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dangerous is the disease, particularly if the time, administer aloetic cathartics; after vital functions be much affected; sonie- the plethoric state of the system is removed, times, although not very frequently, a sin. the care of the disease will be effected by gle violent paroxysm cuts off the patient: antispasmodics: when the disease seems to epilepsy sometimes goes off at the age of arise in consequence of a debilitated state puberty, or on the appearance of the men- of the system, it must be strengthened by ses; an intermittent fever, or a cntaneous cold-bathing, exercise, change of air, a eruption often removes the disease. nourishing diet, tonics, and anti-spasino
Treatment. Blood-letting will sometimes dics; the most suitable tonics are, bark, be of service in the paroxysm, if the disease oxide of arsenic, ammoniate of copper, sulhas not been of long continuance, and the phate of copper, oxide of zinc and chalypatient is in a plethoric state ; in general, beates: the antispasmodics in most general however, it is more advisable pot to take use are, oil of cajeput (melaleuca leucadenaway blood, but to trust to less debilitating dron), æther, musk, digitalis, stramonium, remedies ; immediately the patient is at. belladonna or hyoscyamus, lunar caustic and tacked with a fit, we must endeavour, as far opium, which last is most assuredly the best 25 possible, to prevent his receiving any in and most efficacious antispasinodic, it should jury from the violent agitation of his body, be administered in doses, proportioned to he ought, therefore, to be put into a bed, the age and constitution of the patient, a with his head raised, and to have any pres- short time before the expected return of sure, occasioned by ligatures about his neck, the paroxysm, the opium must be repeated instantly removed; stimulants should be at proper intervals, and it will be necessary applied to the nostrils, as errbines, or vola- to increase the dose in a gradual manner, in tiles, as the spiritus ammoniæ compositus, proportion to the violence or frequent re. the spiritus ammoniæ succinatus, &c. and currence of the fits : whatever antispasmo. the spine should be rubbed with the æther, dic is employed, it will be indispensably re. or with the linimentum ammoniæ fortius, or quisite never to allow its effects to cease on oil of turpentine, and they will be more the system, and to continue its use for serviceable, if combined with stimulants, as months, or even a year or two after the viothe oil of amber, or the tincture of cantha- lence of the disease is overcome, and the rides; it will be proper to administer opiates, fits have ceased, in order to establish a new and other anti-spasmodics, by clyster, par- habit in the system, and it should, on no acticularly musk, and valerian. In the inter- count, be left off all at once, but the dose missions we are to attempt the radical cure should be gradually dimninished, as the fits of the disease; when the disease is sympto- are very apt to return, on the disconmatic of some primary affection, we must, tinuance of the medicine, with increased by a particular attention to the attending violence and danger: it will not be improsymptoms, endeavour to discover the na. per to remark, that antispasmodics are em. ture of that affection; and if we succeed ployed with most advantage, a short time in removing the primary affection, by the previous to the expected recurrence of the proper means adapted to its cause, the epi. paroxysm, and when the fits recur during leptic attacks will cease of course; the aura sleep, a full dose of an opiate should be epileptica has been removed by a tight given at hed-time; the application of a bandage being made round the limb, just cataplasm, formed chiefly of tobacco, to above the part from which that sensation the scrobiculus cordis, about half an hour appears to proceed; we must direct the pa- before the expected return of the pa. tient to carefully avoid the occasional roxysm, has sometimes prevented it, and causes which are within his reach, and the this practice, repeated several successive predisposition must be corrected, as far as days, at the expected periods, has destroyed lies in our power. When the disease is the diseased catenation, and effected a peridiopathic, and appears to depend upon a manent cure: if the disease appears .to . plethoric state of the system, that must be arise from sympathy, some instrument of removed or prevented by moderate exer- terror should be kept in readiness, as the cise, an abstemious diet, and issues, or se- actual cautery, or something that will intons, if the disease appear to arise from any spire horror, which will very frequently suppressed discharge, in particolar the hæ. prevent the fits: should derangement of morrbois, leechies slould be applied to the the primæ viæ, worms, dentition, or any hæmorrboidal vessels, fomentations should other obvious exciting cause, be the means be employed, and we should, at the same of occasioning the disease, it must be re
