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GEN. VII.

SPEC. II. Syspasia Hysteria. Hysterics.

Mode of treatment.

Chiefly to be directed to

Mis-men

struation to

ish kind of bashfulness in some, perverse conceits and opinions, dejection of mind, much discontent, preposterous judgement. They are apt to loathe, dislike, disdain, to be weary of every object. Each thing almost is tedious to them. They pine away, void of counsel, apt to weep, and tremble, timorous, fearful, sad, and out of all hopes of better fortunes. They take delight in doing nothing for the time, but love to be alone and solitary, though that does them more harm. And thus they are affected so long as this vapour lasteth; but by and by they are as pleasant and merry as ever they were in their lives; they sing, discourse, and laugh in any good company, upon all occasions. And so by fits it takes them now and then, except the malady be inveterate, and then it is more frequent, vehement, and continuate. Many of them cannot tell how to express themselves in words, how it holds them, what ails them. You cannot understand them, or well tell what to make of their sayings."*

The mode of treatment bears so close a resemblance to that for the preceding species that it will be unnecessary to enlarge upon it. Pungent applications may be applied to the nostrils, or round the temples, or the face and neck may be sprinkled or dashed with cold water during the paroxysm, and warmth and the friction of the hand be applied to the feet. The peristaltic action of the bowels should be increased, which can only be done by stimulant and cathartic injections, if the contraction of the sphincter ani will allow them to pass.

Our chief attention, however, should be directed to the intervals. the intervals. And here the first recommendation is, sedulously to avoid every remote or exciting cause. If the menstruation be in a morbid state, this must be corrected be corrected, as soon as may be, concerning which, however, we shall have to speak in the ensuing class. If plethora be a striking symptom, the lancet should be applied to. In robust and vigorous habits we may bleed freely and have nothing to fear, but in loose and relaxed constitutions far more

Plethora.

• Anat. of Melancholy. Part 1. Sec. ùi. 2. 4.

caution is necessary, as has been already explained under GEN. VII.

CONVULSIO.

SPEC. II. Syspasia Hysteria. Hysterics.

dics.

In this last state of body tonics should also be had recourse to, and many of the warmer sedatives and antispas- Tonics, aromodics as assafoetida, camphor, most of the verticillate matics, and plants, and cajeput, which was a favourite remedy with antispasmoMieg*. Valerian has often proved serviceable, but is rare- Treatment. ly prescribed in sufficient quantity to produce any good effect. "It seems," says Dr. Cullen, " to be most useful when given in substance and in larger doses. I have never found much benefit from the infusion in water +." The ammoniated tincture of the London College, however, is an excellent form: but even here the quantity of the root employed should be double what is prescribed. The cinchona may be usefully united with valerian, but does not seem to be of much benefit in this disease by itself.

Opium is a doubtful remedy: where the precursive signs are clear it will often allay the irritation, and thus prove of great value. But it so frequently produces head-ache, and adds to the constipation, that it is rarely trusted to in the present day. When resorted to, it is best combined with camphor.

Where the disease occurs in the bloom of life, and there is reason to apprehend the ordinary orgasm of this age to be in excess, the surest remedy is a happy marriage.

* Epist. ad Haller. ut suprà No. v.

↑ Mat. Med. Part μ. Ch. vш.

VOL. IV.

SPECIES III.

SYSPASIA EPILEPSIA.

Epilepsy. Falling-sickness.

SPASMODIC AGITATION AND DISTORTION, CHIEFLY OF
THE MUSCLES OF THE FACE, WITHOUT SENSATION
RECURRING AT PERIODS MORE

OR CONSCIOUSNESS;

OR LESS REGULAR.

GEN. VII. Origin of the generic term.

SPEC. III.

THE Greek physicians gave the name of EPILEPSY, from auCávoμai, to the present disease from its "sudden seizure or invasion," which is its direct import: and as the violence of passion or mental emotion, to which the Roman people were accustomed to be worked up in their coMITIA, or popular assemblies, from the harangues of their demagogues, was one of the most common exciting causes, it was among the latter denominated MORBUS COMITIALIS; in the popular language of our own day" Electioneering By the La- disease," in reference to the time and occasion in which it most frequently occurred; or, according to Seneca, because mitialis, and whenever the disease appeared the comitia were instantly broken up. There are many other names, also, by which epilepsy was distinguished in former times, but it is unnecessary to recount them.

tins called morbus co

why.

