Part 53

Of those Swoonings, which arise from nervous Disorders.

Sec. 500. This Species of Swooning is almost wholely unknown to those Persons, for whom this Treatise is chiefly intended. Yet as there are some Citizens who pass a Part of their Lives in the Country; and some Country People who are unhappily afflicted with the Ailments of the Inhabitants of large Towns and Cities, it seemed necessary to treat briefly of them.

By Disorders of the Nerves, I understand in this Place, only that Fault or Defect in them, which is the Cause of their exciting in the Body, either irregular Motions, that is, Motions without any external Cause, at least any perceivable one; and without our Will's consenting to the Production of them: or such Motions, as are greatly more considerable than they should be, if they had been proportioned to the Force of the Impression from without. This is very exactly that State, or Affection termed the Vapours; and by the common People, the Mother: And as there is no Organ unprovided with Nerves; and none, or hardly any Function, in which the Nerves have not their Influence; it may be easily comprehended, that the Vapours being a State or Condition, which arises from the Nerves exerting irregular involuntary Motions, without any evident Cause, and all the Functions of the Body depending partly on the Nerves; there is no one Symptom of other Diseases which the Vapours may not produce or imitate; and that these Symptoms, for the same Reason, must vary infinitely, according to those Branches of the Nerves which are disordered. It may also hence be conceived, why the Vapours of one Person have frequently no Resemblance to those of another: and why the Vapours of the very same Person, in one Day, are so very different from those in the next. It is also very conceivable that the Vapours are a certain, a real Malady; and that Oddity of the Symptoms, which cannot be accounted for, by People unacquainted with the animal Oeconomy, has been the Cause of their being considered rather as the Effect of a depraved Imagination, than as a real Disease. It is very conceiveable, I say, that this surprizing Oddity of the Symptoms is a necessary Effect of the Cause of the Vapours; and that no Person can any more prevent his being invaded by the Vapours, than he can prevent the Attack of a Fever, or of the Tooth-ach.

Sec. 501. A few plain Instances will furnish out a more compleat Notion of the Mechanism, or Nature, of Vapours. An Emetic, a vomiting Medicine, excites the Act, or rather the Passion, the Convulsion of Vomiting, chiefly by the Irritation it gives to the Nerves of the Stomach; which Irritation produces a Spasm, a Contraction of this Organ. Now if in Consequence of this morbid or defective Texture of the Nerves, which constitutes the Vapours, those of the Stomach are excited to act with the same Violence, as in Consequence of taking a Vomit, the Patient will be agitated and worked by violent Efforts to vomit, as much as if he had really taken one.

If an involuntary unusual Motion in the Nerves, that are distributed through the Lungs, should constrain and straiten the very little Vesicles, or Bladders, as it were, which admit the fresh Air at every Respiration, the Patient will feel a Degree of Suffocation; just as if that Straitening or Contraction of the Vesicles were occasioned by some noxious Steam or Vapour.

Should the Nerves which are distributed throughout the whole Skin, by a Succession of these irregular morbid Motions, contract themselves, as they may from external Cold, or by some stimulating Application, Perspiration by the Pores will be prevented or checked; whence the Humours, which should be evacuated through the Pores of the Skin, will be thrown upon the Kidnies, and the Patient will make a great Quantity of thin clear Urine, a Symptom very common to vapourish People; or it may be diverted to the Glands of the Intestines, the Guts, and terminate in a watery Diarrhoea, or Looseness, which frequently proves a very obstinate one.

Sec. 502. Neither are Swoonings the least usual Symptoms attending the Vapours: and we may be certain they spring from this Source, when they happen to a Person subject to the Vapours; and none of the other Causes producing them are evident, or have lately preceded them.

Such Swoonings, however, are indeed very rarely dangerous, and scarcely require any medical Assistance. The Patient should be laid upon a Bed; the fresh Air should be very freely admitted to him; and he should be made to smell rather to some disagreeable and fetid, than to any fragrant, Substance. It is in such Faintings as these that the Smell of burnt Leather, of Feathers, or of Paper, have often proved of great Service.

Sec. 503. Patients also frequently faint away, in Consequence of fasting too long; or from having eat a little too much; from being confined in too hot a Chamber; from having seen too much Company; from smelling too over-powering a Scent; from being too costive; from being too forcibly affected with some Discourse or Sentiments; and, in a Word, from a great Variety of Causes, which might not make the least Impression on Persons in perfect Health; but which violently operate upon those vapourish People, because, as I have said, the Fault of their Nerves consists in their being too vividly, too acutely affected; the Force of their Sensation being nowise proportioned to the external Cause of it.