moved by laxatives, and other remedies times, during the paroxysm, somewhat adapted to its causes, and as the disease so Aushed and turgid, more commonly, howfrequently, in part, arises from the first ever, it is pale and shrunk: asthma is very mentioned canse, occasional emetics and frequently an hereditary disease, it does not gentle cathartics will be proper, in order to very commonly appear before the time of obviate any accumulation of irritating mat. puberty, and chiefly affects the male sex; ter in the stomach and intestines: when the it is most liable to return in hot weather, disease proves obstinate, especially in those this, however, is not always the case: the who are advanced in life, or have been in- paroxysm is often preceded by lassitude, temperate in the use of fermented, spi. torpor, drowsiness, a sense of weight or rituous, or distilled liquors, we have every pain of the head, and symptoms of dys. reason to suspect some derangement in the pepsia. hepatic system; in which case it will be re- Treatment. In the paroxysm, if the paquisite to employ the hydrargyrus, to a tient be young, and of a plethoric babit, greater or less extent, in proportion to its blood-letting will be often of service, espeeffects on the disease, and it will, if the pa- cially, if employed in the early periods of tient is not in a very debilitated state, the disease, but if it have been of long consometimes be of essential service to push tinuance, it is generally hurtful, but cupping mercury so far as to affect the mouth. A between the shoulders is often of consideratotal change of habit and climate may also
ble service; gentle laxatives and clysters frequently be prescribed with great benefit. should be employed, at proper intervals, so
Asthmu. The paroxysms of this disease as to keep the bowels regular; gentle emevery frequently commence during or after tics should on no account be dispensed the tirst sleep, with a sense of tightness and with, and where a paroxysm is expected to stricture across the chest, and a feeling of occur in the course of the night, an emetic uneasy oppression in the lungs, impeding exhibited in the evening will generally prerespiration; there is either no cough pre- vent it: antispasmodics should be adminisent, or it is not attended with any expecto. stered, as opium, asafoetida, æther, &c.; it ration: the patient, if in a horizontal situa- will be necessary to assist and promote the tion, is immediately under the necessity of expectoration by means of some of the fol. getting into an erect posture, and of flying lowing remedies, either alone, or perhaps a for relief to the open window; the diffi- more preferable manner will be in combiculty of breathing for a time increases, and nation, as milk of ammoniac or of asafæ. both inspiration and expiration are atten- tida, the decoction of seneka, or a solution ded with a wheezing noise, the voice is of spermaceti, with nauseating doses of tar. weak, and the exertion of talking is more tar emetic, or with some of the preparations or less painful: after these symptoms have of squills; the carbonate of ammonia, and continued for some hours, a profuse sweat myrrh, are also medicines of considerable sometimes breaks out, the breathing be- efficacy; but squills are, by far, the most comes less laborious, and the cough, which, valuable expectorant of any in the whole at the commencement, was not present, or
