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A33550 An account of the nature, causes, symptoms, and cure of the distempers that are incident to seafaring people with observations on the diet of the sea-men in His Majesty's navy : illustrated with some remarkable instances of the sickness of the fleet during the last summer, historically related / by W.C. Cockburn, W. (William), 1669-1739. 1696 (1696) Wing C4815; ESTC R24229 70,196 195

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many fatal distempers which 't would be needless to insist upon in this place since the thing is generally agreed upon yet I cannot forbear observing that an untimely use of Sweating Medicines in some and thickning Lozenges in others is more frequently the productive cause of Fevers Phthisicks c. and of more fatal consequence than a Cold could have been if left to the strength of the blood and abstinence without employing any other Auxiliaries but more for the confirmation of this may be easily collected from what follows in this Discourse I say then since so far is already clear and because too the force of the perspiration is only kept up by a certain impetus and degree of the velocity of the blood and that is only interrupted by the falling or diminution of this 't would be an easy task to give a more genuine and conceivable account of catching cold than is generally assign'd to be done by I don't know what nitrosity or nitrous power in the Air which upon various occasions Authors make use of for making the blood fluxile and tenacious two very different effects tho 't is fit for neither as I have already prov'd in its proper place But I shall content my self at present with enumerating those symptoms that constitute the essence of a cold and then proceed to consider the effects of this by the different symptoms that naturally attend it Since then I find 't is agreed on by all Physicians that perspiration in a catch'd cold is not so free as in a natural state but is interrupted and a great deal of that substance that is usually sep●rated that way is detain d in the mass of blood That which is so detain'd will proportionably encrease its bulk and fill the vessels and so becomes the source of all those symptoms that are observed to attend a catch'd Cold by a necessary consequence I shall afterwards have occasion to demonstrate The Symptoms that usually appear in this case are these and in this order First a weight or heaviness a pain in the breast a less activity over all the body sudden weakness a coldness in all the extremities except the Brain Costiveness such a pain in the bones as when one is beat a weak sunk and depressed Pulse sometimes accompanied with a great inclination to sleep in a day or two the Pulse is great and strong they become very warm restless and thirsty the tongue is dry black and rough the breathing difficult the breath striking those that stand near the sick person like Fire they are delirious cannot sleep and their sickness is terminated in Death by Sweating Hemorrhagie Looseness c. Having thus enumerated these symptoms that appear constantly in our Fevers and in the same order in which I have rank'd them I shall now endeavour to evince the necessity of their attending an interruption of perspiration as I intimated before and hereafter I shall endeavour to demonstrate that that fulness which gives rise to all these appearances is more especially to be attributed to an interruption of perspiration than any other cause and so the Hypothesis tho own'd by every one will be more than one that is merely such First then an interruption of perspiration will encrease the Moles or bulk of the Fluids proportionably to what is left unexpell'd of the quantity which usually passeth thro the pores and because Sanctorius in his Statical Medicin has taught us that we perspire according to the different constitutions of our bodies about forty fifty or sixty ounces in 24 hours therefore if but a sixth part of this be detain'd as I could prove it to be it must needs produce a very great Plethora in a day or two in such that were in perfect health before besides the addition may be suppos'd to be made by our daily food and perhaps rarifying liquors The blood upon this consideration admitting of a vast augmentation distends the sides of its Channels is more unfit for motion and presseth the neighbouring parts and so may easily produce the sense we have and very often complain of an unnatural weight for in this weight or heaviness we have the same sensation as when loaded under a great burden and therefore in this the parts are the same way affected as when a weight presses our body but by this weight the Membranes Nerves and Muscles are so prest and the Bones so forc'd into their Joinings that they could not subsist if it were not for the violent Nisus of the Muscles neither could those Muscles be contracted but by a more abundant influx of the animal spirits overcoming this pressure nor could they be propell'd thro the compressed Nerves unless they were pusht on by a greater force and by this greater force is known that by which is meant to press and therefore 't is evident that the blood thus filling its vessels may easily produce that sense of Weight as was said The blood while in this fulness because of its bulk and the viscidity it contracts by this stagnating fulness both in its own nature and by reason of the