Zoonomia/I.XX

SECT. XX.

OF VERTIGO.


 * 1. We determine our perpendicularity by the apparent motions of objects. A person hood-winked cannot walk in a straight line. Dizziness in looking from a tower, in a room stained with uniform lozenges, on riding over snow. 2. Dizziness from moving objects. A whirling-wheel. Fluctuations of a river. Experiment with a child. 3. Dizziness from our own motions and those of other objects. 4. Riding over a broad stream. Sea-sickness. 5. Of turning round on one foot. Dervises in Turkey. Attention of the mind prevents slight sea-sickness. After a voyage ideas of vibratory motions are still perceived on shore. 6. Ideas continue some time after they are excited. Circumstances of turning on one foot, standing on a tower, and walking in the dark, explained. 7. Irritative ideas of apparent motions. Irritative ideas of sounds. Battèment of the sound of bells and organ-pipes. Vertiginous noise in the head. Irritative motions of the stomach, intestines, and glands. 8. Symptoms that accompany vertigo. Why vomiting comes on in strokes of the palsy. By the motion of a ship. By injuries on the head. Why motion makes sick people vomit. 9. Why drunken people are vertiginous. Why a stone in the ureter, or bile-duct, produces vomiting. 10. Why after a voyage ideas of vibratory motions are perceived on shore. 11. Kinds of vertigo and their cure. 12. Definition of vertigo.

1. In learning to walk we judge of the distances of the objects, which we approach, by the eye; and by observing their perpendicularity determine our own. This circumstance not having been attended to by the writers on vision, the disease called vertigo or dizziness has been little understood.

When any person loses the power of muscular action, whether he is erect or in a sitting posture, he sinks down upon the ground; as is seen in fainting fits, and other instances of great debility. Hence it follows, that some exertion of muscular power is necessary to preserve our perpendicular attitude. This is performed by proportionally exerting the antagonist muscles of the trunk, neck, and limbs; and if at any time in our locomotions we find ourselves inclining to one side, we either restore our equilibrium by the efforts of the muscles on the other side, or by moving one of our feet extend the base, which we rest upon, to the new center of gravity.

But the most easy and habitual manner of determining our want of perpendicularity, is by attending to the apparent motion of the objects within the sphere of distinct vision; for this apparent motion of objects, when we incline from our perpendicularity, or begin to fall, is as much greater than the real motion of the eye, as the diameter of the sphere of distinct vision is to our perpendicular height.

Hence no one, who is hood-winked, can walk in a straight line for a hundred steps together; for he inclines so greatly, before he is warned of his want of perpendicularity by the sense of touch, not having the apparent motions of ambient objects to measure this inclination by, that he is necessitated to move one of his feet outwards, to the right or to the left, to support the new centre of gravity, and thus errs from the line he endeavours to proceed in.

For the same reason many people become dizzy, when they look from the summit of a tower, which is raised much above all other objects, as these objects are out of the sphere of distinct vision, and they are obliged to balance their bodies by the less accurate feelings of their muscles.

There is another curious phenomenon belonging to this place, if the circumjacent visible objects are so small, that we do not distinguish their minute parts; or so similar, that we do not know them from each other; we cannot determine our perpendicularity by them. Thus in a room hung with a paper, which is coloured over with similar small black lozenges or rhomboids, many people become dizzy; for when they begin to fall, the next and the next lozenge succeeds upon the eye; which they mistake for the first, and are not aware, that they have any apparent motion. But if you fix a sheet of paper, or draw any other figure, in the midst of these lozenges, the charm ceases, and no dizziness is perceptible.—The same occurs, when we ride over a plain covered with snow without trees or other eminent objects.

2. But after having compared visible objects at rest with the sense of touch, and learnt to distinguish their shapes and shades, and to measure our want of perpendicularity by their apparent motions, we come to consider them in real motion. Here a new difficulty occurs, and we require some experience to learn the peculiar mode of motion of any moving objects, before we can make use of them for the purposes of determining our perpendicularity. Thus some people become dizzy at the sight of a whirling wheel, or by gazing on the fluctuations of a river, if no steady objects are at the same time within the sphere of their distinct vision; and when a child first can stand erect upon his legs, if you gain his attention to a white handkerchief steadily extended like a sail, and afterwards make it undulate, he instantly loses his perpendicularity, and tumbles on the ground.

