ORDO II.
Decreased Irritation.
GENUS V.
Decreased Action of the Organs of Sense.
SPECIES.
1. Stultitia inirritabilis. Folly from inirritability. Dulness of perception. When the motions of the fibrous extremities of the nerves of sense are too weak to excite sensation with sufficient quickness and vigour. The irritative ideas are nevertheless performed, though perhaps in a feeble manner, as such people do not run against a post, or walk into a well. There are three other kinds of folly; that from deficient sensation, from deficient volition, and from deficient association, as will be mentioned in their places. In delirium, reverie, and sleep, the power of perception is abolished from other causes.
2. Visus imminutus. Diminished vision. In our approach to old age our vision becomes imperfect, not only from the form of the cornea, which becomes less convex, and from its decreased transparency mentioned in Class I. 2. 3. 26.; but also from the decreased irritability of the optic nerve. Thus, in the inirritative or nervous fever, the pupil of the eye becomes dilated; which in this, as well as in the dropsy of the brain, is generally a fatal symptom. A part of the cornea as well as a part of the albuginea in these fevers is frequently seen during sleep; which is owing to the inirritability of the retina to light, or to the general paresis of muscular action, and in consequence to the less contraction of the sphincter of the eye, if it may be so called, at that time.
There have been instances of some, who could not distinguish certain colours; and yet whose eyes, in other respects, were not imperfect. Philos. Transact. Which seems to have been owing to the want of irritability, or the inaptitude to action, of some classes of fibres which compose the retina. Other permanent defects depend on the diseased state of the external organ. Class I. 1. 3. 14. I. 2. 3. 25. IV. 2. 1. 11.
3. Muscæ volitantes. Dark spots appearing before the eyes, and changing their apparent place with the motions of the eyes, are owing to a temporary defect of irritability of those parts of the retina, which have been lately exposed to more luminous objects than the other parts of it, as explained in Sect. XL. 2. Hence dark spots are seen on the bed-clothes by patients, when the optic nerve is become less irritable, as in fevers with great debility; and the patients are perpetually trying to pick them off with their fingers to discover what they are; for these parts of the retina of weak people are sooner exhausted by the stimulus of bright colours, and are longer in regaining their irritability.
Other kinds of ocular spectra, as the coloured ones, are also more liable to remain in the eyes of people debilitated by fevers, and to produce various hallucinations of sight. For after the contraction of a muscle, the fibres of it continue in the last situation, till some antagonist muscles are exerted to retract them; whence, when any one is much exhausted by exercise, or by want of sleep, or in fevers, it is easier to let the fibres of the retina remain in their last situation, after having been stimulated into contraction, than to exert any antagonist fibres to replace them.
As the optic nerves at their entrance into the eyes are each of them as thick as a crow-quill, it appears that a great quantity of sensorial power is expended during the day in the perpetual activity of our sense of vision, besides that used in the motions of the eye-balls and eyelids; as much I suppose as is expended in the motions of our arms, which are supplied with nerves of about the same diameters. From hence we may conclude, that the light should be kept from patients in fevers with debility, to prevent the unnecessary exhaustion of the sensorial power. And that on the same account their rooms should be kept silent as well as dark; that they should be at rest in an horizontal posture; and be cooled by a blast of cool air, or by washing them with cold water, whenever their skins are warmer than natural.
4. Strabismus. Squinting is generally owing to one eye being less perfect than the other; on which account the patient endeavours to hide the worst eye in the shadow of the nose, that his vision by the other may not be confused. Calves, which have an hydatide with insects inclosed in it in the frontal sinus on one side, turn towards the affected side; because the vision on that side, by the pressure of the hydatide, becomes less perfect; and the disease being recent, the animal turns round, expecting to get a more distinct view of objects.
In the hydrocephalus internus, where both eyes are not become insensible, the patient squints with only one eye, and views objects with the other, as in common strabismus. In this case it may be known on which side the disease exists, and that it does not exist on both sides of the brain; in such circumstances, as the patients I believe never recover as they are now treated, might it not be adviseable to perforate the cranium over the ventricule of the affected side? which might at least give room and stimulus to the affected part of the brain?
M. M. If the squinting has not been confirmed by long habit, and one eye be not much worse than the other, a piece of gauze stretched on a circle of whale-bone, to cover the best eye in such a manner as to reduce the distinctness of vision of this eye to a similar degree of imperfection with the other, should be worn some hours every day. Or the better eye should be totally darkened by a tin cup covered with black silk for some hours daily, by which means the better eye will be gradually weakened by the want of use, and the worse eye will be gradually strengthened by using it. Covering an inflamed eye in children for weeks together, is very liable to produce squinting, for the same reason.
5. Amaurosis. Gutta serena. Is a blindness from the inirritability of the optic nerve. It is generally esteemed a palsy of the nerve, but should rather be deemed the death of it, as paralysis has generally been applied to a deprivation only of voluntary power. This is a disease of dark eyes only, as the cataract is a disease of light eyes only. At the commencement of this disease, very minute electric shocks should be repeatedly passed through the eyes; such as may be produced by putting one edge of a piece of silver the size of a half-crown piece beneath the tongue, and one edge of a piece of zinc of a similar size between the upper lip and the gum, and then repeatedly bringing their exterior edges into contact, by which means very small electric sparks become visible in the eyes. See additional note at the end of the first volume, p. 567. and Sect. XIV. 5.
M. M. Minute electric shocks. A grain of opium, and a quarter of a grain of corrosive sublimate of mercury, twice a day for four or six weeks. Blister on the crown of the head.
