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The appetite for liquids as well as solids is sometimes observed to be deficient, and sometimes too great. The former can scarcely be considered as a morbid symptom, provided the digestion and health be otherwise good. But when along with diminished thirst, the fauces and tongue are dry, this deficiency may be regarded as a morbid and dangerous symptom.
A more common morbid symptom, however, is too great thirst, which may arise from a deficiency of fluids in the body, produced by violent exercise, perspiration, too great a flow of urine, or too great an evacuation of the intestines. A praeternatural thirst may likewise arise from any acrid substance received into the stomach, which our provident mother, nature, teaches us to correct by dilution; this is the case with respect to salted meats, or those highly seasoned with pepper. It may arise also from the stomach being overloaded with unconcocted aliment, or from a suppressed or diminished secretion of the salivary liquors in the mouth, which may arise from fever, spasm, or affections of the mind; an increased thirst may likewise take place, from a derivation or determination of the fluids to other parts of the body; of this, dropsy affords an example. Indeed, various causes may concur to increase the thirst; this is the case in most fevers, where great thirst is occasioned by the dissipation of the fluids of the body by heat, as well as by the diminished secretion of the salivary humours which should moisten the mouth; to which may be added, the heat and diminished concoctive powers of the stomach.
From what has been said, we can easily understand, why praeternatural thirst may sometimes be a necessary instinct of nature, at other times, an unnecessary craving; why acids, acescent fruits, and weak fermented liquors quench thirst more powerfully than pure water; and lastly, why thirst, in some instances, may be relieved by emetics, when it has resisted other remedies.
There is no organ of the body whose functions are so easily deranged as those of the stomach; and these derangements prove a very fertile source of disease; they ought, therefore, carefully to be guarded against; and it is fortunate for us that we have this generally in our power, if we would but avail ourselves of it: for most of the derangements proceed from the improper use of food and drink, and a neglect of exercise. Indeed, when we examine, we shall find but a short list in the long catalogue of human diseases, which it is not in our power to guard against and prevent: and which surely will be guarded against, when their causes are known, and consequences understood.
Among the diseases arising from a disordered state of the stomach and indigestion, may be enumerated the following: great oppression and anxiety, pain in the region of the stomach, with acid eructations, nausea, vomiting, the bowels sometimes costive, sometimes too loose, but seldom regular, depression of spirits, and all the long list, commonly, but very improperly, termed nervous complaints, deficient nutrition, and consequently general weakness, a relaxed state of the solids, too great a tenuity of the fluids, headach, vertigo, and many other complaints, too numerous to mention here.
The greatest misfortune, and which indeed arises from a want of physiological knowledge, is, that people labouring under these disorders, imagine they may be cured by the reception of drugs into the stomach, and thus they are induced to receive into that organ, half the contents of an apothecary's shop. There is no doubt that these complaints may oftentimes be alleviated, and the cure assisted, by medicines: thus, when the stomach is overloaded, this may be removed by an emetic; the same complaint of the bowels may be removed by a cathartic; and when the stomach is debilitated, we are acquainted with some substances which will give it vigour, such as iron, the Peruvian bark, and several kinds of bitters. These however, when used alone, afford but temporary relief; and unless the cause which induced the disease be removed, it will afterwards return with redoubled violence. When the stomach, for instance, is debilitated by want of exercise, I would ask, is there an article in the whole materia medica, that can cure the complaints of sedentary people, unless proper exercise at the same time be taken? With exercise tonic remedies will undoubtedly accelerate the cure, but without it, they will only make bad worse.
Again, when the stomach is debilitated by the use of improper food, or the abuse of fermented or spirituous liquors, I would say to any one who pretended to cure me of these complaints, without my making a total change in the manner of living, that he either was ignorant of the matter, or intended to deceive me.
In many cases the change of food must be strictly observed and persevered in for a long time before a cure can be effected. In some instances where the powers of the stomach were too weak to prevent the food from undergoing perhaps both a vinous and acetous fermentation, and where, in consequence of the disengagement of gas and the formation of acid, the most excruciating pains were felt, the most dreadful sickness experienced, and all the symptoms of indigestion present in the most aggravated state; after almost every article in the materia medica, generally employed, had been tried without success, I have cured the patient merely by prohibiting food subject to fermentation, such as vegetables, and enjoining a strict use of animal food alone.
In short, wherever the cause of a disease can be ascertained, the grand and simple secret in the cure, is the careful removal of that cause.