3. A second difficulty we have to encounter is to distinguish our own real movements from the apparent motions of objects. Our daily practice of walking and riding on horseback soon instructs us with accuracy to discern these modes of motion, and to ascribe the apparent motions of the ambient objects to ourselves; but those, which we have not acquired by repeated habit, continue to confound us. So as we ride on horseback the trees and cottages, which occur to us, appear at rest; we can measure their distances with our eye, and regulate our attitude by them; yet if we carelessly attend to distant hills or woods through a thin hedge, which is near us, we observe the jumping and progressive motions of them; as this is increased by the paralax of these objects; which we have not habituated ourselves to attend to. When first an European mounts an elephant sixteen feet high, and whose mode of motion he is not accustomed to, the objects seem to undulate, as he passes, and he frequently becomes sick and vertiginous, as I am well informed. Any other unusual movement of our bodies has the same effect, as riding backwards in a coach, swinging on a rope, turning round swiftly on one leg, scating on the ice, and a thousand others. So after a patient has been long confined to his bed, when he first attempts to walk, he finds himself vertiginous, and is obliged by practice to learn again the particular modes of the apparent motions of objects, as he walks by them.

4. A third difficulty, which occurs to us in learning to balance ourselves by the eye, is, when both ourselves and the circumjacent objects are in real motion. Here it is necessary, that we should be habituated to both these modes of motion in order to preserve our perpendicularity. Thus on horseback we accurately observe another person, whom we meet, trotting towards us, without confounding his jumping and progressive motion with our own, because we have been accustomed to them both; that is, to undergo the one, and to see the other at the same time. But in riding over a broad and fluctuating stream, though we are well experienced in the motions of our horse, we are liable to become dizzy from our inexperience in that of the water. And when first we go on ship-board, where the movements of ourselves, and the movements of the large waves are both new to us, the vertigo is almost unavoidable with the terrible sickness, which attends it. And this I have been assured has happened to several from being removed from a large ship into a small one; and again from a small one into a man of war.

5. From the foregoing examples it is evident, that, when we are surrounded with unusual motions, we lose our perpendicularity: but there are some peculiar circumstances attending this effect of moving objects, which we come now to mention, and shall hope from the recital of them to gain some insight into the manner of their production.

When a child moves round quick upon one foot, the circumjacent objects become quite indistinct, as their distance increases their apparent motions; and this great velocity confounds both their forms, and their colours, as is seen in whirling round a many coloured wheel; he then loses his usual method of balancing himself by vision, and begins to stagger, and attempts to recover himself by his muscular feelings. This staggering adds to the instability of the visible objects by giving a vibratory motion besides their rotatory one. The child then drops upon the ground, and the neighbouring objects seem to continue for some seconds of time to circulate around him, and the earth under him appears to librate like a balance. In some seconds of time these sensations of a continuation of the motion of objects vanish; but if he continues turning round somewhat longer, before he falls, sickness and vomiting are very liable to succeed. But none of these circumstances affect those who have habituated themselves to this kind of motion, as the dervises in Turkey, amongst whom these swift gyrations are a ceremony of religion.

In an open boat passing from Leith to Kinghorn in Scotland, a sudden change of the wind shook the undistended sail, and stopt our boat; from this unusual movement the passengers all vomited except myself. I observed, that the undulation of the ship, and the instability of all visible objects, inclined me strongly to be sick; and this continued or increased, when I closed my eyes, but as often as I bent my attention with energy on the management and mechanism of the ropes and sails, the sickness ceased; and recurred again, as often as I relaxed this attention; and I am assured by a gentleman of observation and veracity, that he has more than once observed, when the vessel has been in immediate danger, that the sea-sickness of the passengers has instantaneously ceased, and recurred again, when the danger was over.

Those, who have been upon the water in a boat or ship so long, that they have acquired the necessary habits of motion upon that unstable element, at their return on land frequently think in their reveries, or between sleeping and waking, that they observe the room, they sit in, or some of its furniture, to librate like the motion of the vessel. This I have experienced myself, and have been told, that after long voyages, it is some time before these ideas entirely vanish. The same is observable in a less degree after having travelled some days in a stage coach, and particularly when we lie down in bed, and compose ourselves to sleep; in this case it is observable, that the rattling noise of the coach, as well as the undulatory motion, haunts us. The drunken vertigo, and the vulgar custom of rocking children, will be considered in the next Section.

