Hypersensitivity

“ The more constant, as given by the best authorities, are great heat and dryness of skin, a varying degree of pain in the head, attended oftentimes with giddiness, congestion of the eyes, full, rapid pulse, which grows feeble and irregular as the disease advances, obstinate constipation, irritability of bladder, and great oppression or sense of weight about the region of the heart, with not unfrequently muscular weakness and a disinclination for exertion. If these symptoms continue, the patient soon passes into a state of profound insensibility. ”

“ That debility should, under certain circumstances, dispose to excessive action, and that excessive [155] action should occur in one part of the body, at the same time that debility prevailed in every other, are abundantly evident from the history and phenomena of many diseases. Inflammatory fever, active hæmorrhages, tonic gout, asthma, apoplexy, and palsy, however much they are accompanied by excessive action in the arterial system, are always preceded by original debility, and are always accompanied by obvious debility in every other part of the system. ”

“ Every gland of the body is now stimulated into stronger action than is natural, as its irritability is increased by accumulation of sensorial power during its late quiescence, a superabundance of all the secretions is produced, and an increase of heat in consequence of the increase of these secretions. The skin becomes red, and the perspiration great, owing to the increased action of the capillaries during the hot part of the paroxysm. The secretion of perspirable matter is perhaps greater during the hot fit than in the sweating fit which follows ”

“ This debility from abstraction, moreover, is upon a footing with the debility from action, when it is of a chronic nature. They both alike expend so much of the quality or substance of excitability, as to leave the system in a state in which irritants are seldom able to excite the commotions of fever, and when they do, it is of a feeble nature, and hence [6] we observe persons who have been long exposed to debilitating causes of both kinds, often escape fevers, while those who are recently debilitated, are affected by them, under the same circumstances of exposure to those causes. ”

“ It is evident that the thresholds of the brain have been sensitized. In this hypersensitization we find the following strong evidence as to the identity of the various mechanisms for the production of fever. ”

“ Where the inflammation proceeds with greater violence or rapidity, that is, when by the painful sensation a more inordinate activity of the organ is produced, and by this great activity an additional quantity of painful sensation follows in an increasing ratio, till the whole of the sensorial power, or spirit of animation, in the part becomes exhausted, a mortification ensues, as in a carbuncle, in inflammations of the bowels, in the extremities of old people, or in the limbs of those who are brought near a fire after having been much benumbed with cold. ”

“ They are prepared in the same manner as at Franzensbad and other places, and are much used in cutaneous complaints—rheumatism and gout of obstinate character—deformities and nodosities, the sequences of these maladies—neuralgic and paralytic affections—metallic diseases—tumours and indurations of glandular structures, as of the liver, spleen, mesentery, ovaries, &c. They are wisely forbidden in organic diseases of the heart and other vital viscera, in high grades of nervous irritability, and in all predispositions to hæmorrhages, on account of their high powers of stimulation. ”

“ Another mode, by which life is gradually undermined, is when irritative motions continue to be produced in consequence of stimulus, but are not succeeded by sensation; hence the stimulus of contagious matter is not capable of producing fever a second time, because it is not succeeded by sensation. See Sect. XII. 3. 6. And hence, owing to the want of the general pleasurable sensation, which ought to attend digestion and glandular secretion, an irksomeness of life ensues; and, where this is in greater excess, the melancholy of old age occurs, with torpor or debility. ”

“ The changes in the emotions, for instance, may lead to the recognition of a heart disease; lack of attention may be a hint of the overgrowth of the adenoids; irritability or apathy or delirious character of the mental behavior may indicate whether uræmic acid is in the system or an infectious disease: anæmia and undernutrition may be diagnosed and the [Pg 74] psychology of fever demands too a much closer analysis with the means of the psychological laboratory than it has received so far. ”

“ Hence arise indigestion, constipation, headaches, weariness, depression of spirits, palpitation, and a feeling of oppression at the heart, pain in the side, eruptions on the skin, which either feels chilly all over its surface or sometimes burns, and, what will probably seem of much more importance to those whom vanity has induced to lace tightly, pallor and thickness of complexion, with a yellowish or greyish tinge to the cheeks, and owing to impaired circulation, swelling and redness of the hands and feet, and, worst of all to the would-be beauty, redness of the nose. ”

“ Two sensorial powers exerted in sensitive fevers. Size of the blood. Nervous fevers distinguished from putrid ones. The septic and antiseptic theory. 4. Two kinds of delirium. 5. Other animals are less liable to delirium, cannot receive our contagious diseases, and are less liable to madness. II. 1. Sensitive motions generated. 2. Inflammation explained. 3. Its remote causes from excess of irritation, or of irritability, not from those pains which are owing to defect of irritation. New vessels produced, and much heat. 4. Purulent matter secreted. 5. Contagion explained. ”

“ Hypersensitiveness, which soon is pain, to light, to sound, to smell and taste, to feeling, may all be products of hysteria when the disorder whips up function; when it paralyzes, the victim must get along as best he can until his sensorial servants come back to work. In the sphere of motion, twitchings, tremors, contractions and even convulsions, bear witness to excess of function; paralysis, to loss of it. These functional perversions, these idealistic symptoms, are cast in the same mold as those of structural disease. ”

“ The inflammation may vary in grade from simple hyperæmia, with increased irritability, to the most intense engorgement, exudation, and tumefaction of the membrane, and in activity from the most acute and rapidly-progressive to the most chronic and protracted in duration. ”