Pathology to

The general pathology of the two preceding species, and be collected which has been given at some length under the genus the two pre- CLONUS, will apply to the present: but it is obvious from

from that of

ceding species.

the symptoms that the muscular power, commonly speaking, though not always, is affected to a less extent, and the sentient and intellectual to a much greater; and consequently that the irritative fibres suffer in a smaller degree than the sensific and percipient.

*De Irà, 11. 7.

Before we enter upon the history of the disease it will be convenient to remark that, from the different modifications under which it shows itself, it has been subdivided by many nosologists into very numerous varieties, but that the whole may be reduced to the following:

a Cerebralis.

Cerebral Epilepsy.

B Comitata.

Catenating Epilepsy.

Complicata.

Complicate Epilepsy.

Attacking abruptly without
any evident excitement, ex-
cept, in a few instances, a
slight giddiness. In this
case the predisposing cause
is external violence or some
internal injury, misforma-
tion or disease of the head.
Catenating with some morbid
action of a remote part,
with the sense of a cold va-
pour ascending from it to
the head, or some other
precursive sign.

The limbs fixed and rigid with

clonic agitation of particu-
lar organs.

The causes of epilepsy, like those of the two preceding species, may be mental or corporeal: but to produce this rather than either of the others there must be a peculiar diathesis, which seems to depend upon the state of the nervous organ. Where this exists almost any of the passions or mental emotions, when violently agitated, have been found sufficient to occasion a paroxysm, as anger, grief, fright, consternation; of all which the records of medicine afford abundant examples. In a like diathesis any kind of corporeal irritability will often become an exciting cause, whether more or less remote from the head itself; and particularly where it is productive of a preternatural flow of blood into the vessels of the brain. Thus an irritability in the ear from an inflammation, abscess, or some insect or other foreign substance that has accidentally entered into it, or the sudden suppression of a discharge to

GEN. VII.

SPEC. III. Syspasia Epilepsia. Epilepsy. Falling sick

ness.

Causes men

tal and corporeal.

GEN. VII.
SPEC. III.

Syspasia
Epilepsia.
Epilepsy.
Falling-
sickness.

of the uterus

which it has been subject, has in various instances produced epilepsy*. Hildanus + mentions a case in which it followed upon a considerable degree of irritation excited in the same organ by the accidental introduction of a small piece of glass. In like manner, an irritable state of the stomach, or intestines, or the liver, from chronic inflammation, debility, worms, or the presence of substances that do not naturally belong to it, has proved a frequent origin. Bartholine gives an instance in which it supervened upon swallowing pieces of glass; and Widenfield another upon swallowing a needle §. Confirmed drunkards are peculiarly subject to this complaint.

Like hyste- Particular affections of the uterus are, in like manner, ria often produced by a an occasional source of epilepsy, as well as of hysteria: morbid state and sometimes the latter has run into the former, where in an epileptic the epileptic diathesis has predominated. What this diathesis consists in it is difficult to determine, for it gives no external signs: and hence Dr. Pritchard seems to doubt thesis exist? its existence: but it is otherwise no easy matter to de

diathesis. Whether

such a dia

termine why a like irritation in the uterus should in one woman produce hysteria or convulsions, and in another epilepsy; examples of which last occur very numerously in all the medical collections of cases. Menostation or a suppression or retention of the menstrual flux is, perhaps, the most common of this class of causes: and we may hence see, why it should occasionally be excited by a suppression of the lochial discharge. A sudden suppression, indeed, of discharges of almost every kind natural or morbid, of. long continuance in an irritable habit, has occasionally proved a sufficient source of excitement. And hence, it has followed upon restraining too abruptly a chronic dia

* Hornung, Cista. p. 394, Demerehene, De la Conseillere in Diss. de Auditû. Ultraj. 1710.

† Fabr. Hildan. Cent. 1. Obs. 4. Hist. Anat. Cent. v. Hist. 66.

S Diss. Obs. Med. Triga. Goett. 1768. || On Nervous Diseases, p. 95, 1822. Moranus, Apologia de Epilepsiâ Hystericâ, Orthes. 1626. 4to. Schulze, Diss. Casûs Hysterico-epileptici Resolutio. Hal. 1736. Eickmeyer Diss. de Epilepsia Uterinâ. Ultraj. 1638.

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