333 



ANTISPASMODICS. 



ANTISPASMODICS. 



391 



ordered actions would appear to be owing to some improper stimulus, 

 instead of the appropriate one, being applied to the organ or part 

 affected. Venous blood, circulating in the arteries, is productive of 

 great disturbance ; and if much of it be conveyed to the brain, it will 

 act as a poison to that organ, for which arterial blood is the natural 

 stimulus as well as source of nourishment. In like manner, there are 

 bodies which, though perfectly mild, such as alimentary substances of 

 difficult digestion, yet excite more violent commotions of the stomach 

 than other substances which are of a very acrimonious nature. Undi- 

 gested food, or unhealthy secretions in the intestines, excite more dis- 

 turbance and spasmodic contractions (that is, cholic, in different degrees 

 of severity) than foreign substances, which we might expect to prove 

 very hurtful ; such, for instance, as the poison of the viper, which ia 

 perfectly innocent when received into the stomach. 



Both voluntary and involuntary muscles, and the organs of secretion, 

 are very much influenced by emotions of the mind. Under the influence 

 of hope or joy the heart beats vigorously ; while under the depressing 

 passions its action is slow and laborious, and accompanied with such 

 oppression as to have given origin to the phrase, ' a heavy heart.' Fear 

 excites to irregular contraction and relaxation many of the voluntary 

 muscles, whence comes trembling, and produces relaxation of certain 

 muscles, called sphincters, which are usually contracted ; it also aug- 

 ments several of the secretions. Grief, when not excessive, increases 

 the secretion of the lachrymal gland, producing a flow of tears ; if 

 extreme, it hinders secretion, and forms the state truly characterised by 

 our great poet : 



" A misery too deep for tears." 



Anger often causes the bile to be secreted in greater quantity, to be 

 altered in its quality, and often absorbed into the blood, thus producing 

 jaundice. The state of mind which may be termed vexation often 

 lessens the secretion of bile, but augments that of the kidneys ; and 

 every attack of hysteria terminates in a profuse flow of limpid urine, 

 which is destitute of the usual admixture of bile. 



These mental emotions, either directly, or indirectly through the 

 altered and unhealthy secretions, occasion in many persons spasmodic 

 contractions of some muscular organs, which are so violent as to 

 produce alarming and [often fatal diseases. Of this, ANGINA PECTORIS 

 furnishes an example ; and so powerful are the effects of excessive joy 

 in some instances, that the heart bursting is not a mere figure of 

 speech, and of grief hi other instances, that the heart breaking is not a 

 metaphor, but a reality. Many spasmodic actions, such as the cough of 

 hooping-cough, are kept up by habit ; others, such as the strange gesti- 

 culations of St. Vitus's dance, are acquired from imitation, as stutter- 

 ing or stammering is occasionally ; and both may become a habit, 

 difficult, if not impossible, to lay aside. 



What is termed sympathy is even more powerful than imitation, 

 which implies a voluntary adoption of the peculiarities of others : 

 scarcely any persons in company can avoid yawning if one sets the 

 example. Now, yawning is an involuntary spasm of the muscles of 

 the jaw, which is thus propagated through a large [assemblage of 

 persons ; so hysterical and even epileptic spasms are communicated 

 from one to another, often to a frightful extent, if an individual 

 subject to these complaints suffer an attack in theatres, churches, or 

 private apartments. Such an occurrence is sometimes merely the 

 result of affectation, but more frequently it is the consequence of an 

 irresistible impulse. No one was ever seized with tetanus from witnes- 

 sing the spasms of a person affected with that excruciating disease ; a 

 circumstance which can only be accounted for by observing that in it 

 the mind is in no degree implicated, the mental faculties remaining 

 clear and undisturbed to its termination : and there is reason to believe 

 that in this complaint some inflammation or peculiar state of irritation 

 exists about the origin of the nerves, which no one can induce at will, 

 and which neither primarily nor secondarily happens in the others, 

 which are more strictly nervous affections, that is, merely disorders of 

 the functions of nerves without alteration of structure. The develop- 

 ment of tetanus is slow, often not showing any sign of its intended 

 attack till some days after the cause of it began to operate on the 

 system. The others are mostly instantaneous, unexpected, and rapid 

 in all their stages. The impression they make on the bystanders is 

 increased by the surprise felt at their unlooked-for occurrence, often 

 without any obvious or sufficient cause. The more sensitive of those 

 around are therefore most apt to fall into a similar state or train of 

 actions. Of the persons so affected, the greater number will be found 

 to be females. What causes render them more subject than others to 

 such attacks ? Females, from the larger size of their nerves, are more 

 mobile, as it is technically expressed, that is, more easily operated upon 

 by slight causes than others, and their habits of life and education 

 have often a great tendency to increase this sensibility. Whatever 

 diminishes the strength, whether of mind or body, markedly predis- 

 poses to such complaints. The female children of the higher and 

 middle ranks, feeble by birth, are rendered more so by the improper 

 modes of education, physical as well as mental, to which they are 

 subjected. After emancipation from the nursery and school-room, 

 their minds and bodies are further enervated by an injudicious course 

 of reading, and an early devotion to the prevailing habits and usages of 

 fashionable life. Such pursuits preclude the possibility of applying 

 themselves to solid studies, or the acquisition of any knowledge of the 



;in man system, and of the necessity of maintaining a regular action of 

 every organ and performance of every function. 