6. The motions, which are produced by the power of volition, may be immediately stopped by the exertion of the same power on the antagonist muscles; otherwise these with all the other classes of motion continue to go on, some time after they are excited, as the palpitation of the heart continues after the object of fear, which occasioned it, is removed. But this circumstance is in no class of motions more remarkable than in those dependent on irritation; thus if any one looks at the sun, and then covers his eyes with his hand, he will for many seconds of time, perceive the image of the sun marked on his retina: a similar image of all other visible objects would remain some time formed on the retina, but is extinguished by the perpetual change of the motions of this nerve in our attention to other objects. To this must be added, that the longer time any movements have continued to be excited without fatigue to the organ, the longer will they continue spontaneously, after the excitement is withdrawn: as the taste of tobacco in the mouth after a person has been smoaking it.

This taste remains so strong, that if a person continues to draw air through a tobacco pipe in the dark, after having been smoking some time, he cannot distinguish whether his pipe be lighted or not.

From these two considerations it appears, that the dizziness felt in the head, after seeing objects in unusual motion, is no other than a continuation of the motions of the optic nerve excited by those objects and which engage our attention. Thus on turning round on one foot, the vertigo continues for some seconds of time after the person is fallen on the ground; and the longer he has continued to revolve, the longer will continue these successive motions of the parts of the optic nerve.

Additional Observations on VERTIGO.


 * After revolving with your eyes open till you become vertiginous, as soon as you cease to revolve, not only the circum-ambient objects appear to circulate round you in a direction contrary to that, in which you have been turning, but you are liable to roll your eyes forwards and backwards; as is well observed, and ingeniously demonstrated by Dr. Wells in a late publication on vision. The same occurs, if you revolve with your eyes closed, and open them immediately at the time of your ceasing to turn; and even during the whole time of revolving, as may be felt by your hand pressed lightly on your closed eyelids. To these movements of the eyes, of which he supposes the observer to be inconscious, Dr. Wells ascribes the apparent circumgyration of objects on ceasing to revolve.


 * The cause of thus turning our eyes forwards, and then back again, after our body is at rest, depends, I imagine, on the same circumstance, which induces us to follow the indistinct spectra, which are formed on one side of the center of the retina, when we observe them apparently on clouds, as described in Sect. XL. 2. 2.; and then not being able to gain a more distinct vision of them, we turn our eyes back, and again and again pursue the flying shade.


 * But this rolling of the eyes, after revolving till we become vertiginous, cannot cause the apparent circumgyration of objects, in a direction contrary to that in which we have been revolving, for the following reasons. 1. Because in pursuing a spectrum in the sky, or on the ground, as above mentioned, we perceive no retrograde motions of objects. 2. Because the apparent retrograde motions of objects, when we have revolved till we are vertiginous, continues much longer than the rolling of the eyes above described.


 * 3. When we have revolved from right to left, the apparent motion of objects, when we stop, is from left to right; and when we have revolved from left to right, the apparent circulation of objects is from right to left; yet in both these cases the eyes of the revolver are seen equally to roll forwards and backwards.


 * 4. Because this rolling of the eyes backwards and forwards takes place during our revolving, as may be perceived by the hand lightly pressed on the closed eyelids, and therefore exists before the effect ascribed to it.