LECTURE V. OF THE SENSES IN GENERAL
In this lecture, I propose to take a view of the connexion of man with the external world, and shall endeavour to point out the manner in which he becomes acquainted with external objects, by means of the faculties called senses.
A human creature is an animal endowed with understanding, and reason; a being composed of an organized body, and a rational mind.
With respect to his body, he is pretty similar to other animals, having similar organs, powers, and wants. All animals have a body composed of several parts, and, though these may differ from the structure of the human body in some circumstances, to accommodate it to peculiar habits and wants of the animal, still there is a great similarity in the general structure.
The human body is feeble at its commencement, increases gradually in its progress by the help of nourishment and exercise, till it arrives at a certain period, when it appears in full vigour; from this time it insensibly declines to old age, which conducts it at length to dissolution. This is the ordinary course of human life, unless it happens to be abridged either by disease or accident.
With regard to his reasoning faculties, or mind, man is eminently distinguished from other animals. It is by this noble part that he thinks, and is capable of forming just ideas of the different objects that surround him: of comparing them together; of inferring from known principles unknown truths; of passing a solid judgment on the mutual agreement of things, as well as on the relations they bear to him; of deliberating on what is proper or improper to be done; and of determining how to act. The mind recollects what is past, joins it with the present, and extends its views to futurity. It is capable of penetrating into the causes of events, and discovering the connexion that exists between them.
Governed by invariable laws, which connect him with all the beings, whether animate or inanimate, among which he exists, man has certain relations of convenience, and inconvenience, arising from the particular constitution of the surrounding objects, as well as of his own body. These external objects possess qualities which may be useful or prejudicial to him; and his interest requires, that he should be capable of ascertaining and appreciating these properties.
It is by sensation, or feeling, that the knowledge of external objects is obtained. The faculty of feeling, modified in every organ, perceives those qualities for which the peculiar structure of the organ is fitted; and all the various sensations of sound, colour, taste, smell, resistance, and temperature, find appropriate organs by which they are perceived, without mixing with, or confounding each other. External objects, therefore, act upon the parts of the body endowed with feeling, and their action is diversified in such a manner, as to give us a great number of sensations, which appear to have no resemblance to each other, and which make us acquainted with the various properties of surrounding objects.
It would not, however, have been sufficient for man, merely to have possessed this power of perceiving the different properties of the objects which surround him: it was necessary likewise, that he should be possessed of motion, that he might be able to approach or avoid them, to seize or repulse them, as it suited his convenience or advantage. By the extreme mobility of his limbs, he is able to move his body, and transport it from place to place; to bring external objects nearer to him, to remove them to a greater distance, and to place them in such situations and such circumstances, as may enable them to act on each other, and produce the changes which he wishes.
The human body, therefore, may be regarded as a machine composed (besides the moving parts which have formerly been noticed) of divers organs upon which external objects act, and produce those impressions which convince us of their presence, and make us acquainted with their properties. These impressions are transmitted to the sentient principle, or mind; and the faculty we possess of perceiving these impressions has been called by physiologists, sensibility.
Sensation has generally been defined by metaphysicians to be a change in the mind, of which we are conscious, caused by a correspondent change in the state of the body. This definition, however, leaves the matter where they found it, and throws no light whatever on the nature of sensation; nor can we say any thing more concerning it, than that, when the organs are in a sound state, certain sensations are perceived, which force us to believe in the existence of external objects, though there is no similarity whatever, nor any necessary connexion, that we can perceive, between the sensation and the object which caused it.
All the different degrees of sensation may be reduced to two kinds: pleasant and painful. The nature of these two primitive modes of sensation, is as little known to us as their different species: all that can be said, is, that the general laws by which the body is governed, are such, that pleasure is generally connected with those impressions which tend to its preservation, and pain with those which cause its destruction.
In a general point of view, sensibility may be regarded as an essential property of every part of the living body, disposing each part to perform those functions, the object of which is to preserve the life of the animal. Sensibility presides over the most necessary functions, and watches carefully over the health of the body: she directs the choice of the air proper for respiration, and also of alimentary substances; the mechanism of the secretions is likewise placed under her power; and in the same way that the eye perceives colours, and the ear sounds, so every animated and living part is fitted to receive impressions from the objects appropriated to it.
That every part of the animal is endowed with sensibility, is evident from a variety of facts, particularly from the action which follows when a muscle taken out of the animal body is irritated by any stimulus: this is evident, by a variety of facts mentioned by Whytt, Boerhaave, and others, which show, that parts recently taken from the animal body retain a portion of sensibility, which continues to animate them, and render them capable of action for a considerable time.
