THISSymptombegins with aSwimming,Giddiness, orDizzinessof theHead, and proceeds (in theconceiv’d Woman) fromVapoursof theHumours; which, ascending partly thro’ theVeinsandArteriestending to theBrain, and partly thro’ theOesophagusorGullet, disturb the Animal Spirits.
NOWThisDistemperisTwo-fold, and distinguished by the WordsVertigoandTenebricosa; which last theArabian Physicianshave call’dScotomia, I suppose from theGreekWordΣκοτος,Tenebræ, Darkness; and is now generally receiv’d by that Name.
BUTbecause this sadAffectionis too common to bothSexes, young and old, I shall proceed to a farther Dilucidation of it, for the universal Good and Benefit of All.
FIRSTthen, the[63]VERTIGOis a deprav’dImagination, attended with the vitiatedSensesofHearingandSeeing; proceeding from the violent Commotion of theAnimal Spirits.Secondly, TheSCOTOMIAis also a deprav’dImagination, accompany’d with loss ofSight, and sometimes of theMotionof theAnimalsaffected with it, because of someInterruptionin their circular Passage. In thefirst Case, thePATIENTimagines his Head only to be turn’d round, or winded about: In theother, he thinks thatcircular Motionto consist in theexternal Objects.
NOWtheVERTIGOis attended with the vitiatedSenseofHearing, as well asSeeing: Because, as something like aCloud,Smoak, orWeb, seems to appear before thePatient’sEyes; so there is a certainWhistling,Hissing, or Tinkling always in hisEars. TheScotomia, in like manner, is attended with Loss ofSight, andMotion; because of someDisorderof theVentriclesof theBrainobstructing or impeding theTransitionof theSpirits.
INtheVertigo, anAgitationhappens in theMembranesof theVeinsandArteries, as also in theMembranesof theBrain; by which violentMotion, the veryContinent Partsare vehemently shaken and concuss’d, and at length so disquieted, that thePatientthinks hisHeadwheels round about.
INtheScotomia, theAnimal Spiritshaving in themselves theSpeciesof all Sensibles, and thoseSpeciesbeing presented to theImagination: As suchImagesof externalObjectsare moved in it, so thePartythinks the samereal Objectsto be moved. For, according toAvicen, it is the same thing, whether that which isseen, or that by which wesee, is moved: As seeingLandfrom on board aShip, in a smooth Sea, being insensible of theShip’s Way, we imagine (and sometimes very strongly too) that theLandis inMotion.
THATby which wesee, is thevisible Speciesreserved in theSpirit: Hence when thisSpeciesis moved, theexternal Objectseems also to bemoved.
BUTin explaining theCircular Motionof theAnimal Spirits, we must consider it to betwofold; namely,NaturalandPreternatural: TheNatural Motionis that which begins in theCarotide Arteries, thence tending to thePlexus Choroideus, or theanteriour Ventriclesof theBrain; fromTheseto themiddle; from themiddleto thePosteriours; and from theposteriour Ventriclesof theBrain, theSpiritsare imparted to theNerves. ThePreternatural Motionis just theReverseof this Case.
THECausesof both these Cases and Conditions are eitherimmediateormediate. Theimmediate Causesmay be reduced toThree Classes; to wit,Causesof aninordinate Motionof the Animal Spirits,Causesof theCircular Motions, andCausesof lostSense,Sight, andMotion.
THECausesof theSpirits[64]moving inordinately, are eitherExternalorInternal. TheExternalsare theSun,Hot Baths,Frictions, andConcussions of theHead; or aFall,Blow,Contusion, and all inordinate and immoderateMotionsof the whole Body: such asRunning,Leaping,Riding,Dancing, too muchVenery, or hardDrinking; as also the Use ofAcids, or acrimonious Things, and all Things replenishing or stuffing theHead; such asGarlick,Mustard,Anise,Parsley,Leeks,Onions,Radish, strongSnuffs,Drinks, &c.
