If the quantity of sensorial power remains the same, and the quantity of stimulus be lessened, a weakness of the fibrous contractions ensues, which may be denominated debility from defect of stimulus. If the quantity of stimulus remains the same, and the quantity of sensorial power be lessened, another kind of weakness ensues, which may be termed debility from defect of sensorial power; the former of these is called by Dr. Brown, in his Elements of Medicine, direct debility, and the latter indirect debility. The coincidence of some parts of this work with correspondent deductions in the Brunonian Elementa Medicina, a work (with some exceptions) of great genius, must be considered as confirmations of the truth of the theory, as they were probably arrived at by different trains of reasoning.
Thus in those who have been exposed to cold and hunger there is a deficiency of stimulus. While in nervous fever there is a deficiency of sensorial power. And in habitual drunkards, in a morning before their usual potation, there is a deficiency both of stimulus and of sensorial power. While, on the other hand, in the beginning of intoxication there is an excess of stimulus; in the hot-ach, after the hands have been immersed in snow, there is a redundancy of sensorial power; and in inflammatory diseases with arterial strength, there is an excess of both.
Hence if the sensorial power be lessened, while the quantity of stimulus remains the same as in nervous fever, the frequency of repetition of the arterial contractions may continue, but their force in respect to removing obstacles, as in promoting the circulation of the blood, or the velocity of each contraction, will be diminished, that is, the animal strength will be lessened. And secondly, if the quantity of sensorial power be lessened, and the stimulus be increased to a certain degree, as in giving opium in nervous fevers, the arterial contractions may be performed more frequently than natural, yet with less strength.
And thirdly, if the sensorial power continues the same in respect to quantity, and the stimulus be somewhat diminished, as in going into a darkish room, or into a coldish bath, suppose of about eighty degrees of heat, as Buxton-bath, a temporary weakness of the affected fibres is induced, till an accumulation of sensorial power gradually succeeds, and counterbalances the deficiency of stimulus, and then the bath ceases to feel cold, and the room ceases to appear dark; because the fibres of the subcutaneous vessels, or of the organs of sense, act with their usual energy.
A set of muscular fibres may thus be stimulated into violent exertion, that is, they may act frequently, and with their whole sensorial power, but may nevertheless not act strongly; because the quantity of their sensorial power was originally small, or was previously exhausted. Hence a stimulus may be great, and the irritation in consequence act with its full force, as in the hot paroxysms of nervous fever; but if the sensorial power, termed irritation, be small in quantity, the force of the fibrous contractions, and the times of their continuance in their contracted state, will be proportionally small.
In the same manner in the hot paroxysm of putrid fevers, which are shewn in Sect. [XXXIII]. to be inflammatory fevers with arterial debility, the sensorial power termed sensation is exerted with great activity, yet the fibrous contractions, which produce the circulation of the blood, are performed without strength, because the quantity of sensorial power then residing in that part of the system is small.
Thus in irritative fever with arterial strength, that is, with excess of spirit of animation, the quantity of exertion during the hot part of the paroxysm is to be estimated from the quantity of stimulus, and the quantity of sensorial power. While in sensitive (or inflammatory) fever with arterial strength, that is, with excess of spirit of animation, the violent and forcible actions of the vascular system during the hot part of the paroxysm are induced by the exertions of two sensorial powers, which are excited by two kinds of stimulus. These are the sensorial power of irritation excited by the stimulus of bodies external to the moving fibres, and the sensorial power of sensation excited by the pain in consequence of the increased contractions of those moving fibres.
And in insane people in some cases the force of their muscular actions will be in proportion to the quantity of sensorial power, which they possess, and the quantity of the stimulus of desire or aversion, which excites their volition into action. At the same time in other cases the stimulus of pain or pleasure, and the stimulus of external bodies, may excite into action the sensorial powers of sensation and irritation, and thus add greater force to their muscular actions.
[2]. The application of the stimulus, whether that stimulus be some quality of external bodies, or pleasure or pain, or desire or aversion, or a link of association, excites the correspondent sensorial power into action, and this causes the contraction of the fibre. On the contraction of the fibre a part of the spirit of animation becomes expended, and the fibre ceases to contract, though the stimulus continues to be applied; till in a certain time the fibre having received a supply of sensorial power is ready to contract again, if the stimulus continues to be applied. If the stimulus on the contrary be withdrawn, the same quantity of quiescent sensorial power becomes resident in the fibre as before its contraction; as appears from the readiness for action of the large locomotive muscles of the body in a short time after common exertion.
But in those muscular fibres, which are subject to constant stimulus, as the arteries, glands, and capillary vessels, another phenomenon occurs, if their accustomed stimulus be withdrawn; which is, that the sensorial power becomes accumulated in the contractile fibres, owing to the want of its being perpetually expended, or carried away, by their usual unremitted contractions. And on this account those muscular fibres become afterwards excitable into their natural actions by a much weaker stimulus; or into unnatural violence of action by their accustomed stimulus, as is seen in the hot fits of intermittent fevers, which are in consequence of the previous cold ones. Thus the minute vessels of the skin are constantly stimulated by the fluid matter of heat; if the quantity of this stimulus of heat be a while diminished, as in covering the hands with snow, the vessels cease to act, as appears from the paleness of the skin; if this cold application of snow be continued but a short time, the sensorial power, which had habitually been supplied to the fibres, becomes now accumulated in them, owing to the want of its being expended by their accustomed contractions. And thence a less stimulus of heat will now excite them into violent contractions.