I 



On Tic Douloureux. 349 



that quiet and retirement which has been above recommended ; 

 but it is really provoking to see such means so commonly neg- 

 lected, and the unfortunate patients tormented by blister.-:, 

 fomentations, and galvanism, and their already debilitated 

 / stomachs further overpowered by gigantic doses of powdered 

 bark, rust of iron, and other (in such cases) equally ineffective 

 and hurtful medicines. I write to warn against them. 



I have spoken of Peruvian bark as a remedy in tic doulou- 

 reux. Where the painful affection so called, let it arise from 

 what cause it may, assumes an intermitting form, — and nothing 

 is more common than to have it coming on at stated periods, 

 generally one violent attack in the twenty-four hours, — in such, 

 as in other similar cases, bark has often been effective ; but of 

 late, sulphate of quinine has very properly been substituted for 

 it ; and as this extremely curious and valuable medicine is 

 now in every one's hands, and even finding its way into family 

 medicine chests, a few words respecting its use, or rather 

 abuse, may not be here misplaced. I would first remark, that 

 it is too commonly given in over-doses : it then produces 

 thirst, and a white tongue, and, what is remarkable, it excites 

 in most people that uneasy sensation of fulness about the 

 stomach, which is generally complained of after a large dose 

 of powdered bark, and ascribed to the indigestible nature of 

 the large quantity of inert and insoluble woody fibre in which 

 that substance abounds. For these reasons sulphate of qui- 

 nine is too often laid aside in cases where, if properly and 

 judiciously administered, it might prove of important service ; 

 instead of three or four grains, or even more, repeated every 

 four or six hours, let a grain be given once a day ; and if 

 it agree, and occasion require, let this dose be repeated twice 

 or thrice daily, either in the form of pill or solution. I prefer 

 the latter ; two drachms of tincture of orange-peel being used 

 as the solvent, and diluted afterwards with half a wine-glass of 

 water. It is not meant here to insinuate, that in obstinate 

 agues, and other disorders, large doses" of quinine are always 

 improper, but to enforce the occasional mischief which they 

 produce, and by which the medicine is unjustly brought into 

 di^rust and disrepute. 



Decayed teeth are fertile sources of pains and twitches 

 OCT.— DEC 1827. 2 A 



