GEN. III. SPEC. V. Synclonus Barbiers. of countenance very peculiar, but indicative of great distress and anxiety. The countenance soon became livid; the pulsations of the heart were loud and fluttering; its Beriberia. Beribery. strokes against the side could not be distinctly counted. He was bled two pounds without much relief. The appearance of this poor man was very affecting. The blood drawn was sizy; and, upon re-opening a vein from a large orifice, he again bled freely; but becoming exhausted, it was thought prudent to stop it again. His legs were much swelled, and pitted on pressure. They were covered with small livid spots, as well as other parts of his body, like flea-bites, but much larger. He died in half an hour afterwards. The thighs and abdomen were but little swelled in proportion to his legs, but evidently larger than natural. His arms were emaciated, and no part edeHe appeared of stout make.” matous. General re marks on The intumescence of the legs seems to have been a result of debility from the two prior attacks: but it was ne- the case. vertheless expected that most of the cavities of the body would have given proof of an hydropic affection; and I have selected this case as one of the strongest in support of such an opinion; for, in general, though water is traced, sometimes in one cavity and sometimes in another, yet there is seldom much accumulation, and still more seldom such as to produce oppression. Dr. Dwyer took a minute of sixteen cases, and his remark upon the whole of these is: "water is usually found in some of the cavities, but the organs vary": and such an observation is alone sufficient to take beribery out of the list of proper dropsies, whatever other place we may assign to it. examina An early post-obit examination, however, of the case Post-obit before us showed as follows: "About an ounce of serous tion. straw-coloured fluid escaped in various ways, on opening the dura mater. Filling up the gyri on the surface of the brain, we observed a gelatinous transparent matter of some tenacity and consistence: it looked like a coating of isinglass. In the ventricles there was but very little fluid: in no other part of the cranium were indications of preexisting disease observed." In the thorax there were GEN. III. Spec. V. Synclonus Beriberia. Beribery. Barbiers. Curative intention. Diaphoretics and stimulants. Sand-bath. Spirituous cordials. Local ap plications. Convalescent regimen. various adhesions, especially within the pericardium; on opening which seven ounces of a straw-coloured serum was found in it, yet warm. No fluid in the thoracic cavity.In the abdomen there were few morbid appearances, except in regard to the spleen, which was es large as an ordinary sized liver, and weighed three pounds ten ounces. The liver of its usual size, but had a mottled appearance. Only eleven ounces of serous or dropsical fluid were found in this cavity. The curative intention is to re-excite the absorbent system and the affected branches of the nerves to a discharge of their proper functions by a process of diaphoretics and stimulants. Squill pills and calomel are chiefly depended on for the latter, and James's powder for the former, though the compound powder of ipecacuan seems better calculated for the purpose, as containing a sedative admirably adapted for allaying nervous irregularities. On the Malabar coast, it is no uncommon practice to excite perspiration in this complaint by burying the patient in a sand-bath: for which purpose a hole is dug in the sandy soil, into which he is plunged as deep as to his neck, and confined there as long as he can bear the heat of the sand that surrounds him. The strength, throughout the whole, is supported by cordials, and in many instances even by ardent spirits diluted for the purpose; punch is a common drink on this occasion, and the refreshing and sedative power of the acid entitles it to a preference. To remove the numbness and pricking or formicative pain from the limbs, friction and stimulant liniments are applied locally, and not unfrequently the legs are plunged into a pediluvium. And where the discase assumes an alarming appearance, and the spasmodic symptoms are very violent, recourse is had to a hot-bath, and the strongest cordials and antispasmodics, as brandy, sulphuric ether, or its aromatic spirit, and laudanum, which it is sometimes found necessary to continue for several weeks. In convalescence the patients should be removed, as soon as may be, to a drier and more equable temperature, GEN. III. SPEC. V. and be put upon the ordinary plan of tonics, regular exercise, and nutritive diet. In milder cases they generally Synclonus recover with the shifting of the monsoon, which carries Beriberia. off the remote cause of the disease, and brings a change Barbiers. Beribery. of temperature home to them. sym Beribery has not been hitherto described as existing in any other part of the world, and if it should be found it will probably exhibit a modification of some of the ptoms according to the quarter in which it appears. I. am induced to make this remark from observing in the Transactions of the Medico-Chirurgical Society, an account of a very singular spasmodic disease by Dr. Bostock, which evidently belongs to the present genus, and seems to be a variety of the present species assuming a chronic form. The patient, who was in the middle of life, was first attacked with achings in the lower limb on one side, accompanied with a difficulty and irregularity of motion, which soon spread to the other side, and then gradually to the throat, so as to hinder deglutition except with great pain and severe exertion: the larynx next became affected so as to prevent speech, and afterwards the back of the neck, the muscles affected being the voluntary alone. From the spastic rigidity of the limbs they were both bent and straightened with a like difficulty. The pricking pain like that of pins, or of a limb awaking from stupor, common to the extremities in beribery, was present here also, though apparently without stupor or edematous swellings. Yet the intellectual powers were at length affected and weakened; the failure of understanding gradually increasing but principally showing itself in paroxysms, during one of which the patient died. No cause of the disease could be traced before death or by dissection afterwards. *Vol. IX. Art. 1. p. 1. Treatment. Beribery not existing described as CLASS IV. NEUROTICA. ORDER IV. SYSTATICA. Diseases affecting several or all the sensorial ORDER IV. Present order as contrasted with the preceding divisions. IRRITATION OR INERTNESS OF THE MIND EXTENDING TO THE CORPOREAL SENSES OR THE MUSCLES; OR CLASS IV. THE sensorial powers are those which are dependent on the sensorium or brain as their instrument or origin; and are three in number, the intellectual, the sensific, and the motory. Thus far we have only contemplated these as they are affected singly, or, where more are affected than one, as influencing the rest only secondarily or sympathetically. The diseases of the present order are of a more complicated origin and nature, and affect several or all the sensorial powers conjointly from the first. The order is hence denominated SYSTATICA, a Greek compound from ovvioτnu, "congredior, consocio". Syncopσυνίστημι, Origin of ordinal term. CLASS IV. Systatica. ORDER IV. tica might have been employed and upon as large a scale, so as to denote increased as well as diminished action, impellentia as well as concidentia; but this term is Synonyms. usually limited to express maladies of the latter kind, and, consequently, might have produced confusion, since the present order, like all the preceding, includes diseases evincing different and even opposite states of action. The genera appertaining to it are the following: |