The primary organ of sensation appears to be the brain, its continuation in the form of medulla oblongata and spinal marrow, and the various nerves proceeding from these; and it seems now generally agreed, that unless there be a free communication of nerves between the part where the impression is made, and the brain, no sensation will take place; for instance, if the nerves be cut or compressed.
In a sound body, sensation is caused, whenever a change takes place in the state of the nervous power, whether that change be produced by an external, or an internal cause. The former kind of sensation is said to arise from impression or impulse, the latter from consciousness.
Every impression or impulse is not, however, equally calculated to produce sensation; for this purpose, a middle degree of impulse appears the best. An impulse considerably less produces no sensation, and one more violent may cause pain, but no proper sensation denoting the presence or properties of external objects. Thus too small a degree of light makes no impression on the optic nerve; and if the object be too strongly illuminated, the eye is pained, but has no proper idea of the figure or colour of the object. In the same way, if the vibrations which give us an idea of sound, be either too quick or too slow, we shall not obtain this idea. When the vibration is too quick, a very disagreeable and irritating sensation is perceived, as for instance, in the whetting of a saw: and on the other hand, when the vibrations are too slow, they will not produce a tone or sound. This might be proved of all the senses, and shows, that a certain degree of impression is necessary to produce perfect sensation.
There is another circumstance likewise requisite to produce sensation: it is not enough, that the impression should be of the proper strength; it is necessary likewise, that it should remain for some time, otherwise no sensation will be produced. There are many bodies whose magnitude is amply sufficient to be perceived by the eye; yet, by reason of their great velocity, the impulse they make on any part of the retina is so short, that they are not visible. This is proved by our not perceiving the motions of cannon and musket balls, and many other kinds of motion. On this principle depends the art of conjuration, or legerdemain; the fundamental maxim of those who practise them, is, that the motion is too quick for sight.
If the impulse be of a proper degree, and be continued for a sufficient length of time, the impression made by it will not immediately vanish with the impulse which caused it, but will remain for a time proportioned to the strength of the impulse. This, with respect to sight, is proved by whirling a firebrand in a circular manner, by which the impression of a circle is caused, instead of a moving point: and, with respect to hearing, it may be observed, that when children run with a stick quickly along railing, or when a drum is beaten quickly, the idea of a continued sound is produced, because the impression remains some time: for it is evident, that the sounds produced in succession are perfectly distinct and insulated.
Sensation likewise depends, in a great measure, on the state of the mind, and on the degree of attention which it gives. For if we are engaged in attention to any object, we are insensible of the impressions made upon us by others, though they are sufficiently strong to affect us at other times. Thus, when our attention is fixed strongly upon any particular object, we become insensible of the various noises that surround us, though these may be sometimes very loud. On the contrary, if our attention be upon the watch, we can perceive slight, and almost neglected impressions, while those of greater magnitude become insensible. The ticking of a clock becomes insensible to us from repetition, but if we attend to it, we become easily sensible of it, though at the same time we become insensible of much stronger impressions, such as the rattling of coaches in the streets.
The attention depends in some degree on the will, but is generally given to those impressions which are particularly strong, new, pleasant, or disagreeable; in short, to those which particularly affect the mind. Hence it is, that things which are new, produce the most vivid impressions, which gradually grow fainter, and at last become imperceptible.
There is one circumstance respecting sensation, which will probably account for our only perceiving those impressions to which the mind attends: and this is, that the mind is incapable of perceiving more than one impression at a time: the more accurately we examine this, the greater reason we shall have to think it true; but the mind can turn its attention so quickly, from one object to another, that at first sight, we are led to believe, that we are able to attend to several at the same time.
But though the mind cannot perceive or attend to various sensations at the same time, yet if two or more of these are capable of uniting in such a manner as to produce a compound sensation, this may be perceived by the mind.
This compound sensation may be produced either by impressions made at the same instant, or succeeding each other so quickly, that the second takes place before the first has vanished.
As an instance of the first, we may mention musical chords, or the sounds produced by the union of two or more tones at the same time. We have another instance likewise in odours or smells; if two or more perfumes be mixed together, a compound odour will be perceived, different from any of them.
As an instance of the latter, if a paper painted of various colours be made to revolve rapidly in a circle, a compound colour, different from any of them, will be perceived. These observations apply particularly to the senses we have mentioned, and likewise to taste: but the sensations afforded us by touch do not seem capable of being compounded in this manner.
