CASES IN PRIVATE PRACTICE. EPILEPSY. TWO ATTEMPTS TO COMMIT SUICIDE.

CASES IN PRIVATE PRACTICE. EPILEPSY. TWO ATTEMPTS TO COMMIT SUICIDE.

512 the unfortunate monomania which beset him, ject of the preceding case owes his death and which made him one of the victims of I solely to the rea...

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the unfortunate monomania which beset him, ject of the preceding case owes his death and which made him one of the victims of I solely to the reading of these, with a too apt this now prevailing and rapidly-increasing belief that they 11 must be true," emanating, fully of the present day, the cold-water apparently, from respectable physicians or mania. surgeons, or, at least, from those who have It is little creditable to the boasted intel- the assurance, the unblushing assurance, to ligence of our countrymen, that Great Bri- appear as such by appending the letters tain should, in the nineteenth century, be still " M. D.," &c. &c., to their names. The acknowledged as the El Dorado of quacks, majority of these hydropathic doctors being the paradise of charlatans. Let any propo- well educated, they cannot exculpate their sition, however absurd,-perhaps the more conduct by throwing over themselves the irrational it is the greater credence it ob- shield of ignorance. They are not fools, but tains,-emanate from any part of the world, wise enough in their generation and in designing and desperate men immediately worldly cunning. Not being fools then, appropriate it here, make it a source of I will leave others to decide what sub. profit to themselves, unscrupulous of the in- stantive will best express their proper jury they may be inflicting on others, but appellation. The respectable members of knowing they have a rich mine to work in our profession have long looked with the gullibility of a certain portion of the mingled pity and sorrow upon the suffering public, which must bring to themselves that victims to this water-drenching treatment. which alone they covet-gold. They have acted upon the populus vult decipi A few years have seen the rise and fall of decipiutur principle, and have waited, ex. Saint John Long’s inhalations and embroca- pecting that the water-bubbte would burst, tions, of Morison’s pills, of mesmerism, of and that the whole system would gradually homoeopathy, of the braudy-and salt mania, be immured in that contemptuous tomb of all and of numerous other quackerie.3. All of the Capulets in which so many of its prede. these have had innumerable advocates, and cessors have been interred. I have partici. many, too, of them many victims. Their pated in those feelings, and have refrained diminished heads are now all hidden, how- from making any observations to destroy ever, under a sheet of water,-that which that which has appeared to be so likely to has been christened by the name ofhydro- be its own annihilator if peaceably left to pathy,"and well named too, for, literally itself; yet the case I have related is so translated, this term means watei,-disease. striking in its course, and so fearful in its Hydropathy is now the panacea for all ills, termination, that I have considered it a duty the remedy for every disease, and, moreover, incumbent upon me to give it publicity. I the exclusive one, none being required but have the honour to remain, Sir, your very water-only water. It might be supposed obedient servant, that all diseases were composed of nothing R. S. HUTCHINSON, M.D., M.R.C.S. 1.1i.C.S. Senior Physician to the General butfii-e, which could alone be destroyed or extinguished by water. After a few years Hospital, near Nottingham. it may with safety be prophesied that the exNottingham,Jan.l, 11d. istence of a folly so extreme as this will the be believed unless some of hyscarcely CASES IN PRIVATE PRACTICE. dropathic establishments which, on a larger or a smaller scale, exist in most of our more EPILEPSY. important towns, should remain as monu- TWO ATTEMPTS TO COMMIT ments of a bygone and almost incredible inSUICIDE. fatuation. But if it is to be lamented that a EMPLOYMENT OP SULPHATE OF ZINC. so baneful to so quackery health, dangerous, from the extreme manner in which it is ap- By WILLIAM RYAN, Esq., Surgeon, Sutton Coldfield. plied, as hydropathy" (I admire the name), should receive credence with a certain portion of the public, what terms of indignaHistol’Y of the Cltse previous to my attend. tion can be found sufficiently strong to apply ance.-Thomas Spencer, set. 50, attacked by to its advocates who, to the disgrace of those epilepsy for the first time thirteen years universities where they obtained their de- since ; was previously, his wife says, as grees, still continue members of our honour- stout a man as any in the country, in the able profession ? In what words shall we flower of health, and never complained of speak of those medical men who, pandering, headach. He had, at this time, nine dis. for the sake of filthy gain, to this credulous tinct fits, and afterwards " slept" for a week, spirit, publish, in every manner, plausible during which time he was given a little and sophistical arguments, and pretended nourishment, by force. When raised for facts, with the sole object of bringing to that purpose he cried, like a child, but never themselves gain, though to others loss of had the use of his faculties. At the end of the week he awoke, and said it was time to health, if not of life. The press is, in every sense of the word, go to work, inquiring why they allowed him