materia medica; a blister should be applied was without any expectoration, now be. to the chest, the vapour of warm water comes more free, and a more or less copious should be inhaled, and its effects will be iu. secretion of mucus takes place, and the creased, if the water is impregnated with other symptoms abate, but there is a greater æther; warm pediluvia, or the warm bath or less degree of tightness across the chest, should be ordered; the respiration of an and of difficulty of breathing, throughout atmosphere, mixed with hydrogen gas, or the course of the day; towards evening, or any other innocuous air, which might dilute about midnight, for several successive nights, the oxygenous gas, would be useful in spasthe symptoms suffer au exacerbation, and á modic asthma, by decreasing the sensibility remission takes place towards morning; of the system, and preventing the recor. and after some days, on the expectoration rence of the paroxysms; the respiration of becoming and continuing more copious, the an atmosphere, with an increased propor. paroxysms for a time cease altogether: the tion of oxygen, is recommended in what is pulse is, for the most part, quick, weak, and called the humoral asthma : in the intersmall; and the urine, which, at the com. missions, the remote causes should, as far mencement of the paroxysm, was pale, on as lies in our power, be carefully avoided; its remission becomes high-coloured, and the use of fermented liquors, and particuoften deposits a sediment; the face is some- larly of distilled spirits, must be strictly in
hibited, the diet should be light, of easy spirits may be added to the fomentations ; digestion, not flatulent, and the food should friction of the abdomen with warm oil, or be taken in moderate quantities, taking care bags filled with hot sand, or bladders filled not to oppress the stomach; but when the with hot water, may be employed also with disease has been of loug continuance, a great advantage ; blisters or rubefacients, more full diet may be allowed; riding on together with warm pediluvia, will be reborseback, or in a carriage, and more par. quisite ; antispasmodics should be adminiticularly a sea voyage, should, if convenient, stered internally, and where the disease has be advised, or the patient should change not been preceded by long costiveness, the air, and try different situations, until, opium will be the most efficacious remedy, either by accident or by perseverance, he especially if vomiting prevents the exhibifinds out a situation to live in, in which the tion of cathartics : where, however, the disdisease is rendered less distressing, or is en. ease has been preceded by costiveness, the tirely removed; repeated blisters should be hyoscyans will be found to be a more applied about the chest, or an issue be made suitable remedy, as along with its narcotic in the neighbourhood: smoking tobacco is it also possesses a gently cathartic quality : useful; and garlic or onions, by way of cathartics must be ordered, and they will sauce, may be also found serviceable. be more efficacious when given in combiBark, chalybeates, and aloes should be had nation; calomel, above all, ought never to recourse to towards the close of the pa. be given alone, its operation is always renroxysm.
dered more certain and easy by combining Colic commences with an acute pain over it with other cathartics, and the addition the abdomen, the navel is twisted towards of a few drops of some essential oil will, in a the spine, and the muscles of the abdomen great measure, obviate their griping effects; are spasmodically contracted into separate laxative clysters must be ordered; at first portions, giving it the appearance of a bag they should be mild, and tolerably large; the full of round balls; there is vomiting of a addition of a portion of oil, or of a solution bilious matter, obstinate costiveness, and of Epsom salts, will be an useful auxiliary; generally coldness of the extremities; the and if we do not succeed in procuring the urive is high coloured, is voided in small evaenation of the intestines by the above quantity, and with some degree of difficulty means, we must have reconrse to the injecand pain; the disease is seldom attended tion of the smoke of tobacco, or a more with pyrexia in the first instance. Some certain and efficacious remedy is, a decoctimes, bowever, an inflammation of that tion of tobaceo, in the proportion of half part of the intestine, where the disease is a drachm to four ounces of water, to be situated, supervenes, and aggravates the thrown up as an enema. If all the above disease : when the peristaltic motion of the means prove of no avail, we must have rewhole intestinal canal is inverted, the dis- course to mechanical dilatation, as, by ad. ease is called ileus, which is only to be re- ministering one or two ounces of the hy. garded as a more violent degree of colic; drargyrus every hour or two, or a large it is, lowever, more apt to terminate in en- quantity of warm water should be injected terius, or gangrene.
