148 
MEDICINE. 
bolh in theory and practice, ought always to 
be retained in the memory ; this is, that the 
spasmodic or convulsive state of parts inva- 
riably implies debility. To act irregularly, 
is in all instances to act with deficient vigour; 
for the sum total of these disorderly move- 
ments, performed in a given time, will not 
amount to the quantum of power displayed 
in the same time by healthy and. steady ac- 
tion. This fact appears to be a sufficient re- 
futation of Dr. Darwin’s hypothesis, that 
convulsions are voluntary exertions of the 
muscles to relieve pain, even if we concede 
to this author, that the strict definition of vo- 
lition ought to be “the active state of the 
sensorial faculty in producing motion, in 
consequence of desire or aversion, whether 
we have the power of restraining that action 
or not;” for, according to this principle, con- 
vulsion should bean actual and positive in- 
crease of vigour, which it is not; for while 
the utmost agitation is carrying on in the con- 
vulsed member or organ, if a due quantity 
of stimulus be thrown in, excitement will im- 
mediately follow, and in consequence of this 
excitement, quiescence and firmness; in the 
same manner, but upon a different principle, 
as tightening the sail of a. ship arrests its vi- 
bratory motions, but increases its actual and 
integral force. 
If it appear difficult to conceive why a 
stimulant or exciting agent should produce 
this debilitated action, we must refer to the 
invariable law of living existence, that exci- 
tation carried beyond a certain point, is im- 
mediately productive of indirect debility : 
thus when the galvanist convulses the leg of 
a frog, he throws in more of stimulus than is 
adapted to the fibrous excitability of the or- 
gan in question; he exhausts the irritability 
of the part; and the convulsion that follows 
is the consequence of such exhaustion, ex- 
actly upon the same principle that half a pint 
of wine shall give steadiness to the longue, 
and firmness to the step, while a quart of this 
stimulus, taken in the same time, shall pro- 
duce a temporary paralysis of the limbs, and 
render the speech faultering and inarticu- 
late. 
We have indiscriminately employed in 
the above observations, the terms spasm and 
convulsion. As it relates tq the excitement, 
they are virtually the same states ; and thus, 
whether convulsion or spasm, that is, whe- 
ther rigid immoveable contraction, or rapid 
alternations of contraction and relaxation, fol- 
low the debilitating causes upon which they 
depend, in one sense they are scarcely to be 
distinguished; the difference of physiognomy 
which they assume appears to have depend- 
ence upon the complicated associations of 
living actions, which are but little under- 
stood, and both in theory and practice too 
much disregarded. 
From the above remarks we hope it lias 
been rendered evident, that in attempting to 
overcome a spasm or convulsion, the leading 
principle of cure must be stimulative ; the 
disease in question, however originating, in- 
variably implying debility, or more properly, 
perhaps, deficiency of excitement. 
Sect. I. Spasmodic affections in the ani- 
mal Junctions. 
Genus I. Tetanus. A spasmodic rigi- 
dity of a great part of the body: in some in- 
stances it ts drawn violently backward,, at 
others forwards, and in both cases the disease 
is generally followed or attended by .trismus 
or lock-jaw ; these symptoms may last with 
greater or inferior violence from twenty-four 
hours to a month or more. 
The immediately exciting causes of teta- 
nus are, wounds or pricks of tendons ; the 
sudden application of cold after extreme 
heat; great intemperance, or other vices: 
the disease may likewise be consequent upon 
viscid mucus, worms, and other irritating sub- 
stances, in the alimentary passages. 
M. J\l. As in fevers, it is highly necessary 
to preserve thealimentary canal free from cot- 
luvies, in order that the return of dueaudor- 
derly excitement may not be prevented by 
this cause; so is it especially necessary in 
nervous and spasmodic affections carefully to 
keep in mind the incalculable importance of 
this principle. Indeed, among the actually 
exciting causes of the malady now under no- 
tice, these intestinal crudities are perhaps the 
most frequent. Let the practitioner then, in 
every spasmodic disorder, pay solicitous at- 
tention to the condition of the stomach and 
bowels: it is in these organs “ that the 
archer may be seated,” in whatever direc- 
tions he may send out his arrows. It is not, 
let it he as carefully remembered, by the act 
of evacuation in reducing the system, that 
either emetics or purgatives operate thus be- 
neficially ; but by the disposition that a free- 
dom in the 'first passages favours to the due 
susceptibility of the exciting powers, on the 
agency of which the return of health de- 
pends. Indeed, as far as either purging or 
vomiting are in themselves immediately in- 
strumental in dissolving spasm, as it has been 
expressed, independantly of the source just 
referred to, it is by virtue of the agitation 
and stimulus, not by the discharge of which 
they are productive. (See Infancy.) 
