III.  Another mode of mental exertion to relieve pain, is by producing a train of ideas not only by the efforts of volition, as in insanity; but by those of sensation likewise, as in delirium and sleep.  This mental effort is termed reverie, or somnambulation, and is described more at large in Sect.  XIX. on that subject.  But I shall here relate another case of that wonderful disease, which fell yesterday under my eye, and to which I have seen many analogous alienations of mind, though not exactly similar in all circumstances.  But as all of them either began or terminated with pain or convulsion, there can be no doubt but that they are of epileptic origin, and constitute another mode of mental exertion to relieve some painful sensation.

1.  Master A. about nine years old, had been seized at seven every morning for ten days with uncommon fits, and had had slight returns in the afternoon.  They were supposed to originate from worms, and had been in vain attempted to be removed by vermifuge purges.  As his fit was expected at seven yesterday morning, I saw him before that hour; he was asleep, seemed free from pain, and his pulse natural.  About seven he began to complain of pain about his navel, or more to the left side, and in a few minutes had exertions of his arms and legs like swimming.  He then for half an hour hunted a pack of hounds; as appeared by his hallooing, and calling the dogs by their names, and discoursing with the attendants of the chase, describing exactly a day of hunting, which (I was informed) he had witnessed a year before, going through all the most minute circumstances of it; calling to people, who were then present, and lamenting the absence of others, who were then also absent.  After this scene he imitated, as he lay in bed, some of the plays of boys, as swimming and jumping.  He then sung an English and then an Italian song; part of which with his eyes open, and part with them closed, but could not be awakened or excited by any violence, which it was proper to use.

After about an hour he came suddenly to himself with apparent surprise, and seemed quite ignorant of any part of what had passed, and after being apparently well for half an hour, he suddenly fell into a great stupor, with slower pulse than natural, and a slow moaning respiration, in which he continued about another half hour, and then recovered.

The sequel of this disease was favourable; he was directed one grain of opium at six every morning, and then to rise out of bed; at half past six he was directed fifteen drops of laudanum in a glass of wine and water.  The first day the paroxysm became shorter, and less violent.  The dose of opium was increased to one-half more, and in three or four days the fits left him.  The bark and filings of iron were also exhibited twice a day; and I believe the complaint returned no more.

2.  In this paroxysm it must be observed, that he began with pain, and ended with stupor, in both circumstances resembling a fit of epilepsy.  And that therefore the exertions both of mind and body, both the voluntary ones, and those immediately excited by pleasurable sensation, were exertions to relieve pain.