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ON THE TREATMENT OF EPILEPSY, WITH CASES.
695 ear, he appears to have position where he has been again placed by no idea of modulating his voice-not, at the Council. Again and again do we inof the he delivers the one-and an Council, quire why they rely upon best, agreeable
hsring a musical
whole of every sentence in the same key. private representations and testimonials in to a searching public co-2,couRs ; Ile begins his lectures in a low tone, it is that " Even fools are made and delivers of his to the voice, said, top npidly he can-we wise were the remainder as loudly as by experience." about to say scream,, without the slightest vuiation or modulation of tone. This may bafe been a reason why at least some of the ON THE students preferred to sit on the most reTREATMENT OF EPILEPSY, mote benches. It is a misfortune to this WITH CASES. gentleman, now too late to be remedied, PATRICK SHARKEY, A.M., M.D., Senior that he was foisted into a public engage- By Physician to the Cork General Dispenment as a teacher before he had acquired a sary. knowledge of the classical languages. Hence ALTHOUGH I acknowledge the utility of forth even isolated cases of success his best friends have been obliged to in the treatment of any disease, as tending knowledge that he is in the constant habit of to the advancement of medical science, vet, making false quantities and inaccurate ter- knowing the many disappointments which minations. He has been accused of being have followed upon the adoption of a practice built upon single reports, sent forward incorrect in his anatomical descriptions, and into the world with all the gloss of language desultory in the distribution of his facts. and strained force of analogical argument, The latter charge is certainly well founded, or unwarrantable induction, I cannot but say that I feel much more confidence than I and there is ground for believing that Mr. otherwise should, in submitting for pnblicaPATTISON has not kept pace with the pro- tion in your highly-respectable pages the following cases, a few out of’ a number of gress which general anutomy especially has results derived from experiments conducted made, during the last few years, in Europe. on an extensive scale, during a practice of years and upwards. These few Having hastily run through this list of twenty-five have selected, not from any singularity in what we believe to be well-founded facts, the event or mode of treatment, hut as bewe sball next week enter fully into an ex- ing, by reason of their greater inveteracy, instar onznium." I put them forward midatioti of Alr. PATTISON’S charges against also, under the extremely forcible recomthe Council, his colleagues, and students, mendation of their having been all referred
risespreference but
ac-putting I
I
to
me after the ordinary and diversified, but who, it would appear from his representatreatment of others. I conunsuccessful, were at last all actuated a tions, by desire to fess t was, in the commencement, very timid, and am still very cautious in resortaccomplish his ruin !
the novel and apparently hazardous mode of treatment which 1 am about to lav before you, lest any untoward accident should arise, which might have damned me in the
ing to LONDON UNIVERSITY.
infancy of my professional career,or even now Surgical injure me, and, therefore, 1 never attempt without throwing the responsibility from bittionary, has been elected by the Coun- it, myself upon the relatives or friends of the cil Professor of Surgery to this Institution ; explaining to them the severe naMr. S.
COOPER, author of
the
patients,
has ture of the process, and in doin so, 1 uniLeen appointed, for one year, to the Chair formly receive for answer, that even death, it follow, would be preferable in their of Medical Jurisprudence. After the Doc- , estimation to the continuance of so frightful tor’s uuhappy display in this a disease, attended with perpetual alarm, department, and which may terminate in an accidental during the last session, we were not pre- death, more distressing in its cirpared fur his renewed installation into the cumstances. Yet I would recommend to and Dr. ANTHONY TODD THOMSON
should
infinitely
696
disposed to give this remedy a trial, not to do so indiscriminately, without ascertaming, as far as possible, that there exists .no organic derangement of any of the viscera, especially the brain, lungs, stomach, liver, or intestinal canal. I have,
then called in, and, in conjunction with Dr. Mills, adopted the following as I find in my notes.
in very many instances, found epilepsy connected with derangement of the liver, and I will add, that this connexion prevails far
Contunde in nzortario in pulpom; dein adde cerevisiœ fortioris, j; infunde per horas septem; dem cola exprimendo.—
those who may be
more
It is
extensively
than is
was
treatment,
September 4th, 1807. R Foliar. digitalis 5 iijss ;
generally thought.