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gone to bed on the previous night. During her opinion, but he will not hear of it. He the first three days of the attack he spat out answers questions till the last moment prewhatever was given him. Had fits all the ceding the fit. No aura. He used to bite first night, every two hours, from twelve his tongue during the fits, but has " grated" o’clock, the time of his first attack. He got all his teeth out during the attacks. He up after the third fit, acting outrageously ; has twice attempted to hang himself. Once, snatched his watch, and would have broken six or seven years since, went into the hovel it, and endeavoured to tear his clothes off. and fastened the door; when his wife got in He came down stairs, where lie had the she found his neckerchief laid aside, his remaining fits. " His eyes shone like silver; shirt-collar unbuttoned, the rope fixed to a he looked wild." He remains dogged and joist and a noose on the other end, ready to speaks surlily a day or two before the attack, put round his neck. His wife expostulated, but knows nothing of its approach until the and he burst into tears. He looked frightlast moment, when he is struck down, fully pale. He obtained a rope a second making a muttering kind of noise, and thus time, but was, luckily, observed. This first generally remains in the fit three or four days. attack he was bled in the temple and arm He will not believe a fit to be coming on, but to a great extent, and had another fit at the Was bled again if warned of it, feels annoyed, and asks why slopping cf the blood. they trouble him by their nonsense. I cannot during the week. The fits, from this period, find that it was inherited, none of his family came on every six or eight weeks, for twelve being subject to it. He was employed in months, when they disappeared for some making roads about thirteen years since, time, and then began again with another bad and was then affected by severe relaxation of attack, repeated, as hefore, every six or the bowels during three or four days, accom- eight weeks, he being bled during each attack panied by delirium. After this he always to about a pint. Remarks and Treatment.- Such is the appeared poorly for three or four months, zchen the first attack came on. Before the history of this interestiug case up to the first attack his wife noticed that he had period of my attending him for the first time great difficulty of breathing in his sleep, the in March, 1839. He was sitting up when I act of respiration taking greater time than saw him, maintaining a dogged silence, and usual, and accompanied bya loud (sonorous) scarcely answered my questions by a mononoise. Some time before the fits come syllable. The expression of his face was on he complains of headach,; his feet cold peculiarly sullen. You felt, having asked as ice; on touching his head with his hat he him a question, doubtful whether he might observed it felt hollow, like a drum, and as if or might not strike you; until the monoa noise were in it. Feels pain going up the tonous tone of voice being heard, and the right side of head, and is much troubled by passive fcatures observed, a person felt conflatulence, being often obliged therefrom to vinced that the fierce look was not assumed, leavehiswork,unbuttonhissmall-clothes,and but that the poor patient was stamped by hold them so on his way home. Some time the "peculiar physiognomy" of the disease. before and after the fits he is very irritable, He seemed anxious to avoid conversation. and no one can do anything to please him. Sallow countenance; pulse slow, very weak Passes urine during the fits, and once, after and small, and stopped by the smallest comthe second or third fit, passed faeces. When pression. The whole appearance of the he gets thoroughly out of one fit, another patient convinced me that whether or not comes on, two hours generally intervening, but there might, at times, be cerebral vascular the interval depends on the time elapsing be. action, the case was, in fact, one of asthenic tween the first and second ; thus, if an hour’s epilepsy, with deficient nervous influence, remission take place, the subsequent fits and derangement of the digestive organs. observe the same time. Has sometimes got I felt satisfied that to adopt a course of off with one fit, and continued an hour or depletion would be to aggravate the disease, more before perfect consciousness returned, and therefore resolved on a fair trial of " When the ninth fit comes on he gets as tonics, and amongst the first, that which I black in the face as possible, and then his had before found of great service, when used looks are awful indeed." I-lis eyes look with discrimination, sulphate of zinc. On very dim, as if he were dead, and this is heariug his wife attribute the complaint to certainly much more observable after a ninth great exertion in raising a weight, followed fit than at any other time. After having by a severe attack of the bowels, we are many fits he ltes almost insensible for three reminded of the remark of Frank and others, days. When spoken to and offered any- that epilepsy seldom occurs in persons prething he pushes it off, merely asking why viously perfectly healthy ; and we also they trouble him. During this time, if left observe that material fact, so judiciously to himself, he never speaks ; seems dozing, observed by Copland, that injudicious bleedalthough not in a regular sleep. 11 Days ing causes a return, when the stream is before the fits a semicircle appears, white stopped, of the paroxysm-which fact, when as snow," above the eyebrows, his ears also occurring under the care of a practitioner, being white. His wife then informs him of should prove a valuable index to his future

No. 1063.