 * And fifthly, I now come to relate an experiment, in which the rolling of the eyes does not take place at all after revolving, and yet the vertigo is more distressing than in the situations above mentioned. If any one looks steadily at a spot in the ceiling over his head, or indeed at his own finger held up high over his head, and in that situation turns round till he becomes giddy; and then stops, and looks horizontally; he now finds, that the apparent rotation of objects is from above downwards, or from below upwards; that is, that the apparent circulation of objects is now vertical instead of horizontal, making part of a circle round the axis of his eye; and this without any rolling of his eyeballs. The reason of there being no rolling of the eyeballs, perceived after this experiment, is, because the images of objects are formed in rotation round the axis of the eye, and not from one side to the other of the axis of it; so that, as the eyeball has not power to turn in its socket round its own axis, it cannot follow the apparent motions of these evanescent spectra, either before or after the body is at rest. From all which arguments it is manifest, that these apparent retrograde gyrations of objects are not caused by the rolling of the eyeballs; first, because no apparent retrogression of objects is observed in other rollings of the eyes: secondly, because the apparent retrogression of objects continues many seconds after the rolling of the eyeballs ceases. Thirdly, because the apparent retrogression of objects is sometimes one way, and sometimes another, yet the rolling of the eyeballs is the same. Fourthly, because the rolling of the eyeballs exists before the apparent retrograde motions of objects is observed; that is, before the revolving person stops. And fifthly, because the apparent retrograde gyration of objects is produced, when there is no rolling of the eyeballs at all.


 * Doctor Wells imagines, that no spectra can be gained in the eye, if a person revolves with his eyelids closed, and thinks this a sufficient argument against the opinion, that the apparent progression of the spectra of light or colours in the eye can cause the apparent retrogression of objects in the vertigo above described; but it is certain, when any person revolves in a light room with his eyes closed, that he nevertheless perceives differences of light both in quantity and colour through his eyelids, as he turns round; and readily gains spectra of those differences. And these spectra are not very different except in vivacity from those, which he acquires, when he revolves with unclosed eyes, since if he then revolves very rapidly the colours and forms of surrounding objects are as it were mixed together in his eye;. as when, the prismatic colours are painted on a wheel, they appear white as they revolve. The truth of this is evinced by the staggering or vertigo of men perfectly blind, when they turn round; which is not attended with apparent circulation of objects, but is a vertiginous disorder of the sense of touch. Blind men balance themselves by their sense of touch; which, being less adapted for perceiving small deviations from their perpendicular, occasions them to carry themselves more erect in walking. This method of balancing themselves by the direction of their pressure against the floor, becomes disordered by the unusual mode of action in turning round, and they begin to lose their perpendicularity, that is, they become vertiginous; but without any apparent circular motions of visible objects.


 * It will appear from the following experiments, that the apparent progression of the ocular spectra of light or colours is the cause of the apparent retrogression of objects, after a person has revolved, till he is vertiginous.


 * First, when a person turns round in a light room with his eyes open, but closes them before he stops, he will seem to be carried forwards in the direction he was turning for a short time after he stops. But if he opens his eyes again, the objects before him instantly appear to move in a retrograde direction, and he loses the sensation of being carried forwards. The same occurs if a person revolves in a light room with his eyes closed; when he stops, he seems to be for a time carried forwards, if his eyes are still closed; but the instant he opens them, the surrounding objects appear to move in retrograde gyration. From hence it may be concluded, that it is the sensation or imagination of our continuing to go forwards in the direction in which we were turning, that causes the apparent retrograde circulation of objects.


 * Secondly, though there is an audible vertigo, as is known by the battement, or undulations of sound in the ears, which many vertiginous people experience; and though there is also a tangible vertigo, as when a blind person turns round, as mentioned above; yet as this circumgyration of objects is an hallucination or deception of the sense of sight, we are to look for the cause of our appearing to move forward, when we stop with our eyes closed after gyration, to some affection of this sense. Now, thirdly, if the spectra formed in the eye during our rotation, continue to change, when we stand still, like the spectra described in Sect. III. 3. 6. such changes must suggest to us the idea or sensation of our still continuing to turn round; as is the case, when we revolve in a light room, and close our eyes before we stop. And lastly, on opening our eyes in the situation above described, the objects we chance to view amid these changing spectra in the eye, must seem to move in a contrary direction; as the moon sometimes appears to move retrograde, when swift-gliding clouds are passing forwards so much nearer the eye of the beholder.