6. Auditus imminutus. Diminished hearing. Deafness is a frequent symptom in those inflammatory or sensitive fevers with debility, which are generally called putrid; it attends the general stupor in those fevers, and is rather esteemed a salutary sign, as during this stupor there is less expenditure of sensorial power.
In fevers of debility without inflammation, called nervous fevers, I suspect deafness to be a bad symptom, arising like the dilated pupil from a partial paralysis of the nerve of sense. See Class IV. 2. 1. 15.
Nervous fevers are supposed by Dr. Gilchrist to originate from a congestion of serum or water in some part of the brain, as many of the symptoms are so similar to those of hydrocephalus internus, in which a fluid is accumulated in the ventricules of the brain; on this idea the inactivity of the optic or auditory nerves in these fevers may arise from the compression of the effused fluid; while the torpor attending putrid fever may depend on the meninges of the brain being thickened by inflammation, and thus compressing it; now the new vessels, or the blood, which thickens inflamed parts, is more frequently reabsorbed, than the effused fluid from a cavity; and hence the stupor in one case is less dangerous than in the other.
In inflammatory or sensitive fevers with debility, deafness may sometimes arise from a greater secretion and absorption of the ear-wax, which is very similar to the bile, and is liable to fill the meatus auditorius, when it is too viscid, as bile obstructs the gall-ducts.
M. M. In deafness without fever Dr. Darwin applied a cupping-glass on the ear with good effect, as described in Phil. Trans. Vol. LXIV. p. 348. Oil, ether, laudanum, dropped into the ears.
7. Olfactus imminutus. Inactivity of the sense of smell. From our habits of trusting to the art of cookery, and not examining our food by the smell as other animals do, our sense of smell is less perfect than theirs. See Sect. XVI. 5. Class IV. 2. 1. 16.
M. M. Mild errhines.
8. Gustus imminutus. Want of taste is very common in fevers, owing frequently to the dryness or scurf of the tongue, or external organ of that sense, rather than to any injury of the nerves of taste. See Class. I. 1. 3. 1. IV. 2. 1. 16.
M. M. Warm subacid liquids taken frequently.
9. Tactus imminutus. Numbness is frequently complained of in fevers, and in epilepsy, and the touch is sometimes impaired by the dryness of the cuticle of the fingers. See Class IV. 2. 1. 16.
When the sense of touch is impaired by the compression of the nerve, as in sitting long with one thigh crossed over the other, the limb appears larger, when we touch it with our hands, which is to be ascribed to the indistinctness of the sensation of touch, and may be explained in the same manner as the apparent largeness of objects seen through a mist. In this last case the minute parts of an object, as suppose of a distant boy, are seen less distinctly, and therefore we instantly conceive them to be further from the eye, and in consequence that the whole subtends a larger angle, and thus we believe the boy to be a man. So when any one's fingers are pressed on a benumbed limb, the sensation produced is less than it should be, judging from visible circumstances; we therefore conceive, that something intervened between the object and the sense, for it is felt as if a blanket was put between them; and that not being visibly the case, we judge that the limb is swelled.
The sense of touch is also liable to be deceived from the acquired habits of one part of it acting in the vicinity of another part of it. Thus if the middle finger be crossed over either of the fingers next to it, and a nut be felt by the two ends of the fingers so crossed at the same time, the nut appears as if it was two nuts. And lastly, the sense of touch is liable to be deceived by preconceived ideas; which we believe to be excited by external objects, even when we are awake. It has happened to me more than once, and I suppose to most others, to have put my hands into an empty bason standing in an obscure corner of a room to wash them, which I believed to contain cold water, and have instantly perceived a sensation of warmth, contrary to that which I expected to have felt.
In some paralytic affections, and in cold fits of ague, the sensation of touch has been much impaired, and yet that of heat has remained, See Sect. XIV. 6.
M. M. Friction alone, or with camphorated oil, warm bath. Ether. Volatile alcali and water. Internally spice, salt. Incitantia. Secernentia.
10. Stupor. The stupor, which occurs in fevers with debility, is generally esteemed a favourable symptom; which may arise from the less expenditure of sensorial power already existing in the brain and nerves, as mentioned in species 6 of this genus. But if we suppose, that there is a continued production of sensorial power, or an accumulation of it in the torpid parts of the system, which is not improbable, because such a production of it continues during sleep, to which stupor is much allied, there is still further reason for believing it to be a favourable symptom in inirritable fevers; and that much injury is often done by blisters and other powerful stimuli to remove the stupor. See Sect. XII. 7. 8. and XXXIII. 1. 4.
Dr. Blane in his Croonian Lecture on muscular motion for 1788, among many other ingenious observations and deductions, relates a curious experiment on salmon, and other fish, and which he repeated upon eels with similar event.
- "If a fish, immediately upon being taken out of the water, is stunned by a violent blow on the head, or by having the head crushed, the irritability and sweetness of the muscles will be preserved much longer, than if it had been allowed to die with the organs of sense entire. This is so well known to fishermen, that they put it in practice, in order to make them longer susceptible of the operation called crimping. A salmon is one of the fish least tenacious of life, insomuch, that it will lose all signs of life in less than half an hour after it is taken out of the water, if suffered to die without any farther injury; but if, immediately after being caught, it receives a violent blow on the head, the muscles will shew visible irritability for more than twelve hours afterwards."
Dr. Blane afterwards well remarks, that "in those disorders in which the exercise of the senses is in a great measure destroyed, or suspended, as in the hydrocephalus, and apoplectic palsy, it happens not uncommonly, that the appetite and digestion are better than in health."