M E D I C I N E. 



13 



rymptom* and their treatment. The connexion which 

 we observe between the state of the alimentary canal 

 and the bead is difficult to explain ; and what increases 

 the difficulty is. that symptoms wnich very nearly re- 

 semble those of HvJiucauhuIni not unfrequently exist, 

 where it would appear that the bead ia not actually 

 the umt of iliisssr. arid which are referred to the effect 

 of worms. But every thing that respects the existence 

 of worms, or the aympteuia which they produce, ia 

 re, and ia so much involved in empiricism, 



that we are always at a loss to deauminu what de- 

 gree of credit is to be attacked to the statements that 

 are made on Uus subject L'pon the whole, we are 

 disposed to consider the peculiar state of the bowels 

 M partly the cause and partly the effect of the condi- 

 tion of the brain, and, a* far as regards the point of 

 practice, whichever i* actually the primary disease, 

 the plan of treatment ia not materially different. 



The cure of Hydroeephalot ia to be attcmpted'by di- 

 minishipg the over-excitement of the veaarla of the 

 brain, ana by restoring the action of the elementary 

 canal Tba feat ia 10 be attempted by 



M M far M the 'strength of the patient, or the other 

 i connected with the case, will admit, but 

 h U eidom * factual mil* as it be carried to an ex- 

 which would not be . 



Purgatives are to be 



until the 

 Mara natural aspect, and it 



* of relief, re .p,.y bltrr 



M ' 



; wr 

 eagerness to 

 awf*rmf*of the patient, 

 tuc?e. disturb the abort 



Cbi 



SICT. IX. Spaimi Eaiitptia. Epilepsy. 



Practice. 



After the two first orders of the Neuroses, including Epilepsy. 

 the diseases that are characterised respectively by an 

 increase, and by a diminution of tlie nervous power, 

 we come to the third order, where it is exercised in 

 an irregular manner ; to these we give the name of 

 Spans i. We derive the genera of the Spasmi from the 

 relation which the part affected bears to the exercise of 

 volition, into diseases of the voluntary muscles, the in. 

 voluntary rausda*, and those which possess a middle 

 rank between the two. One of the most important of 

 the species belonging to the first genus U Epilepsy. 

 This disease may be shortly defined a sudden accession 

 of violent convulsions of the whole body, with a loss 

 of sensation aad voluntary motion. Each' attack con- 

 tinues for, comparatively, a short period only, when 

 the patient, recovers his usual state of body and mind, 

 and experience* a degree of stupor and drowsiness, but 

 without any recollection of what has passed. Al- 

 though, however, the effect of a single fit is not pro. 

 ductive of any visible change upon the animal economy, 

 yet, when the disease recun frequently, and the attack* 

 are violent, the function* that depend upon the nervous 

 yktam gradually become weakened, and ultimately 

 much deranged, so as to bring on imbecility of the men- 

 tal fucaJrie*. and an imperfect power over the voluntary 

 muscles. It ha* been usual to divide Kpilepsy into 

 ' etic ; the latter being supposed 



'-. .v I thr 



which we have now been de- 

 r . which i* altogether of a very acute kind, there 

 ia a chronic Hydrorenhalu*. where the disease < 

 on so slowly a* scarcely to produce any general 

 tion of the system. The bones of the .kull in 



give way to the preasure of the fluid 

 fin the inferior part* of the bra n. and the head 

 d to a degree which would have been 

 uible with the exercise of any of the 

 or indeed with the actual continuance of 

 life. Tbi* complaint U irremediable, or. if any relief 

 obtained, it must be by hanrding an operation 

 M little advantage, that nothing but 

 i state of existence in which the patient i* 

 by the disease could sanction the experi- 



likewiat 



,1.1 Mk*e> sV^ mm4a4*B> ^*4 ftw *sV ^^ . _! 



IwW Wen FvMWum M Htmj W HUJwCuwWW WT Maw VOVmV 



--- -_, |__ ___ - 



f *w WT lT 



':. ! !. 



every means will be unavailing, but 

 duty to attempt what oueta the moat probable ehance 

 of relief, and acMsng the remedies which have been re- 

 commended at this period ia u>uuii, given so aa to 

 produce its speeinc cwect upon the system. Mow far 

 we are ttitl to u*e blood-letting ia a question which 



1^. *- ' k. , l_ - ---- . -J- --- - : ;_;j 



. >\i \ N ' J T \ . - - , . : . ! |,|'! '!!'* . i! 



of purgative* will still be 



i'. i^' i." . . KI >',r 



maoscines, we aggravate the 

 and, by an id-directed f lici- 

 period of his exirt> 



obvious exciting caute ; but we 

 t there ia any real foundation (or 

 Una division ; it ia fact amounts to no more than that 

 ia MM* eases we are able to detect the exciting cause, 

 while in others we an ignorant of it. The exciting 

 appear to be very various, originating from a 

 great number of different circumstance*, that bear dif- 

 ferent relations to each other, and all produce nearly the 

 same symptoms. Tkoat that generally fall under our 

 observations are. 1st, Injury and malconformation of 

 the skull, or the parts included in it ; Sd, Certain statea 

 of the alimentary cannl, particularly worms, or that 

 mm bid condition of their contents which is supposed 

 to be favourable to the production of the*e parasitical 

 animals ; 3d, The peculiar irritation caused by teething; 

 4th, Violent mental emotions, especially surprise and 

 terror; 5th. Kepeaud intoxication ; and, lastly, an he- 

 reditary tendency in the constitution, which we are 

 not able to describe or define, although we can have 

 Kale doubt of ha existence. The invasion of Epilepsy 

 ia sometime* so sudden that the patient has not the 

 least warning of its approach but falU down at once 

 in a stale of complete insensibility, at other times there 

 ia a feeling of mjpreasion in the head, with vertigo, 

 dimneas ofsight, and confusion of thought, and occa- 

 sionally there is a peculiar sensation of cul<l, hi< h ha* 

 be. n itamrd the aura eptleptka, passing up from some 

 part of the body to the head, when the complete pa- 

 roxysm cornea on. 



Aa the diiease set ins to originate from such a varie- TraatmcDi. 

 ty of cau*ea, so Ha prognonis is extremely uncertain, 

 and its cure has been attempted by a great variety of 

 Mas When the exciting cu r i clrarly ascertained, 

 we. of course, tlirrct ur whole attention to the rcmo- 

 vil itit; . ' Mr luccese of our attempt* in this way 

 inu-t entirely drprnd upon the degree in which this 

 can be accompli l>r<l N hen the cause b not obvious, 

 we have but little to guide ni in our operations, except 