astonishing to what extent this and other viscera
disorder of
purp. recentium,
Capiat liquoris colati, ziv, c. ;
frequently exists for
,
a Pulv. foliar. polypodii querc?zs sicta. length of time, without much apparent distarurra, aut radicis siccatœ, gr, x. turbance of the system. The appetite may of leucophlegmatic temperament, was She be good, digestion unimpaired, alvine and fair hair and complexion ; the disease not and evacuations regular, yet, upon urinary a more mintite investigation, a very dis- hereditary. 5. Took the draught yesterday, and in eased state of these organs may be found to have existed. In many of the cases which ten minutes had a fit less severe and shorter I have treated, I have been obliged to em- than usual; vomited frequently and violent. o’clock this day, her pu!se ploy an active preparatory course of medi- ly till twelve cine for one, two, or even three months sinking from 120 to 54, intermittent and irbefore I could venture upon the appropriate regular ; complains much of pain of headi anti-epileptic remedy ; and in two of the and soreness of epigastrium on pressure, cases in which I was successful, one of We ordered a blister to epigastrium, and a p of strong coffee. She bad cramps in them ot twenty years’ standing and muscles of her legs this moment; extre. the the abdominal was other of six, congestion cold at times. i so obstinate, that I could not remove it endecocti secunda until I ventured the Capt. quaque avenœ, jj lb ; upon tirely, appropriate hora. remedy. In a few cases in which I was un6. Has bad no fit; vomiting continued successful, I found such a state to tt both before and after it; and in one I never violently till ten o’clock this morning; pu:;e was able to rectify a disordered state of the 40, irregular, and intermittent ; great pros. primæ via3, indicated by foul, deep-fissured tration of strength. Took a cup of coffee As we have no hospital here yesterday, and continues decoct. avena. tongue, &c. for epileptics, I have had but little expeof legs returned last night. Pupih rience with the lower orders, who would have been dilated from beginning of treatnever exercise sufficient perseverance, and ment. 7. Continues to vomit very bilious matwould rather depend on amulets and quackery, than on a course of remedial measures, ter ; faeces also bilious, of r.ark.brolfn cooften of necessity protracted. I may add, lour. Pulse as before, but less irregular; that I have succeeded with many by the pre. great weakness; has slight cramps; pupils paratory treatment alone (principally pur- dilated. ’ Cont. decoct. avence. 8. Continues free from fits; vomits much gation and treatment directed to liver disease if it exist), without resorting to thebilious matter as before; faeces also of same ultimate remedy, adding- to such preparapulse still irregular, about oO: tory treatment the ordinary tonics, &c., ex- great weakuess; pupils dilated. cepting nitrate of silver, which I never ’ 16. Continues free from fits; strength employ in consequence of its discoloration restored ; pupils contract; appetite a0oa. , of the skin, without possessing any claim to I watched this case for two years, and theri the character of a specific. After having was no return of fits, which had been oi had an authentic account of the success of almost daily occurrence. the treatment about to be detailed in several cases, particularly that of the son of Mr. The next case which I select, is that of Angel of Dublin, a respectable teacher of i gentleman of this city, who had been sethe deaf and dumb, I was resolved to try it i verely affected with epilepsy for twenty in the first case whickshould present Itself, years. He was of robust form, sangum, and the first was that of Miss Fowkes, niece temperament, great abdominal congestion; of a respectable alderman of Dublin, aetat. general health very good. He was treated about seventeen years. She had been seized by several physicians of eminence, and pnwith epilepsy twelve months before. She nounced incurable. Amongst other remehad been under the care of the late Dr. dies he took nitrate of silver tu a Thomas Alills, and was daily growing worse amount, which discolotred him under the use of the medicines then recom- without advantage. Suffice it to say, for the sake of brevity, that I had him under premended by the most able practitioners;
themities
exist,
Cramps
character ;
I
697
paratory
treatment for two
or
three months " Verum medicamentum hoc robustioribu
without any abatement of the fits. I admi tantum convenrt, siquidem violenter admo nistered the digitalis and polnpody (ths dum purgat, et vomitiones immanes exci tat.
—Vid. Raii Hist., p. 767.