As soon as that particular Cause is distinguished from all the rest, which has occasioned the present Swooning; it is manifest that this Swooning is to be remedied by removing that particular Cause of it.

Of Swoonings occasioned by the Passions.

Sec. 504. There have been some Instances of Persons dying within a Moment, through excessive Joy. But such Instances are so very rare and sudden, that Assistance has seldom been sought for on this Occasion. The Case is otherwise with Respect to those produced from Rage, Vexation, and Dread or Horror. I shall treat in a separate Article of those resulting from great Fear; and shall briefly consider here such as ensue from Rage, and vehement Grief or Disappointment.

Sec. 505. Excessive Rage and violent Affliction are sometimes fatal in the Twinkling of an Eye; though they oftener terminate in fainting only. Excessive Grief or Chagrine is especially accompanied with this Consequence; and it is very common to see Persons thus affected, sink into successive Faintings for several Hours. It is plainly obvious that very little Assistance can be given in such Cases: it is proper, however, they should smell to strong Vinegar; and frequently take a few Cups of some hot and temperately cordial Drink, such as Bawm Tea, or Lemonade with a little Orange or Lemon-peel.

The calming asswaging Cordial, that has seemed the most efficacious to me, is one small Coffee Spoonful of a Mixture of three Parts of the Mineral Anodyne Liquor of Hoffman, and one Part of the spirituous Tincture of Amber, which should be swallowed in a Spoonful of Water; taking after it a few Cups of such Drinks as I shall presently direct.

Our sweet Spirit of Vitriol is a similar, and as effectual a Medicine. K.

It is not to be supposed that Swoonings or Faintings, from excessive Passions, can be cured by Nourishment. The physical State or Condition, into which vehement Grief throws the Body, is that, of all others, in which Nourishment would be most injurious to it: and as long as the Vehemence of the Affliction endures, the Sufferer should take nothing but some Spoonfuls of Soup or Broth, or a few Morsels of some light Meat roasted.

Sec. 506. When Wrath or Rage has risen to so high a Pitch, that the human Machine, the Body, entirely exhausted, as it were, by that violent Effort, sinks down at once into excessive Relaxation, a Fainting sometimes succeeds, and even the most perilous Degree of it, a Syncope.

It is sufficient, or rather the most that can be done here, to let the Patient be perfectly still a while in this State; only making him smell to some Vinegar. But when he is come to himself, he should drink plentifully of hot Lemonade, and take one or more of the Glysters No. 5.

Sometimes there remain in these Cases Sicknesses at Stomach, Reachings to vomit, a Bitterness in the Mouth, and some vertiginous Symptoms which seem to require a Vomit. But such a Medicine must be very carefully avoided, since it may be attended with the most fatal Consequence; and Lemonade with Glysters generally and gradually remove these Swoonings. If the Nausea and Sickness at Stomach continue, the utmost Medicine we should allow besides, would be that of No. 23, or a few Doses of No. 24.

Of symptomatical Swoonings, or such, as happen in the Progress of other Diseases.

Sec. 507. Swoonings, which supervene in the Course of other Diseases, never afford a favourable Prognostic; as they denote Weakness, and Weakness is an Obstacle to Recovery.

In the Beginning of putrid Diseases, they also denote an Oppression at Stomach, or a Mass of corrupt Humours; and they cease as soon as an Evacuation supervenes, whether by Vomit or Stool.

When they occur at the Beginning of malignant Fevers, they declare the high Degree of their Malignancy, and the great Diminution of the Patient's natural Strength.

In each of these Cases Vinegar, used externally and internally, is the best Remedy during the Exacerbation or Height of the Paroxysm; and Plenty of Lemon Juice and Water after it.

Sec. 508. Swoonings which supervene in Diseases, accompanied with great Evacuations, are cured like those which are owing to Weakness; and Endeavours should be used to restrain or moderate the Evacuations.

Sec. 509. Those who have any inward Abscess or Imposthume are apt to swoon frequently. They may sometimes be revived a little by Vinegar, but they prove too frequently mortal.

Sec. 510. Many Persons have a slighter or a deeper Swooning, at the End of a violent Fit of an intermitting Fever, or at that of each Exacerbation of a continual Fever; this constantly shews the Fever has run very high, the Swooning having been the Consequence of that great Relaxation, which has succeeded to a very high Tension. A Spoonful or two of light white Wine, with an equal Quantity of Water, affords all the Succour proper in such a Case.

Sec. 511. Persons subject to frequent Swoonings, should neglect nothing that may enable them to remove them when known; since the Consequences of them are always detrimental, except in some Fevers, in which they seem to mark the Crisis.