TRANSACTIONS OF THE SECTIONS. 129 
inquiry. But we may conjecture with plausibility, that it would be found, that to do 
justice to the treatment of the affected children, tour or five separate establishments 
in Scotland, and fifteen or twenty in England would be required. These ought to 
be situated in the vicinity of the districts most affected with the disease. They would 
fall to be supported, just as the lunatic asylums are, partly by the contributions of 
parish-funds for paupers, and partly by the fees of parents sending children. 
The first element necessary to a right determination as to what ought to be done 
to meet the necessities of the case, is the obtaining of a clear view of the extent of the 
evil with which it is proposed to grapple; and this can be attained in no other way 
than by making an accurate statistical investigation. 
Observations on Hysteria, Hydrophobia, and other Convulsive Affections, 
embracing an Analysis of the Phenomena of Water-dread. By JouHn 
DauzieL, M.D. 
Prefixed to Dr. Dalziel’s dissertation is the following intimation :— 
“{Ν. Β. The original paper, of which this is substantially a copy, was written up- 
wards of twenty years ago; and a brief notice of it was published in the Glasgow 
Medical Journal for November 1830.]” 
Dr. Dalziel’s paper obviously resolves itself into two distinct parts :— 
"I. The theory of convulsive affections; and II. The analysis of the corporeal and 
mental process undergone by the hydrophobic patient on the presence, &c. of liquids. 
I. The theory of convulsive affections as regards hysteria and hydrophobia is ex- 
pressed by Dr. Dalziel in the three following propositions :— 
‘1st, The globus hystericus, as well as the similar affection of the throat in hydro- 
phobia, which is occasioned by the idea, &c. of liquids, is a spasmodic stricture of the 
glottis, whereby respiration is obstructed. 
“2nd. Obstructed respiration, whether suspended or impeded, occasions cerebral 
congestion, as well as that feeling of ‘ general uneasiness’ designated ‘sensation of 
suffocation,’ which is an attendant on the diseases under consideration. 
‘3rd. Cerebral congestion and this ‘ general uneasiness,’ separately or conjointly, 
may, especially in an irritable habit, occasion convulsion.” 
Convulsions from foreign bodies in the larynx do not, he argues, proceed directly 
from the local irritation, as the “‘ current language of surgery” would indicate; but 
are induced indirectly by suffocation, ὅς. Convulsions from local irritation else- 
where, he conceives, flow from the same source,—violently obstructed respiration,— 
the aperture of the glottis being instinctively closed and the muscles of expiration 
called into vigorous action for the purpose of mitigating pain. By this process, he 
alleges, the pain is actually mitigated through means of the consequent “cerebral 
congestion,” although the temporary relief is occasionally purchased at the expense 
of a convulsive or even an apoplectic attack. 
We may insert here the practical inference Dr. Dalziel deduces from the preceding 
three propositions, viz. ‘‘ that in the treatment of hydrophobia, the performance of the 
operation of bronchotomy is advisable, with the view, not only of warding off or pal- 
liating the convulsive paroxysm, but also of preventing other injurious effects of ob- 
structed respiration, which will afterwards be specified.” These we may mention are 
inflammatory affections of the lungs and brain, emphysema and spasmodic constric- 
tion of the muscles of the chest,—formidable accessories all. 
II. Of the author’s analysis of water-dread it is difficult to give an abstract. He 
assumes that it is more difficult, because it requires a greater degree of contraction of 
the muscles of deglutition, to swallow a liquid than a solid; and violent contraction 
of muscular fibre will induce spasm, in a state of health, much more when in an inri- 
table state. Again, there being little relish for food, ἐξ will be swallowed with indif- 
ference, and hence with ease, while, there being urgent thirst, liquids will be swallowed 
with avidity, especially water. But the very preference of water to any other liquid 
is precisely the reason why, at a certain point in the progress of the malady, the swal- 
lowing of it excites convulsion, &c. Only now increase the thirst, and the mere pre- 
sence of water will be sufficient to produce the effect. Yet, again, add to the feeling 
of thirst, or increase the irritability, and the very ideal presence of the tempting be- 
' verage will excite the muscles of the throat and effect the catastrophe :—a general 
miniature type this of many of the ills of life. 
1850. K 