Others remark to him as above, with similar effects The prostration of strength and diminutior speaking of its successful exhibition Sfd ob nimiam remedii vehe of pulse in this case were absolutely fright. ful. He has had no return of fits for ten mentiam, ejus necessarian years. I also cured his brother six years detrectavit."—Vid. Murray flpp. Med ago, who likewise has been since exempt. v ol. 1, p. 192. But I do not agree with ltay I have found the delicate to bear it, a: The third case which I have selected is that of the daughter of an eminent surgeon, well, at least, as the more robust. Wit) who had been afflicted for six years. Site polypodium, although sys in general assrt that its vir. was of the melancholic temperament : much tematic abdominal congestion ; state of bowels so tues reside in the root alone, this is not torpid as not to be acted on except by in- true ; I have used the leaves oftener than ordinate drastic purgatives, of which she the root, andwith equal success ; and Dr. took great quantities, often without effect. Hill, author of the "Vegetable System," I employed the preparatory treatment for says that the leaves possess all the virtues two or three months mtlrout success. She of the plant until fructification is completed. was setat. 16, had never menstruated, and I have succeeded with the digitalis without laboured under euuresis. I subjected her and have succeeded in a vast also to the above treatment, which affected number of cases by the preparatory treather severely. She vomited incessantly for ment alone. The number of cases which three days, taking decoct. avenœ, every were pronounced incurable, and which retwo hours ; bowels costive eas - usual. I sisted my own ordinary treatment, though was greatly alarmed in her case, as she did pursued with activity, and in which I have not vomit for a whole hour after taking the been obliged to resort to the specific (shall dose, which is unusual. Prostration of I call it ?) remedy with success, amount to strength was excessive ; pulse very irregu- about fifty. I never administered it where lar, intermittent, and scarcely to be felt, 44 fatuity existed, or where I suspected malin a minute. Shortly after taking the dose formation or disorganisation of any part of she complained of pain in the occiput, and the cerebro-spinal system. I am satisfied said she felt as if she were tipsy. The ab- that digitalis may be administered in this dominal congestion has disappeared, the way with much more safety than other poibowels are now obedient to mild purgatives, sons generally are, because it seldom or and she is also cured of enuresis. She has never needs to be used more than once ; and then it has not time to be taken into the svshad no recurrence of fits. tern ;this differs widely from the habitual Remarks. exhibition of poison. I must however acI have observed that when cramps occu:r kuowledge thatI have failed in several cases, witliin forty-eight hours the cure generallyI but they were chiefly those in which the was not administered under my own is effected, though success may follow with. out them. If they be alarming they may be) eye, being remote, and therefore I cannot relieved by giving a pint of chicken-broth;, say how far mismanagement might have or some mild stimulant ; but otherwise it isi taken place ; for instance, the juice of a better not to check them. In no case in succulentplant may have undergone decomwhich I employed it did any untoward acci- position in a short space of time, especially dent happen, and I conceive that whatever in the summer season, which was chiefly danger occurred to the ancients arose from that in which I have made the experiment. the injudicious use of it in minor doses at I should have mentioned that in the case last distant periods, giving it time to be absorb- related turpentine was among the remedies ed by the system, in which case it must used without benefit, and I mention this the have acted deleteriously. Under this im- more particularly as that medicine has been to have succeeded so well pression I never varied the dose in regard of late to age, lest an under-dose might prove poi- in the hands of some physicians, especially sonous. I am at present engaged in making that able and philosophic practitioner Dr. experiments to find accurately what pro- Elliotson, of London, as to have been conportion of the dried leaves may be equiva sidered more entitled to the claim of being lent in infusion to three ounces and a half of specific than any other of the medicines used the succulent leaves of the fresh plant, in in the disease. order that I may be free to order it in wiuNow, as to the rationale of the practice ter as well as in summer, in the adjustment here advocated I can scarcely hazard a conof which I conceive I cannot be too cautious. jecture ; perhaps it is that bv giving such Ray, in remarking on a case of epilepsy, a tremendous shock to the system
leaves)
scrofula,-continuationem
for
regard to the
writprs
polypodium,
remedy-
reported
cured,
as
reported
nervous
by Parkinson,
says,
it completely alters
its habit, and
that
the
698 and the violent spasms of great sedative power of the medicine re-of the duces the excitability of the nervous system the intestines, an irritable state of the mus.
