SPASMODIC AFFECTIONS. 503 



however, frequently discover these, and often be able to give 

 the patient proper directions how to avoid them. But his proper 

 business is to correct the predisposing cause, and enable the pa- 

 tient to resist occasional causes. 



" It is the indolent and luxurious life which leads to the plethoric 

 state that is very often the cause of the disease : and it is hard- 

 ly to be expected that people will give up indolence, late hours, 

 and full living, for the fear of a distant evil. I had occasion 

 to know a person who laboured heavily under hysterics, when, 

 by her easy circumstances, she was enabled to lead an idle life! 

 but a sudden reverse of fortune obliging her to employ both 

 body and mind, she got perfectly well. 



" 2. To take off the plethoric state where it prevails. We think 

 we may obviate this by evacuations ; and accordingly, blood-let- 

 ting is a very general practice. Its use, however, is very precarious 

 in curing this plethoric state ; for, sometimes, instead of prevent- 

 ing the recurrence of it, it will even induce and increase it. It 

 requires, therefore, a very nice attention to judge what quantity of 

 blood may betaken away, when the quantity will be recovered again, 

 and whether it may be repeated before the quantity is recover- 

 ed, always diminishing it each time. This has been mentioned 

 by other practitioners ; but it should be attended to in particu- 

 lar in this view, that if we produce an inanition, we do as much 

 harm in inducing the disease, as the plethoric state did before. 

 Accordingly this disorder is frequently produced by too copi- 

 ous blood-lettings. Thus, in a particular case, a plethoric young 

 women had her menses stopped by taking cold, and finding a 

 distention to arise from this circumstance, was bled three or 

 four times by her own directions ; in consequence of which she 

 was attacked with a severe hysterical disorder, which still conti- 

 nues. Venesection, therefore, is very dangerous, either as it may 

 increase the plethora, or induce inanition, and it is only to be 

 used in recent cases, and where there is manifestly a full habit. 



" Indeed we could never recommend the obviating a pletho- 

 ric habit by this, but rather by low diet and exercise. From ihe\ 

 frequent mixture of dyspepsia with epilepsy, it has been com- 

 mon to prescribe to our patients a full animal diet, than which 

 nothing has been more pernicious. On the contrary, a spare 

 diet has been of remarkable service in preventing the recurrence 



