12 



MEDICINE. 



Treatment. 



is a degree of weakness over the whole body, and espe- 

 cially in tin- voluntary muscles, accompanied by tremor, 

 partial convulsions, numbness, and frequently by * ge- 

 neral wasting of the part. This kind of Paralysis is 

 the consequence of the excessive use of opium, or a too 

 free indulgence in ardent spirits, and is occasionally 

 observed to come on in old age without any assignable 

 exciting cause. In the more severe cases of Palsy, and 

 in those that are left after an apoplectic attack, we 

 usually find that exactly one half of the body is affected, 

 constituting the variety of Hemiplegia ; and upon dis- 

 section we find, in most of these cases, that the injury 

 to the brain is on the opposite side to that of the paralytic 

 limbs, a fact which has been much employed by those 

 who have speculated upon the pathology of the nervous 

 system. Another variety of Palsy is Paraplegia, where 

 the diseased is separated from the sound part of the body 

 by a transverse section ; this proceeds, in almost all 

 cases, from an injury to the spine, and of course tne 

 extent of the disease depends upon the part in which 

 the spine is affected. 



Where the Paralysis occurs in its violent form, or is 

 the sequel of Apoplexy, its treatment must, in every re- 

 spect, coincide with what was recommended above for 

 this complaint: we must begin with copious depletion of 

 the sanguiferous system, then administer active purga- 

 tives, apply blisters, and gradually have recourse to sti- 

 mulants. But, in many cases, the accession of Palsy does 

 not indicate that state of the blood vessels, which leads 

 us to suppose that bleeding is necessary ; and although, 

 perhaps, purgatives are always proper, we place our 

 chief reliance upon the stimulating plan, after we have 

 done all that lies in our power to remove the exciting 

 cause. The stimulants that have been employed in 

 Palsy, both general and local, are very numerous; the 

 choice must depend upon circumstances connected with 

 the nature of the constitution of the patient and the 

 part affected. They consist both of various articles of 

 the materia raedica. and of different mechanical appli- 

 cations ; among the former, we may enumerate ether, 

 and spiritous compounds, lytta, oleum terebinth inae, am- 

 monia, sjnapis, the warm essential oils, and the whole 

 class of vesicants, and rubifacients. Among the more 

 efficacious of the mechanical applications, is friction in 

 various forms, hot fomentations, electricity, and gal- 

 vanism, a remedy which, however, has not answered 

 the high expectations that were formed respecting it : 

 the natural thermal springs are had recourse to with 

 benefit in the later stages of Palsy. 



Partial pal- It would be incompatible with our object to point 

 out the means employed for removing the various local 

 causes of Palsy ; but there is one that is connected 

 with diseases of the spine, which forms so important 

 an object of our attention, as to require being distinct- 

 ly noticed. When the disease occurs spontaneously, it 

 has been conceived to originate from a scrofulous ten- 

 dency in the constitution, and it must therefore be 

 combated by all those means which are supposed to be 

 useful in counteracting this tendency. Practitioners, 

 however, are but too well aware of the little benefit 

 that is to be derived from the most approved of these 

 means, and generally all that lies in our power is to 

 endeavour to remove the local complaint, and this has 

 been usually attempted by the application of caustic 

 issues near the part affected. A new plan of treatment 

 has been lately proposed, in which, instead of issues, 

 the patient is strictly confined, for a great length of 

 time, to the horizontal posture. When we consider 

 the nature of the affection, and especially when we 



ie ; dis- 

 ease of the 



spine. 



perceive the ravages which it commits in the structure Practice, 

 of tJie bones, we can scarcely imagine how mere rest, T~~ ' 

 although a powerful adjunct, can alone perform a cure, 

 and we jve Ird to conjecture, that in those cases where 

 this plan has been successful, the symptoms depended 

 simply upon weakness, or a loss of voluntary power, 

 arising from a nervous affection, but without any struc- 

 tural disease. In Palsy of long continuance, where the 

 original cause ot the disease is removed, and where the 

 structure of the part is irremediably injured, it has 

 been found of great importance for the patient to use 

 as much voluntary exertion as possible in the affected 

 muscles, and in this way the healthy action has been 

 restored in parts which were previously almost quite 

 useless. 



SECT. VIII. Hydrocephatus. WateY in the Head. 



WE have placed this disease in the genus Dyscinesia, Hydroce- 

 although it is in fact a species of dropsy, because both phalus. 

 its symptoms and its treatment connect it more with 

 the primary diseases of the nervous system, than with 

 those of any other part of the animal economy. The 

 origin of this disease, and its predisposing causes, are 

 obscure : it affords a remarkable instance of the exist- 

 ence of a peculiar train of symptoms, indicating an af- 

 fection of a part remote from that whence they might 

 naturally be supposed to proceed, and of the sympathy 

 between two p.-u-ts. not related to each other by their 

 local situation, or by any obvious action of their func- 

 tions. The disease, when it exists under its usual 

 form, commences with fever, violent pain of the head, 

 characterized by an acute darting sensation, which is 

 generally felt in the temples or across the forehead ; 

 great sensibility to light and noise, extreme agitation 

 and restlessness, with the expression of sudden parox- 

 ysms of severe suffering ; along with these symptoms 

 there is great derangement of the digestive organs, 

 vomiting, and obstinate constipation, with a peculiar 

 morbid appearance of the evacuations. After these 

 symptoms have continued, the state of excitement ap. 

 pears to be succeeded by one of oppression ; there is a 

 considerable degree of coma and stupor, while the 

 pulse becomes preternaturally slow, the pupils dilated, 

 and the bowels still more torpid. The indications of 

 severe suffering are exchanged for those of insensibili- 

 ty, and at length a complete state of Paralysis super, 

 venes, and announces the near approaches of death. 

 The acute disease is seldom, if ever, found after the 

 age of puberty : it has been supposed, although, as we 

 think, without sufficient foundation, to be connected 

 with a tendency to Scrofula or Rickets ; it is, however, 

 hereditary, and therefore may be conceived to attach 

 to some original peculiarity in the structure of the 

 body. Its exciting causes are not well ascertained; 

 for although it may occasionally appear to follow an, 

 injury of the head, in most cases we are unable to trace 

 it to any thing of the kind. With respect to its proxi- 

 mate cause, we apprehend it must be regarded as ori- 

 ginating in on inflammatory action of the capillaries of 

 the brain, although probably of some specific kind, and 

 that the effusion of the fluid is the consequence of the 

 increased action of the vessels. In what consists the es- 

 sential difference between Hydrocephalus and Phreni. 

 tis is not well ascertained, whether upon a different set 

 of vessels, or upon a different action of the same ves- 

 sels ; the diseases are, however, in all respects very 

 different from each other, both with respect to their 