By a neglect of one of the most important of the natural functions, 

 that is, regular and complete evacuation of the bowels, the tone of the 

 intestines is lessened. Now, when the muscular fibres of any parti- 

 cular part are under a state of more or less tension than the rest of the 

 system, this is communicated by sympathy to every other part of the 

 body. This is particularly observable in the blood vessels and intes- 

 tines, both of which are muscular tubes ; for a relaxation in any part 

 of these will produce a like affection in every other part of the system. 

 And as irritability and sensibility are very much affected by the 

 degree of tension, a want of it in the vessels constitutes what is called 

 a nervous habit, such as is most commonly met with in the female sex, 

 and weak effeminate members of the other sex : such persons will 

 generally be found to be of a costive habit. The peculiarities of the 

 female system have a large share in increasing the disposition to be 

 powerfully acted upon, at times, by trifling causes. Exhausting dis- 

 charges, to which they are very subject, greatly augment the irritabi- 

 lity ; and all diseases of a very weakening nature will produce a 

 similar effect in the individuals of either sex : during convalescence 

 from these, a disposition to irregular distribution of the blood exists, 

 and a slight excess sent to one part, or a deficient supply of it to 

 another, will cause disorder of the functions of that part. If it be any 

 portion of the nervous structure which is subjected to these errors, 

 spasmodic action is almost surely the consequence. Nothing is more 

 clear or open to proof, than that convulsive motions result from two 

 opposite conditions of the circulatory system, as relates to the quantity 

 of blood, or rapidity of its flow. An animal while bleeding to death 

 suffers violent convulsions, and an excess of blood sent to the head, or 

 its stagnation in the vessels, will produce the same effect ; which, 

 indeed, often follows mechanical pressure of the brain, from a por- 

 tion of depressed bone of the skull, or from effusion of the serum of 

 the blood, in inflammation of the membranes of the brain. The 

 fullness and distension of the vessels of the brain which precedes 

 apoplexy often occasion vomiting, which is a convulsive action of the 

 stomach and some other muscles, and is a warning sign, often un- 

 happily neglected, of the approach of this disease. The more exten- 

 sive and violent convulsions of epilepsy are, in all probability, the 

 result of a temporarily deranged state of the circulation within the 

 brain, as the loss of consciousness at the time of the attack, the pro- 

 gressive impairment of the intellectual powers, and the usual termina- 

 tion of the disease in apoplexy, palsy, fatuity, and death, attest. 



The nature of the causes of the different diseases of which spasm forms, 

 in general, a feature, the complication of these with other diseases or 

 morbid states, and the manner in which each terminates, should all be 

 taken into consideration, if we hope to make a beneficial selection of a 

 remedial t agent from among the number of antispasmodic medicines. 

 But such a judicious preliminary measure is rarely adopted ; and these 

 articles are often administered in a manner truly empirical, by many 

 professional as well as all unprofessional persons. A brief review of the 

 diseases hi which antispasmodic medicines are employed, and which 

 agree only in having spasm for one of their symptoms, while they 

 often differ widely in their causes, nature, and termination, will 

 convince every one how needful is a knowledge of these points to guide 

 us in the choice of the means of cure. The following is not given as a 

 perfect classification or even as an approximation to one, but is merely 

 intended to show the diversified nature of spasmodic diseases, and to 

 furnish an argument for caution in the management of them. The 

 treatment must vary greatly, according as the particular disease ia 

 attended with inflammation or not, or according as there is a risk of 

 its occurring, either in the natural progress of the disease, or in con- 

 sequence of the employment of improper means of treatment. The 

 selection of remedies must be determined also according to the stage 

 of the complaint, and according to the mode in which it is con- 

 nected with the state of the mental faculties, or its tendency to involve 

 these in the train of morbid actions, if it be not cured before such a 

 calamitous termination take place. Keeping these points in mind, we 

 may arrange spasmodic diseases, in some degree, as follows : 



Unattended with inflammation, primarily, or disturbance of the 

 mental faculties : 



Simple Cramp. Cholic. These generally proceed from some un- 

 digested substance, or hardened faeces, irritating the bowels : but in 

 the latter disease inflammation is apt to come on ; and in the worst 

 forms of cholic, called Ileus, or Iliac-passion, and painter's cholic, it 

 seldom fails to supervene, and then becomes the chief source of danger, 

 as well as most important object of the treatment. 



Diarrhoea, or simple looseness, and Cholera. In these the cramps or 

 spasms are never the first signs, but seem to result from the exhaustion 

 occasioned by the profuse liquid discharges. Inflammation may occur 

 during, or from, diarrhcca, and fever is the most common con- 

 sequence of cholera, that is, of epidemic cholera ; the occurrence of 

 which in either case must lead to a modification or alteration of the 

 plan of treatment. 



Angina Pectoris. Asthma. Affecting the organs of respiration and 

 circulation. 



Attended with inflammation, primarily, but causing no disturbance 

 of the mental faculties : 



Dytentery. Affecting the organs of digestion. 



