THIS Symptom begins with a Swimming, Giddiness, or Dizziness of the Head, and proceeds (in the conceiv’d Woman) from Vapours of the Humours; which, ascending partly thro’ the Veins and Arteries tending to the Brain, and partly thro’ the Oesophagus or Gullet, disturb the Animal Spirits.
NOW This Distemper is Two-fold, and distinguished by the Words Vertigo and Tenebricosa; which last the Arabian Physicians have call’d Scotomia, I suppose from the Greek Word Σκοτος, Tenebræ, Darkness; and is now generally receiv’d by that Name.
BUT because this sad Affection is too common to both Sexes, young and old, I shall proceed to a farther Dilucidation of it, for the universal Good and Benefit of All.
FIRST then, the[63]VERTIGO is a deprav’d Imagination, attended with the vitiated Senses of Hearing and Seeing; proceeding from the violent Commotion of the Animal Spirits. Secondly, The SCOTOMIA is also a deprav’d Imagination, accompany’d with loss of Sight, and sometimes of the Motion of the Animals affected with it, because of some Interruption in their circular Passage. In the first Case, the PATIENT imagines his Head only to be turn’d round, or winded about: In the other, he thinks that circular Motion to consist in the external Objects.
NOW the VERTIGO is attended with the vitiated Sense of Hearing, as well as Seeing: Because, as something like a Cloud, Smoak, or Web, seems to appear before the Patient’s Eyes; so there is a certain Whistling, Hissing, or Tinkling always in his Ears. The Scotomia, in like manner, is attended with Loss of Sight, and Motion; because of some Disorder of the Ventricles of the Brain obstructing or impeding the Transition of the Spirits.
IN the Vertigo, an Agitation happens in the Membranes of the Veins and Arteries, as also in the Membranes of the Brain; by which violent Motion, the very Continent Parts are vehemently shaken and concuss’d, and at length so disquieted, that the Patient thinks his Head wheels round about.
IN the Scotomia, the Animal Spirits having in themselves the Species of all Sensibles, and those Species being presented to the Imagination: As such Images of external Objects are moved in it, so the Party thinks the same real Objects to be moved. For, according to Avicen, it is the same thing, whether that which is seen, or that by which we see, is moved: As seeing Land from on board a Ship, in a smooth Sea, being insensible of the Ship’s Way, we imagine (and sometimes very strongly too) that the Land is in Motion.
THAT by which we see, is the visible Species reserved in the Spirit: Hence when this Species is moved, the external Object seems also to be moved.
BUT in explaining the Circular Motion of the Animal Spirits, we must consider it to be twofold; namely, Natural and Preternatural: The Natural Motion is that which begins in the Carotide Arteries, thence tending to the Plexus Choroideus, or the anteriour Ventricles of the Brain; from These to the middle; from the middle to the Posteriours; and from the posteriour Ventricles of the Brain, the Spirits are imparted to the Nerves. The Preternatural Motion is just the Reverse of this Case.
THE Causes of both these Cases and Conditions are either immediate or mediate. The immediate Causes may be reduced to Three Classes; to wit, Causes of an inordinate Motion of the Animal Spirits, Causes of the Circular Motions, and Causes of lost Sense, Sight, and Motion.
THE Causes of the Spirits[64] moving inordinately, are either External or Internal. The Externals are the Sun, Hot Baths, Frictions, and Concussions of the Head; or a Fall, Blow, Contusion, and all inordinate and immoderate Motions of the whole Body: such as Running, Leaping, Riding, Dancing, too much Venery, or hard Drinking; as also the Use of Acids, or acrimonious Things, and all Things replenishing or stuffing the Head; such as Garlick, Mustard, Anise, Parsley, Leeks, Onions, Radish, strong Snuffs, Drinks, &c.
THE internal immediate Causes are the Imagination of the Patient, Vapours of the whole Body, frigid Flatulencies, and[65]a sudden Fluxion of the vital Spirits into the Head.
THE mediate Causes are Material; and this Matter[66] (almost all Physicians agree) is frigid. From hence it is certain, that the Distemper proceeds from Crudities, and Victuals of a crude Juice; such as Pulses, Cheese, Tarts, Fish, and all other Sorts of the like frigid and humid Qualities: But these are only to be reckon’d concurring, not efficient Causes.
THE most common material Cause is, according to Galen[67], the Bile; which, seeking for Vent at the Mouth of the Stomach, is the Cause of these Symptoms, and is[68]properly to be educed or evacuated by a due Vomit.
BUT in Case of Vapours, Heat is always the efficient Cause, elevating them from the peccant Matter; since a Cold, or a refrigerated Body, can never engender Vapours or Wind from any Material Cause.
I shall not now enter upon the particular Diagnosticks of this Distemper, because they are as Various, as the Causes, and affected Places are different. Let me observe only, that the simple Vertigo is easily known by the Imagination of the Circular Motion of the Patient’s Head, or That of external Objects, or by vitiated Seeing and Hearing.
BUT the Scotomia differs from the Vertigo, in that besides the Imagination of the circular Motion, the Patient often loses his Sight, staggers, tumbles, or falls to the Ground. And yet the same is distinguished from the Epilepsy, in that the Patient retains his principal Functions, and neither Foams at Mouth, nor is Convulsive.
HOWEVER, as to the Distinction of Causes, if the internal Cause proceeds from Calidity, it is known by the hot Temperament of the whole Body, as well as by a Swelling and Pulsation of the Arteries about the Throat: Besides that this Vertigo easily accedes and recedes, it is always attended with Calidity and Redness of Face and Eyes; with Watchings, Deliriums, &c: And it commonly follows Fevers, Watchings, Anger, the Use of Calids, hot Things, &c. In which Cases, it is always to be helped by the Use of Frigids, or Coolers.
IF it arises from frigid Flatulencies, the Paroxysms or Fits are preceded by a Hissing or Tingling in the Ears; the Patient turns pale and wan, and is taken with an odd extensive Pain of the Head: And if these Flatulencies generate in the Head, the Party feels it ponderous, lumpish, and heavy; and is consequently much inclin’d to Sleep, Stupidity, Dullness, and Inactivity.
IF the Distemper is derived from a flatulent Stomach, the PATIENT is troubled with Rifting and Rumbling of the Belly; with Sobbing and Sighing, with Hickups, Yawnings, Extensions, Inflations, and frequent Spittings.
IF it comes from a Mordacity of the Mouth of the Stomach, the Party is infested with a Nausea, Loathing and Fastidy; with a Dejection of Appetite, a lasting or frequent Thirst, and a Bitterness of the Mouth. But this Affection also very often proceeds from the Womb, and that either because of the suppress’d Menstrua, or longretain’d Seed; as will hereafter more fully appear in Sect. ix. Chap. 8.
AS to the Prognosticks of this Distemper, it does not always seem Dangerous, much less Lethal, at first; but its Consequences are (however) very Fatal[69], if not timely prevented: For it often turns to Inflammations[70] of the Head, or Convulsions; sometimes to Melancholy or Madness; and sometimes to Epilepsies or Apoplexies.
NOW because this Affection observes Lunar Periods, and in extreme Cases, is near a-kin to the Falling-Sickness;[71] Cœlius Aurelianus informs us, That it was call’d by the Ancients the little Epilepsy: And as it admits of periodical Accessions and Circulations (I mean coming and going Fits) which depend chiefly upon the Power and Influence of the New and Full-Moon; so it is to be treated with respect to Cure, in a different manner; one way in the Access, another in the Interval.
BUT this Cure is as different, as the Causes and Degrees of the Distemper are various; wherefore I can, by no means, enter upon it in this place, for Brevity-sake.