diminution of its motion is not so capable to separate its subtile parts or animal spirits because it is not so well divided or broken into such small particles Now since the abundance and separation of the spirits in the brain are necessary for the motion of the muscles upon the contraction of which the strength and activity of the whole body depends 't is plain that in such a case where the motion of the blood is so languid and the secretion of the animal spirits so small there will be a laziness and a diminution of activity over all the body And because this artificial Plethora that lessens the activity is very sudden i. e. in two or three days this less activity will be sudden too or a sudden weakness will happen which was to be shown When the blood is thus stopt and become very viscid 't is evident that the body must proportionably want of its warmth since that is only an effect of the greater liberty the small parts of the blood that make the heat have to disperse themselves over the body and this liberty is procur'd by the parts of the blood in their motion justling and breaking each other into smaller parts But the blood being viscid or tough is not so easily in its nature broken and dissolved and therefore the warmth is still more violently lock'd up and confin'd Moreover while the blood is so viscid its motion is ev'n slower than naturally it should be and consequently the heat is lessen'd and the blood not so well divided because the breaking of it into smaller parts depends upon its motion So that according as the motion is diminished and the force of the viscidity greater the coldness is proportionably greater over the whole body and because the blood hath its motion from the heart and in its whole journey round the body
all the external senses may be faulty when the mind is in a thinking condition supposing that this viscid stuff is huddled up by chance in a greater quantity about any Artery or plexus of Arteries and if these Arteries involve or go round the Nerve that serves for Hearing Seeing Tasting c. These Arteries then being stuff'd up and fill'd by the continual afflux of new blood their sides will be more distended and bent outwards so that the Nerve that touches with them shall be comprest till at length by this continual stuffing the Nerve is so totally comprest that it hinders the motion of the animal spirits or at least interrupts their motion tho the sides of the Nerve are not quite squeez d together and therefore it may very well happen that one may be thick of hearing or perfectly deaf may not see taste c. and yet recover of a sudden the coldness being over and this lentor protruded into the veins And if this stoppage of the blood in the brain be so great and its cohesion so firm ●hat it cannot be dissolv'd by a thousand justlings in the plexus of the Pia Mater so that almost no animal spirits flow thro the Nerves either because there can be no spirits made out of this viscid blood or that those few that are made cannot be deriv'd in the Nerves that are shut up by the force of this stagnating blood then those spirits equally distributed into the muscles keep them equally pois'd and in this equilibration and viscidity there will be a want of motion and sense with an intense coldness and these being the conditions of a dead body or Corpse 't is evident at this time our bodies will be like a Corpse This lentor being so great over all the body 't is so too in the Arteries that furnish matter for the Spittle that is separated in the Glands about the mouth and throat and no Spittle can be separated from the Arteries in these Glands so that in this lesser secretion there can be no afflux of that moisture to these parts and the want of that occasioning a driness and drought therefore this stoppage is attended with a drought Yet tho there is but a small quantity of animal spirits separated in the brain and they deriv'd into the comprest nerves and muscles very sparingly and disorderly so that the actions of the body seem at an end and the muscles in equilibrio the heart which has no antagonistical muscle shall have its contraction continued and if that motion thus continued can dissolve and attrite this blood not quite stagnating the body that seem'd dead and a Corpse shall become warm as before and have its life prolong'd So the blood being once more free and fluxil and the body hot in the way we demonstrated before the attrition and comminution that produce this heat depending very much upon the velocity of the blood so that the greater it is the greater is the solution of heat and the greater the solution of heat is the velocity is the greater too because there 's a greater quantity of animal spirits separated by this solution of heat and so successively til● the viscid blood thus subsisting is so comminuted and attrited and acquires that degree of velocity we determined it to have when fit for perspiring and in that the small parts of the blood will be propell'd thro the neighbouring pores in a great quantity and produce that appearance we call Sweat so that this warmth is continu'd and ends in Sweat as we shall see more clearly in the sequel Yet before this sweating while the blood is thus commiuuted there 's both a greater quantity of animal spirits and this quantity is faster convey'd to the heart and the heart is oftner contracted and that with greater force and therefore the Pulse will be