CLASS IV. spasm; while those that are conspicuous for continuity of action are chiefly subject to rigid or entastic spasm.

ORDER III. Cinetica. Diseases affecting the muscles.

Continuity of action in the involuntary muscles

and whence derived, compared with the supply of the voluntary muscles.

Though more uniform in

their action, still subject to abnor

mities, especially spasms. Different

organs and functions

Continuity of exertion, however, is generally less evident in the voluntary than in the involuntary muscles, of which last some organs, as the heart, continue their efforts through life without intermission; though all of them relax or remit occasionally or periodically. For this greater permanency and regularity of action they are indebted to the peculiar provision which has been made for their supply of nervous power; for while the voluntary muscles are furnished in a direct line from the sensorium, whence indeed the close connexion they hold with it, the control the will exercises over them, and their catenation with the prevailing emotion of the moment: the involuntary muscles are dependent chiefly on the intermediate or ganglionic system described in the proem to the present class, and are more remotely connected with the sensorium: they are in consequence far less influenced by the variable impulses of the mental faculties, and are placed beyond the jurisdiction of the will. And hence the tenour of their action is more equable, more permanent, more uninterrupted, and less subject to fatigue or weariness.

But as these organs are by no means free from the power of injury, or diseased action, they are also subject at times, in common with the voluntary organs, to those abnormal motions which are ordinarily denominated spasms and it is not a little curious to observe the uniform tendency which different spasmodic affections manifest towards some organs or functions rather than towards others. Thus the vital function, in which the heart and the subjects lungs are such prominent agents, is chiefly disturbed by palpitation and syncope; the natural, or that in which the abdominal organs so generally co-operate, by hysterics; and the animal, extending through the range of the voluntary organs, by tetanus and epilepsy. In the prosethe general cution of the present order, indeed, we shall see that this does not hold universally; that epilepsy, for instance, is often a disease rather of the stomach or intestines, than of any other organ, and that the heart is sometimes af

of different

kinds of spasmodic motions.

A few ex

ceptions to

rule.

ORDER III.

Diseases af

muscles.

that all

spasms depend upon a of the brain.

morbid state

fected with rigid instead of with clonic spasm: but the CLASS IV. rule holds generally and is not essentially shaken by these Cinetica. casual exceptions. Dr. Cullen has contended that in all spasmodic affec- fecting the tions the brain is the actual seat of disease, and that they Cullen's consist in some morbid modifications of its energy. "The doctrine of all that he has said," he tells us, scope and purpose "is to establish the general proposition that spasmodic 'affections, whether they arise primarily in the brain or in particular parts, do consist chiefly, and always in part, in an affection and particular state of the energy of the brain: and that the operation of antispasmodic medicines must consist in their correcting this morbid or preternatural state in the energy of the brain, by their correcting either the state of preternatural excitement or collapse, or by obviating the too sudden alteration of these states."

this doctrine

ousness

pointed out.

This proposition seems rather to follow from Dr. Cul- Origin of len's singular doctrine concerning the mutable condition accounted of the energy of the brain, and the immutable nature of for. the nervous power which is propagated from it by vibrations, than from the clear face of facts before us. Spasms, its erronein many instances, are altogether local; they are confined to particular muscles, or particular sets of associate muscles, and have no effect on the brain whatever so as to disturb its energy; of which we have examples in hiccough, priapism, chorea, and often in palpitation. They depend upon some irritation existing not at the origin, but at the extremity of the nerves: and, where such is their source, even though the chain of morbid action should at length reach the brain and affect its energy, as in convulsions from teething, epilepsy from worms, or some palpitations from ossific or polypous concretions, all the antispasmodics in the world will afford no relief so long as the local cause of irritation continues to operate; while the moment this is removed, where it is capable of removal, as by the use of a gum-lancet or active anthelmintics, all the powers of the brain become instantly tranquillized; its faculties are rendered clear, its energy is re-invigorated, and its motive power or sensorial fluid The greater flows forward in an uninterrupted tenour.

ORDER III.
Cinetica,

Diseases af-
fecting the
muscles.

