PATHOLOGY. 
molt trifling impreflions. But it frequently happens, that 
an attentive obferver may detect other fymptoms : the 
child may ftart in its deep ; it may be very readily awak¬ 
ened ; when awake, it may Hart at the flighted noife, as 
at the ihutting of a door, moving a chair, palling the finger 
over the wicker-work of its cradle, or on being flightly 
moved, or touched gently; a fudden frown may pals 
over the forehead, and may quickly difappear; the eyes 
may be clofed irregularly, or alternately, or a winking of 
one eye, or frequent winking of both eyes, or a firm 
clofing of both eyes, may be from time to time de¬ 
tected ; the hand may be raided frequently to the 
head ; the child may cry, without any evident caufe, 
as if it were pricked with a pin ; at other times, it may 
Ihriek; the fills may be clenched, the thumb being bent 
in, and laid flat acrofs the palm of the hand, the fore¬ 
arms being bent upwards on the arms. Should a 
iimilar condition of the fpinal brain be prefent, the 
child may be bent backwards, prefenting a Hate of 
opijlhotonus ; its legs may be drawn up, while the head is 
thrown backwards.” 
There is another form of infantile erithifm characterized 
by want of animation, fretfulnefs when roufed, want of 
fleep, and yet “ a ftate that can hardly be called waking ;” 
indifference to furrounding objeCls, pallor and chillinefs 
of the body, rolling of the eyes, plaintive moaning or 
Ihrieking, jactitation of the hands, and other minor fy tnp- 
toms ; which our author denominates torpid erelliifm. 
Scrofulous children have generally the greateft ten¬ 
dency to cerebral erithifm ; and, where this tendency 
exilts, the flighteft irritation of the nervous fyftem will 
call it into aCtion. In the milder forms and earlier ftages 
of this affeCtion, the fymptoms which it produces may be 
great wakefulnefs, great fenfibility to flight impreflions, 
with reltlelfnefs and high animation. 
It is to be remarked, that irritants applied to any of 
the nervous expanfions may produce eretliifm, fo that it is 
juft poflible that it may arife independent of gaftric or 
intellinal diforder. It is to be noticed likewife, that this 
ftate is extremely liable to run into inflammation of the 
brain and hydrencephalus, wdiich it fometimes refembles in 
the clofeft manner, particularly where worms are the irri¬ 
tants applied. 
The refpiratory function is often much difordered by 
dyfpepfia. Paroxyfins of oppreflive dyfpnoea come on, 
which very clofely refemble afthma ; fo clofely indeed, 
that it is only by attending to the increafe of the fymp¬ 
toms after eating, to its hiftory, and the ftate of the ali¬ 
mentary canal, that we can eftablifli a diagnofis. And it 
is not improbable that afthma properly fo called, fre¬ 
quently, if not generally, originates in a complication of 
this nature; but is afterwards continued, or repeated, 
either from a degree of diforganization induced in the 
heart or lungs, from the influence of the external caufes 
of afthma, or from the caufes of indigeftion. 
The affeStions of the heart which occur in confequence 
of the Mimofis acuta, are fluttering, palpitation, and irre¬ 
gular aCtion. Fluttering and palpitation of the heart 
are amongft the tnoft frequent fymptoms. To eftablilh a 
correCt diagnofis in the feverer cafes it will be neceffary to 
watch the effeCt of the remedies in removing this diforder. 
The palpitation of the heart, if a confequence and effeCt 
merely, will be mitigated or removed with the original 
affeCtion. In the lefs fevere form of this.complaint, the 
difcrimination mull be principally founded on a cautious 
obfervation of the effeCt of bodily exercife on the aCtion 
of the heart, when the fymptom of palpitation is other- 
wife abfent, and when the patient is leaft indifpofed, and 
on the continued hiftory of the complaint. In difeafe of 
the heart, it is bodily exertion and mental agitation which 
renew.and recall this dreadful difeafe; but, in the com¬ 
plication of dyfpepfia with palpitation, the patient, if not 
prevented by weaknefs, can, at the time when the hur¬ 
ried movement of the heart is abfent, run pretty rapidly, 
or walk up flairs, without fuftering more than is ufual; 
133 
and periods occur when he has puffed feveral days, weeks, 
or months perhaps, without experiencing the palpitation. 
