MEDICINE. 



Pwticr. a reference to the general slate of the functions, and 

 S ~"Y" 1 ' some analogies which are too often very obscure and 

 uncertain. The state of the bowels is one of the first 

 things to be attended to ; and, in children, we are of- 

 ten able to remove very formidable attacks of the dis- 

 ease by completely evacuating the alimentary canal. 

 Jt is generally the custom to in-ike calomel one of the 

 principal ingredients in the purgatives that are admini- 

 stered in Epilepsy, '"! ' l ' s probably used with more 

 advantage when united to jalap, scammony, colocynth, 

 or some of the drastic medicines of this description. 

 When the digestive organs seem to suffer from acidity 

 and flatulence, or from any other particular symptom, 

 we are to endeavour to remove them by the appropriate 

 remedies; and when there is a general weakness of the 

 digestive organs, we employ, according to circumstances, 

 stimulants, stomachics, and tonics. It has been pro- 

 posed, in those cases where the fit is preceded by the 

 aura, to cut off the communication between the part 

 whence the peculiar sensation proceeds and the brain, 

 by compressing the nerve, or even dividing it ; but it 

 is doubtful how far this practice has been attended with 

 success, or how far we ought to expect any benefit 

 to be derived from it. When there is no obvious ex- 

 citing cause, and when the different organic functions 

 do not exhibit any evident irregularity, we can have 

 but a faint prospect of removing the disease ; and our 

 practice must, for the most part, proceed entirely upon 

 empirical principles. In this, as in all other similar 

 cases, we find, that in proportion to the obscurity of the 

 complaint, and the real difficulty which there is in re- 

 lieving it, so is the number of infallible remedies that 

 are held out to the hopes and fears of the unfortunate 

 sufferers. The remedies that have been proposed for 

 epilepsy under this form of the disease may be divided 

 into three classes, those that are called antispasmodics, 

 generally possessing some property that powerfully af- 

 fects the external senses ; tonics ; and a miscellaneous 

 description of remedies, which can only be referred to 

 their power of acting upon the imagination. Some of 

 the principal antispasmodics are ether, valerian, castor, 

 and musk, to which it has been the custom to add 

 opium, and various other sedatives. In certain cases of 

 convulsions, we conceive it not impossible that benefit 

 may have been derived from these substances ; but 

 we have no conception that they can have any great 

 power over proper Epilepsy. The second division of 

 remedies, the tonics, although of very problematical 

 operation, possess more claim upon attention. Of these 

 the most powerful are certain metallic salts, as the ni- 

 trate of silver, cuprum ammoniatum, the oxide of zinc, 

 and various salts of iron and arsenic. In what manner 

 these substances act, and for what particular varieties 

 of the disease, or states of the system, they are each of 

 them more particularly serviceable, are points on which 

 we have little certain knowledge. Vegetable tonics are 

 among the remedies usually prescribed for Epilepsy ; 

 of these cinchona may be supposed to supersede all the 

 rest, although, by way of giving variety to our prescrip- 

 tions, we may substitute other articles of the same de- 

 scription, or may occasionally give them in combina- 

 tion. We have mentioned worms among the exciting 

 causes of Epilepsy, and this appears to be the case 

 more particularly with the tape-worm. As the oil of 

 turpentine seems to act very powerfully upon these 

 animals, we may be fairly allowed to try the effect of 

 turpentine in all cases of Epilepsy that havs.- baffled our 

 other, means, even when we have no evidence of the 



existence of the tacnia, more especially as the indications Practice, 

 of its presence in the intestines are not always very ob- "Y"""' 

 vious. 



Nearly allied to Epilepsy, and perhaps differing from Convul. 

 it chiefly in degree, are the convulsions with which sions - 

 children are so frequently attacked, more especially 

 about the period of dentition. These affections are ge- 

 nerally removed as the exciting cause ceases to operate, 

 and are not productive of any permanent injury to the 

 constitution. It is, however, necessary to use the ap-* 

 propriate means for facilitating the passage of the teeth 

 through the membrane that covers them ; while, at the 

 same time, it will be desirable to evacuate the bowels 

 completely, and to be extremely guarded with respect 

 to the diet. The paroxysm is supposed to be shortened 

 or relieved by immersing the patient in the warm bath ; 

 and it is a remedy which may be always employed with 

 safety, if not with advantage. 



SECT. X. Hysteria. Hysteric Disease. 



Hysteria is a disease of so multifarious an aspect, Hysteria. 

 which exists under such a variety of forms, differs so 

 much in its violence at different times, and is so pecu- 

 liar in its nature and in its effects upon the animal eco- 

 nomy, that we feel some difficulty in giving a concise 

 and summary account of it. 



It usually occurs in fits or paroxysms, which consi- 

 derably resemble those of Epilepsy, except that they are 

 less violent, and that the consciousness is not altogether 

 lost ; but there is the same convulsive exertion of the 

 limbs, and the sensations and mental faculties, although 

 not entirely suspended, are much disordered and per- 

 verted. There is likewise in Hysteria a symptom which 

 may be conceived to bear some analogy to the aura epi- 

 leptica, which has obtained the name of the globus hys- 

 tericus. It commences with a peculiar feeling of pain 

 and distention in some part of the abdomen, which gra- 

 dually rises up the course of the intestinal canal until it 

 reaches the stomach, and, finally, the upper part of the 

 throat, where it remains stationary, and seems to threat- 

 en immediate suffocation. The convulsive affections 

 now come on, and are attended with faintness and par- 

 tial insensibility, while the patient laughs and cries al- 

 ternately, exhibiting almost an appearance of delirium 

 or fatuity, until the paroxysm is terminated by an 

 eructation of flatus, to which succeeds a copious dis- 

 charge of pale urine, and sometimes a degree of stupor 

 and drowsiness. 



The nature of the convulsions, as well as of the other 

 symptoms, varies in all possible ways. Sometimes the 

 limbs are rigidly fixed in one position ; at other times 

 they are violently agitated : occasionally there is a ge- 

 neral stupor approaching to coma ; at other times pains 

 are felt, which are so violent as to cause the patient to 

 utter the most horrid screams. 



There is something very mysterious about the excit- 

 ing causes of Hysteria. It appears, in many cases, to be 

 merely a mental affection, induced by. violent passions 

 or strong emotions ; and so much is this the case, that 

 the patient is certainly able, by voluntary exertion, t9 

 prevent the accession of the disease, which, if it had 

 been suffered to proceed in its usual course, would have 

 assumed the formidable appearance that has been de- 

 scribed above. The symptoms are frequently induced 

 by a kind of imitation, where the sight of a patient la- 

 bouring under the disease will bring a similar disease 

 on the bye-standers. These facts have led some per-. 



