10 



MEDICINE. 



Practice, of a specific nature, which it is not easy to account for 

 > uixin general principle*. of which the use of the oxide 

 of hiMinith in simple pain of tlie stomach may be ad- 

 duifd us an example. In deciding tliat the disease is 

 either idinp.-ithic. or that it must l>e made the object of 

 direct medical treatment, we first inquire whether then; 

 re any symptoms of inflammation which may fender 

 depict ion" necessary, or the other means by which we 

 subdue the inflammatory action ; we then apply blis- 

 ter*, issues, or other stimulating remedies, upon the 

 principle of exciting what is called counter-irritation, 

 proceeding upon a general law of the animal economy, 

 according to which we remove a morbid action, by sub- 

 stituting for it a new, and probably a more consider- 

 able one, in some contiguous part, which latter is at- 

 tended with no dangerous consequence, and which we 

 have it in our power to remove at pleasure. In the 

 Autalgite, as well as in the Hypersesthesier, purgatives 

 are generally useful, although perhaps not so universal- 

 ly ; and opium, if it does not accomplish a radical cure, 

 is at least one most effectual means for affording tem- 

 porary relief. It has been observed, that some of the 

 most severe pains to which the human frame is liable, 

 recur at periodical intervals ; and it has been found that 

 in these, as in all other periodical diseases, bark, and 

 even arsenic, may be employed with success; this lat- 

 ter remedy, however, we should not be disposed to 

 try, until all other methods had failed; and it should 

 likewise be accompanied by proper evacuations. Of 

 their mode of operation, as well as of the circumstan- 

 ces which tend to give the diseases in question their pe- 

 riodical character, we are totally ignorant, and our 

 practice, in these instances, is entirely empirical. 



SECTION IV. Neivous Fever. 



Xervous THE second order of the Neuroses is Asthenia, includ- 

 ftvcr. ing those diseases which consist in a diminution of the 

 nervous energy ; and under this we include three gene- 

 ra, the first of which is simple Nervous fever. \V e are 

 aware of the apparent incongruity in placing the dif- 

 ferent kinds of fevers in different classes, and in sup- 

 poa ng them to proceed from totally different causes, 

 connected with a different set of functions, more par- 

 ticularly as it must, at the same time, be admited, that 

 the two diseases slide into each other by almost imper- 

 ceptible degrees, so that it is often extremely difficult 

 to know into what class any particular case ought to 

 be referred. But, notwithstanding these objections, 

 we are clearly of opinion that certain sporadic cases of 

 fever, as well as certain general epidemics, exhibit 

 symptoms which may be sup|>ostd to arise from a 

 primary affection of the nervou- system, while the 

 sanguiferous system is but little affected, and that the 

 two fevers are not merely different gradations of the 

 same species of disease, in which the proportion be- 

 tween the symptoms remains the same, while the de- 

 gree of lioth is equally dimiunbed. We think it is not 

 difficult to perceive a difference in the exciting cause, 

 as well as in the effect produced ; for while contagion 

 is probably the sole cause of the proper Typhus, or 

 putrid fever, the nervous fever never arises' from this 

 sou.rr, but from ment .1 agitation, from over-fatigue, 

 from complete exhaustion, or from other circumstances 

 which might be expected to act upon Hie brain and 

 nerves, more than upon the heart and arteries. The 

 symptom*, and general character of the two diseases, 

 when we take the most sti ongly marked cases, are no 



less easy to discriminate from each other. In the Nerv- Practice. 

 ous fever we do not observe the successive stages T"" 

 which we have in Typhus; there are no marks of op- 

 pression or congestion, nor of the subsequent attempt 

 at re-action ; but, from the very commencement, there 

 are indications of weakness and irritability, the pulse 

 quick and feeble, the heart little affected, not much 

 thirst or disorder of the alimentary canal, except a less 

 relish for food than ordinary ; while, on the contrary, 

 we have delirium, and all that derangement of the 

 sensations, which indicates an irregular action of the 

 brain and nerves, but, at the same time, without any 

 appearance of turgescence in their vessels, or of that 

 oppression which arises from a congestion of the fluids. 



In the cure of Nervous fever, we must refer to the Treatment 

 same principles which we have laid down with respect 

 to its pathology ; we require no general depletion, but 

 we begin from the first with stimulants and excitants, 

 exhibited in moderate doses, and proportioned to the 

 effect which they have in rousing the dormant powers 

 of the system. It is obviously of great importance to 

 remove, if possible, the exciting cause, when it still 

 remains applied, and in the later stages of the disease 

 we mast have recourse to stimulants and tonics, and 

 shall find the proper management of the diet a most ef- 

 fectual part of the medical treatment. It is in fevers 

 of this description that wine becomes a valuable reme- 

 dy, and it is often found more grateful to the stomach 

 than any stimulating compound which we can procure 

 from the apothecary. It would have been fortunate 

 for mankind if its use had been restricted to this dis- 

 ease, and had not been extended, by a false or imper- 

 fect analogy, to other affections which it resembles 

 scarcely in any thing but in name. 



SECTION V. Aneesthesue. 



TUB second genus of the Asthenias, Anaesthesia, is Anaesthe* 

 divided into complaints which consist in general debi- 

 lity of the nervous system ; defects of the external 

 senses, not depending upon a change in the structure 

 of the organs; and in debility of the organic functions. 

 The two first of these subdivisions may, almost all of 

 them, be considered as symptomatic of some more ge- 

 neral affection ; the latter, under which we include 

 Aphonia, Dysphagia, Anorexia, Dysuria, and Anaphro- 

 disia, are not unfrequently primary, although at other 

 times, like the former, only symptomatic. They de- 

 pend occasionally upon an obvious change of mecha- 

 nical structure, when they properly belong to a differ- 

 ent part of the nosological system, and must be remov- 

 ed by mecanical remedies, as is frequently the case with 

 Dysphagia and Dysuria. When, however, they are 

 merely nervous affections, the cure is to be accomplish- 

 ed upon the same general principles which were detail- 

 ed above, regard being always had to the local situa- 

 tion and specific functions ot the part. 



SECTION VI. Apoplexia. Apoplexy, 



THE third genus of Asthenia is formed by the Dys- 

 cincsiae, those diseases which essentially consist in a 

 loss or diminution of the power of voluntary motion, 

 arising, for the most part, from an organic derange- 

 ment of the brain ; we include under it the species 

 Apoplexia, Paralysis, Hydrocephalu*, and Lethargus. 



Apoplexy is characterized by a sudden abolition, or Apoplexia. 

 considerable diminution of both the external and the 

 internal senses, and of the power over the muscles of 



