AXTISPASMODIC8. 





tV*ap, /fiM0M-r*y. Affecting the organ* of respiration. 

 t'nattended with infl*mlain to an appreciable degree perhaps in 



/foajrw. Hot affecting UM BMntal faculties, except the volition. 

 OUm. . Fiji*'* ZSJMP. Ontctendad with loa* of oonsciou*- 



Ail***. Attended with toa* of oonaciouaneaa. 



The** two di**aM* sooner or later aflat* the mental faculties, and 

 bar* a tendency to a common termination, namely, fatuity, unless they 

 rabstd* spontaneously. or are cored by medical treatment. Chorea 

 Mutually originate* from, or it connected with, accumulations of the 

 bowel*, and epilepsy frequently from a similar irritation of theae parta, 

 but it* eauae* are numeroui, and ita cure, in most 



Spasmodic disease*, of an obaeure nature, chiefly affecting the organ* 

 of respiration : 



nti*> and Lart-jatr. fTfrimpkohia. Theae may at aome period 

 baootne attended with inflammation, or rather fever ; but thin appears 

 to ba the result of the constant suffering, and in seldom the direct 

 cause of death, which aeems to be the consequence of thnt depression 

 of the heart's action which long-continued pain or unpleasant sensa- 

 tions produce. 



Diseases in which inflammation Is the primary affection, *pamn the 

 secondary: 



Injlammatirm of At Bnti acute, PhrnStit. 



Acute or chronic, HtidrorrjAalia, that in. Water tit tlir Hraiit, occur- 

 mostly in children of a acrofulou* habit. 



ring mos 



The treatment of theae disease* is as diversified as their cause*, and. 

 to be succeasful, requires a degree of judgment and knowledge which 

 few possess. To comprehend the nature of those spasmodic diseases 

 which are unaccompanied by inflammation, and for which anti-spasmo- 

 dic medicines are chiefly employed, we must 1* made aware that, in the 

 human system, there are two distinct sets of nerves, having different 

 origins, and fulfilling separate functions ; the one net arc called nerves 

 el sensation, the other nerves of motion. The former receive impres- 

 sions and convey the sensations from all parts of the l>ody to the brain ; 

 the latter execute the dictates of the brain, by conveying on impulse 

 from it to the organs of motion. The organs of motion that is. the 

 muscle* ar so adjusted, and in the healthy state so equally supplied 

 with nervous energy, ax precisely to balance or antagonise each other 

 [AXTAOOSIST MUSCLE] ; and one muscle, or set of muscles, can only 

 overbalance another, or several muscles, when it receives an additional 

 apply of nervous energy from an effort of volition. Thus the hand is 

 opened and shut at will : when opened, the extensor muscles over- 

 power the flexor muscles ; when shut, the flexor muscle* overpower the 



the equilibrium, from which forced state all mnaolea may imultaneoualjr 



In diseased conditions of the nervous system, this fine balance is lost 

 from various causes: the nerves of sensation may become preter- 

 naturally sensitive ; the nerves of motion may become paralysed : the 

 power of voluntary motion may be perverted in various ways and 

 iUglius; the flexor muscles, independent of volition, may overpower 

 the extensor*, or the extensors the flexors. When affected with tetanic 

 spaam, the extensor muscles of the back of a delicate girl could not bo 

 replaced in the natural state of equilibrium by nny effort of the will, 



nor by a weight of eight hundred pounds ; and under the influciu t 



hysterical or epileptic excitement, a delicate person cannot be con- 

 trolled by three or four robust men. The action of the muscles is an 

 violent that the fibres are sometimes torn across, or even the bones 

 fmetnred. 



BOOM of thca* spasmodic diseases give, .it times, an intimiti<-n of 

 their approach, generally by a peculiar sensation being experienced in 

 one part of the body often the thumb in epilepsy, or between the 

 *"" and throat in hysteria ; the spasmodic actions not commencing 

 till these sensations have reached the brain. At other times no warn- 

 ing enaation I* felt; yet often, on careful examination, some t. n.l. >- 

 rwill be discovered, of which the patient waa not in the least 

 w e previously aware. In hysteria this tenderness is generally felt 

 at aome point along the cmirse of the spine or back 

 cue of pasmodifi disease should we ever omit a minute examination of 

 tan* part. Should drawing the finger along the course of the spine, 

 and making Arm pressure as we proceed, not reveal ita exit 

 sponge, dipped in water as hot as can be borne, will, in ita progress 

 along the spine, cause the patient to start when it reaches the tender 

 pot. The discovery f this will often furnish a key in all the strange 

 symptoms and spasmodic actions, as well a* explain the capricious r.. n - 

 <hMt, of the miflerer, which has alarmed the friends nnd puzzled the 

 madfca) attendant. Whan appropriate treatment is directed to this 

 point, most of the trouhleaotne symptoms abate, or cease altogether. 



As moat apamnodfe diseases, especially if connected with affections of 

 the nrind, bare a great tendency te recur and become habitual, it in of 

 taM utmost importance to (top them at an early period. 



The remedies which have been found most eflicacion* hi stopping or 

 PW anting thwa, art cMhcr Mok as make strong and new impressions 

 on the organ* of sense, and thereby diminish the effect of sensations 

 airaady exiating. or such as blunt the sensibility in general, nnd thereby 

 diminish all effects of sensation ; or else such as raise, the whole of the 

 system to a lard with the part spasmodically excited, and so establish 



The fibre* of each muacle act generally in concert : if a few act 

 pendenUy of the others, thaw are in state of cramp. Particular set* 

 of muacle* act in concert, as all the flexors, or all to* extensors ; cm or 

 man of theae acting independently of the rest cauaa spasm. Now wa 

 often relieve this by calling the others into action; and a* volition 

 simply is not equal to this, we use mechanical or medicinal means. 

