438 GENERAL NEUROSES, OF UNKNOWN ANATOMICAL ORIGIN. 



f ul ovary ; and that further pressure upon the affected part may 

 induce a true hysterical attack. 



The following is said to be a favorite prescription with Dr. 

 Brown- Sequard : Bromides of sodium, iodinium, and ammonium, 

 each 3 iij ; iodides of potassium and ammonium, each 3 iss. ; am- 

 mon. sesquicarb. 3 j ; tinct. calumbae f iss ; aquae dest. ad viij. 

 S. teaspoonful and a half before each meal and three teaspoonf uls 

 at bedtime. If bromide of potassium fails, try conium, cannabis 

 indica, or oxide of zinc. 



Chapman's ice-bags applied to the spine for two to eighteen 

 hours have proved useful in some cases. Electricity, even in the 

 constant current, has not fulfilled expectations ; when used as an 

 adjunct, we try to affect the pons and medulla oblongata by placing 

 the electrodes on each side of the neck ; or we may galvanize the 

 sympathetic or peripheral nerves from which there is any reflex ex- 

 citement. 



Dr. S. W. Mitchell recommends inhalations of from two to five 

 drops of nitrite of amyl for averting attacks ; but they can only be 

 tried where there is a protracted aura, and in cases where the face 

 becomes pale at the onset, showing spasm of the vessels. Sometimes 

 this remedy seems not only to avert attacks, but to render them less 

 frequent and severe ; in other cases the escape was followed by 

 severe attacks. 



2. P. 418. 



Hysterical spasms may resemble epilepsy, or the latter may oc- 

 cur in hysterical patients. There may be hysterical paralysis of 

 almost any muscles, but especially of those of the extremities. The 

 electro-muscular contractility remains normal ; in most cases there 

 is cutaneous anaesthesia. Rarely with paralysis of a limb there is 

 facial paralysis, anaesthesia of the skin of the face, ptosis, etc. 

 There may be paralysis of the pharynx or oesophagus, which may 

 be diagnosed from spastic dysphagia by the passage of a sound. 

 Sometimes enormous tympanites occurs, the accumulation of gas 

 seeming due to temporary arrest of the gastric and intestinal con- 

 tractions ; the same sluggishness of peristaltic action may cause 

 constipation. Aphonia, due to paralysis of the glottis muscles, is 

 seen quite often. In rare instances paralysis of the diaphragm has 

 been seen, when on respiration the movements were in the reverse 

 direction, viz., sinking in inspiration and protruding in expira- 

 tion. There may be paralysis of the bladder with hemi- or paraple- 





