The symptoms finally yielded to the efficacy of the remedy, and her constitution improved in strength. When her feelings are affected by circumstances not of an ordinary nature, the limbs tremble, and the fingers move, but these symptoms pass off on recovering herself." 46. We think we may confidently affirm that the foregoing case was not one of shaking palsy, but of CHOREA. And this mistake will account for the numerous cases of the disease which Mr. Mart has entered in his note-book. The candid manner, however, in which Mr. M. has stated the symptoms, absolves him from all intention to deceive his brethren. If authors were thus to act, the science of medicine would not be blotted so often by "false facts" as it long has been! AMAUROSIS. In this disease, too often found incurable, "strychnine has been highly beneficial in the hands of the author." "At the onset of this malady some constitutional symptoms generally are present, such as derangement of the digestive organs, torpidity of the liver, and pains about the front of the head: sometimes indeed symptoms referable to Palsy, come on at distant parts of the body; transient flushes of the face occur, and patients are assailed with fanciful sounds, as buzzing noises, and the dropping of water; or alarming sensations are created by the forcible pulsation of the internal vessels of the neck and head. Among the primary symptoms of impaired vision, are the appearances of insects, cobwebs, or a piece of gauze appended between the affected eyes, and the object viewed; these observations increase in magnitude, and become more opaque. Sometimes the failure of vision is only occasional, recurring at longer or shorter intervals. Zones of bright light appear to surround objects, and flames of candles or lamps assume every position but the real one. Rays of light flit about the eyes, scintillations verge out in every direction, or yellow sparks pass across at every turn of the orbit, occasionally becoming vivid or forked like lightning." 53. Five cases are detailed by Mr. Mart. We shall briefly notice some of them. Case 7. Mr. W., a stockbroker, had suffered several years from defects of vision. "At first he became unable to read by candlelight, afterwards he had pain at the bottom of the orbit, while the external parts of the eyes were tender and irritable, and when pressed, however gently, pain was produced; he had a dull pain in the forehead, generally aggravated at night, and there were frequent involuntary movements of the eyelids. He saw best at noon-day in the sun, or in a room brilliantly illuminated. He transacted all business in which a pen was required as expeditiously as possible, for whenever the eyes were employed, especially while writing, uneasy sensations invariably occurred." When the treatment was commenced he wrote in large characters, and he could not recognize the features of a person at the distance of three yards. The pupils were generally dilated. Strychnine was given night and morning, in doses of a tenth of a grain. Small blisters were applied over the eye-brows, and dressed twice a-day with a quarter of a grain of strychnine. This treatment was continued seven weeks. The patient was very irritable, and would not continue the blisters. A spirituous solution of the strychnine was therefore applied to the neighbourhood of the eyes for four weeks. In the course of a fortnight candlelight ceased to produce pain, and the power of vision was improved. He did not, however, completely recover. Case 8. Fryer, (Case 2, already noticed) had amaurotic blindness of both eyes. "When in a room he could only distinguish the aperture through which the light entered. He knew no one by sight," nor could he distinguish a male from a female by their dress in the streets. This state of vision followed a severe attack of apoplexy occurring subsequently to the paralysis before described. He had epileptic fits every month. He was under treatment for eight months, and was twelve times blistered about the outer angle of the eyes and over the eye-brows. The restoration of vision was very gradual. Many weeks elapsed before the slightest improvement took place. When last examined he detected a fly creeping on the window. His vision was always deteriorated previous to an attack of epilepsy. These fits have now disappeared, and the sight continued to improve long after the treatment was left off. Case 9. Mr. D. residing in the New Road, had been afflicted with amaurotic blindness many years. The deprivation was sudden, and both eyes were affected. "The patient can scarcely distinguish the outlines of a human form, and requires a strong light even to perceive a white object on a dark ground." He has difficulty in standing or walking at times. "During these attacks of nervous debility in the lower extremities, and whenever great atmospherical vicissitudes occurred, he was seized by neuralgic pains at various parts, frequently preventing sleep at night, and causing much disquietude through the day." The principal seats of pain were the legs and arms. This patient had been seen and treated by some of the most eminent medical practitioners. The strychnine was employed for three months, internally and externally, together with blisters. The result was decided benefit-so that the patient could walk round the Regent's Park. It is curious that, one day during dinner, the sight became almost perfect; but soon deteriorated, and