PATHOLOGY. 
nerves, even when plethora is not the caufe of the exci¬ 
tation, leeching or cupping (liould be alfo reforted to in 
all fevere cafes. If the pain continues unabated, bella¬ 
donna orconium may often be prefcribed with advantage; 
and we give preference to the former, as being more pow¬ 
erful. 
Many cafes of Neuralgia have been cured by dividing 
the difeafed nerve. Neverthelefs it has fo often failed 
entirely, in confequence of the intenfity of fome nervous 
fibril which has caufed the irritation ; its effects have 
been fo little permanent, and the operation itfelf fo 
painful ; that it is of all others the laft furgical operation 
we tliould undertake. It feems that in neuralgia, as in 
nervous irritation in general, the irritant being re¬ 
moved, the difeafe ftill continues from fome internal 
change having taken place in the nerve itfelf. It is in 
fuch cafes that arfenic is a ufeful remedy. The life of 
this powerful mineral has however lately been fuperfeded 
by the carbonate of iron introduced by Mr. Hutchinfon: 
it is given in dofes of a half drachm or a drachm twice or 
three times a-day. It is in this advanced and habit.ual 
Huge of the difeafe that electricity fometimes performs a 
cure. 
Genus III. Clonus, [i. e. agitation, perturbation ; from 
xXovw, to (hake.] Convullive fpafm. Generic characters 
—Forcible agitation of one or more mufcles in fudden 
and irregular fnatches. There are fix fpecies. 
1. Clonus fingultus, hiccough : convulfive catch of 
the refpiratory mufcles, with l'onorous infpiration; ite¬ 
rated at lliort intervals. 
This difeafe is merely fympathetic of diftant irritation. 
Flatulence of the Itomach, difeafe of the liver, or indeed 
of any of the vifcera contiguous to or fituated near the 
diaphragm, will caufe the fymptom. It is often found 
to attend fevere operations; and is well known as a fa¬ 
tal indication in mortifications. Otherwife it may fome¬ 
times exilt for days without injury to the patient. — It is 
fometimes periodic. Bonet, Sepulchr. lib. iii. Obf. 4.— 
Sometimes chronic ; and has continued three months. 
Schenck, lib. iii:—Four years. Bartholin. Hilt. Anat. 
Cent. ii. hilt. 4.—Twenty-four years. Alberti, Differt. 
Cafus fingultus chronici. Hall, 1743. See alfo Hunter 
on Blood, p. 410. 
2. Clonus (ternutatio, fneezing: irritation of the mem¬ 
brane of the noltrils, producing fudden, violent, and fo- 
norous, expiration through theirchannel.-—At times peri¬ 
odic. Brejl. Snmmlung. 1725. ii. 82. Eph. Nat. Cur. Cent. V. 
Obf. 19.—Of long continuance. Horftii Opp. ii. 298.— 
Three hundred times in a paroxyfm. Eph. Nut. Cur. 
ann. iii. obf. 138. It is particularly induced by phlogo- 
fis of the mucous expanfion of the air-paffages. Hence 
its frequency in mealies, catarrh, &c. 
3. Clonus palpitatio, palpitation : irregular and vibra¬ 
tory motion of the heart or arteries. There are three 
varieties; the moft frequent of which is, 
os. P. cordis, or palpitation of the heart alone.—The 
palpitation has fometimes been fonorous. Cajiell (P. V.) 
Exercit. et eftedt. thoracis. Tr. IX. Tolofa, 1616. A 
Vega, de Arte Med. So violent as to dillocate the ribs. 
Horjl. ii. 137 . *39*—To break them. Schenck. Obf.215. 
ex Fernelio. Vidorius, Confil. n. 97. In like manner 
the humerus has been diflocated by a convulfion-fit. 
The moft important circumftance to be underftood in 
regard to palpitation of the heart, is whether it depends 
on nervous irritation or organic alterations. Its nature, 
when arifing from the former caufe, the reader will find 
difeuffed under Dyjpepfu; and, when from the latter, 
under Carditis. The two following varieties appear to 
anfwer to the difeafe we have deferibed under the title of 
Arteritis, p. 246. 
/ 3 . P. arteriofa; of the arteries alone. 
y. P. complicata; extending from the heart more or 
lefs through the courfe of the arteries. 