There are many things necessary to perfect sensation, besides those that have been mentioned. The degree and perfection of sensation will depend much on the mind, and will be continually altered by delirium, torpor, sleep, and other circumstances; much likewise depends on the state of the organs with respect to preceding impressions; for if any organ of sense have been subjected to a strong impression, it will become nearly insensible of those which are weaker.
Of this innumerable instances may be given: an eye which has been subjected to a strong light, becomes insensible of a weaker: and on the contrary, if the organs of sense have been deprived of their accustomed impressions for some time, they are affected by very slight ones. Hence it is, that when a person goes from daylight into a darkened room, he can at first see nothing; by degrees however he begins to have an imperfect perception of the different objects, and if he remain long enough, he will see them with tolerable distinctness, though the quantity of light be the same as when he entered the room, when they were invisible to him.
Sensation often arises from internal causes, without any external impulse. To this source may be referred consciousness, memory, imagination, volition, and other affections of the mind. These are called the internal senses. The senses, whether internal or external, have never been accurately reduced to classes, orders, or genera; the external indeed are generally referred to five orders; namely, seeing, hearing, smelling, tasting, and feeling, or touch. With respect to the four first, the few qualities of external bodies which each perceives may be easily reduced to classes, each of which may be referred to its peculiar organ of sensation, because each organ is so constituted, that it can only be affected by one class of properties; thus the eye can only be affected by light; the ear by the vibrations of the air, and so of the rest.
The same organ, whatever be its state, or whatever be the degree of impulse, always gives to the mind a similar sensation; nor is it possible, by any means we are acquainted with, to communicate the sensation peculiar to one organ by means of another. Thus we are incapable, for instance, of hearing with our eyes, and seeing with our ears: nor have we any reason to believe that similar impressions produce dissimilar sensations in different people. The pleasure, however, as well as the pain and disgust, accompanying different sensations, differ very greatly in different persons, and even in the same person at different times; for the sensations which sometimes afford us pleasure, at other times produce disgust.
Habit has a powerful influence in modifying the pleasures of sensation, without producing any change in the sensation itself, or in the external qualities suggested by it. Habit, for instance, will never cause a person to mistake gentian or quassia for sugar, but it may induce an appetite or liking for what is bitter, and a disgust for what is sweet. No person perhaps was originally delighted with the taste of opium or tobacco, they must at first be highly disgusting to most people; but custom not only reconciles the taste to them, but they become grateful, and even necessary.
Almost every species of sensation becomes grateful or otherwise, according to the force of the impression; for there is no sensation so pleasant, but, that, by increasing its intensity, it will become ungrateful, and at length intolerable. And, on the contrary, there are many which on account of their force are naturally unpleasant, but become, when diminished, highly pleasant. The softest and sweetest sounds may be increased to such a degree as to be extremely unpleasant: and when we are in the steeple of a church, the noise of a peal of bells stuns and confounds our senses, while at a distance their effect is very pleasant. The smell of musk likewise at a distance, and in small quantity, is pleasant; but when brought near, or in large quantity, it becomes highly disagreable. The same may be observed with respect to the objects of the other senses.
For a similar reason, many sensations which are at first pleasing, cease to delight by frequent repetition; though the impression remains the same. This is so well known that illustrations are unnecessary. Those who are economical of their pleasures, or who wish them to be permanent, must not repeat them too frequently. In music, a constant repetition of the sweetest and fullest chords, cloys the ear; while a judicious mixture of them with tones less harmonious will be long relished. Those who are best acquainted with the human heart need not be told, that this observation is not confined to music.
On the same principle likewise we can account for the pleasure afforded by objects that are new; and why variety is the source of so many pleasures; why we gradually wish for an increase in the force of the impression in proportion to its continuance.
The pleasures of the senses are confined within narrow limits, and can neither be much increased nor too often repeated, without being destructive of themselves; thus we are admonished by nature, that our constitutions were not formed to bear the continual pleasures of sense; for the too free use of any of them, is not only destructive of itself, but induces those painful and languid sensations so often complained of by the voluptuary, and which not unfrequently produce a state of mind that prompts to suicide.
As the transition from pleasure to pain is natural, so the remission of pain, particularly if it is great, becomes a source of pleasure. There is much truth, therefore, in the beautiful allegory of Socrates, who tells us, that Pleasure and Pain were sisters, who, however, met with a very different reception by mankind on their visit to the earth; the former being universally courted, while the latter was carefully avoided: on this account, Pain petitioned Jupiter, who decreed that they should not be parted; and that whoever embraced the one, obtained also the other.