secretions,
far below its natural standard that it cant cular and mucous membranes of the stonever after return to that morbid conditioni mach and intestines exists iu a very high of over-excitability in which it formerly had[ degree. I very much doubt whether the been. But in the present state of our know- liver has any-thing to do with the disease. ledge respecting the pathology of the nerv- The bile that is vomited appears in general ous system, such speculations are equally healthy, and I should attribute its quantity rather to the pressure the liver receives in vague and destitute of practical utility. the act of vomiting, than to any morbid Cork, August 9, 1831. state of that viscus. so
CASE
evening
1.
July 27. Geo. Brown, police constable, ON THE UTILITY OF HYDROCYANIC ACID IN about 35. I was called to him this age ENGLISH CHOLERA. at a quarter before ten. He had By JOSEPH CURTIS, Esq., Surgeon. home from his duty half an hour I TAKE the liberty of sending you the fol- previously, and felt nothing the matter On his way home he was on duty. i towing cases, showing’ the efficacy of hydro- while attacked with violent pain in the abdomen, cyanic acid in English cholera. I might and shortly afterwards with violent retching have the number, having multiplied i easily had from thirty-five to forty cases in piivate and purging, and great prostration of strength. At present has hardly strength sufficient to practice, and among the police ; buttlie symp- hold his head over a basin ; pulse very small ,:’ toms, treatment, and termination, have been and weak ; what he brings up appears to so similar, that a history of one case is a history of almost all the rest. What effect be healthy bile. it might produce in the Indian species I R Acid. hydrocian., ; m Mucil. acaciœ, 3ij; cannot, of course, pretend to say ; but from ). Mist. cathart., 3j ; the very sudden and effectual relief it apAq. purœ, 3v. M. pears to give in all cases depending uponn Sumat cochl. ij, magna tertiis horis. an irritable state of the stomach and intestines, I should think it well worth a trial." If the first dose return, to take another in I have used it during the last seven or eightIt three quarters of an hour. months at the rate of an ounce per month, 28. Seven A.M. lie threw up the first and within the last month at a much greaterdose, and took another in three quarters of rate, and in doses to adults of from three to° an hour, which remained ; was sick once five minims, yet I have never observed anyYafter the third dose, but has not been sick bad effects follow its exhibition, exceptt since ; bowels open eight or nine times sometimes, though very rarely, pain in the’ without pain ; complains of pain in the head stomach, and sometimes I have thought itt and back when he rises in bed, which he attributes to the violent retching he had produced pain in the head. These pains, however, are not severe, and soon go off.yesterday evening ; pulse much stronger. As many of the patients, to whom I have Continuetur mistura. P.M. Has been up since eleven o’clock given the hydrocyanic acid, have been policemen belonging to a division under my the morning, and is at present out taking in care, who are obliged to come to me if theya{ a walk. leave their duty on account of ill health 29. Bowels open six or seven times only for an hour, if it had produced any bad yesterday without pain ; was not at all sick; effects six or nine months afterwards I mustfeels rather so this morning , has no headhave seen them.acb. Rept. mist. In a report of a case of English cholera, July 30. Bowels not open yesterday; which occurred in Westminster Hospital, pain in the abdomen twice in the published in the Number of THE LANCET night; open once this morning. for the 23d of July, the hydrocyanic acid R Quininœ sulph., gr. xij; appears to have been administered once iu Acid. sulph. d., tttxij a dose of one drop, but was not repeated in Tinct. calumbœ, 3j ; of I have consequence debility ensuing. Mist. cathart., 3j ; never seen debility produced by it, and Aq. purœ, :5v. M. doubt the probabdity of its having such an Sumat cochl. ij, magna quartis horis. effect. In a dose of one drop I should 31. Still unless effect, slight ’pain in the abdomen; ltardlv expect any perceptible bowels open thiee times ; no sickness ; apcontinued for some time. As to the morbid anatomy of this disease petite tolerable; feels much stronger. Rep. I can say very tittle, not having as yet lost mist. a patient; but, undoubtedly, from the state Aug. 1. Cured.
returned
.