by means of a large syringe : when every The remoral of this disease will generally purgative, and even all other means that be effected by blood-letting, in the repeti. a'e in most common ise, have failed, the tion of nbich we must be guided by the action of the intestines has sometimes been state of the pulse, violence of the attack, effectually excited by throwing cold water and strength of the patient; in all violent on the lower extremities. attacks of colic, if the patient be in tolera. The Colica Pictonum vel Saturnina, or ble vigour, it will not only be advisable, Colic from Lead, differs from the species but prudent to take away a moderate quan- above described, in not coming on in so tity of blood (except the disease arise in sudden and violent a manner, and also in conseqnence of lead being received into the its cause, that of lead taken into the body, system), more particularly so if the pulse is under various circumstances, as by exposure full or bard, and there are any symptoms to the action of it, or by drinking cyder, denoting a tendency to enteritis, it will, at or other liquors, impregnated with it; the the same time, be the means of relaxing disease generally commences with slight the spasm, and procuring stools : the warm uneasiness in the bowels, or with a sense of bath should be ordered, or the abdomen weight, or of an aching, rather than an should be fomented, and strong peppers and acute pain, about the pavel, which is in creased after eating; the pain remits, and system must be kept under the influence of is sometimes relieved by pressure upon mercury, in a greater or less degree, accordthe abdomen : this, however, is frequently ing to the violence of the disease, for two not the case. After a time the pain in- or three weeks after every symptom of the creases, becomes permanent, and intole. disease has disappeared, as it is very apt to rably excruciating; there is retraction of return, and with increased force. As a disthe umbilicus, the integuments of the abdo. position to costiveness often remains, it men, and the intestines are violently con- should be obviated by some of the above tracted, and drawn towards the spine, and cathartics. It sometimes happens that the the spasms are often so obstinate, that it is pain in the bowels shifts suddenly, and at. with the greatest difficulty a clyster can be tacks the head, causing extreme misery : thrown into the rectum ; thc pulse is hard in this case nothing affords so much relief and tense, there is obstinate costiveness, as blisters applied to the back, behind the and often strangnary; after several attacks ears, and to the temples, successively, acparalysis comes on, chiefly of the upper ex. cording to the urgency or continnance of tremities, although there are numerons cases the pain: opiates may be administered at recorded, in which the lower are affected the same time with advantage. The para. also, and sometimes it terminates in swel-lytic affections, which are the consequence lings of the joints, and loss of sight; some- of this disease, and the ileus, will be retimes, but more rarely, the disease is suc- moved hy the internal and external employ. ceeded by paralysis after the first attack; ment of Bath waters. the patients cannot rest in bed for the vio. In Diabetes the most prominent symplence of the disease, and they find relief in toms, according 10 Dr. Rollo, are vora. walking about, if they have sufficient ciousness and keenness of appetite, or a strength : those who liave once laboured frequent craving for food, without the feel under the disease are very liable to relapse, of entire satiation ; a parched mouth, with in which case the disease comes on in a constant spitting of a thick viscid phlegm, more violent manner than before, and the of a mawkish, sweetish, or bitterish taste; recovery is then nidre slow, and less com- intense thirst; a whitish tongue, with red plete. In the removal of this violent dis. bright sides; red and swelled gums, with ease, we must, in the first place, restore the teeth feeling as on edge from acids, and the intestines to their natural irritability, loose in their sockets ; head-ach ; a dry hot by the exhibition of a large dose of opium; skin, with flushing of the face; a pulse most we should then administer some cathartic generally about eighty-four or six ; an inmedicine at proper intervals, as the sn!plate crease of clear urine, of a light straw coof magnesia or soda, or the pliosphate of soda, lour, having a sweetish taste, resembling dissolved in broth, or some aromatic fluid, sugar, or rather honey and water ; an uncastor or almond, may be given, combined easiness of the stomach and kidneys; a wastwith tincture of senna ; and if the stomach ing of the flesh, a wearine:s and d'sinclination be in a very irritable state, the medicines to motion or exertion, with the feeling of must be exhibited in the form of pills, for weakness; an excoriation, with soreness of which purpose the calomel, joined with ex. the glans, penis, and prepuce, which is tract of jalap or colocynth, and a few drops sometimes swelled, and there is no desire of some essential oil, will be the most suit- of venery: in females there is a peculiar able ; laxative clysters will be necessary, to uneasiness about the meatus urinarins. which may be added some cathartic salt, or The predisposing causes of this disease oil, the pain of the abdomen will be re- are at present obscure, but the disease has lieved by rubbing it with tepid oil, or by been found to occur in those who have inapplying spiced fomentations, or by the dulged in fruits, sweetmeats, pickles, liigiiwarm batli, or by bays of hot sand, and seasoned food, warm, stimulating condi. similar antispasmodics ; the application of a ments, wine and fermented liquors, or indullarge blister to the abdomen is, however, a gence even in farinaceous foods, with large much more efficacious remedy. When we quantities of small beer, accompanied by have relieved the urgent symptoms, the great bodily exercise, with or without acdisease will, ou its first attacks, be effectu- tive mental employment; moisture, grief, ally removed by employing mercury inter- vexation or agitation of mind; sudden vapally and externally. Mercury must be riations of temperature may also be regard. pushed so far as to occasion some affection ed as predisposing or exciting causes. The of the mouth as soon as possible, and the proximate calise is supposed to be a mor
