صور الصفحة
PDF
النشر الإلكتروني

winced of of the bapter

The A. eithe

quently used by learned writers, are all improper. We may take it for granted here, that the conditions and properties of the nerves, in their natural vital state, (wbich is so difficult, if not impossible, to inspect) did not wholly escape the contemplations of this eminent physician and professor; though perhaps they might afford him but little, sufficiently conclusive, to prefent to bis readers.

Towards the end of this curious and inquisitive chapter, Dr. W. acknowledges and exemplifies certain corporal sympathies, which he thinks owing to the vicinity of the parts; and though he refers many of these to the general sympathy obtaining throughout the body, he instances several others, for which he despairs to account; very justly concluding, that the farther we push, our enquiries into nature, the more, shall we be convinced of our ignorance, and how small a portion is known of the works of the great CREATOR.'

The second chapter treats of nervous and hypochondriac disorders in general. The Author having observed that the nerves may be disordered, either from a fault in their coats, their medullary substance in the brain, or fpinal marTow, adds, that, with respect to the fluid they are supposed to contain, as we are wholly ignorant of its nature, we can never know when diseases of the nerves arise from a faulo in it; though their action must be considerably affected, whenever it is vitiated. He takes notice of the little benefit that could result from a long contemplation of those faults, in parts, whose fubtilty often makes it impossible for us to discover, either before or after death, the precise causes of their diseases; yet he thinks their effects may be reduced to some change in that, sensibility or motion the nerves communicate throughout the body. This sentient or feeling power of the neryes, he supposes, may be either too acute, too obtuse, depraved, or wholly wanting; and through several pages he exemplifies the effects of these causes. But here he observes, that from the very general distribution of the nerves to every part, and the consequent sensibility of almost every part of the body, it proves extremely difficult, or perhaps impossible, to fix a certain criterion for distinguishing nervous diseases froin all others; since all diseases may, in some sense, be called nervous affections, the nerves being, more or less, affected in all. Nevertheless; he adds here some very illustrating instances to diftinguish what may, or what should not, be called nervous diseases or fymptoms; as in the tooth-ach, which is not termed nervous, notwithstanding the severe pain from the affected nerve of the too:h: though if the violence of the pain occasion convulsions of: fainting, these symptoms are justly termed nervous : and to this instance many others equally clear and distinguishing are addedo What he proposes, however, to consider as nervous diseases, are

such,

change, in Yere he thinks after death, the in

fuch, he says, as physicians commonly term flatulent, spasınodic, hypochondriac and hysteric, whatever parts or organs they may affect; concluding (with the celebrated Dr. Mead) of the hypochondriac disease, that it is not confined to any one part, but may be termed a disease of the whole body.

Some ensuing pages are employed in a long catalogue of these disorders and symptoms, with their variously fatal consequences, when of a long continuance: after which, he divides the subjects of nervous disorders into three classes ; considering the complaints of the first as fimply nervous : the second, in compliance with custom, he terms hysteric, and the last hypochondriac; tho' he chuses to diffent from those learned writers, who suppose the two last to be distinct diseases; for which dissent he gives some availing arguments. The remainder of this chapter is chiefly emproyed in enumerating what various physicians have considered as the causes of this disease, and in subjoining his opinion, which does not entirely co-incide with any of them...

The third chapter treats of the predisposing causes of these diseases; which causes he resolves into, 1. Too great a delicacy and sensibility of the whole nervous system; and, 2. An uncommon weakness, or a depraved, or an unnatural feeling in some of the organs of the body. He supposes the first may be either natural, or the effect of diseases or irregularities which he specifies. Many succeding pages contain several appofite refections, with which fome illustrating cases, and not a few pertinent physiological queries, are occasionally interspersed, on this subject; the whole being expatiated on and connected, in as clear and pleasing a manner as can be expected. The rationale of the effect of different medicines and applications is also discussed, in the modest and diffident style of interrogation.

In entering on the second cause, viz. an exceeding and morbid sensibility, or unnatural depraved feeling of the nervous sys. tem in general, he gives many instances from his own knowlege, or from different authors, of some odd and personal antipathies to different smells, or substances. But he supposes the unnatural state of the stomach and alimentary canal, to be by much the most frequent cause of the diseases he treats of. And this morbid state of the stomach and bowels he does not suppose to consist folely in their weakness, but chiefly in the uncommon dir. position of their nerves, which have a feeling very different from what is natural. Dr. W. had previously mentioned, with a just and pious admiration, the divine wisdom, in annexing certain very different sensations and feelings to different organs, which are so perfectly adapted to those things nature intended to be applied to them. Here he also reflects, how much the condition of ihe stomach and intestines will vary in the same individual at different times, of which he recites some instances, such as many

may

may have experienced in themselves, or have seen in others, But wherein the various kinds and degrees of the feelings of the cardiac and other nerves consist, we no more know, as he justly observes, than we know their peculiar structure, or how they are endued with any sensation ; though we fee manifest morbid. changes effected in different nerves. However, as these predisposing causes alone do not very commonly produce the many nervous or hypochondriac diseases and fymptoms, our learned and methodical Author proceeds to his fourth chapter, which treats of those procatarctic, or occasional causes, that, meeting with the former, effectually bring on this numerous train of complaints and diseases.