’
&mid ot;
’
( Six ,
slight
bowels
‘
hsring a musical
whole of every sentence in the same key. private representations and testimonials in to a searching public co-2,couRs ; Ile begins his lectures in a low tone, it is that " Even fools are made and delivers of his to the voice, said, top npidly he can-we wise were the remainder as loudly as by experience." about to say scream,, without the slightest vuiation or modulation of tone. This may bafe been a reason why at least some of the ON THE students preferred to sit on the most reTREATMENT OF EPILEPSY, mote benches. It is a misfortune to this WITH CASES. gentleman, now too late to be remedied, PATRICK SHARKEY, A.M., M.D., Senior that he was foisted into a public engage- By Physician to the Cork General Dispenment as a teacher before he had acquired a sary. knowledge of the classical languages. Hence ALTHOUGH I acknowledge the utility of forth even isolated cases of success his best friends have been obliged to in the treatment of any disease, as tending knowledge that he is in the constant habit of to the advancement of medical science, vet, making false quantities and inaccurate ter- knowing the many disappointments which minations. He has been accused of being have followed upon the adoption of a practice built upon single reports, sent forward incorrect in his anatomical descriptions, and into the world with all the gloss of language desultory in the distribution of his facts. and strained force of analogical argument, The latter charge is certainly well founded, or unwarrantable induction, I cannot but say that I feel much more confidence than I and there is ground for believing that Mr. otherwise should, in submitting for pnblicaPATTISON has not kept pace with the pro- tion in your highly-respectable pages the following cases, a few out of’ a number of gress which general anutomy especially has results derived from experiments conducted made, during the last few years, in Europe. on an extensive scale, during a practice of years and upwards. These few Having hastily run through this list of twenty-five have selected, not from any singularity in what we believe to be well-founded facts, the event or mode of treatment, hut as bewe sball next week enter fully into an ex- ing, by reason of their greater inveteracy, instar onznium." I put them forward midatioti of Alr. PATTISON’S charges against also, under the extremely forcible recomthe Council, his colleagues, and students, mendation of their having been all referred
risespreference but
ac-putting I
I
to
me after the ordinary and diversified, but who, it would appear from his representatreatment of others. I conunsuccessful, were at last all actuated a tions, by desire to fess t was, in the commencement, very timid, and am still very cautious in resortaccomplish his ruin !
the novel and apparently hazardous mode of treatment which 1 am about to lav before you, lest any untoward accident should arise, which might have damned me in the
ing to LONDON UNIVERSITY.
infancy of my professional career,or even now Surgical injure me, and, therefore, 1 never attempt without throwing the responsibility from bittionary, has been elected by the Coun- it, myself upon the relatives or friends of the cil Professor of Surgery to this Institution ; explaining to them the severe naMr. S.
COOPER, author of
the
patients,
has ture of the process, and in doin so, 1 uniLeen appointed, for one year, to the Chair formly receive for answer, that even death, it follow, would be preferable in their of Medical Jurisprudence. After the Doc- , estimation to the continuance of so frightful tor’s uuhappy display in this a disease, attended with perpetual alarm, department, and which may terminate in an accidental during the last session, we were not pre- death, more distressing in its cirpared fur his renewed installation into the cumstances. Yet I would recommend to and Dr. ANTHONY TODD THOMSON
should
infinitely
696
disposed to give this remedy a trial, not to do so indiscriminately, without ascertaming, as far as possible, that there exists .no organic derangement of any of the viscera, especially the brain, lungs, stomach, liver, or intestinal canal. I have,
then called in, and, in conjunction with Dr. Mills, adopted the following as I find in my notes.
in very many instances, found epilepsy connected with derangement of the liver, and I will add, that this connexion prevails far
Contunde in nzortario in pulpom; dein adde cerevisiœ fortioris, j; infunde per horas septem; dem cola exprimendo.—
those who may be
more
It is
extensively
than is
was
treatment,
September 4th, 1807. R Foliar. digitalis 5 iijss ;
generally thought.