stronger and more frequent than in a natural state And because of the great rarifaction and comminution of the blood and its rapid motion the sides of the Arteries are distended to a greater pitch and very strongly therefore the more superficial Arteries going outward with a great deal of force affect the parts that are touch'd by them and produce that feeling and noise that 's convey'd to us upon the beating of one body upon another While the blood is thus hurry'd about in this rapid and impetuous motion and no great secretions of any sort there is a great driness in our mouth because of the small quantity of Spittle that is separated and that little is so divided into insinite parts by the force and warmth of the circulating blood that these parts are left perfectly dry and they dispoil'd of their moisture produce that insatiable drought And since this lentor is at length entirely carried out of the Arteries they will be of their natural wideness after it is carried out and so the blood may be propell'd thro them without its being more attrited comminuted or dissolved or the heat of the blood will not encrease in its progress thro the vessels and since the blood thus dissolv'd perspires very easily this heat shall not only not encrease but be diminisht the Perspiration lessening its quantity Moreover the heat thus dissolv'd partly perspires as was said and is partly mixt with the rest of the blood and is not comminuted the slowness in which the blood moves thro the veins giving sufficient time for this mixture and the heat may easily insinuate it self into the grosser parts and they may somewhat confine this heat and restrain its force by opposing this Penetration Besides since there 's an abundance of time betwixt both Excursus the blood must frequently flow thro the Lungs and so be frequently dissolv'd and have its hot parts conveniently mixt with the other parts and for this reason will be more natural from which every thing that 's natural will come and therefore the body will be in perfect health at least for some time Tho then the paroxism is thus judg'd by the assigned perspiration yet if that viscidity that produc'd the first is not consum'd but returns in a certain time or if that is consum'd and purg'd off by some of the known ways of Excretion or so comminuted that it is chang'd into the nature of sincere blood yet the cause that produc'd the first viscidity produces its like that can last out the same time affect with the like symptoms and be reduc'd to sincere blood like it and so there are two ways of making these returns as we see Let us suppose then that there are two returns every day and at the same hour there may be assigned the same reason for the rest that recurr in the same difference of time and the first is produced by a lentor that lasts for one day and threafter is either purg'd out of the body or chang'd into sincere blood and the second by a piece of viscidity of the same quantity and
is still losing part of that motion for the reasons assign'd before more or less in respect of the wideness of the vessels thro which it is propell'd and their distance from the heart therefore 't is evident that that Coldness will not be so sensible in the parts that are nearer the heart or about the heart it self and the Thorax as in the parts that are more remote or the extremities of the body for not only for the reasons we have just nam'd this Coldness is first felt in the parts that are furthest from the heart but the motion of the muscles in the extremities is not so strong and therefore they do not so powerfully press the blood that glides thro those veins and arteries that go to the composing of these muscles as in the other muscles whose contraction is perform'd with greater force and energy And consequently the blood too will be more apt to stagnate in those remote parts than in the other so that this coldness will be more sensible in them as was asserted Moreover the vessels in those remote parts growing always smaller and smaller the further they go this thick blood will be propell'd with the greater difficulty thro these vessels than if they were wider besides that by reason of the Glewiness of this ●ough and thick blood 't is more apt to stick to the coats of the vessels and so more ready to subsist and to produce the abovemention'd coldness but tho this coldness is more apt to begin in the extremities than in any other parts and tho there are a great many small arteries in the Brain as well as in the other parts yet this coldness will not be felt in it so soon as in them because the arteries are but short and soon discharge themselves into the wide Sinus's so that tho the blood is very apt to stagnate and produce that coldness in the extremities yet that happens not so soon in the Brain Now the real continuation of this coldness over the whole body may be very well conceived if we consider that while the blood is thus stopt in the capillary arteries we can assign no time in the whole circulation in which a lesser quantity of blood flows not from the arteries into the veins than would have flown in a natural state and therefore a lesser quantity of blood flowing more slowly in the ordinary time of the circulation than is naturally usual there will a lesser than a natural quantity come into the heart in every contraction and this small quantity will not fill the arteries in that proportion that