Erasmus Darwin

“ The clattering of the teeth on going into cold water, or in the beginning of ague-fits, is an exertion along with the tremblings of the skin to relieve the pain of cold. The teeth and skin being more sensible to cold than the more internal parts, and more exposed to it, is the reason that the muscles, which serve them, are thrown into exertion from the pain of cold rather than those of respiration, as in screaming from more acute pain. ”

“ Sleep-walking is a part of reverie, or studium inane, described in Sect. XIX. In this malady the patients have only the general appearance of being asleep in respect to their inattention to the stimulus of external objects, but, like the epilepsies above described, it consists in voluntary exertions to relieve pain. The muscles are subservient to the will, as appears by the patient's walking about, and sometimes doing the common offices of life. The ideas of the mind also are obedient to the will, because their discourse is consistent, though they answer imaginary questions. ”

“ When epilepsy first commences, the patients are liable to utter one scream before they fall down; afterwards the convulsions so immediately follow the pain, which occasions them, that the patient does not recollect or seem sensible of the preceding pain. Thus in laughter, when it is not excessive, a person is not conscious of the pain, which so often recurs, and causes the successive screams or exertions of laughter, which give a temporary relief to it. ”

“ When children are gaining teeth, long before they appear, the pain of the gums often induces convulsions. This pain is relieved in some by sobbing and screaming; but in others a laborious respiration is exerted to relieve the pain; and this constitutes the true asthma convulsivum. In other children again general convulsions, or epileptic paroxysms, are induced for this purpose; which, like other epilepsies, become established by habit, and recur before the irritation has time to produce the painful sensation, which originally caused them. ”

“ The convulsions of dying animals, as of those which are bleeding to death in the slaughter-house, are an effort to relieve painful sensation, either of the wound which occasions their death, or of faintness from want of due distention of the blood-vessels. Similar to this in a less degree is the subsultus tendinum, or starting of the tendons, in fevers with debility; these actions of the muscles are too weak to move the limb, but the belly of the acting muscles is seen to swell, and the tendon to be stretched. ”

“ There are two diseases, which bear the name of asthma. The first is the torpor or inability of the minute vessels of the lungs, consisting of the terminations of the pulmonary and bronchial arteries and veins, and their attendant lymphatics; in this circumstance it resembles the difficulty of breathing, which attends cold bathing. If this continues long, a congestion of fluid in the air-cells succeeds, as the absorbent actions cease completely before the secerning ones ”

“ Epileptic fits generally commence with setting the teeth, by which means the tongue is frequently wounded; and with rolling the eyeballs in every kind of direction; for the muscles which suspend the jaw, as well as those which move the eyes, are in perpetual motion during our waking hours; and yet continue subservient to volition; hence their more facile and forcible actions for the purpose of relieving pain by the exhaustion of sensorial power. ”

“ In melancholy madness the patient is employed in voluntarily exciting one idea, with those which are connected with it by voluntary associations only, but not so violently as to exclude the stimuli of external objects. In reverie variety of ideas are occasionally excited by volition, and those which are connected with them either by sensitive or voluntary associations, and that so violently as to exclude the stimuli of external objects. These two situations of our sensual motions, or ideas, resemble convulsion and epilepsy ”

“ These violent voluntary exertions of our muscles or ideas to relieve the sensation of pain constitute convulsions and madness; and are distinguished from the muscular actions owing to increased sensation, as in sneezing, or coughing, or parturition, or ejectio feminis, because they do not contribute to dislodge the cause, but only to prevent the sensation of it. ”

“ Whence it appears, that when a very quick pulse accompanies convulsion or insanity, it simply indicates the weakness of the patient; that is, that the expenditure of sensorial power is too great for the supply of it. But if the strength of the patient is not previously exhausted, the exertions of the muscles are attended with temporary increase of circulation, the reciprocal swellings and elongations of their bellies push forwards the arterial blood, and promote the absorption of the venous blood ”

