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which he says : " The treatment I would now propose instead of 

 tracheotomy is simply the application of a solution of nitrate of 

 silver, varying in strength with the. requirements of the case, to 

 the glottis of the patient, with the view of diminishing the 

 nervous excitability of the part in question. A similar treat- 

 ment has been found by me remarkably successful in alleviating 

 and removing, in a short time, the susceptibility of the patient 

 to laryngysmus, in cases of hooping cough, and of spasmodic 

 'croup (laryngysmus stridulusj) nor can I see any reason why a 

 similar result should not ensue in chronic cases of epilepsy." 



The reasons given by Dr. E. Watson are partly the same by 

 which I had been led long before him to perform the operation 

 he suggests. But I had also some other reasons. It is perfectly 

 known, in the actual state of Medical Science, that the great- 

 est changes may be produced in the nervous centres, as well as 

 in the nerves, by a very strong excitation of the termination of 

 the nervous fibres in the skin or the mucous membranes. On 

 this principle are founded many modes of treatment of some dis- 

 eases of the spinal cord and of neuralgia. The application of 

 caustics, blisters, cupping, hot iron, etc., is based on this princi- 

 ple. In accordance with it I am inclined to believe that epilepsy 

 might be cured by a mere application of a hot iron to the skin 

 of the neck ; at least I have had two guinea-pigs cured after such 

 an application, repeated three or four times. 



The operation of tracheotomy proposed by Marshall Hall has 

 proved successful in some cases. But it is a dangerous operation, 

 and if it is proved that another one much slighter can produce 

 the same good effects, it ought not to be practised. 



That other operation is the cauterization of the larynx ; it 

 prevents the closure of the glottis, and thus is able to cure 

 or to relieve epileptic patients as well as it cures some other 

 diseases. Every learned physician knows that it is sufficient to 

 cauterize the larynx once or twice to cure hooping cough in 

 almost every case. 



When the cause of the epileptic fits is excessive, and when the 

 spinal cord is very excitable, to allow free breathing merely 

 will not be sufficient to prevent the general convulsions. But 

 their violence, if respiration is free, will be deprived of all the 

 effect that would be produced by the excitation of black blood 

 if breathing did not take place. 