is necessary to force it forward so as to break and divide it and to display its heat Besides the blood being in this tough and viscid condition there will ev'n be fewer of its fine and subtile parts separated in the Brain and dispos'd of into the muscles of the whole body and the heart in course will have a fainter contraction and a weaker power to propel the blood which consequently will not be so well divlded nor the heat so well diffus'd Now supposing that this Lentor or Toughness could consist with the natural motion of the blood and that the viscidity could not be broken or dissolv'd by the natural motion it cannot be expected it ever should by a degree of motion much below that which is natural and therefore this sense of cold must be felt in the other parts and over the whole body Pain is nothing else but a solution or disjoyning of continuous parts and while the blood stagnates and its quantity is constantly augmented it must needs distend the sides of its channels where it stops and stretch the arteries beyond their ordinary pitch And therefore those vessels that have not a natural or an adventitious resistance to oppose this forcing outward of the blood will have their parts disunited i. e. this sense of pain will be produc'd in them Now the bones in themselves are not affected with pain neither is there any such sensation produc'd in them but by the membrane that surrounds and invests them called the Periostium 't is evident that because this may be affected with any sort of pain the bones are said to be thus affected and in beating there are great contusions i. e. the vessels have their sides so prest by the weight and motion of the instrument by which these contusions are made that the blood either circulates very slowly or not at all in those sections of the vessels so comprest And the Periostium is either so prest by the contus'd muscles that this feeling is produced in it or having its vessels a little comprest the subsisting liquors in the comprest part do stop the succeeding liquors in the same channel that they actually protrude the sides of their vessels and make this sensation of pain And since the blood in this accidental fulness and viscidity may affect the vessels after the same manner 't is but natural to conclude that such a pain as when one is beaten may be produc'd in this state of the mass of the blood The blood in this state of viscidity is less capable of separating its fine and subtile parts as has been said and there being a less quantity of them the contraction of the whole muscles will be so much the weaker and consequently since the heart gives the greatest force to the blood's motion and its contraction being weaker the blood will be squeezed out of the left ventricle into the Aorta and thro the whole series of the Arteries with less velocity and therefore cannot distend the sides of the Arteries with that force that is usual but affects our touch more weakly so that the Pulse is weak in this state of the blood for the same reason those spirits being produced in a less quantity and longer in falling into the muscles and their contraction not being so frequent Now the motion of the heart and arteries being synchronical i. e. the contraction of the first and the filling of the second being perform'd at the same time since the contraction of the Heart is not so frequent the sides of the Arteries are not so frequently forced outward and seldomer affect our touch i. e. the pulse will be that which we call a Rare Pulse The blood too in this its thick and viscid state is less attrited and less fluxil as has been said but its parts being thus penn'd up and compact cannot possess that space it did when its parts roll'd more freely one upon another and were kept at a greater distance by the impulse of its subtile parts and therefore it has not force enough to sustain the weight of the sides of its Channels and they falling closer one upon another diminish as to their bigness sensibly and even to our sight so that they being thus contracted shrunk and as 't were withdrawn from our touch and the pulse being thus removed is said to be depressed sunk
c. While the blood is so viscid and the contraction of the muscles so weak so few animal spirits separated and all the secretions almost stopt the musculous Coat of the Stomach will lose a great deal of its force and the liquor of the Stomach will be separated in a less quantity the contraction of the Ventricle is not only weaker but our victuals that are lodged there are not dissolv'd attrited and turned to Chyle but putrifie and remain undigested and therefore the Stomach being constantly full there can be no sence of hunger as our experience tells us The same Unactivity and want of contraction we find in the muscles of the stomach are felt for the same reasons in the muscles of the intestines so that their vermicular contraction being much abated whatever is contained in their cavity will not be sufficiently comprest that it may be protruded thro the whole process of the guts besides their incapacity in respect of the excrements that are contained in them for these excrements being in a very small quantity both because of the small supply that is sent from the stomach and yet smaller from the blood by the known passages they want of that weight that is necessary to overcome the constriction of the muscles of the Anus and little or no secretion