astonishing to what extent this and other viscera
disorder of
purp. recentium,
Capiat liquoris colati, ziv, c. ;
frequently exists for
,
a Pulv. foliar. polypodii querc?zs sicta. length of time, without much apparent distarurra, aut radicis siccatœ, gr, x. turbance of the system. The appetite may of leucophlegmatic temperament, was She be good, digestion unimpaired, alvine and fair hair and complexion ; the disease not and evacuations regular, yet, upon urinary a more mintite investigation, a very dis- hereditary. 5. Took the draught yesterday, and in eased state of these organs may be found to have existed. In many of the cases which ten minutes had a fit less severe and shorter I have treated, I have been obliged to em- than usual; vomited frequently and violent. o’clock this day, her pu!se ploy an active preparatory course of medi- ly till twelve cine for one, two, or even three months sinking from 120 to 54, intermittent and irbefore I could venture upon the appropriate regular ; complains much of pain of headi anti-epileptic remedy ; and in two of the and soreness of epigastrium on pressure, cases in which I was successful, one of We ordered a blister to epigastrium, and a p of strong coffee. She bad cramps in them ot twenty years’ standing and muscles of her legs this moment; extre. the the abdominal was other of six, congestion cold at times. i so obstinate, that I could not remove it endecocti secunda until I ventured the Capt. quaque avenœ, jj lb ; upon tirely, appropriate hora. remedy. In a few cases in which I was un6. Has bad no fit; vomiting continued successful, I found such a state to tt both before and after it; and in one I never violently till ten o’clock this morning; pu:;e was able to rectify a disordered state of the 40, irregular, and intermittent ; great pros. primæ via3, indicated by foul, deep-fissured tration of strength. Took a cup of coffee As we have no hospital here yesterday, and continues decoct. avena. tongue, &c. for epileptics, I have had but little expeof legs returned last night. Pupih rience with the lower orders, who would have been dilated from beginning of treatnever exercise sufficient perseverance, and ment. 7. Continues to vomit very bilious matwould rather depend on amulets and quackery, than on a course of remedial measures, ter ; faeces also bilious, of r.ark.brolfn cooften of necessity protracted. I may add, lour. Pulse as before, but less irregular; that I have succeeded with many by the pre. great weakness; has slight cramps; pupils paratory treatment alone (principally pur- dilated. ’ Cont. decoct. avence. 8. Continues free from fits; vomits much gation and treatment directed to liver disease if it exist), without resorting to thebilious matter as before; faeces also of same ultimate remedy, adding- to such preparapulse still irregular, about oO: tory treatment the ordinary tonics, &c., ex- great weakuess; pupils dilated. cepting nitrate of silver, which I never ’ 16. Continues free from fits; strength employ in consequence of its discoloration restored ; pupils contract; appetite a0oa. , of the skin, without possessing any claim to I watched this case for two years, and theri the character of a specific. After having was no return of fits, which had been oi had an authentic account of the success of almost daily occurrence. the treatment about to be detailed in several cases, particularly that of the son of Mr. The next case which I select, is that of Angel of Dublin, a respectable teacher of i gentleman of this city, who had been sethe deaf and dumb, I was resolved to try it i verely affected with epilepsy for twenty in the first case whickshould present Itself, years. He was of robust form, sangum, and the first was that of Miss Fowkes, niece temperament, great abdominal congestion; of a respectable alderman of Dublin, aetat. general health very good. He was treated about seventeen years. She had been seized by several physicians of eminence, and pnwith epilepsy twelve months before. She nounced incurable. Amongst other remehad been under the care of the late Dr. dies he took nitrate of silver tu a Thomas Alills, and was daily growing worse amount, which discolotred him under the use of the medicines then recom- without advantage. Suffice it to say, for the sake of brevity, that I had him under premended by the most able practitioners;
themities
exist,
Cramps
character ;
I
697
paratory
treatment for two
or
three months " Verum medicamentum hoc robustioribu
without any abatement of the fits. I admi tantum convenrt, siquidem violenter admo nistered the digitalis and polnpody (ths dum purgat, et vomitiones immanes exci tat.
—Vid. Raii Hist., p. 767.