 * To make observations on faint ocular spectra requires some degree of habit, and composure of mind, and even patience; some of those described in Sect. XL. were found difficult to see, by many, who tried them; now it happens, that the mind, during the confusion of vertigo, when all the other irritative tribes of motion, as well as those of vision, are in some degree disturbed, together with the fear of falling, is in a very unfit state for the contemplation of such weak sensations, as are occasioned by faint ocular spectra. Yet after frequently revolving, both with my eyes closed, and with them open, and attending to the spectra remaining in them, by shading the light from my eyelids more or less with my hand, I at length ceased to have the idea of going forward, after I stopped with my eyes closed; and saw changing spectra in my eyes, which seemed to move, as it were, over the field of vision; till at length, by repeated trials on sunny days, I persuaded myself, on opening my eyes, after revolving some time, on a shelf of gilded books in my library, that I could perceive the spectra in my eyes move forwards over one or two of the books, like the vapours in the air of a summer's day; and could so far undeceive myself, as to perceive the books to stand still. After more trials I sometimes brought myself to believe, that I saw changing spectra of lights and shades moving in my eyes, after turning round for some time, but did not imagine either the spectra or the objects to be in a state of gyration. I speak, however, with diffidence of these facts, as I could not always make the experiments succeed, when there was not a strong light in my room, or when my eyes were not in the most proper state for such observations.


 * The ingenious and learned M. Sauvage has mentioned other theories to account for the apparent circumgyration of objects in vertiginous people. As the retrograde motions of the particles of blood in the optic arteries, by spasm, or by fear, as is seen in the tails of tadpoles, and membranes between the fingers of frogs. Another cause he thinks may be from the librations to one side, and to the other, of the crystalline lens in the eye, by means of involuntary actions of the muscles, which constitute the ciliary process. Both these theories lie under the same objection as that of Dr. Wells before mentioned; namely, that the apparent motions of objects, after the observer has revolved for some time, should appear to vibrate this way and that; and not to circulate uniformly in a direction contrary to that, in which the observer had revolved.


 * M. Sauvage has, lastly, mentioned the theory of colours left in the eye, which he has termed impressions on the retina. He says, "Experience teaches us, that impressions made on the retina by a visible object remain some seconds after the object is removed; as appears from the circle of fire which we see, when a fire-stick is whirled round in the dark; therefore when we are carried round our own axis in a circle, we undergo a temporary vertigo, when we stop; because the impressions of the circumjacent objects remain for a time afterwards on the retina." Nosolog. Method. Clas. VIII. I. 1. We have before observed, that the changes of these colours remaining in the eye, evinces them to be motions of the fine terminations of the retina, and not impressions on it; as impressions on a passive substance must either remain, or cease intirely. See an additional note at the end of the second volume.

Any one, who stands alone on the top of a high tower, if he has not been accustomed to balance himself by objects placed at such distances and with such inclinations, begins to stagger, and endeavours to recover himself by his muscular feelings. During this time the apparent motion of objects at a distance below him is very great, and the spectra of these apparent motions continue a little time after he has experienced them; and he is persuaded to incline the contrary way to counteract their effects; and either immediately falls, or applying his hands to the building, uses his muscular feelings to preserve his perpendicular attitude, contrary to the erroneous persuasions of his eyes. Whilst the person, who walks in the dark, staggers, but without dizziness; for he neither has the sensation of moving objects to take off his attention from his muscular feelings, nor has he the spectra of those motions continued on his retina to add to his confusion. It happens indeed sometimes to one landing on a tower, that the idea of his not having room to extend his base by moving one of his feet outwards, when he begins to incline, superadds fears to his other inconveniences; which like surprise, joy, or any great degree of sensation, enervates him in a moment, by employing the whole sensorial power, and by thus breaking all the associated trains and tribes of motion.

7. The irritative ideas of objects, whilst we are awake, are perpetually present to our sense of sight; as we view the furniture of our rooms, or the ground, we tread upon, throughout the whole day without attending to it. And as our bodies are never at perfect rest during our waking hours, these irritative ideas of objects are attended perpetually with irritative ideas of their apparent motions. The ideas of apparent motions are always irritative ideas, because we never attend to them, whether we attend to the objects themselves, or to their real motions, or to neither. Hence the ideas of the apparent motions of objects are a complete circle of irritative ideas, which continue throughout the day.

Also during all our waking hours, there is a perpetual confused sound of various bodies, as of the wind in our rooms, the fire, distant conversations, mechanic business; this continued buzz, as we are seldom quite motionless, changes its loudness perpetually, like the sound of a bell; which rises and falls as long as it continues, and seems to pulsate on the ear. This any one may experience by turning himself round near a waterfall; or by striking a glass bell, and then moving the direction of its mouth towards the ears, or from them, as long as its vibrations continue. Hence this undulation of indistinct sound makes another concomitant circle of irritative ideas, which continues throughout the day.