being made into the guts from the blood there 's somewhat wanting of that due fluxility for their easier propulsion thro the intestines besides what excrements so fluxil may be suppos'd to do by way of Stimulus so that upon all these accounts especially by the help of our Bisket as has been said there will be a vast disposition to costiveness Lastly if at any time the blood is so viscid that it is even interrupted or has a great deal slower motion in the brain than is usual and keeps the coats of the arteries bent outward then both because of the small secretion of spirits there and the arteries compressing the origin of the nerves there cannot be a sufficient quantity of spirits derived thro these nerves and consequently is produced that Stupor or Sleepiness we sometimes observe Now since the warm parts of the blood are confin'd and penn'd up in its viscid parts and if they be so prest that the force of this pression together with the natural force that the small hot and fiery particles have to extricate themselves be greater than the power that confines them these hot particles will at last break out and running along by the sensible parts excite the sense of heat and seeing this viscid blood stagnates and stops in the small arteries they are so stuff'd up with that constant supply that is made in the parts where it thus stagnates that this compression will be very considerable by the blood that is constantly added and by the power of contraction in the arteries that hinder this stuffing and bending outwards of their sides so that this compression being continually augmented at length its power will become greater than the power of cohesion betwixt the viscid and small parts of the blood and so the heat will be extricated and give its sense to the nerves and after that some part of it is set at liberty and moves to and fro with all freedom it must mightily facilitate the setting at liberty of the other small parts from the viscid parts of the blood by wedging themselves into them and breaking their continuity and making the viscid parts themselves more fluxil Now since the hot and warm parts of the blood are delivered from their confining viscid parts because the power of compression is greater than the power of cohesion which proceeds from that viscidity and since the power of compression is proportionable to the velocity of the blood and its velocity is greatest in these arteries that are next the heart the power then of compression in those arteries that are next the heart will be greater than in these that are more remote i. e. the heat will be felt in the parts that are more remote from the heart or the extremities a great while after 't is felt in the parts that are nearer the heart and they have been warm and the coldness in the remote limbs after the rest of the body has been warm may last even till the power of compression in their arteries be augmented by the continual afflux of blood and is able to subdue the force of the viscid and intangling parts and since these two powers are uncertain and undetermined there can be no time assigned wherein this coldness may last in the remote limbs after the rest of the body has been hot only we may assert that the coldness will last the longer in the extremities the more viscid the blood is and the more firmly and closely it envelopes and confines the heat Thus a great deal of heat being set at liberty it is derived with the other parts that can easily be dissolv'd and are more fluxile into the veins and therefore this heat being more free rarifies and warms the blood it meets with in the veins and excites a great sence and feeling of heat over all the body The heat then proceeding thus the blood is more free moveable warm and rarified and consequently the arteries are fuller and distend their sides further and so seem to rise up out of the flesh and to come nearer the skin and the vessels being fuller the pulse will also feel greater and because the blood is now more than naturally warm more perfectly dissolv'd and carried in a greater quantity to the Brain there is also a more plentiful secretion of animal spirits which coming into the heart in a greater quantity and degree of determination make its contraction the stronger and consequently propel the blood thro the vessels with more force and distend more strongly the sides of the arteries and produce that sort of Pulse we call strong so that tho the Pulse in the cold fit was not to be felt either because the blood was not propell'd thro these parts where we observe the Pulse or propell'd with lesser velocity than was necessary to affect our Touch yet the velocity being recovered the blood circulates thro these parts again affects our Touch and makes the Pulse great and strong as has been said If we consider in the next place the extraordinary warmth of which our Patients complain we shall not need to have recourse to any unnatural contraction of the muscles to account for their Restlessness and continual tossing about the Bed but if we remember either what incites our selves to it or what our Patients tell us induces them we may very fairly account for that symptom and this is nothing but a constant desire to remove into those places we had not lain in before for a relief to our scorching heat and so as we warm in one place we cast about and tumble into another which is truly that Restlessness we may observe