Argument further illustrated.

CLASS IV. number of spasmodic affections therefore, do not so much depend upon the state of the brain as of the living fibres that issue from it, and maintain a correspondence with it; for the stream may be vitiated while the fountain is untouched. We have seen, indeed, in the proem to the present class, from the concurrent results of various physiological experimenters, that although, while the organ of a brain exists, it exerts a certain influence over the principle of muscular motion, this principle is far less dependent upon the encephalon than that of general feeling or of the local senses: that it is found abundantly in animals totally destitute of a brain; and that hence, those possessing a brain may be excited not only into abnormal and spasmodic, but even into a continuation or re-production of regular and natural, motions of various muscular organs after the brain has been separated from the spinal chain, by stimuli applied to this chain, or even by the artificial breath of a pair of bellows.

Sensific and

motific fibres.

double.

We have seen also that the nervous filaments of the muscles are of two kinds, sensific and motific, the former proceeding from the cerebellum, or the posterior trunk of Spinal chord the spinal chord, to which it gives rise, and the latter from the cerebrum, or anterior trunk of the same double chord: and, as these two sets of filaments do not necessarily concur in the same affection, it is obvious that the muscles of a limb, or of the whole body, may be thrown into the most violent agitation, or the firmest rigidity, without much, or perhaps any degree of painful emotion, or increased sensibility. And we can hence readily account for the little complaint that is made by patients upon this severe fits of subject, on their being freed from a severe paroxysm of tetanus, convulsion-fit, or hysterics.

Why often little pain felt during

tetanus or convulsions.

The following are the genera of diseases which will be found to appertain to the present order:

I. ENTASIA.

II. CLONUS.

III. SYNCLONUS.

CONSTRICTIVE SPASM.

CLONIC SPASM.

SYNCLONIC SPASM.

GENUS I.

ENTASIA.

Constrictive Spasm.

IRREGULAR MUSCULAR ACTION PRODUCING CONTRAC-
TION, RIGIDITY, OR BOTH.

GEN. I.

explained.

ENTASIA is derived from the Greek vraois, "intentio”, "vehementia", "rigor", from EvTEívw, "intendo". By Origin of generic many nosologists the genus is called tonos, or tonus, name and which is here dropped in favour of the present term, be- its necessity cause tonus or tone is employed by physiologists and pathologists, in direct opposition to irregular vehemence or rigidity, to import a healthy and perfect vigour or energy of the muscles; and by therapeutists to signify medicines capable of producing such or similar effects.

The genus ENTASIA includes the following species:

GEN. I. SPEC. I. Origin of the specific

name.

How used by Galen.

Peculiarly

a disease of

debility.

Sometimes chronic.

SPECIES I.

ENTASIA PRIAPISMUS.

Priapism.

PERMANENT RIGIDITY AND ERECTION OF THE PENIS
WITHOUT CONCUPISCENCE.

THE specific term is derived from the name of Priapus, the son of Venus and Bacchus, who is usually thus represented in paintings and sculptures, but with a concupiscent feeling. Galen applies the term also to females, as importing a rigid elongation of the clitoris without concupiscence.

Spasm is, in all instances, a disease not of vigour, but of debility with a high degree of irritability: and there is no case in which this is more striking than in the present species. It has been found occasionally in infancy; but it is far more frequently an attendant upon advanced years. It has sometimes also followed upon cold, and especially local cold, clap, dysury, and the use of cantharides as a cure for seminal weakness. It has at times been a result of free living, and particularly hard drinking. The spasms consist in a stiff and permanent contraction of the erectores penis, unconnected with any stimulus arising from a fulness of the vesiculæ seminales.

Dr. Darwin says, he had met with two cases where the erection, producing a horny hardness, continued two or three weeks without any venereal desire, but not without pain. The easiest attitude was lying upon the back with the knees bent upwards. The corpus cavernosum urethræ at length became soft, and in a day or two the whole rigidity subsided. One of these patients had been a free drinker, had a gutta rosacea on his face, and died suddenly a few months after his recovery from the present