Zoonomia/II.II.I.VII
ORDO I.
Increased Sensation.
GENUS VII.
With increased Action of the Organs of Sense.
SPECIES.
1. Delirium febrile. Paraphrosyne. The ideas in delirium consist of those excited by the sensation of pleasure or pain, which precedes them, and the trains of other ideas associated with these, and not of those excited by external irritations or by voluntary exertion. Hence the patients do not know the room which they inhabit, or the people who surround them; nor have they any voluntary exertion, where the delirium is complete; so that their efforts in walking about a room or rising from their bed are unsteady, and produced by their catenations with the immediate affections of pleasure or pain. See Section XXXIII. 1. 4.
By the above circumstances it is distinguished from madness, in which the patients well know the persons of their acquaintance, and the place where they are; and perform all the voluntary actions with steadiness and determination. See Sect. XXXIV. 2. 2.
Delirium is sometimes less complete, and then a new face and louder voice stimulate the patient to attend to them for a few moments; and then they relapse again into perfect delirium. At other times a delirium affects but one sense, and the person thinks he sees things which do not exist; and is at the same time sensible to the questions which are asked him, and to the taste of the food which is offered to him.
This partial delirium is termed an hallucination of the disordered organ; and may probably arise from the origin of one nerve of sense being more liable to inflammation than the others; that is, an exuberance of the sensorial power of sensation may affect it; which is therefore thrown into action by slighter sensitive catenations, without being obedient to external stimulus, or to the power of volition.
The perpetual flow of ideas in delirium is owing to the same circumstance, as of those in our dreams; namely, to the defect or paralysis of the voluntary power; as in hemiplagia, when one side of the body is paralytic, and thus expends less of the sensorial power, the limbs on the other side are in constant motion from the exuberance of it. Whence less sensorial power is exhausted in delirium, than at other times, as well as in sleep; and hence in fevers with great debility, it is perhaps, as well as the stupor, rather a favourable circumstance; and when removed by numerous blisters, the death of the patient often follows the recovery of his understanding. See Class I. 2. 5. 6. and I. 2. 5. 10.
Delirium in diseases from inirritability is sometimes preceded by a propensity to surprise. See Class I. 1. 5. 11.
M. M. Fomentations of the shaved head for an hour repeatedly. A blister on the head. Rising from bed. Wine and opium, and sometimes venesection in small quantity by cupping, if the strength of the arterial system will allow it.
2. Delirium maniacale. Maniacal delirium. There is another kind of delirium, described in Sect. XXXIII. 1. 4. which has the increase of pleasureable or painful sensation for its cause, without any diminution of the other sensorial powers; but as this excites the patient to the exertion of voluntary actions, for the purpose of obtaining the object of his pleasureable ideas, or avoiding the object of his painful ones, such as perpetual prayer, when it is of the religious kind, it belongs to the insanities described in Class III. 1. 2. 1, and is more properly termed hallucinatio maniacalis.
3. Dilirium ebrietatis. The drunken delirium is in nothing different from the delirium attending fevers except in its cause, as from alcohol, or other poisons. When it is attended with an apoplectic stupor, the pulse is generally low; and venesection I believe sometimes destroys those, who would otherwise have recovered in a few hours.
M. M. Diluting liquids. An emetic.
4. Somnium. Dreams constitute the most complete kind of delirium. As in these no external irritations are attended to, and the power of volition is entirely suspended; so that the sensations of pleasure and pain, with their associations, alone excite the endless trains of our sleeping ideas; as explained in Sect. XVIII. on Sleep.
5. Hallucinatio visûs. Deception of sight. These visual hallucinations are perpetual in our dreams; and sometimes precede general delirium in fevers; and sometimes belong to reverie, and to insanity. See Class III. 1. 2. 1. and 2. and must be treated accordingly.
Other kinds of visual hallucinations occur by moon-light; when objects are not seen so distinctly as to produce the usual ideas associated with them, but appear to us exactly as they are seen. Thus the trunk of a tree appears a flat surface, instead of a cylinder as by day, and we are deceived and alarmed by seeing things as they really are seen. See Berkley on Vision.
6. Hallucinatio auditûs. Auricular deception frequently occurs in dreams, and sometimes precedes general delirium in fevers; and sometimes belongs to vertigo, and to reverie, and to insanity. See Sect. XX. 7. and Class III. 1. 2. 1. and 2.
7. Rubor a calore. The blush from heat is occasioned by the increased action of the cutaneous vessels in consequence of the increased sensation of heat. See Class I. 1. 2. 1. and 3.
8. Rubor jucunditatis. The blush of joy is owing to the increased action of the capillary arteries, along with that of every moving vessel in the body, from the increase of pleasurable sensation.
9. Priapismus amatorius. Amatorial priapism. The blood is poured into the cells of the corpora cavernosa much faster than it can be reabsorbed by the vena penis, owing in this case to the pleasurable sensation of love increasing the arterial action. See Class I. 1. 4. 6.
10. Distentio mamularum. The teats of female animals, when they give suck, become rigid and erected, in the same manner as in the last article, from the pleasurable sensation of the love of the mother to her offspring. Whence the teat may properly be called an organ of sense. The nipples of men do the same when rubbed with the hand. See Class I. 1. 4. 7.