4. Clonus nidfitatio, twinkling of the eye-lids: rapid 
arid vibratory motion of the eye-lids. 
309 
5. Clonus fubfultus, twitching of the tendons: fudden 
and fubfultory elevations of the tendons. This feems to 
arife from a deficient fupply of nervous powers to the 
mufcles, or at leaft a fupply fuddenly applied and ex- 
haufted. It is found in moft cafes when the nerves have 
been much weakened, as after long fatigue, fevers, and 
towards the approach of death. 
6. Clonus pandiculatio: tranfient elongation of the 
extenfor mufcles, with deep infpiration and fenfe of laf- 
fitude. Two varieties. 
a.. P. maxiilarum, yawning or gaping. 
( 3 . P. artuum, ftretching of the limbs, frequently 
noted as a fymptom in fatigue, hyfterics, reftlelfnels, 
dyfpepfy, and the acceftion of fevers. As an idiopathic 
affedtion, acquired chiefly from a habit of idlenefs. 
Genus IV. Synclonus, [from a-w, together, and clonus.] 
General fpafm. Generic characters—Tremulous, fimul- 
taneous, and chronic, agitation of various mufcles, ef- 
pecially when excited by the will. There are four fpe¬ 
cies. 
1. Synclonus tremor, trembling : Ample, tremulous 
agitation of the head, limbs, or both; moftly on volun¬ 
tary motion. 
2. Synclonus chorea, St. Vitus’s dance: alternately 
tremulous and jerking motion of the face, legs, and 
arms, efpecially when voluntarily called into adtion ; 
refembling the grimaces and geftures of buffoons; ufu- 
ally appearing before puberty. 
According to Horftius, the name of St. Vitus’s dance 
was given to this difeafe, or more probably to a difeafe 
pofleffing fome refemblance to it, in confequence of the 
cure produced on certain women of difordered mind upon 
their paying a vifit to the chapel of St. Vitus near Uim, 
and exerciling themfelves in dancing from morning to 
night, or till they became exhaufted. He adds, that the 
difeafe returned annually, and was annually removed by 
the fame means. But the French give to another faint 
the honour of exciting or of curing this difeafe: they 
call it Dance de Saint Guy. 
Dr. Hamilton, in his work on Purgative Medicines, 
gives the following excellent hiltory of this difeafe. 
“ Chorea Sandti Viti attacks boys and girls indiferimi- 
nately 5 and thofe chiefly who are of a weak conftitution, 
or whole natural good health and vigour have been im¬ 
paired by confinement, or by the ufe of fcanty or im¬ 
proper nouriffiment. It appears moft commonly from 
the eighth to the fourteenth year. I faw it in two young 
women, who were from fixteen to eighteen years of age. 
The approaches of chorea are flow. A variable and of¬ 
ten a ravenous appetite, lofs of ufual vivacity and play- 
fulnefs, a fwelling and hardnefs of the lower belly in 
moft cafes, in fome a lank and foft belly, and, in general, 
a conftipated ftate of the bowels, aggravated as the dif- 
tafe advances, and flight irregular involuntary motions 
of different mufcles, particularly of thofe of the face, 
which are thought to be the effedt of irritation, precede 
the more violent convulfive motions, which now attrail 
the attention of the friends of the patient. Thefe con¬ 
vulfive motions vary. The mufcles of the extremities 
and of the face, thofe moving the lower jaw, the head, 
and the trunk of the body, are at different times, and in 
different inftances, affedted by it. In this ftate the pa¬ 
tient does not walk lteadily ; his gait refembles a j ump- 
ing or ftarting; he fometimes cannot walk, and feems 
palfied ; he cannot perform the common and neceffary 
motions with the affedted arms. This convulfive motion 
is more or lefs violent, and is conftant, except during 
fleep, when, in moft inftances, it ceafes altogether. Al¬ 
though different mufcles are fometimes fucceflively con- 
vulfed, yet, in general, the mufcles affedted in the early' 
part of the difeafe remain fo during the courfe of it. 
Articulation is now impeded, and is frequently com¬ 
pletely fufpended. Deglutition is alfo occafionally per¬ 
formed with difficulty. The eye lofes its luftre and in¬ 
telligence ; the countenance is pale, and expreffive of 
vacancy 