Such causes he divides into general and particular, the former being supposed to reside in the mass of Auids; the latter, in fome particular organ: and these general causes are resolved either into,-1. Some morbid matter bred in the blood. 2. The diminution or retention of fome accustomed evacuation; or, 3. The want of a sufficient quantity of blood, or of blood of a proper density. In proof of these distinctions, Dr. W. gives us two curious cafes, from p. 144 to 152: and though he supposes this morbid matter may arise, either from bad food; from a fcorbutic or scrophulous habit; from fevers attended with imperfect crises, &c. yet as he judges, and we think very rationally, the most frequent taint in the blood affecting the nerves, to be an arthritic matter determined to different parts, he gives two remarkable cales on this point, from p. 156 to 161. All these cases deserve the young medical Reader's attention ; not only for the clear and exact manner in which they are related, but for an ingenuous detail of all the medicines the patient took ; and for a particular acknowledgment of those, which were of no use to them. Our Author having had such frequent occasion to mention this arthritic matter in the course of this chapter, and which is certainly not a little active in many cases that have been termed nervous, fays very rationally of it, p. 173,

• Physicians have widely differed about the nature of that humour, wbich is the cause of the gout, some making it tartareous, or acid; others urinous, or alkaline. But, fenfible how vain all such disquisitions are, I fhall not attempt to define the nature of that noxious matter in the blood, so often the cause of nervous, 'hypochondriac, and hysteric disorders, farther than as I have already endeavoured to thew, that it is most commonly of the arthritic kind;'--'Indeed there is no reason to believe, that, whatever is hurtful to the human body, must be either acid or alkaline, or of some other known species of acrimony;' he having justly said of it, p. 168, that the arthritic matter af

swiv feating

morbid effects froconfined to this : but not Wetor

fecting the stomach was too subtile to be seen, although active enough to destroy.'

Our Author's medical and practical reflections, on nervoully morbid effects from the retention of some accustomed evacuation, are chiefly confined to the discharge through the vessels of the uterus, and the hæmorrhoids : but not without mentioning the ceffation of the discharges from issues, setons, or old sores fuddenly dried up, as producing similar effects. What may be thought a little new here, is his ascribing the regular menstrual discharge, en passant, rather to the particular structure of the womb, than to any gradual monthly increase of the quantity of blood, in the female system.

In the section, on the want of a sufficient quantity, or proper density, of the blood, as one general occasional caule of nervous disorders, our Author confiders all immoderate hemorrhages from any part, as often occasioning violent nervous symptonis. This is entirely agreeable to experience; hypochondriac, hysteric and nervous disorders, being generally exasperated by any exceflive discharge, through whatever passages or excretories. Three or four illustrating cases are added in proof of this, and conclude the fourth chapter.

The fifth treats of the particular occasional causes of these diseases, which Dr. W. supposes to be, 1. Wind; 2. Tough phlegm; or, 3. Worms; in the stomach or bowels. 4. Aliments improper in quantity or quality. 5. Schirrhous or other obstructions in the viscera of the belly: and, 6. Violent affections of the mind. He treats of the consequences of the first five causes, and of the rationale of each, in a brief, though phyfiological manner, having some cases occasionally interspersed, and an account of the appearances on dissecting those who died, which was the case of a majority. On the article of the passions he is much more diffuse, and cites many curious instances of their morbific energy. After affirming the effect of sympathy, of terror, or of a mixture of both, from his own experience of seeing women seized with hysteric fits at the Royal Infirmary in Edinburgh, by their seeing others attacked with them, he adds an extraordinary instance of the salutary efficacy of fuperior fear, in curing other convulsion fits, which had been propagated, or catched as it were, by looking on in the poor's house at Haarlem, in Dr. Boerhaave's time, as recorded by his nephew, Dr. Kaau Boerhaave. The relation in Latin takes up two pages, but the substance of it is,—that after the failure of the most celebrated remedies directed by the most eminent phyficians, the famous Dr. Boerhaave ordered all the servants of the house, and all the children, to be called together; when he declared, that as all medicines and methods had failed, he could think of no other remedy, but that several little hand-ftoves, with burning coals in them, should be kept ready in the hall; and that some iron hooks should be prepared and shaped in a particular manner :- then very gravely and authoritatively commanded, that whatever boy or girl was first taken with a fit, 'fhould be burnt into the very bone, with one of these red-hot iron hooks, in a particular part of the arm. The effect of this, according to the author from whom it is cited, was, that whoever felt the symptoms of an approaching fit, having their minds terribly impressed with the notion of being dreadfully burnt, were enabled to suppress the invasion of the fit, by the force of a more horrible expectation ; so that they are said to have been all cured. • The description of some such nervous convulsive disorder in Zetland, which is propagated in the 'same manner, immediately follows this relation. And as this is a truly curious, though fomewhat metaphysical, mode of contagion, we think our inge. Author's reasoning upon it must be agrecable to most readers, and may satisfy many of them.

. We have seen above, that there is a remarkable sympathy, by means of the nerves, between the various parts of the body; and now it appears that there is a still more wonderful sympathy between the nervous systems of different persons, whence various motions and morbid symptoms are often transferred, from one to another, without any corporeal contact or infection. · "In these cases, the impression made upon the mind or sensorium commune, by seeing others in a disordered state, raises, by means of the nerves, such motions or changes in certain parts of the body as to produce similar affections in them : and hence it is, that the fight only of a person vomiting has often excited the same action in others; that sore eyes become sometimes infectious; that yawning is propagated from one person through a whole company, and that convulsive disorders are caught by looking on those who are affected with them. Now, although we cannot explain how different impressions made on the sensorium commune fhould occasion, by means of the nerves, those various changes in the body ; yet that the nerves are really capable of producing very sudden changes in the circulation and distribution of the Auids, when the mind is variously affected, we have full proof in that redness of the face which accompanies a sense of shame, that increased flux of the faliva which happens to a hungry person upon the fight of grateful food, and that plentiful discharge of tears which is so often produced by piteous objects or tragical stories.

? Thus far we know, from certain experience, that, when the nervous system is extremely delicate, a small impression on any of the organs of sense will often throw the whole body into disorder. For example, I have known people of weak nerves,

subject

« السابقةمتابعة »