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/hivering ; it is fixed both in refped to the intenfity and to 

 the feat of it ; and it is attended by fymptoms of fever, heat 

 of (kin, a quick and hard pulfe, third, &c. The kind of 

 pain, too, is defcribed as different : that of fpafm being ac- 

 companied by a fenfe of conttrittion ; while that of inflam- 

 mation is combined with a fenfe of itabbing or cutting, and 

 often of throbbing, burning, &c. 



Of thefe painful fpafmodic difeafes, the tetanus is the 

 moft formidable and fatal, in which all the voluntary mufcles 

 are rigidly contrafted, and the body and limbs ftiffly ex- 

 tended ; in ftort, an univerfal .cramp exifts, and the pain of 

 fuch a condition may be conceived, if we confider the fuf- 

 fering produced by a partial cramp. Sometimes the anta- 

 gonill mufcles of the back are mofl affefted, when the body 

 is rigidly bent backwards, like a bow, and rells upon the 

 back of the head and the heels, when it is called cpijlhctonos ; 

 and fometimes the anterior mufcles are moll contrafted, and 

 the bend is forwards, which is called emprqfthotonos. ( See 

 Tetanus.) The jaw is firmly locked in this complaint ; 

 and when the fpafm is confined to that part, it is called 

 Trismus, or locked-jaw ; which fee. Lefs formidable, 

 though very painful, fpafms occur in the mufcular coat of 

 the inteftines, conftituting colic ; or in that of the ftomach, 

 which is ufually called cramp In the Jlomach. In hyiterical 

 women, various cramps of thefe parts, and of the voluntary 

 mufcles, are liable to occur. The fit of fpafmodic eifthma 

 is principally produced by a fpafmodic contraftion of the 

 mufcular fibres about the larynx, and of the mufcles fub- 

 fervient to refpiration. 



In the pathological doftrines of Dr. Cullen relative to 

 the nature of fever, fpafm holds a diftinguiflied place, and is 

 confidered, indeed, as the eflence of fever. This hypo- 

 thetical fpafm was fuppofed by him to take place in the ex- 

 tremities of the arteries, and efpecially of thofe on the iurface 

 of the body, and to be demonftrated by the palencfs and 

 fhrinking of the external parts, and the fuppreflion of the 

 excretions, conftituting the cold fit ; and the hot fit, which 

 enfues, was believed to be an effort of the conftitution, a re- 

 aftion of the powers of hfe, and of the heart and arteries in 

 particular, to overcome and to relax this fpafmodic con- 

 ftriftion of the extreme veflels ; and this reaftion, or fever, 

 therefore, is fcen to continue until the relaxation of the 

 fpafm is effefted. ( See Firit Lines of Praft. of Phyfic, 

 par. 4c. et feq.) We have confuted this hypothefis at 

 confiderable length, in another place, (fee Feveh, Dr. 

 Cul/en's Theory,) and (hall not dwell upon it here. It is 

 altogether gratuitous, and uhfupported by fa£ls ; but it has 

 had confiderable influence in modern pradice. 



The caufes of fpafm may be reduced to two heads : de- 

 tility, and its concomitant irritability, in the whole fyftem, 

 or in particular organs, whic!i are, therefore, excited to in- 

 ordinate aftions by the ordinary ftimuli ; and irritation, that 

 is, the aftual operation of unufual and extraordinary ftimuli. 

 If thefe two caufes are combined, it is obvious that any ex- 

 citement, very little greater than ordinary, may produce 

 violent fpafm, or very inordinate adlions : whence it hap- 

 pens, that in conftitutions of particular irritability, very 

 flight irritations will occafionally produce the moit fevere 

 fpafmodic diforders. Thus the moit violent of all, the te- 

 tanus, is often occafioned by a fcratch or flight wound of 

 the fkin ; and the locked-jaw of new-born infanta appears to 

 originate in the irritation of the meconium retained in the 

 bowels. If the irritation of worms, and even morbid fecre- 

 tions, in the inteftines are fufficienl, in children, to produce 

 aftual convulfions, it need not be matter of furprife that 

 colic and cramp of the ftomach fliould be occafiooed, in 

 irritable adults, by undigelted food, and hot ftimulating 



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drinks. Very flight irritations, both external and internal, 

 excite fpafms in fuch habits ; even the punfture of a needle 

 (Mem. of the Med. Society of Lond. vol. ii.); and the 

 preffure of a tumour on a nerve, irritation from diftended 

 veffels, or bony excrefcences in the cranium, have all given 

 rife to fpafm. 