There is a great diversity with respect to the duration of the pleasures of the different senses: some of the senses become soon fatigued, and lose the power of distinguishing accurately their different objects: others, on the contrary, remain perfect a long time. Thus smell and taste are soon satiated; hearing more slowly; while, of all the external senses, the objects of sight please us the longest. We may, however, prolong the pleasures of sense by varying them properly, and by a proper mixture of objects or circumstances which are indifferent, and afford less delight. But the very constitution of our nature limits our enjoyments, and points out the impossibility of perpetual pleasures in this state of our existence. To a person who is thirsty, water is delicious nectar; to one who is hungry, every kind of food is agreeable, and even its smell pleasant; to a person who is hot and feverish, the cool air is highly refreshing. But to the same persons in different circumstances, the same things are not only indifferent, but even disgusting; for instance, a person cannot bear the sight or smell of food, after having satiated himself with it, and perpetual feasting will cloy the appetite of the keenest epicure.
I shall conclude this account of the general laws of sensation, by a short recapitulation of those laws.
And, in the first place, it may be observed, that the energy or force of any sensation, is proportioned to the degree of attention given by the mind to the external object which causes it.
Secondly, A repetition of sensations diminishes their energy, and at last nearly destroys it; but this energy is restored by rest, or the absence of these sensations.
Thirdly, The mind cannot attend to two impressions at the same time: so that two sensations never act with the same force at the same instant; the stronger generally overcoming the weaker. The mind, however, can attend to the weaker sensation, in such a manner, as to overpower the stronger, or to render it insensible.
Having fully considered the general laws of sensation, I shall now proceed to examine those proper to each sense; and in this examination, two objects will engage our attention. 1. The structure of the organ which receives and transmits the impulse to the mind. 2. The qualities or properties of external bodies, particularly those by which they are fitted to excite sensation.
The first sense that we shall examine is touch, which, of all the external senses, is the most simple, as well as the most generally diffused. By means of this sense, we are capable of perceiving various qualities and properties of bodies, such as hardness, softness, roughness, smoothness, temperature, magnitude, figure, distance, pressure, and weight; this sense is seldom depraved; because the bodies, whose properties are examined by it, are applied immediately to the extremities of the nerves, without the intervention of any medium liable to be deranged, as is the case with the eye, and ear.
The organ of touch is seated chiefly in the skin, but different parts of this covering possess different degrees of sensibility. The skin consists of three parts. 1. The cutis vera, or true skin, which covers the greatest part of the surface of the body. When the skin is examined by a microscope, we find it composed of an infinite number of papillae, or small eminencies, which seem to be the extremities of nerves, each of which is accompanied by an artery and a vein, so that when the vessels of the skin are injected, the whole appears red. 2. Immediately over the true skin, and filling up its various inequalities, lies a mucous reticulated substance, which has been called by Malpighi, who first described it, rete mucosum. The real skin is white in the inhabitants of every climate; but the rete mucosum is of various colours, being white in Europeans, olive in Asiatics, black in Africans, and copper coloured in Americans. This variety depends chiefly on the degree of light and heat; for, if we were to take a globe, and paint a portion of it with the colour of the inhabitants of corresponding latitudes, we should have an uniform gradation of shade, deepening from the pole to the equator.
The diversity of colour depends upon the bleaching power of the oxygen, which, in temperate climates, combines more completely with the carbonaceous matter deposited in the rete mucosum; while, in hotter climates, the oxygen is kept in a gaseous state by the heat and light, and has less tendency to unite with the carbonaceous matter. In proof of this, the skins of Africans may be rendered white by exposure to the oxygneated muriatic acid.
Over the rete mucosum is spread a fine transparent membrane, called the cuticle, or scarf skin, which defends the organ of feeling from the action of the air, and other things which would irritate it too powerfully. In some parts of the body this membrane is very thick, as in the soles of the feet, and palms of the hands; and this thickness is much increased by use and pressure.
In general, the thinner the cuticle is, the more acute is the sense of touch. This sense is very acute and delicate about the ends of the fingers, where we have the most need of it; but in the lips, mouth, and tongue, it is still more delicate; a galvanic or electrical shock being felt by the tongue, when it is impossible for us to perceive it by the fingers.
This sense, like the others, becomes more exquisite when its organ is defended from the action of external bodies; it is on this account that the cuticle becomes so sensible under the end of the nail, which defends it from the action of external objects; and when part of the nail is taken away, we can scarcely bear to touch any thing with this newly exposed part of the skin.
When we place our fingers upon the surface of any body, the first sensation we experience is that of resistance, after which the other properties are perceived in a natural order; such as heat or cold, moisture or dryness, motion or rest, distance, and figure or shape.
