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GEN. V. remaining strength can support: and the man who tries it
$pec. I. Dinus
trembles in every limb and becomes immediately vertiVertigo.
ginous. In like manner whatever be his degree of strength Vertigo.
he will feel vertiginous by exchanging the motion to which Second, motion to he has been uniformly accustomed for one of a different
kind, and which he has seldom or never engaged in ; and system has not been ac- hence, the reason of the vertigo that accompanies swing
ing, sailing in a ship, walking in a circle, sitting backward in a carriage, or standing on one's head; for the uniformity of the external habit has by length of time associated itself with the uniform flow or secretion of the sensorial fluid, and the one cannot be interfered with without interfering with the other. And that this is the cause of the dizziness hereby produced is obvious, since as soon as the old habit is overpowered by a new one, or, in other words, as soon as the man has accustomed himself to the new action, it may be persevered in without any vertiginous sensation whatever. In some persons this sympathy of association is not so strong as in others, and hence, they are not so soon affected : in infants and young children such a kind of sympathy has rarely commenced, for while their age has not given time for it, they have had so little walking in a straight line, and been accustomed to so much swinging and tossing about in the arms, in every direction, that they are equally prepared for all; and hence can run round a circle, or even circumvolve on their feet, without any feeling of giddiness
whatever. Third kind, For the same reason hurried, tumultuous, or confused hurried or
motion of any kind, whether external or internal, has a' motion ex- tendency to produce the same effect; for the current of ternal or
the nervous supply will partake of the agitation, and dizziness be a necessary result. Hence the vertigo that accompanies intoxication, in which, from the inordinate excitement that prevails throughout the system, the regular and uniform stream of the sensorial fluid is quickened into a confused and disorderly rush. And hence the same effect from congestion, or compression of any kind, as also from a sudden influence of mental emotion, and
particularly of the depressing passions : though in such Gen. V.
SPEO, I. cases the uniformity of the sensorial stream is interfered Dinus. with by a check, instead of by a rapidity of action : and Vertigo, where the check is considerable, as in cases of sudden fright or apprehension, a fainting-fit is at once produced without the preceding stages. It is to this cause, exercised indeed in a less degree, Whence
vertigo on that we are to ascribe the dizziness which is felt on look- looking ing down a precipice, climbing a tall ladder, or walking down a pre
8 cipice or over a very narrow bridge, with a roaring torrent below; climbing a for in all these cases we are conscious of danger, and lose ladder. our firmness in our fear. And that such is the real cause is quite obvious from the fact that those who possess their firmness, and have no apprehension or trembling whatever, have no dizziness: and that we ourselves are able to endure an exposure to the same scenes and the same motion with as great a freedom from it, when habit has given us calmness, and we have no longer any apprehension. So the sleep-walker has been known to tread firmly and fearlessly over planks and precipices, the sight of which has whirled all his brains when awake.
Vertigo, then, as thus explained, consists in a clonic action of the nervous fibres subservient to the faculty of perception ; and lays open to us the three following varieties : a Undulans.
Dizziness with a sense of Swimming of the head. swimming or undulatory
motion. B Illusoria.
Dizziness with dimness of
sight, and imaginary ob-
senses. g Scotoma.
Dizziness with blindness and Blind head-ache.
tendency to swoon; often Nervous fainting-fit. succeeded by head-ache.
Vertigo is not generally an alarming affection, but it Vertigo not is only to be remedied by a particular attention to its alarming af
generally an cause, and especially the predisposition of the system to fection. a relapse.
Gex. V. If we have reason to suspect congestion or extravasa
SPEC. I. Dinus
• tion in the head, bleeding, and especially from the temVertigo. poral artery, will often afford effectual relief. I have seen Vertigo.
a very severe attack of vertigo cease instantly, as by matreatment gic, on opening this artery, although not more than a tea
cup full of blood was drawn from it. Where the stomach ferent causes and circum- has been gorged, an emetic, and afterwards a purgative
will prove most effectual; where the cause, on the contrary, is debility or exhaustion, it is best relieved by cordials and a generous diet : and where it is an idiopathic affection of the nervous system, the warm antispasmodics and tonics, with a tonic regimen, will bid fairest to succeed. Such persons will derive great benefit by a change of air, of scene, and of company; by visiting the most quiet of our watering-places, cold bathing, and a cold ablution of the head, or of the whole body every morning. Here also a particular attention should be paid to the state of the bowels, as costiveness is always an exciting cause. During the paroxysm, perfect rest and a reclined position will be always found necessary; and, where there is a tendency to fainting, stimulant odours may be applied to the nostrils, and ether, ammonia, and the volatile fetids to the stomach in draughts of cold spring water.
MOTION OF THE HEART AND LUNGS FEEBLE OR IM
PERFECT : DIMINISHED SENSIBILITY: INABILITY OF
SYNCOPE, from ougróa TW “ concido”, “ to fell or cut Gen. VL.
Origin of the down”, is a neoteric rather than an antique term. It generic occurs, indeed, among the Greek writers, but rather in term. the description of battles than of diseases. I cannot find who first introduced it into the medical nomenclature. In Leipopsy
chia of HipHippocrates the common synonym is leipopsychia, and in Galen apopsychia : but it answers its purpose, and is, in Apopsychia the present day, so generally established, that there is no of Galen. kind of necessity for exchanging it. Dr. Cullen's definition of the genus is “ motus cordis Cullen's de
n finition in imminutus vel aliquamdiu quiescens”. But this is by no
no adequate, means sufficient: for the heart has been sometimes to- and why. tally void of motion without syncope, as in acrotismus, and especially in the well-known case of Mr. John Hunter, which we have noticed under that division. The lei- Leipothymia
of Sauvages pothymia of Sauvages and other nosologists is only syn- what. cope in its first attack or mildest degree. Its character is “ subitanea et brevis virium dejectio, superstite pulsûs vigore, et cognoscendi facultate”. The pulse is, perhaps, always affected in some measure; but in slight cases it still retains a certain degree of power: the perception rarely fails altogether : but the voice seems to be uniformly lost.
The species in some systems of nosology are very numerous, and unnecessarily multiplied. Out of deference to high and established authorities, the author was induced,
Gen. VI. in his volume of Nosology, to offer five: but as several Syncope.
of these differ only in cause or some accidental symptom, Syncope.
they may be reduced to the two following, and the acci-
1. SYNCOPE SIMPLEX. SWOONING.
OCCURRING SUDDENLY AND ACCIDENTALLY, AND CEAS
ING WITHOUT ANY TENDENCY TO A RECURRENCE.
Gen. VI. In vertigo, the defective or irregular action is chiefly
Spec. I. Pathological confined to the nerves, and particularly to those of perexplanation ception: in swooning it is sometimes a result of nervous to be collect
exhaustion as in cases of exquisite pain or torture, whesiderable de- ther of body or of mind, but it more commonly originates that already in the sanguific or digestive organs, though the sentient offered un- participate in the affection. Vertigo, as we have already der vertigo.
observed, occasionally terminates in swooning; and in like manner swooning is not unfrequently succeeded by
To maintain the faculty of perception clear and true illustration.
to the impressions that are made on the external senses, we endeavoured to show, under the preceding genus, that the motion of the nervous power which connects it with those senses must be equable and uniform; and to main
tain the action of the heart in a firm and regular order, it To mamtain is necessary that the blood should flow into it in an equal a regular motion in the and uniform stream: for if its volume be altered from heart the any cause, whether of obstruction, surcharge, or defi