The chief remedies for fpafm are thofe which lelTen irrita- 

 bility, or which excite increafed power of aftion, or produce 

 a fudden and confiderable commotion, and thofe which re- 

 move the irritating caufe. The firft mentioned are ufually 

 called antifpafmodic medicines. The moit effeftual of thefe 

 are anodyne or narcotic fubftances, efpecially opium, hyof- 

 cyamus, and conium, which tend to lefTen the fenfibility 

 of the whole frame, and, therefore, to render it lefs liable 

 to be afted upon by irritants. The term antifpafmodic, 

 however, has been much applied to medicines of a llimulant 

 quahty, and efpecially to fome ftrong-fmelling fubftances, 

 which alone are much lefs efficacious in relieving fpafm than 

 the narcotics. Of the latter clafs are mufk, caflor, cam- 

 phor, and afTafcetida ; and of the more ftimulant clafs are 

 alcohol, xther, ammonia, the eflential oils, &c. Perhaps 

 the moft efficacious remedy is compofed by uniting the 

 latter with the anodynes ; for we know of no relief to vio- 

 lent fpafmodic pain mere effeftual than that produced by a 

 combination of laudanum with sether. Among the ftimu- 

 lants that are often remedial in cafes of fpafm, heat is not 

 the leaft important. Fomentations, hot water, a hot brick, 

 a bag of heated bran, S:c. applied externally near the feat 

 of fpafm, will often aflford fpeedy relief ; and a large draught 

 of hot water, taken as warm as the ftomach will bear it, has 

 produced a ilmilar good effeft. 



It is probably chiefly from the ftimulant effeft of violent 

 emotions that relief is obtained from them in fpafmodic 

 pain ; but fudden terror, or furprife, or apprehenfion, have 

 fucceeded in removing it. The influence of mental emo- 

 tions, indeed, both in producing and curing fpafm, and 

 even convulfions of the moft violent nature, is equally cu- 

 rious and inexplicable. See Imit.a.tion and Convul- 



SION.S. 



Where fpafm depends upon irritation, the caufe muft be 

 inveftigated, and, if poffible, removed by appropriate re- 

 medies, if within their reach. Thus clearing the bowels, 

 where there i^ an obvious irritation from worms, undigefted 

 aliment, morbid bile, &c. will fometimes entirely remove 

 the fpafms. In order to prevent a recurrence, by in- 

 vigorating the fyftem, and thus leflening its irritabihty, 

 after the ipafms have been fubdued, it is often neceffary to 

 refort to the ufe of tonic remedies. Of thefe a great va- 

 riety has been employed, at different periods, with various 

 reputation. Cold bathing, the ufe of the (hower-bath, or 

 tepid bathing, as at Buxton, may be confidered as one of 

 the moft efleftu.il tonics ; after which may be mentioned 

 fome of the metallic tonics, fuch as the various preparations 

 of iron, copper, zinc, and filver, all of which are often 

 efficient remedies. The cinchona, columba, cafcarilla, gen- 

 tian, and other vegetable aromatic bitters, with or without 

 an addition of the mineral acids, have alfo their value as 

 tonics, and contribute to reilore vigour and lefFen irritability 

 in debilitated habits. 



SPASMODIC, fomething belonging to a fpafm, or 

 convulfion ; as fpafmodic medicine, fpafmodic difeafe, &c. 



Hunger, according to M. Hecquet, is a fpafmodic affec- 

 tion of the fibres of the ftomach ; unlefs it arife from the 

 fibres being too much moiftened by the liquors thereof, fo 

 as to incapacitate them for their office See Hunger. 



SPAT, a terra ufed by the fifhermen for the fpawn of 

 oyfters, which is caft, iu the month of May. 



X SPATA- 