We hear this undulating sound, when we are perfectly at rest ourselves, from other sonorous bodies besides bells; as from two organ-pipes, which are nearly but not quite in unison, when they are sounded together. When a bell is struck, the circular form is changed into an eliptic one; the longest axis of which, as the vibrations continue, moves round the periphery of the bell; and when either axis of this elipse is pointed towards our ears, the sound is louder; and less when the intermediate parts of the elipse are opposite to us. The vibrations of the two organ-pipes may be compared to Nonius's rule; the sound is louder, when they coincide, and less at the intermediate times. But, as the sound of bells is the most familiar of those sounds, which have a considerable battement, the vertiginous patients, who attend to the irritative circles of sounds above described, generally compare it to the noise of bells.

The peristaltic motions of our stomach and intestines, and the secretions of the various glands, are other circles of irritative motions, some of them more or less complete, according to our abstinence or satiety.

So that the irritative ideas of the apparent motions of objects, the irritative battements of sounds, and the movements of our bowels and glands compose a great circle of irritative tribes of motion: and when one considerable part of this circle of motions becomes interrupted, the whole proceeds in confusion, as described in Section XVII. 1. 7. on Catenation of Motions.

8. Hence a violent vertigo, from whatever cause it happens, is generally attended with undulating noise in the head, perversions of the motions of the stomach and duodenum, unusual excretion of bile and gastric juice, with much pale urine, sometimes with yellowness of the skin, and a disordered secretion of almost every gland of the body, till at length the arterial system is affected, and fever succeeds.

Thus bilious vomitings accompany the vertigo occasioned by the motion of a ship; and when the brain is rendered vertiginous by a paralytic affection of any part of the body, a vomiting generally ensues, and a great discharge of bile: and hence great injuries of the head from external violence are succeeded with bilious vomitings, and sometimes with abscesses of the liver. And hence, when a patient is inclined to vomit from other causes, as in some fevers, any motions of the attendants in his room, or of himself when he is raised or turned in his bed, presently induces the vomiting by superadding a degree of vertigo.

9. And conversely it is very usual with those, whose stomachs are affected from internal causes, to be afflicted with vertigo, and noise in the head; such is the vertigo of drunken people, which continues, when their eyes are closed, and themselves in a recumbent posture, as well as when they are in an erect posture, and have their eyes open. And thus the irritation of a stone in the bile-duct, or in the ureter, or an inflammation of any of the intestines, are accompanied with vomitings and vertigo.

In these cases the irritative motions of the stomach, which are in general not attended to, become so changed by some unnatural stimulus, as to become uneasy, and excite our sensation or attention. And thus the other irritative trains of motions, which are associated with it, become disordered by their sympathy. The same happens, when a piece of gravel sticks in the ureter, or when some part of the intestinal canal becomes inflamed. In these cases the irritative muscular motions are first disturbed by unusual stimulus, and a disordered action of the sensual motions, or dizziness ensues. While in sea-sickness the irritative sensual motions, as vertigo, precedes; and the disordered irritative muscular motions, as those of the stomach in vomiting, follow.

10. When these irritative motions are disturbed, if the degree be not very great, the exertion of voluntary attention to any other object, or any sudden sensation, will disjoin these new habits of motion. Thus some drunken people have become sober immediately, when any accident has strongly excited their attention; and sea-sickness has vanished, when the ship has been in danger. Hence when our attention to other objects is most relaxed, as just before we fall asleep, or between our reveries when awake, these irritative ideas of motion and sound are most liable to be perceived; as those, who have been at sea, or have travelled long in a coach, seem to perceive the vibrations of the ship, or the rattling of the wheels, at these intervals; which cease again, as soon as they exert their attention. That is, at those intervals they attend to the apparent motions, and to the battement of sounds of the bodies around them, and for a moment mistake them for those real motions of the ship, and noise of wheels, which they had lately been accustomed to: or at these intervals of reverie, or on the approach of sleep, these supposed motions or sounds may be produced entirely by imagination.

