Many parts of the body are excited into perpetual action, as the sanguiferous vessels consisting of the heart, arteries, and veins; others into nearly perpetual action, as the conglomerate and capillary glands; and others into actions still somewhat less frequent, as the alimentary canal, and the lacteal and lymphatic absorbents with their conglobate glands: all these are principally actuated by the sensorial powers of irritation, and of association; but in some degree or at some times by those of sensation, and even of volition. There are three kinds of stimulus, which may easily be occasionally diminished, that of heat on the skin, of food in the stomach, and of the oxygenous part of the atmosphere, which mixes with the blood in respiration, and stimulates the heart and arteries.
[2]. When any parts, which are naturally excited into perpetual action by stimulus, become torpid or less active from decrease of that stimulus; there first occurs a decrease of the activity of the parts next catenated with them; thus going into cold water produces a torpor of the capillary vessels of the lungs, as is known by the difficult respiration, which immediately occurs; for the sensorial power of association, which naturally contributes to actuate the lungs, is now less excited by the decreased actions of the cutaneous vessels, with which they are catenated. This constitutes the cold fit of fever.
There next occurs an accumulation of the sensorial power of irritation in the parts, which were torpid from defect of stimulus, as the cutaneous vessels for instance when exposed to cold air; and a similar accumulation of the sensorial power of association occurs in the parts which were catenated with the former, as the vessels of the lungs in the example above mentioned. Whence, if the subduction of stimulus has not been too great, so as to impair the health of the part, the activity of the irritative motions returns, even though the stimulus continues less than usual; and those of the associate motions become considerably increased, because these latter are now excited by the previous fibrous motions, which now act as strong or stronger than formerly, and have also acquired an accumulation of the sensorial power of association. This accounts for the curious event of our becoming warm in a minute or two after remaining in water of about 80 degrees of heat, as in the bath at Buxton; or in the cold air of a frosty morning of about 30 degrees of heat.
But if the parts thus possessed of the accumulated sensorial powers of irritation and of association be exposed again to their natural quantity of stimulus, a great excess of activity supervenes; because the fibres, which possess accumulated irritation, are now excited by their usual quantity of stimulus; and those which possess accumulated association, are now excited by double or treble the quantity of the preceding irritative fibrous motions, with which they are catenated; this constitutes the hot fit of fever.
Another important circumstance occurs, when the parts, which are torpid from decreased stimulus, do not accumulate a quantity of sensorial power sufficient for the purpose of renewing their own natural quantity of action; but are nevertheless not so torpid, as to have the life of the part impaired. In this situation the superabundance of the accumulated power of irritation contributes to actuate the associate motions next catenated with them. Thus, when a person breathes air with less oxygene than natural, as by covering his head in bed, and thus respiring the same atmosphere repeatedly, the heart and arteries become less active by defect of the stimulus of oxygene; and then the accumulation of sensorial power of irritation becomes instantly very great, as these organs are subject to perpetual and energetic action. This accumulation nevertheless is not so great as to renew their own activity under this defect of stimulus, but yet is in sufficient abundance to increase the associability of the next link of catenation, that is, to actuate the capillaries of the skin with great and perpetual increase of energy. This resembles continued fever with weak pulse; in which the accumulation of the sensorial power caused by the lessened motions of the heart and arteries, actuates the capillaries with increase of energy.
[3]. When the accumulation of the sensorial power of association, which is caused as above explained by deficient excitement owing to the lessened quantity of action of the irritative fibrous motions, with which the associate train is catenated, is not in quantity sufficient to renew the natural actions of the first link of an associate train of motions; it is nevertheless frequently so abundant as to actuate the next link of the associated train with unnatural energy by increasing its associability; and that in a still greater degree if that second link of the associated train was previously in a torpid state, that is, had previously acquired some accumulation of the sensorial power of association. This important circumstance of the animal economy is worthy our most accurate attention. Thus if the heart and arteries are deprived of their due quantity of the stimulus of oxygene in the blood, a weak and quick pulse ensues, with an accumulation of the sensorial power of irritation; next follows an increase of the action of the capillaries by the superabundance of this accumulated power of irritation; but there also exists an accumulation of the power of association in these acting capillaries, which is not now excited by the deficient actions of the heart and arteries; but which by its abundance contributes to actuate the next link of association, which is the sick stomach in the case related from Sydenham in Class [IV. 1. 1. 2]. and explained in this Supplement I. [4]. And as this sick stomach was in a previous state of torpor, it might at the same time possess an accumulation of some sensorial power, which, if it was of association, would be thus more powerfully excited by the increased actions of the capillaries; which existed in consequence of the weak action of the heart and arteries. This also resembles in some respects the continued fevers with weak pulse, and with increased activity of the capillaries.
[4]. When a torpor of some irritative motions occurs from a previous exhaustion of the sensorial power of irritation by the action of some very great stimulus, it is long before any accumulation of the sensorial power of irritation is produced; as is experienced in the sickness and languor, which continues a whole day after a fit of drunkenness. But nevertheless there occurs an accumulation of the sensorial power of association in the first link of the associate train of motions, which is catenated with these torpid irritative ones; which accumulation is owing to deficient excitement of that sensorial power in the first link of the associate train. This first link therefore exists also in a less active or torpid state, but the accumulation of the sensorial power of association by its superabundance contributes to actuate the second link of the associate train with unnatural quantity of motion; and that though its own natural quantity of the power of association is not excited by the deficient action of preceding fibrous motions.
When this happens to the stomach, as after its irritative motions have been much exerted from the unnatural stimulus of wine, or opium, or of contagious matter mixed with the saliva, a torpor or inactivity of it succeeds for a greater or less length of time; as no accumulation of the sensorial power of irritation can occur, till the natural quantity, which has been previously expended, is first restored. Then the heart and arteries which are next in catenation, become less active from the want of sufficient excitement of the sensorial power of association, which previously contributed to actuate them. This sensorial power of association therefore becomes accumulated, and by its superabundance contributes to actuate the link next in association, which has thus acquired so great a degree of associability, as to overbalance the less quantity of the excitement of it by the torpid action of the previous or first associate link. This happens to the capillaries, when the heart and arteries are affected as above by the torpor of the stomach, when it is occasioned by previous great expenditure of its sensorial power, and thus constitutes fever with weak pulse, which is here termed inirritative fever, typhus mitior.
[5]. When a deficiency of stimulus is too great or too long continued, so as to impair the life of the part, no further accumulation of sensorial power occurs; as when the skin is long exposed to cold and damp air. In that case the link in catenation, that is, the first of the associate train, is rendered torpid by defect of excitement of its usual quantity of the sensorial power of association, and from there being no accumulation of the sensorial power of irritation to increase its associability, and thus to contribute to actuate it by overbalancing the defect of the excitement of its association.
Thus on riding long and slowly on a cold and damp day, the exhalation of the vapour, which is impinged on the skin, as the traveller proceeds, carries away his warmth faster, than it is generated within the system; and thus the capillaries of the skin have their actions so much impaired after a time, that no accumulation of the sensorial power of irritation occurs; and then the stomach, whose motions are catenated with those of the capillaries, ceases to act from the deficient excitement of the power of association; and indigestion and flatulency succeed, instead of the increased digestion and hunger, which occur, when the cutaneous capillaries are exposed to a less degree of cold, and for a shorter time. In which latter situation the accumulation of the sensorial power of irritation increases by its superabundance the associability of the fibres of the stomach, so as to overbalance the defect of the excitement of their association.