PATHOLOGY. 
134 
ral or partial, of violent or of continued, convulfion, or 
of fixed fpafmodic contra&ion, takes place, and difplays 
every poflible variety in mode and form. The fevere form 
fometimes confifts chiefly in a general or partial pain and 
throbbing of the head. Occafionally this pain is confined 
to one particular fpot, and is fo acute as to have ob¬ 
tained the appellation of clavus hyflericus. Sometimes 
there is intolerance of light and noife ; fometimes a ftate 
of ftupor; fometimes delirium. The refpiration is fre¬ 
quently much affe&ed: an oppreflive and fuft’ocative 
dyfpncea takes place ; or the breathing is rapid, anxious, 
and irregular; or varioufly attended with fobbing, figh- 
ing, much rapid heaving of the cheft, and fometimes 
with a fpafmodic a6tion of the diaphragm, inducing a pe¬ 
culiar elevation of the abdomen, or an equally-peculiar 
fuccuflory movement of the trunk in general; fome¬ 
times the refpiration appears to befufpended altogether 
for fome time, the pulfe continuing to beat as before. 
A crowing noife, or fcreaming, is apt to occur in this 
affeftiorx. There is, occafionally, hoarfenefs, or even an 
entire lofs of the voice, continued for fome time. There 
is fometimes a painful, violent, dry, hoarfe cough, conti¬ 
nued, or recurrent in paroxyfms. There is occafionally 
acute pain of the cheft or abdomen. Palpitation of the 
heart, and fyncope, are alfo ufual affeftions. The pulfe 
is otherwife little aft'efted. There is frequently an ur¬ 
gent fenfe of fuffocation, accompanied with the feeling 
of a ball afcending into the throat; this fymptom is fo 
peculiar as to have obtained the denomination of globus 
hyjlericus, and is confidered as diagnoftic of this affe&ion. 
Hiccough, and violent fingultus ; retching and vomiting; 
the fenfe of a ball rolling within the abdomen ; borbo- 
rygmus ; a peculiar great and fudden tumidity of the ab¬ 
domen, apparently from flatus; conftipation, &c. 
3. The inveterate form of the Mimofis urgens (id enim 
vitium quibufdam feminis crebro revertens perpetuum 
evadit) confifts fometimes in an almoft-perpetual agita¬ 
tion of fome part of the body, the limbs, the refpiration, 
the throat, or the ftomach ; and fometimes in a ftate of 
continued contraction of the hand or foot, or of fome 
other part. In different inftances too, there is a conti¬ 
nued ftate of nervous agitation from the flighted noife 
or other caufe ; of paralytic, epileptic, or fpafmodic, dif- 
eafe ; or of imbecility of the mind. In fhort, this affec¬ 
tion is characterized, by affeCting in the fame or in dif¬ 
ferent inftances, fingly or conjointly, all the feveral fyf- 
tems which conftitute the human frame; the organs of 
animal and of organic life ; the different fets of mufcles, 
voluntary, involuntary, mixed, and fphinCter; the fa¬ 
culties of the mind, and the emotions of the heart; the 
functions of the head, the heart, the ftomach, &c. “It 
is in thus viewing the Mimofis urgens, that the diagnofis 
is often formed between its different and very-various 
attacks, and other affeCtions having a different origin, 
but of which it is the imitator, nam nullos fere non amu- 
latur ex iis affeCtibus quibus atteruntur miferi mortales.” 
Hall, p. 162. 
The diagnofis in Mimofis urgens is founded partly on 
the peculiar and different appearance of the particular 
cafes, and partly on the precurfory, concomitant, or fuc- 
eefiive, occurrence of fome unequivocal fymptom, and 
efpecially of the appearances of mental emotion, &c. be¬ 
fore noticed ; and of hurry and apparent urgency of 
complaint in general. It is, in particular, in this manner 
that the paroxyfm of convulfion in the Mimofis urgens 
is to be diftinguiflied from epileptic or puerperal convul- 
fions ; for, though the appearances are very fimilar, there 
is probably fome fymptom of mental emotion, or fome 
appearance peculiar to the Mimofis urgens, efpecially 
the hurried and heaving refpiration, or fome circumftance 
in the hiftory of the attack, which may lead to the diag¬ 
nofis. Otherwife the phyfician mult wait awhile, and 
watch the courfe of the affection, and the fucceflion of 
fymptoms; in this manner fome fymptoms decidedly pe¬ 
culiar to the Mimofis urgens will occur to prompt the 
diferimination. In the epileptic or puerperal convulfion, 
there is an abfence of thefe fymptoms of mental emotion, 
as joy, grief, &c. and the patient feems to be rather a 
prey to fome power which exerts a violent empire over 
the fource of fenfe and mufcular motion. The Mimofis 
urgens may excite alarm ; but the epileptic or puerperal 
convulfion prefents a far more dreadful afpeCt; the fa<;e 
perhaps becoming deeply flufhed and livid, with foaming 
at the mouth, more fhocking diftortions of the counte¬ 
nance and of the body, and a very different and a more 
ferious affeCtion of the refpiration. By iuch means thefe 
affections will generally be diftinguiflied. 