Others remark to him as above, with similar effects The prostration of strength and diminutior speaking of its successful exhibition Sfd ob nimiam remedii vehe of pulse in this case were absolutely fright. ful. He has had no return of fits for ten mentiam, ejus necessarian years. I also cured his brother six years detrectavit."—Vid. Murray flpp. Med ago, who likewise has been since exempt. v ol. 1, p. 192. But I do not agree with ltay I have found the delicate to bear it, a: The third case which I have selected is that of the daughter of an eminent surgeon, well, at least, as the more robust. Wit) who had been afflicted for six years. Site polypodium, although sys in general assrt that its vir. was of the melancholic temperament : much tematic abdominal congestion ; state of bowels so tues reside in the root alone, this is not torpid as not to be acted on except by in- true ; I have used the leaves oftener than ordinate drastic purgatives, of which she the root, andwith equal success ; and Dr. took great quantities, often without effect. Hill, author of the "Vegetable System," I employed the preparatory treatment for says that the leaves possess all the virtues two or three months mtlrout success. She of the plant until fructification is completed. was setat. 16, had never menstruated, and I have succeeded with the digitalis without laboured under euuresis. I subjected her and have succeeded in a vast also to the above treatment, which affected number of cases by the preparatory treather severely. She vomited incessantly for ment alone. The number of cases which three days, taking decoct. avenœ, every were pronounced incurable, and which retwo hours ; bowels costive eas - usual. I sisted my own ordinary treatment, though was greatly alarmed in her case, as she did pursued with activity, and in which I have not vomit for a whole hour after taking the been obliged to resort to the specific (shall dose, which is unusual. Prostration of I call it ?) remedy with success, amount to strength was excessive ; pulse very irregu- about fifty. I never administered it where lar, intermittent, and scarcely to be felt, 44 fatuity existed, or where I suspected malin a minute. Shortly after taking the dose formation or disorganisation of any part of she complained of pain in the occiput, and the cerebro-spinal system. I am satisfied said she felt as if she were tipsy. The ab- that digitalis may be administered in this dominal congestion has disappeared, the way with much more safety than other poibowels are now obedient to mild purgatives, sons generally are, because it seldom or and she is also cured of enuresis. She has never needs to be used more than once ; and then it has not time to be taken into the svshad no recurrence of fits. tern ;this differs widely from the habitual Remarks. exhibition of poison. I must however acI have observed that when cramps occu:r kuowledge thatI have failed in several cases, witliin forty-eight hours the cure generallyI but they were chiefly those in which the was not administered under my own is effected, though success may follow with. out them. If they be alarming they may be) eye, being remote, and therefore I cannot relieved by giving a pint of chicken-broth;, say how far mismanagement might have or some mild stimulant ; but otherwise it isi taken place ; for instance, the juice of a better not to check them. In no case in succulentplant may have undergone decomwhich I employed it did any untoward acci- position in a short space of time, especially dent happen, and I conceive that whatever in the summer season, which was chiefly danger occurred to the ancients arose from that in which I have made the experiment. the injudicious use of it in minor doses at I should have mentioned that in the case last distant periods, giving it time to be absorb- related turpentine was among the remedies ed by the system, in which case it must used without benefit, and I mention this the have acted deleteriously. Under this im- more particularly as that medicine has been to have succeeded so well pression I never varied the dose in regard of late to age, lest an under-dose might prove poi- in the hands of some physicians, especially sonous. I am at present engaged in making that able and philosophic practitioner Dr. experiments to find accurately what pro- Elliotson, of London, as to have been conportion of the dried leaves may be equiva sidered more entitled to the claim of being lent in infusion to three ounces and a half of specific than any other of the medicines used the succulent leaves of the fresh plant, in in the disease. order that I may be free to order it in wiuNow, as to the rationale of the practice ter as well as in summer, in the adjustment here advocated I can scarcely hazard a conof which I conceive I cannot be too cautious. jecture ; perhaps it is that bv giving such Ray, in remarking on a case of epilepsy, a tremendous shock to the system
leaves)
scrofula,-continuationem
for
regard to the
writprs
polypodium,
remedy-
reported
cured,
as
reported
nervous
by Parkinson,
says,
it completely alters
its habit, and
that
the
698 and the violent spasms of great sedative power of the medicine re-of the duces the excitability of the nervous system the intestines, an irritable state of the mus.
secretions,
far below its natural standard that it cant cular and mucous membranes of the stonever after return to that morbid conditioni mach and intestines exists iu a very high of over-excitability in which it formerly had[ degree. I very much doubt whether the been. But in the present state of our know- liver has any-thing to do with the disease. ledge respecting the pathology of the nerv- The bile that is vomited appears in general ous system, such speculations are equally healthy, and I should attribute its quantity rather to the pressure the liver receives in vague and destitute of practical utility. the act of vomiting, than to any morbid Cork, August 9, 1831. state of that viscus. so
CASE
evening
1.
