[XII]. Torpor of the Stomach and upper Intestines.

[1]. The principal circumstance, which supports the increased action of the capillaries in continued fever with weak pulse, is their reverse sympathy with those of the stomach and upper intestines, or with those of the heart and arteries. The torpor of the stomach and upper intestines is apparent in continued fevers from the total want of appetite for solid food, besides the sickness with which fevers generally commence, and the frequent diarrhœa with indigested stools, at the same time the thirst of the patient is sometimes urgent at the intervals of the sickness. Why the stomach can at this time take fluids by intervals, and not solids, is difficult to explain; except it be supposed, as some have affirmed, that the lacteal absorbents are a different branch from the lymphatic absorbents, and that in this case the former only are in a state of permanent torpor.

[2]. The torpor of the heart and arteries is known by the weakness of the pulse. When the actions of the absorbents of the stomach are diminished by the exhibition of small doses of digitalis, or become retrograde by larger ones, the heart and arteries act more feebly by direct sympathy; but the cellular, cutaneous, and pulmonary absorbents are excited into greater action. Whence in anasarca the fluids in the cellular membrane throughout the whole body are absorbed during the sickness, and frequently a great quantity of atmospheric moisture at the same time; as appears by the very great discharge of urine, which sometimes happens in these cases; and in ileus the prodigious evacuations by vomiting, which are often a hundred fold greater than the quantity swallowed, evince the great action of all the other absorbents during the sickness of the stomach.

[3]. But when the stomach is rendered permanently sick by an emetic drug, as by digitalis, it is not probable, that much accumulation of sensorial power is soon produced in this organ; because its usual quantity of sensorial power is previously exhausted by the great stimulus of the foxglove; and hence it seems probable, that the great accumulation of sensorial power, which now causes the increased action of the absorbents, is produced in consequence of the inactivity of the heart and arteries; which inactivity is induced by deficient excitement of the sensorial power of association between those organs and the stomach, and not by any previous exhaustion of their natural quantity of sensorial power; whereas in ileus, where the torpor of the stomach, and consequent sickness, is induced by reverse sympathy with an inflamed intestine, that is, by dissevered or defective association; the accumulation of sensorial power, which in that disease so violently actuates the cellular, pulmonary, and cutaneous absorbents, is apparently produced by the torpor of the stomach and lacteals, and the consequent accumulation of the sensorial power of association in them owing to their lessened action in sickness.

[4]. This accounts for the dry skin in fevers with weak pulse, where the stomach and the heart and arteries are in a torpid state, and for the sudden emaciation of the body; because the actions of the cellular and cutaneous absorbents are increased by reverse sympathy with those of the stomach, or with those of the heart and arteries; that is by the expenditure of that sensorial power of association, which is accumulated in consequence of the torpor of the stomach and heart and arteries, or of either of them; this also explains the sudden absorption of the milk in puerperal fevers; and contributes along with the heat of the respired air to the dryness of the mucous membrane of the tongue and nostrils.

[5]. Besides the reverse sympathy, with which the absorbent vessels of the stomach and upper intestines act in respect to all the other absorbent vessels, as in the exhibition of digitalis, and in ileus; there is another reverse sympathy exists between the capillaries, or secretory vessels of the stomach, and those of the skin. Which may nevertheless be occasioned by the accumulation of sensorial power by the torpor of the heart and arteries, which is induced by direct sympathy with the stomach; thus when the torpor of the stomach remains in a fever-fit which might otherwise have intermitted, the torpor of the heart and arteries remains also by direct sympathy, and the increased cutaneous capillary action, and consequent heat, are produced by reverse sympathy; and the fever is thus rendered continual, owing primarily to the torpor of the stomach.

[6]. The reverse sympathy, which exists between the capillaries of the stomach and the cutaneous capillaries, appears by the chillness of some people after dinner; and contrary-wise by the digestion being strengthened, when the skin is exposed to cold air for a short time; as mentioned in Class [IV. 1. 1. 4]. and [IV. 2. 1. 1]. and from the heat and glow on the skin, which attends the action of vomiting; for though when sickness first commences, the skin is pale and cold; as it then partakes of the general torpor, which induces the sickness; yet after the vomiting has continued some minutes, so that an accumulation of sensorial power exists in the capillaries of the stomach, and of the skin, owing to their diminished action; a glow of the skin succeeds, with sweat, as well as with increased absorption.

[7]. Nevertheless in some circumstances the stomach and the heart and arteries seem to act by direct sympathy with the cutaneous capillaries, as in the flushing of the face and glow of the skin of some people after dinner; and as in fevers with strong pulse. In these cases there appears to be an increased production of sensorial power, either of sensation, as in the blush of shame; or of volition, as in the blush of anger; or of irritation, as in the flushed face after dinner above mentioned.

This increased action of the capillaries of the skin along with the increased actions of the stomach and heart is perhaps to be esteemed a synchronous increase of action, rather than a sympathy between those organs. Thus the flushing of the face after dinner may be owing to the secretion of sensorial power in the brain being increased by the association of that organ with the stomach, in a greater proportion than the increased expenditure of it, or may be owing also to the stimulus of new chyle received into the blood.

[8]. When the stomach and the heart and arteries are rendered torpid in fevers, not only the cutaneous, cellular, and pulmonary absorbents are excited to act with greater energy; but also their correspondent capillaries and secerning vessels or glands, especially perhaps those of the skin, are induced into more energetic action. Whence greater heat, a greater secretion of perspirable matter, and of mucus; and a greater absorption of them both, and of aerial moisture. These reverse sympathies coincide with other animal facts, as in eruption of small pox on the face and neck the feet become cold, while the face and neck are much flushed; and in the hemiplagia, when one arm and leg become disobedient to volition, the patient is perpetually moving the other. Which are well accounted for by the accumulation of sensorial power in one part of an associated series of actions, when less of it is expended by another part of it; and by a deficiency of sensorial power in the second link of association, when too much of it is expended by the first.