In the beginning of some fevers, along with incessant vomiting, the patients complain of disagreeable tastes in their mouth, and disagreeable odours; which are to be ascribed to the general debility of the great trains and tribes of associated irritative motions, and to be explained from their direct sympathy with the decreased action of a sick stomach; or from the less secretion of sensorial power in the brain. These organs of sense are constantly stimulated into action by the saliva or by the air; hence, like the sense of hunger, when they are torpid from want of stimulus, or from want of sensorial power, pain or disagreeable sensation ensues, as of hunger, or faintness, or sickness in one case; and the ideas of bad tastes or odours in the other. This accords with the laws of causation, Sect. IV. 5.
[17]. Pulsus mollis in vomitione. The softness of the pulse in the act of vomiting is caused by direct association between the heart and the stomach; as explained in Sect. XXV. 17. A great slowness of the pulsation of the heart sometimes attends sickness, and even with intermissions of it, as in the exhibition of too great a dose of digitalis.
[18]. Pulsus intermittens a ventriculo. When the pulse first begins to intermit, it is common for the patient to bring up a little air from his stomach; which if he accomplishes before the intermission occurs, always prevents it; whence that this debility of the heart is owing to the direct association of its motions with those of the stomach is well evinced. See Sect. XXV. 17.
I this morning saw Mr. ——, who has long had at times an unequal pulse, with indigestion and flatulency, and occasional asthma; he was seized two days ago with diarrhœa, and this morning with sickness, and his pulse was every way unequal. After an emetic his pulse still continued very intermittent and unequal. He then took some breakfast of toast and butter, and tea, and to my great surprise his pulse became immediately perfectly regular, about 100 in a minute, and not weak, by this stimulus on his stomach.
A person, who for many years had had a frequent intermission of his pulse, and occasional palpitation of his heart, was relieved from them both for a time by taking about four drops of a saturated solution of arsenic three or four times a day for three or four days. As this intermission of the pulse is occasioned by the direct association of the motions of the heart with those of the stomach, the indication of cure must be to strengthen the action of the stomach by the bark. Spice. Moderate quantities of wine. A blister. Half a grain of opium twice a day. Solution of arsenic?
[19]. Febris inirritativa. Inirritative fever described in Class [I. 2. 1. 1]. belongs to this place, as it consists of disordered trains and tribes of associated irritative motions, with lessened actions of the associated organs. In this fever the pulsations of the heart and arteries are weakened or lessened, not only in the cold paroxysm, as in the irritative fever, but also in the hot paroxysm. The capillary arteries or glands have their actions nevertheless increased after the first cold fit, as appears by the greater production of heat, and the glow of arterial blood, in the cutaneous vessels; and lastly, the action of the stomach is much impaired or destroyed, as appears by the total want of appetite to solid food. Whence it would seem, that the torpid motions of the stomach, whatever may occasion them, are a very frequent cause of continued fever with weak pulse; and that these torpid motions of the stomach do not sufficiently excite the sensorial power of association, which contributes in health to actuate the heart and arteries along with the irritation produced by the stimulus of the blood; and hence the actions of these organs are weaker. And lastly, that the accumulation of the sensorial power of association, which ought to be expended on the motions of the heart and arteries, becomes now exerted on the cutaneous and pulmonary capillaries. See Supplement I. [8]. and Sect. XXXV. 1. 1. and XXXIII. 2. 10.
I have dwelt longer on the vertiginous diseases in this genus, both because of their great intricacy, and because they seem to open a road to the knowledge of fever, which consists of associated trains and tribes of irritative or sensitive motions, which are sometimes mixed with the vertiginous ones, and sometimes separate from them.