“ With this new organization, or accretion of parts, new kinds of irritability may commence; for so long as there was but one living organ it could only be supposed to possess irritability; since sensibility may be conceived to be an extension of the effect of irritability over the rest of the system. These new kinds of irritability and of sensibility in consequence of new organization appear from variety of facts in the more mature animals; thus ... the lungs must be previously formed before their exertions to obtain fresh air can exist ”

“ Many other parts of the system subject to perpetual motion in health may rest for a time without much inconvenience to the whole; as when the fingers of some people become cold and pale; and during this complete rest great accumulation of irritability may be produced, But where the heart and arteries are previously feeble, they cannot much diminish their actions, and certainly cannot rest entirely, for that would be death; and therefore in this case their accumulation of the sensorial power of irritation or of association is slowly produced, and a long fever supervenes in consequence ”

“ With the single exception immediately to be stated, the severest cases are those in which, together with a severe primary affection of the nervous system, this inflammatory action is in the greatest degree of intensity, and is seated in the greatest number of organs; and they are the most severe, not only on account of the severity of the primary affection of the nervous system, but also because it is in them that the inflammation is the most intense, and because that inflammation attacks the system at one and the same time in the greatest number of points. ”

“ When the sensibilities of the sense of smell become dulled, they give no warning of the sense of danger, and the individual may not feel conscious of the harm, although the nervous centers may be greatly depressed, and, because discomfort has not been experienced in a vitiated atmosphere, it does not follow that harm has not been done. The effects are slowly and imperceptibly cumulative, but are on this account none the less injurious, and are now recognized as being among the most potent and wide-spread of all the predisposing causes of disease. ”

“ So that by irritation, or by sensation in consequence of irritation, or by association of motions, a material is formed by the extremities of certain cutaneous vessels, exactly similar to the stimulating material, which caused the irritation, or consequent sensation, or association.
Many glands of the body have their motions, and in consequence their secreted fluids, affected by pleasurable or painful ideas, since they are in many instances influenced by sensitive associations, as well as by the irritations of the particles of the passing blood. ”

“ Hence it happens, that those surfaces, which are the most exposed to such agents as exalt the sensibility, are also the most subject to local inflammation, as may be remarked in the conjunctiva and the lungs; at which time such is usually the increase of sensibility in the part, that of organic, which it was, it becomes animal, and transmits to the brain the impressions, which are made upon it.
Inflammation lasts as long as there subsists an excess of sensibility; by degrees it diminishes, the red globules cease to pass into the serous vessels and resolution takes place. ”

“ I cannot too often or too strongly warn every one against warm baths, who has the slightest degree of local chronic inflammation going on in any of the organs of the body, as evinced by white tongue, dryness of skin, accelerated pulse, evening thirst, or scanty action of the kidneys. The exciting mineral waters, taken internally or externally, will be almost certain to raise the chronic into a subacute, or even acute, inflammation, with a corresponding grade of constitutional irritation. ”

“ The organic sensibility of the exhalants, like that of every other part, may be disordered in different ways, 1st, by a direct stimulant, as when cold contracts the skin, when a very cold fluid acts upon the stomach, &c.; 2d, by sympathies, as when the acute affection of the fibrous and muscular organs produces sweat in rheumatism; 3d, oftentimes without our being able to say how, a derangement takes place in the vital forces of a part; of this inflammation presents frequent examples. ”

“ In what is called a cold, when the function of the skin has been suddenly interfered with, and the vaporous transpiration is all thrown upon the lungs, producing irritation or inflammation of the respiratory mucous surface, Diaphoretics are generally required. In Fevers, and some other disorders, as Gout and Rheumatism, which are apt to improve or to pass off with an increase of perspiration, and in which it often seems likely that some morbid material may be eliminated by this channel, the same medicines are constantly necessary. ”

“ Certainly attention to any part of the skin surface causes a tingling and hyperemia may follow. Blushing is an illustration of mental influence on the skin, and anything that would tend to make this endure for some time would give rise to erythematous conditions. We know the creepy, uncomfortable, hot feelings that come over us in times of suppressed excitement when we are waiting for something to happen; and, on the other hand, there is a pallor and tremor that accompanies fright or fear, which points to mental influences over the vasomotor system in the skin. ”

“ As we have said, the attention given to a part leads to a widening of the minute blood vessels located there so that the nerve endings to the part are supplied with more blood and therefore become more sensitive. We know from experience in cold windy weather that when the cheek is hyperaemic the drawing of a leaf or even of a piece of paper across it may produce a very acute painful sensation. Hyperaemia always makes parts of the body much more sensitive than before. Attention has just this effect over all the surface of the body, as we can demonstrate to ourselves. ”

“ With every change, therefore, of organic form or addition of organic parts, I suppose a new kind of irritability or of sensibility to be produced; such varieties of irritability or of sensibility exist in our adult state in the glands; every one of which is furnished with an irritability or a taste or appetency, and a consequent mode of action peculiar to itself. ”

“ The remote causes are pneumony, catarrh, hæmoptysis, rheumatism, gout, asthma, scrophula, chronic diseases of the stomach, liver, and kidneys, nervous and intermitting fevers, measles, repelled humours from the surface of the body, the venereal disease, obstructed menses, sudden growth about the age of puberty, grief, and all other debilitating passions of the mind ”

“ But this only happens when the Disorders depend solely and simply on stopt or abated Perspiration, to which such Pain instantly succeeds; where immediately, before the Fever has thickened the Blood, and inflamed the Humours; and where before any internal Infarction, any Load, is formed, some warm Drinks are given, such as Faltranc and Honey; which, by restoring Transpiration, remove the very Cause of the Disorder. ”