In a difeafe of the heart, thefe circumftances are by no 
means obferved ; the uneafy fenfations which accompany 
this difeafe, if abfent at times, are always excited on any 
corporeal exertion; and, moreover, difeafe of this organ 
is in general highly characterized, and diftinguifhed from 
certain fymptomatic diforders of its functions, by the 
permanency of the affeCtion ; by its invariable aggrava¬ 
tion on mufcular exertion, as well as mental emotion 
and by the particular relief obtained at firft from blood¬ 
letting. Difeafe of the heart, although its fymptoms 
may be mitigated at one period and aggravated at another, 
is however permanent ; the fymptoms are never entirely 
abfent; and they may at any time be renewed, in an ag¬ 
gravated form, by mufcular exertion. In dubious cafes, 
the patient may be made to run up fairs ; the fymptoms 
of an organic difeafe of the heart are invariably aggra¬ 
vated by this mufcular exertion, the pulfation of the 
heart becoming violent, the pulfe perhaps irregular, the 
refpiration exceedingly difficult, &c. circumftances not 
equally obferved in iymptomatic derangements of the 
functions of this organ, unlefs when they are attended 
with great debility. There is almolt always, too, great 
but tranfitory relief from blood-letting, in a degree not 
obferved in the fymptomatic affeCtions. 
The affeCtions of the mufcular fruBurc , independent of 
the debility, &c. juft noticed, are partial paralyfes, fuch 
as are termed fpafmodic, among which tetanus often ap¬ 
pears. The belt illuftration of this ftate is afforded by 
the hiftory of hyfteria, when it arifes from gaftric irrita¬ 
tion. The abfurdity, however, of applying the term hyf- 
tcria to a difeafe which does not at all implicate the ute¬ 
rine fyftem, and which even affeCts men, is obvious 
enough : we (hall therefore ufe the term of Dr. Hall, viz. 
Mimofis urgens, and referve the term hyfteria to defignate 
fymptoms of uterine irritation. The Mimofis urgens, 
then, is generally denoted by combining fome coniider- 
able emotion of the mind, denoted by fighing, fobbing, 
tears, or laughter, with a fenfe and exprellion of fuffoca- 
tion, and with fome urgent affeCtion of the head, heart, 
refpiration, ftomach, or mufcular fyftem, and a peculiar 
and high degree of hurry, and apparently imminent 
danger. 
Of the Mimofis urgens there are three forms, the mild, 
the fevere, and the inveterate ; and there are molt nume¬ 
rous modifications. 
i. The mild form of the Mimofis urgens fubfifts as a ten¬ 
dency to alternate high, and low fpirits, to fits of laugh¬ 
ter, to frequent deep fighing, and to tears. A fit of 
laughter, or of crying, fometimes takes on an aggravated 
character; the laughing, or the fobbing, becomes immo¬ 
derate, convulfive, and involuntary, and there is fre¬ 
quently a peculiar fpafmodic chucking in the throat. 
The countenance changes, being alternately flulhed and 
pale, and denoting great anxiety. There is frequently 
an urgent difficulty in breathing, with much rapid hea¬ 
ving of the chelt. Sometimes a dry, fpafmodic, and vio¬ 
lent, fit of coughing occurs. There is generally a fenfe, 
an appearance, and an urgent fear, of impending fuffb- 
cation. In different inftances there is palpitation, hic¬ 
cough, retching, or borborygmus. The patient is de- 
fpondent, and aggravates all her fufferings. 
a. The fevere form of the Mimofis urgens confifts in a 
various attack, catenation or combination of the follow¬ 
ing fymptoms: The commencement, courfe, or termina¬ 
tion, of this and indeed of every form of the Mimofis 
urgens, is generally marked, and the cafe diftinguiflied, 
by the figns of fome inordinate mental emotion, (joy, 
grief, or other affeCtion,) which conftitute the moft cha- 
raCteriftic fymptoms of this diforder. The attack is fre¬ 
quently ulhered in by an unufual appearance of the 
countenance; a rapid change of colour, rolling of the 
eyes, diftortion or fpafmodic affeCtion of the face. The 
extremities are apt to become very cold. A ftate of gene- 
