, gentian, quassia ; exercise 
and mental amusement, without violent ex- 
citation. Journeys to Bath or elsewhere.] 
Preserve the body regularly open, without 
violent purgations. Avoid sudden exposure 
to cold, especially cold and wet feet. If the 
fit has followed the suppression ef any ac- 
customed discharge, or cutaneous eruption,, 
let them, if possible, be restored. 
Genus II. Paralysis, palsy. 
Partial interruption of the loco-motive far 
culty, sometimes with a degree of apoplectic 
stertor. 
This is partial apoplexy, arising from simi- 
lar causes operating in a less degree. It 