 Cramp of the limb* is often removed by pressing the toes or fingers 

 against a resisting body, by which all the muscular fibre* are brought 

 to the same level. This example of a mechanical process i the only 

 one worthy of mentioning, and i* applicable both in ught cases, as 

 cramp of the limb* is generally merely a symptom' of some internal 

 derangement of the bowels, of the spinal chord, or of the brain, and 

 also in the severe cramps of cholera. 



The medicinal means constitute the antispaimodic remedies, and are 

 of different kinds. Very few article* are, strictly speaking, merely 

 antispasmodica ; that is, used solely to allay spaam, and incapable of 

 being employed for any other purpose. On the contrary, this is only a 

 particular application of substances capable of sen-ing other nnd more 

 general end*. Consequently, many of the so-called antispa?i 

 belong to other classes of medicines, such as the stimulant", particularly 

 diffusible stimulants, as alcohol (brandy), sulphuric ether, runiphor. ft !; 

 or to the narcotics, such as opium, belladonna, Ice., or to the 

 such a* metallic salt*, namely, of inm. zinc, nnd silver : or \<: 

 bitters, as cinchona bark. The first set, or stimulating 

 spasmodic*, act, apparently, by rousing the nervous energy of t Ill- 

 system, and raising the neighbouring muscle* to a level with the part 

 in a state of spasmodic excitement. The second get act by rendering 

 the nervous system torpid, and insensible to every sensation ; In large 

 doses producing complete insensibility, even to the extent of coma and 

 death. These two are administered when an attack in threat. 

 actually begun ; the tonics are administered while the patient 

 from an attack, and act by strengthening the system, so as to render it 

 -eptible of being acted upon by slight causes, particularly tin- 

 irritating cause, known, or supposed, to excite the paroxysm or fit. 

 The substance* which are more especially considered aa antispasmodic 

 are volatile oils, such as mint, lavender, fte., derived chiefly from the 

 tribe of tin' /.,ti,i,itrr : or cnjeput oil, fn.ni .V >-i.i<-rir ; or dill, anise, 

 fennel, ftc., from the I'mlxllifenr, from which tribe also are derr 

 fojtid gums, as they are improperly termed, being gnm-ro- 

 asRafortida, galbanum, Ac. These, with valerian nnd myri ' 

 vegetable kingdom, and musk and castor from the animal kingdom, are 

 the most valuable ant (spasmodic*. All the volatile oils seem to act in 

 the same way a* the purely stimulating antispaamodie- : while the foetid 

 gum-resins act by substituting new and powerful sensations instead of 

 the morbid ones, and must be administered generally when the attack 

 is threatened or begun. 



These kinds of antispasniodlcs differ in value, not only aa relates to 

 their mode of action, but to their safety. The stimulating anti- 

 spasmodic* are only admissible when a fit is threatened, or may have 

 begun; and as they greatly excite the vascular system that is, quicken 

 the circulation if upon their being given once they fail to remove the 

 spasm, they should not be repeated. This caution is more especially 

 necessary in respect to brandy, which is too commonly resorted to on 

 every threatening or attack of spasm, such ag cholic. So many of these 

 diseases being connected with, or disposed to end in, inflami. 

 the free use of brandy, or other stimulant, is decidedly injurious. 

 The inflammation in croup, hooping-cough, and dysentery must first be 

 removed by appropriate means, when the spasm will generally c 

 or disappear entirely : if it should remain, in hooping-cough, in a great 

 measure from mere habit, antispasmodic* may be used, but even 

 the narcotic antisnasmodics, such as Pnissic acid, paregoric, or henbane, 

 are In be preferred. The propriety of employing belladonna extensively 

 in this disease Is very questionable. The external employment. iTi (In- 

 form of embrocations, of the stimulating antispaamodics, is more 

 allowable in i-lmlie or hooping-cough ; but hen- they not mi 

 principle, namely, t) -it.itioii. This is, in ifcwlf, n 



uring spasmodic disease*. An irritating appli 



to the spine is of much service in hooping-cough : tartrate of antimony 

 ointment or plaster [Avrniosr] applied to the 



have said often exists in hysteria, and other cimilnr diseases, will be 

 productive of more good than all the antispAsmodie medicine* which 



,-11! ) 



materially diminished by repeated irritating . .-is blisters, 



t.irtmt<- of antimony ointment, fte . t" tin- inj' mid idc of the neck. 

 Severe I :' inning for several days, and which resisted all 



internal remedies, has yi .1 along the side of the 



neck. Every physiologist will understand how this happen*. 



The means which may ! employed to intercept the passage of the 

 peculiar sensation to th- bnin .in- merely mechanical for example, tying 

 a string tightly round the thumb prevent* tl . in epilepsy, 



reaching the brain, and wards off the attack. A cupping-glass would 



';' t when the 8*0 itioa aroM, 

 Free scarification of the g<.- r-n, when teething, is much 



m< >re cfKcaf ious in allaying convulsive affections than internal medicines, 



except mild purgnt 

 The medicine* which may be administered while the patient is free 