“ In difficult parturition it sometimes happens, that general convulsions are excited to relieve the pain of labour, instead of the exertions of those muscles of the abdomen and diaphragm, which ought to forward the exclusion of the child. See Class III. 1. 1. That is, instead of the particular muscular actions, which ought to be excited by sensation to remove the offending cause, general convulsions are produced by the power of volition, which still the pain, as in common epilepsy, without removing the cause ”

“ Bardsley has endeavoured to prove, that dogs never experience the hydrophobia, or canine madness, without having been previously bitten or infected; and secondly, that the disease in this species of animal always shews itself in five or six weeks; and concludes from hence, that this dreadful malady might be annihilated by making all the dogs in Great Britain perform a kind of quarantine, by shutting them up for a certain number of weeks. ”

“ The insensibility of the lungs to cold is observable on going into frosty air from a warm room; the hands and face become painfully cold, but no such sensation is excited in the lungs; which is another argument in favour of the existence of a peculiar set of nerves for the purpose of perceiving the universal fluid matter of heat, in which all things are immersed. See Sect. ”

“ There is one kind of restlessness attending fevers, which consists in a frequent change of posture to relieve the uneasiness of the pressure of one part of the body upon another, when the sensibility of the system, or of some parts of it, is increased by inflammation, as in the lumbago; which may sometimes be distinguished in its early stage by the incessant desire of the patient to turn himself in bed. ”

“ Nevertheless opium duly administered, so as to precede the expected paroxysm, and in such doses, given by degrees, as to induce intoxication, is principally to be depended upon in this deplorable malady. To which should be added, that if venesection can be previously performed, even to but few ounces, the effect of the opium is much more certain; and still more so, if there be time to premise a brisk cathartic, or even an emetic. The effect of increased stimulus is so much greater after previous defect of stimulus ”

“ Opium a grain every half hour. Wine. Spirit of wine. If the patient becomes intoxicated by the above means, the fit ceases, and violent vomitings and debility succeed on the subsequent day, and prevent a return. Blisters or sinapisms on the small of the leg, taken off when they give much pain, are of use in slighter convulsions. ”

“ When the pains from defect or excess of motion are more distressing than those already described, and are not relievable by such partial exertions, as in screaming, or laughter, more general convulsions occur ”

“ In these cases something should be offered to the patient to bite, as a towel, otherwise they are liable to tear their own arms, or to bite their attendants, as I have witnessed in the painful epilepsy.
13. Tetanus trismus. Cramp. The tetanus consists of a fixed spasm of almost all the muscles of the body; but the trismus, or locked jaw, is the most frequent disease of this kind. It is generally believed to arise from sympathy with an injured tendon. In one case where it occurred in consequence of a broken ankle from a fall from a horse, it was preceded by evident hydrophobia. ”

“ These weak convulsions, as they are occasioned by the disagreeable sensation of faintness from inanition, are symptoms of great general debility, and thence frequently precede the general convulsions of the act of dying. ”

“ Thus when the skin is exposed to great cold, the activity of the cutaneous vessels is diminished, and in consequence an accumulation of sensorial power obtains in them, because they are usually excited into incessant motion by the stimulus of heat, as explained in Sect. ”

“ Yet are the lungs nevertheless very sensible to the deficiency of oxygen in the atmosphere, as all people experience, when they go into a room crowded with company and candles, and complain, that it is so close, they can scarcely breathe ”

“ Four patients I have now in my recollection, all of whom I believed to labour under the angina pectoris in a great degree; which have all recovered, and have continued well three or four years by the use, as I believe, of issues on the inside of each thigh ”

“ Opium. Bark. Steel. Arsenic. Opium one grain twice a day for years together. See the preceding article.
8. Epilepsia dolorifica. Painful epilepsy. In the common epilepsy the convulsions are immediately induced, as soon as the disagreeable sensation, which causes them, commences; but in this the pain continues long with cold extremities, gradually increasing for two or three hours, till at length convulsions or madness come on; which terminate the daily paroxysm, and cease themselves in a little time afterwards. ”