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It should be also particula1’ly INTERESTING CASE OF borne in mind that it was after the last bleedCONGENITAL BLINDNESS ing of thefirst attack that the man 1’emained TREATED, soporose for a week. I first ordered compound extract of colo- SUCCESSFULLY, BY OPERATION, AT THE cynth, a drachm ; chloride of mercury, five grains-mix for twelve pills, two to be taken AGE OF EIGHTEEN YEARS. occasionally ; and after their operation, I of distilled twelve By Dr. FRANZ. sulphate zinc, grains ; water, six ounces-mix, and let two tableTHE son of a physician residing in Lon. spoonfuls be taken three times daily. Six or eight weeks afterwards he wasdon, scrofulous, but otherwise robust and of attacked as usual. The zinc was then in- good powers of understanding, of a family creased to three, and, finally, to four grainswhich is predisposed to diseases of the eye, three or four times a day, a moderate action was born with strabismus convergens and A much cataract of both eyes. An injury and inof the bowels being kept up. longer period intervened before the next flammation of the eye occurred to the mother seizure, and by the end of the year, instead ofin the eighth month of pregnancy, and she the usual number of six or eight, he had had experienced from that time continual but four attacks, the last being very severe anxiety for the health of the child, imagining and consisting of ninefits. From that time, the offspring might have some share in the until about the 15th of the present November, disease. Keratonyxis was performed at the a period of three years and three-quarters, end of the second year on the right eye, and lie was not affected by the complaint. About was twice attempted on the left, in the two months since, he felt from a very high ensuing four years. The first operation was tree, and it is a question of some interest followed by violent iritis and partial atrophia whether such fall might have been a cause bulbi ; the second was without any effect. of the subsequent attack. In the present By degrees, however, the turbidity and seizure he had had four fits, but weaker than opacity diminished, and the patient was any he had erel’ previously. I have again put enabled to distinguish light from darkness I him on the sulphate of zinc, and, permissu(lichtempfindung). When the patient came to Dr. Franz he SCALPELLI, will at some future time pubthe following symptoms:-An exlish the result. ] presented Hel’edita’f’Y Predisposition.-As addendacessive degree of strabismus convergens; to the foregoing, and intimately relating tothe right eye insensible to light, more im. the question of hereditary predisposition tomoveable than the left, clearly shrunken and the complaint, I may remark as fol]ows:— doughy : the left was of its natural form; Spencer has seven children ; one boy, aged cornea clear ; iris tolerably normal ; the seventeen, has fits, sometimes forty in a day; pupil drawn downwards and inwards, and his mother once counted forty-seven. He is insensible ; the anterior wall of the capsule When seized of the lens darkened, at many points hypernot aware of their coming on. he goes backwards some yards before he trophied, and of the appearance of mother-offalls. " His heart stops working, and when pearl. On looking in a very oblique direction his heart begins to move he comes to himself that instant." Attacks come on every five or from the temporal side into the pupil, there ten minutes, with perfect consciousness be- was perceptible in the anterior wall of the tween. If standing at the time of the capsule a narrow perpendicular slit, about seiztire, he never falls without first walking a line and a quarter (Paris) in length. backwards. He is sometimes a day or two This little opening was perfectly covered by without fits. Complains of great headach. the pupillar border of the iris ; and since, on Head cut all over with the numerous falls. account of an adherence of its lower border In falling he broke the clock with his head, to the uvea, it was held somewhat open, and once fell into an open well, said to be the aqueous humour had free access into the eight yards deep. Has been thus attacked interior of the capsule. The patient had seven or eight years. His mother also been able to distinguish, with this eye, light, observes a curious squinting (convulsive), and even colours ; and, excepting an occaoccasionally, in a boy, six years old, and in a sional feeling of pressure in the eye, there child a year and a halt old, and fears was no pain. The touch of the patient had epilepsy. When the eldest falls he does reached, by long practice, to an extraordinot seem convulsed, but like one dead, and nary degree of perfection, especially in the remains so "until his breath comes;" he lips, but he could not distinguish colours, then leaps up in an instant, and goes to any The touch of silken stuff gave him great thing he has to do, appearing ushamed of any pleasure. one seeing him. Recollects nothing of the fit. Couching was now performed, the usual This seems to be the 11 petit MM<" of Andral. antiphlogistic treatment followed, and the I shall try what can be done. I attended the case went on well. infant during dentition for convulsions. On the third day after the operation the treatment.

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