Emetics, cathartics with calomel. Pouring 
large quantities of cold water over the body 
during the spasm, in order forcibly to sever 
the catenated motions by which it is consti- 
tuted. Warm bathing. Very large quanti- 
ties of opium. More than four hundred 
drops of the tincture have been given in some 
violent tetanic affections in the course of 
twenty-four hours, and without producing 
any intoxicating effect. Other antispasmo- 
dic medicines. Mercury. If the spasm has 
originated from a lacerated or punctured ten- 
don, divide it freely, and produce pain and 
inflammation. 
Genus II. Convulsio, convulsions. On 
the cause and treatment of these, vve need 
not enlarge, after the remarks we have intro- 
duced on the nature, predisposing and ex- 
citing causes, of convulsive and spasmodic 
disorders in general. 
Genus III. Chorea, St. Vitus’s dance. 
Symptoms. Convulsive agitations of the 
limbs, in general almost confined to one side 
of the body. When the patient attempts to 
walk, he produces involuntary gesticula- 
tions. * 
M. M, Emetics, cathartics with calomel; 
anthelmintics ; bark, steel, and other tonics ; 
electricity, galvanism, tepid bathiug, sea- 
bathing. 
Genus IV. Raphania, contractions in the 
joints. 
Symptoms, Spastic contractions of the 
joints, with excruciating pain, and coivulsivc 
motions, returning periodically, and continu- 1 
ing for many days. It appears to be a spe- 
cies of rheumatism. , 
M. M. Purges, followed by tonics; mer- \ 
cury combined with opium. 
Genus V. Epilepsia, epilepsy. Violent '] 
convulsions of the muscles, attended with j 
sleep. 
Epilepsy in Us nature and causes appears ; 
to hold a kind of intermediate situat.on be- 
tween apoplexy and convulsion; it las the 
sudden fall and the sopor of the one, with the 
irregular muscular action of the other. Epi- i 
lepsy, in a greater or less degree, is a disease j 
of extreme frequency: indeed, all the con- 
vulsions of children may be called epileptic, j 
In its full and formidable shape, it is not so 
: frequently met with as several other diseases. 
I A physician, however, may denominate, with : 
i propriety, all fits epileptic, of which alternate 3 
or combined convulsions and sleep constitute 
the characters, especially if these are connect- j 
ed in any degree with an increased action of 
the salivary glands. 
M. M. Epileptic fits are sometimes conge- 
nital,. hereditary, and depend upon seme oc- 
cult state of the nervous system. In these 
eases the disorder is generally irremediable. 
All that can be done by art is merely to as- , 
certain, and endeavour, if possible, to obviate, j 
the exciting causes of the disease ; and during 
the paroxysm to loosen every bandage about 
the neck and head, preserve the apartment 
in which the fall is made as airy as possible,] 
and be careful that the patient do net inflict 
injury upon himself by the violence of bis. 
agitation. In some cases, indeed, the indi -> \ 
v ideal can obviate the full formation of the 3 
paroxysm by tying a ligature round the limb 
in which the sensation threatening the attack. I 
is perceived, between the point at w hich such 
sensation commences and the brain. This ^ 
sensation constitutes what is called the epi- ] 
leptic aura : its abstract cause is obscure; but ; 
no less' so than the phenomena of spasm ini 
general. 
In treating the complaint, particular atten- . 
tion is to be given to the predisposing and 
exciting cause or causes, which are extremely ] 
numerous; such as youthful intemperance, in- 
dulgence in secret vices, mental passions and! 
affections, imitation of other epileptics, lively! 
recollections of previous impressions, repel leal 
eruptions -or discharges, sudden alternations'! 
oi the extremes of temperature, unpleasant! 
odours, and, as by T far the most common j 
source of those epileptic fits which scarcely ! 
amount to absolute epilepsy, worms. These! 
causes must all necessarily be removed before! 
the physician can have the least prospect of 
overcoming the disease. Emetics, cathartics,* 
with calomel; anthelmintics: suddenly dis-| 
sever the chain ot associations, by plunging! 
the patient in the cold bath, or dashing with j 
violence cold water over his naked body. ] 
Induce a new disease, as the itch ; a plan j 
which Dr. Darwin adopted with success ini 
the treatment of St. Vitus’s dance, with which! 
the present has a great affinity. Patients have! 
likewise been cured ot epilepsy, by the acci- ■ 
dental occurrence of a quartan ague. These ] 
are instructive cases to the reflecting and spe- 
culative. Tonics. Galvanism. By this newly j 
discovered source of nervous excitation, the * 
writer oi this article recollects to have wit- 