We may conclude from this account of vertigo, that sea-sickness is not an effort of nature to relieve herself, but a necessary consequence of the associations or catenations of animal motions. And may thence infer, that the vomiting, which attends the gravel in the ureter, inflammations of the bowels, and the commencement of some fevers, has a similar origin, and is not always an effort of the vis medicatrix naturæ. But where the action of the organ is the immediate consequence of the stimulating cause, it is frequently exerted to dislodge that stimulus, as in vomiting up an emetic drug; at other times, the action of an organ is a general effort to relieve pain, as in convulsions of the locomotive muscles; other actions drink up and carry on the fluids, as in absorption and secretion; all which may be termed efforts of nature to relieve, or to preserve herself.

11. The cure of vertigo will frequently depend on our previously investigating the cause of it, which from what has been delivered above may originate from the disorder of any part of the great tribes of irritative motions, and of the associate motions catenated with them.

Many people, when they arrive at fifty or sixty years of age, are affected with slight vertigo; which is generally but wrongly ascribed to indigestion, but in reality arises from a beginning defect of their sight; as about this time they also find it necessary to begin to use spectacles, when they read small prints, especially in winter, or by candle light, but are yet able to read without them during the summer days, when the light is stronger. These people do not see objects so distinctly as formerly, and by exerting their eyes more than usual, they perceive the apparent motions of objects, and confound them with the real motions of them; and therefore cannot accurately balance themselves so as easily to preserve their perpendicularity by them.

That is, the apparent motions of objects, which are at rest, as we move by them, should only excite irritative ideas: but as these are now become less distinct, owing to the beginning imperfection of our sight, we are induced voluntarily to attend to them; and then these apparent motions become succeeded by sensation; and thus the other parts of the trains of irritative ideas, or irritative muscular motions, become disordered, as explained above. In these cases of slight vertigo I have always promised my patients, that they would get free from it in two or three months, as they should acquire the habit of balancing their bodies by less distinct objects, and have seldom been mistaken in my prognostic.

There is an auditory vertigo, which is called a noise in the head, explained in No. 7. of this section, which also is very liable to affect people in the advance of life, and is owing to their hearing less perfectly than before. This is sometimes called a ringing, and sometimes a singing, or buzzing, in the ears, and is occasioned by our first experiencing a disagreeable sensation from our not being able distinctly to hear the sounds, we used formerly to hear distinctly. And this disagreeable sensation excites desire and consequent volition; and when we voluntarily attend to small indistinct sounds, even the whispering of the air in a room, and the pulsations of the arteries of the ear are succeeded by sensation; which minute sounds ought only to have produced irritative sensual motions, or unperceived ideas. See Section XVII. 3. 6. These patients after a while lose this auditory vertigo, by acquiring a new habit of not attending voluntarily to these indistinct sounds, but contenting themselves with the less accuracy of their sense of hearing.

Another kind of vertigo begins with the disordered action of some irritative muscular motions, as those of the stomach from intoxication, or from emetics; or those of the ureter, from the stimulus of a stone lodged in it; and it is probable, that the disordered motions of some of the great congeries of glands, as of those which form the liver, or of the intestinal canal, may occasion vertigo in consequence of their motions being associated or catenated with the great circles of irritative motions; and from hence it appears, that the means of cure must be adapted to the cause.

To prevent sea-sickness it is probable, that the habit of swinging for a week or two before going on shipboard might be of service. For the vertigo from failure of sight, spectacles may be used. For the auditory vertigo, æther may be dropt into the ear to stimulate the part, or to dissolve ear-wax, if such be a part of the cause. For the vertigo arising from indigestion, the peruvian bark and a blister are recommended. And for that owing to a stone in the ureter, venesection, cathartics, opiates, sal soda aerated.

12. Definition of vertigo. 1. Some of the irritative sensual, or muscular motions, which were usually not succeeded by sensation, are in this disease succeeded by sensation; and the trains or circles of motions, which were usually catenated with them, are interrupted, or inverted, or proceed in confusion. 2. The sensitive and voluntary motions continue undisturbed. 3. The associate trains or circles of motions continue; but their catenations with some of the irritative motions are disordered, or inverted, or dissevered.