July 27. Geo. Brown, police constable, ON THE UTILITY OF HYDROCYANIC ACID IN about 35. I was called to him this age ENGLISH CHOLERA. at a quarter before ten. He had By JOSEPH CURTIS, Esq., Surgeon. home from his duty half an hour I TAKE the liberty of sending you the fol- previously, and felt nothing the matter On his way home he was on duty. i towing cases, showing’ the efficacy of hydro- while attacked with violent pain in the abdomen, cyanic acid in English cholera. I might and shortly afterwards with violent retching have the number, having multiplied i easily had from thirty-five to forty cases in piivate and purging, and great prostration of strength. At present has hardly strength sufficient to practice, and among the police ; buttlie symp- hold his head over a basin ; pulse very small ,:’ toms, treatment, and termination, have been and weak ; what he brings up appears to so similar, that a history of one case is a history of almost all the rest. What effect be healthy bile. it might produce in the Indian species I R Acid. hydrocian., ; m Mucil. acaciœ, 3ij; cannot, of course, pretend to say ; but from ). Mist. cathart., 3j ; the very sudden and effectual relief it apAq. purœ, 3v. M. pears to give in all cases depending uponn Sumat cochl. ij, magna tertiis horis. an irritable state of the stomach and intestines, I should think it well worth a trial." If the first dose return, to take another in I have used it during the last seven or eightIt three quarters of an hour. months at the rate of an ounce per month, 28. Seven A.M. lie threw up the first and within the last month at a much greaterdose, and took another in three quarters of rate, and in doses to adults of from three to° an hour, which remained ; was sick once five minims, yet I have never observed anyYafter the third dose, but has not been sick bad effects follow its exhibition, exceptt since ; bowels open eight or nine times sometimes, though very rarely, pain in the’ without pain ; complains of pain in the head stomach, and sometimes I have thought itt and back when he rises in bed, which he attributes to the violent retching he had produced pain in the head. These pains, however, are not severe, and soon go off.yesterday evening ; pulse much stronger. As many of the patients, to whom I have Continuetur mistura. P.M. Has been up since eleven o’clock given the hydrocyanic acid, have been policemen belonging to a division under my the morning, and is at present out taking in care, who are obliged to come to me if theya{ a walk. leave their duty on account of ill health 29. Bowels open six or seven times only for an hour, if it had produced any bad yesterday without pain ; was not at all sick; effects six or nine months afterwards I mustfeels rather so this morning , has no headhave seen them.acb. Rept. mist. In a report of a case of English cholera, July 30. Bowels not open yesterday; which occurred in Westminster Hospital, pain in the abdomen twice in the published in the Number of THE LANCET night; open once this morning. for the 23d of July, the hydrocyanic acid R Quininœ sulph., gr. xij; appears to have been administered once iu Acid. sulph. d., tttxij a dose of one drop, but was not repeated in Tinct. calumbœ, 3j ; of I have consequence debility ensuing. Mist. cathart., 3j ; never seen debility produced by it, and Aq. purœ, :5v. M. doubt the probabdity of its having such an Sumat cochl. ij, magna quartis horis. effect. In a dose of one drop I should 31. Still unless effect, slight ’pain in the abdomen; ltardlv expect any perceptible bowels open thiee times ; no sickness ; apcontinued for some time. As to the morbid anatomy of this disease petite tolerable; feels much stronger. Rep. I can say very tittle, not having as yet lost mist. a patient; but, undoubtedly, from the state Aug. 1. Cured.
returned
.
’
&mid ot;
’
( Six ,
slight
bowels
‘