THEinternal immediate Causesare theImaginationof thePatient,Vapoursof the whole Body, frigidFlatulencies, and[65]a suddenFluxionof thevital Spiritsinto theHead.
THEmediate CausesareMaterial; and thisMatter[66](almost allPhysiciansagree) isfrigid. From hence it is certain, that theDistemperproceeds fromCrudities, andVictualsof a crude Juice; such asPulses,Cheese,Tarts,Fish, and allother Sortsof the like frigid and humidQualities: Buttheseare only to be reckon’dconcurring, notefficient Causes.
THEmost commonmaterial Causeis, according toGalen[67], theBile; which, seeking for Vent at theMouth of the Stomach, is theCauseof theseSymptoms, and is[68]properly to be educed or evacuated by a dueVomit.
BUTin Case ofVapours,Heatis always theefficient Cause, elevating them from the peccantMatter; since aCold, or a refrigeratedBody, can never engenderVapoursorWindfrom any Material Cause.
I shall not now enter upon the particularDiagnosticksof thisDistemper, because they are asVarious, as theCauses, and affectedPlacesare different. Let me observe only, that thesimpleVertigois easily known by theImaginationof theCircular Motionof thePatient’sHead, or That ofexternal Objects, or by vitiatedSeeingandHearing.
BUTtheScotomiadiffers from theVertigo, in that besides theImaginationof thecircular Motion, thePatientoften loses hisSight, staggers, tumbles, or falls to the Ground. And yet thesameis distinguished from theEpilepsy, in that thePatientretains his principalFunctions, and neitherFoamsat Mouth, nor isConvulsive.
HOWEVER, as to theDistinctionof Causes, if theinternal Causeproceeds fromCalidity, it is known by thehot Temperamentof the whole Body, as well as by aSwellingandPulsationof theArteriesabout theThroat: Besides that thisVertigoeasilyaccedesandrecedes, it is always attended withCalidityandRednessof Face and Eyes; withWatchings,Deliriums, &c: And it commonly followsFevers,Watchings,Anger, theUse of Calids, hot Things,&c.In whichCases, it is always to be helped by theUse of Frigids, or Coolers.
IFit arises fromfrigid Flatulencies, theParoxysmsor Fits are preceded by aHissingorTinglingin theEars; thePatientturnspaleandwan, and is taken with an odd extensivePainof theHead: And if theseFlatulenciesgenerate in theHead, thePartyfeels itponderous,lumpish, andheavy; and is consequently much inclin’d toSleep,Stupidity,Dullness, andInactivity.
IFtheDistemperis derived from aflatulent Stomach, thePATIENTis troubled withRiftingandRumblingof the Belly; withSobbingandSighing, withHickups,Yawnings,Extensions,Inflations, and frequentSpittings.
IFit comes from aMordacityof theMouth of the Stomach, thePartyis infested with aNausea,LoathingandFastidy; with a Dejection ofAppetite, a lasting or frequentThirst, and aBitternessof the Mouth. But thisAffectionalso very often proceeds from theWomb, and that either because of the suppress’dMenstrua, or longretain’dSeed; as will hereafter more fully appear inSect.ix.Chap. 8.
ASto thePrognosticksof thisDistemper, it does not always seemDangerous, much lessLethal, at first; but itsConsequencesare (however) veryFatal[69], if not timely prevented: For it often turns toInflammations[70]of theHead, orConvulsions; sometimes toMelancholyorMadness; and sometimes toEpilepsiesorApoplexies.
NOWbecause thisAffectionobservesLunar Periods, and in extreme Cases, is near a-kin to theFalling-Sickness;[71]Cœlius Aurelianusinforms us, That it was call’d by theAncientsthelittle Epilepsy: And as it admits ofperiodical AccessionsandCirculations(I mean coming and goingFits) which depend chiefly upon the Power and Influence of theNewandFull-Moon; so it is to be treated with respect toCure, in a different manner; one way in theAccess, another in theInterval.
BUTthisCureis as different, as the Causes and Degrees of theDistemperare various; wherefore I can, by no means, enter upon it in this place, for Brevity-sake.