Inflammation of the membranes of the brain leads to the engorgement of the face, ears, and eyes with blood. The first stage of an epileptic fit appears to be the contraction of the vessels of the brain, and the first outward manifestation is, an extreme pallor of countenance. Erysipelas of the head commonly induces delirium. Even the relief given to a severe headache by burning the skin with strong lotion, depends, I presume, on the same principle.

Dr. Browne has often administered to his patients the vapour of the nitrite of amyl,[22] which has the singular property of causing vivid redness of the face in from thirty to sixty seconds. This flushing resembles blushing in almost every detail: it begins at several distinct points on the face, and spreads till it involves the whole surface of the head, neck, and front of the chest; but has been observed to extend only in one case to the abdomen. The arteries in the retina become enlarged; the eyes glisten, and in one instance there was a slight effusion of tears. The patients are at first pleasantly stimulated, but, as the flushing increases, they become confused and bewildered. One woman to whom the vapour had often been administered asserted that, as soon as she grew hot, she grew MUDDLED. With persons just commencing to blush it appears, judging from their bright eyes and lively behaviour, that their mental powers are somewhat stimulated. It is only when the blushing is excessive that the mind grows confused. Therefore it would seem that the capillaries of the face are affected, both during the inhalation of the nitrite of amyl and during blushing, before that part of the brain is affected on which the mental powers depend.

Conversely when the brain is primarily affected; the circulation of the skin is so in a secondary manner. Dr. Browne has frequently observed, as he informs me, scattered red blotches and mottlings on the chests of epileptic patients. In these cases, when the skin on the thorax or abdomen is gently rubbed with a pencil or other object, or, in strongly-marked cases, is merely touched by the finger, the surface becomes suffused in less than half a minute with bright red marks, which spread to some distance on each side of the touched point, and persist for several minutes. These are the _cerebral maculae_ of Trousseau; and they indicate, as Dr. Browne remarks, a highly modified condition of the cutaneous vascular system. If, then, there exists, as cannot be doubted, an intimate sympathy between the capillary circulation in that part of the brain on which our mental powers depend, and in the skin of the face, it is not surprising that the moral causes which induce intense blushing should likewise induce, independently of their own disturbing influence, much confusion of mind.

[22] See also Dr. J. Crichton Browne's Memoir on this subject in the `West Riding Lunatic Asylum Medical Report,' 1871, pp. 95-98.

_The Nature of the Mental States which induce Blushing_.--These consist of shyness, shame, and modesty; the essential element in all being self-attention. Many reasons can be assigned for believing that originally self-attention directed to personal appearance, in relation to the opinion of others, was the exciting cause; the same effect being subsequently produced, through the force of association, by self-attention in relation to moral conduct. It is not the simple act of reflecting on our own appearance, but the thinking what others think of us, which excites a blush. In absolute solitude the most sensitive person would be quite indifferent about his appearance. We feel blame or disapprobation more acutely than approbation; and consequently depreciatory remarks or ridicule, whether of our appearance or conduct, causes us to blush much more readily than does praise. But undoubtedly praise and admiration are highly efficient: a pretty girl blushes when a man gazes intently at her, though she may know perfectly well that he is not depreciating her. Many children, as well as old and sensitive persons blush, when they are much praised.

Charles Darwin

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