bidly increased action of the stomach, with last have been observed to have been eaten consequent secretion, and vitiation of the with impunity. The drink should consist of gastric fluid, marked by an eagerness of ap- such liquors as afford the least saccharine petite and acidity; the direct effects of matter, as weak brandy or rum and water, which are the formation or evolution of sac- with the occasional nse of bitters. Costive. charine matter, with a certain defect of as. ness must be obviated by gentle laxatives, similation, preventing the healthy combina- as flowers of sulphur, oil of castor, or alotions, and exciting the immediate separa etics, combined with soap. The exciting tion of the imperfectly formed chyle by the and keeping up a degree of nausea, with kidneys. Dr. Baillie thinks it probable, proper doses of tartar emetic, is recomthat diabetes depends, in a considerable de mended in the early stages of the disease; gree, upon a deranged action of the secre. the camplior and other narcotics, besides tory structure of the kidneys, by which the opium, are deserving of a trial : alum whey, blood there is disposed to new combina- which is made by boiling a drachm of the tions ; the effect of these combinations is alum in a pint of milk, is said to considerathe production of a saccharine matter: he bly reduce the quantity of urine : nut-galls further thinks it probable, at the same time, and lime-water have been employed with that the chyle may be so imperfectly formed, as to make the blood be more readily Order IV. Vesaniæ. INTELLECTUAL DEchanged into a saccharine substance, by the action of the kidneys; an opinion well worth minute enquiry.
Disorders of the judgment without pyrexy The cure of this disease consists in con- or coma. The following are the genera. 1. finement, an entire abstinence from every Anientia ; an imbecility of judgment, by species of vegetable matter, a diet solely of which people either do not perceive, or do animal food, and that in as small quantities not remember, the relations of the things : as the stomach will be satisfied with; eme- the species are three; connate, from old age, tics, hepatised ammonia and narcotics will from evident external causes. 2. Melancho. be necessary, and they should be assisted by lia, a partial madness, without dyspepsy or the daily use of alkalies and lime water; indigestion : varying according to the diffethe hepatised ammonia should at first be
rent subjects concerning which the person exhibited in doses of five or six drops, raves; and hence, admitting an almost inthree or four times a day, the dose is to be finite multiplicity of varieties. 3. Mania, gradually increased, so as to produce some universal madness ; idiophathic and symp. degree of nausea, or slight giddiness, it tomatic; under the former section, menshould not be mixed up in draughts, or in tal and corporeal, or arising from some any other forin, as it is readily decomposed, evident disease of the body: under the latbut it should be dropped from the pbial, at ter, proceeding from poisons, from passion, the time of using it, into a proper vehicle, from febrile affection, and hence rather and taken immediately, distilled water is referable to the corporeal species. 4. Oneithe best vehicle; an opiate should be ad. rodynia, a violent and troublesome ima. ministered at bed-time, with from twenty gination in time of sleep. Two species ; 0. to thirty drops of the antimonial wine; activa, semnambulism, or sleep-walking : this plan is to be pursued until the more and 0. gravans, night-mare. bid condition of the stomach is removed, To Mania, with which Melancholia is so the marks of which are, a scarcity and nearly allied, we shall devote an observahigh-coloured state of the urine, with tion or two. turbidness, furnishing, on evaporation, an
Mania often arises from intense study, offensively-smelling and saltish-las:ed resi- violent emotions of the mind, unrestrained duum without tenacity, accompanied with passions, long exposure to the scorching a want of appetite, and loathing of food: rays of the sun, overstraining the faculties at this time the tongue and gums will be of the inind, intemperance, organic affecfound to have lost their florid red clour, and tions of the cranium, an hereditary disposito bave become pallid. When this state oc- tion, sanguine temperament, long.continued curs, exercise is to be enjoined, and a gra. melancholy, suppressed evacuations, repeldual return to the use of bread is to be al. led eruptions, and religious enthusiasm. lowed, and vegetables, such as brocoli, spi. The proximate cause is supposed to consist nach, peas, cauliflower, cabbage, lettuce, in an increased excitement of the brain. It and parsnip, in moderate quantity: these is distinguished from phrenitis by the ab