The occurrence of delirium is not very frequent; but 
Dr. Hall has witnefled it repeatedly. The cafe is identi¬ 
fied by the occurrence of fome fymptoms peculiar to the 
Mimofis urgens. 
The occurrence of ftupor as a form of the Mimofis 
urgens is by no means unfrequent. Dr. Hall relates the 
followingx;afes: “Some time ago I received an urgent 
call to vifit a poor woman faid to be in an alarming ftate 
of infenfibility. She was without fenfe or motion, but, 
in other refpeCts, unafteCted with any particular fymp¬ 
tom. The medical attendant had prepared his lancet to 
open a vein in the arm. In a Ihort time, however, tire 
patient recovered herfelf, and manifefted fymptoms which 
are peculiar to the Mimofis urgens.—In another cafe 
which occurred in an aged woman, a vein had been 
opened, under the idea that fhe was afteCted with apo¬ 
plexy. Some fymptoms of an anomalous kind occurred, 
and file became affeCted with an unequivocal attack of the 
Mimofis urgens.—In fimilar or dubious cafes it is proper 
to wait, and obferve the change of fymptoms; and parti¬ 
cular inquiry mull be made into the hiftory, mode of at¬ 
tack, &c. of the affeftion. Perhaps the patient foon 
opens the eyes, fighs, is aft'eCted with dyfpncea, or burfts 
into tears. In general fome unexpected and anomalous 
fymptom occurs, to denote the nature of the aft'eCtion.” 
In pain of the cheft in Mimofis urgens, the countenance 
is expreflive of great anxiety, hurry, and agitation ; and 
the noftrils are moved with rapidity. The patient com¬ 
plains much, manifefts great impatience, is urgent for 
relief, and calls out from the pain. The pain of the 
cheft is extremely acute, and the part affeCted is de- 
feribed as excruciatingly tender on being touched, and 
the hand applied to it is ufually puftied rudely away. 
With or without the pain of cheft, there is often an ur¬ 
gent dyfpncea; the refpiration is rapid, hurried, with 
much oharaCteriftic heaving of the cheft, fometimes with 
great and rapid movements both of the cheft and abdo¬ 
men, and often with a peculiar hifling noife. 
Cough occurring as a form of the Mimofis urgens, 
comes-on in continued fits ; it is frequent, hoarfe, and 
hifling; “ seger creberrime tuflit, fere fine intermiflione, 
nihil prorfus expeCtorans.” Hall, 176. 
The affeCtion of the diaphragm in the Mimofis urgens 
is attended by the moft acute pain in the epigaftric region, 
extending to each fide along the falfe ribs, and to the 
back ; it is augmented occafionally by moving, or by the 
aCtion of the diaphragm in refpiration, and caufes the pa¬ 
tient to cry out. The refpiration is irregular, perhaps 
performed by the cheft alone ; the noftrils move, the face 
is fometimes fluftied, and there is often ftiedding of tears. 
Thefe cafes are diftinguiflied from inflammation, by the 
occurrence of lymptoms peculiar to the Mimofis urgens ; 
the mode of attack, which is fudden; and the general 
afpeCt of the cafe, which is hurried and urgent; con- 
trafted with the ufual charaCteriftics of inflammation, 
The imitation of croup by the Mimofis urgens takes 
place in fuch a manner as to deceive a curfory obferver. 
The refpiration and cough have precifely the character of 
thefe fymptoms as occurring in inflammation of the tra¬ 
chea. It is by inquiry, waiting, and by cautjoufly ob- 
ferving the cafe, that the diagnofis is to be inftituted. 
On inquiry, the attack will probably be found to have 
been marked by fome fymptom or character of the Mi- 
5 mofis 