has since remained so. Two or three other cases are related; but we cannot afford space for their details here. CHAP. II-NERVOUS INDIGESTION. This chapter is not susceptible of analysis, though it evinces considerable powers of observation in the author. We confess that it is the least satisfactory chapter in the work. The following passage will serve to explain this. Nervous affections of the stomach, and of other parts of the system, are often subdued by a well-directed course of medicines; but sometimes they resist every mode of treatment, and it is in such instances that strychnine should be administered. This remedy, however, will not always succeed in eradicating the malady. The difficulty in some instances of removing the causes of nervous disorders has frequently prevented the strychnine from affording more than partial relief. When the causes were as active as at the commencement of the disease, no benefit has accrued." 101. The third Chapter is on TIC DOULOUREUX. This is a disease of modern recognizance, though, probably, it has existed time immemorial. Fothergill, in 1766, gave the first description of it, and our continental neighbours, since that period, investigated its nature and causes with more zeal than success. Its etiology and pathology are indeed involved in impenetrated, if not impenetrable obscurity! "The attention of the medical profession has lately been directed to the production of this disease by the growth of bony particles within the head, operating through the medium of the brain. Although these and similar causes are always present, yet the pain is generally of an intermittent character. The same obtains in other nervous diseases, as has been fully demonstrated in the results of dissections of persons whose brains were penetrated by points of bone growing from the internal surface of the bones of the head, but who during life had periodical head-aches, or epileptic seizures. Upon a more extended view of the subject, of its origin, and its primary seat, the probability is, that the source of irritation is more frequently in a portion of the brain; sometimes in those portions from which the nerves of the face have their immediate origin, and sometimes at the roots of the nerves themselves. That the seat of the disease is not often in the sentient extremities of the nerves which are distributed over those parts of the face where pain is experienced, may be clearly inferred by the failure of ordinary and external means of obtaining relief, even including the operation of dividing the nerves." 108. Mr. Mart thinks, and probably with reason, that the disease consists more frequently in functional disorder than in any cognizable disease of structure in the parts affected-or may be sympathetic of disease, or even disorder, in a distant part. Hence it is, that medicines directed to the constitution generally, are more beneficial than local applications. Mr. Mart has found strychnine very useful in this painful malady. He has frequently found the blood of patients labouring under neuralgia to be buffy, and he seems inclined to connect a diseased condition of the blood with tic douloureux. We shall now glance at one or two of the cases. Case 10. A young officer had been exposed to wet, and suffered from what was considered to be rheumatism of the face for several weeks. The pain remitted in the night. The extraction of a molaris relieved him for three or four months. But in the succeeding Autumn the paroxysms of pain became almost insupportable, and he had been the victim of intense suffering. In this condition he applied to Mr. Mart. The principal seat of the pain was now the left side of the upper jaw, extending to the nose, corner of the eye and forehead. The upper lip and front teeth were also affected. The gums were red, swollen, painful, and spongy. The general health appeared good. The gums were freely scarified, and it was found that some portions of the sockets were denuded. "The patient was directed to apply daily two small leeches to the gums of the upper jaw. After six applications the symptoms were palliated, the attacks diminished in intensity, and the remissions between the paroxysms were longer. He continued thus improving for twenty days, when the disease became stationary. The pain being now more obtuse, the cheek could be pressed with impunity. The side of the face was rubbed with a spirituous solution of strychnine, (one grain and a quarter being used at each application), three times a day. A sense of heat and tingling was felt in the skin. The attacks gradually lessened, and after persisting in the external use of the remedy seven weeks, the patient found himself free of every uneasy sensation. Three months afterwards the patient informed the author, that there was a disposition in the disease to return, and of his own accord he had used the strychnine fourteen days. More than two years have now elapsed without a recurrence of the malady." 126. Case 11. A relation of the Marquess of Anglesea had been afflicted for many years with tic douloureux, the attacks continuing for indefinite periods. The pain was chiefly in the right side of the face. One or two suspected teeth had been extracted. He had occasional fulness in the head. Medical assistance, of the first quality, had been procured, yet to no purpose. There appeared to be no derangement of the general health, excepting that the circulation was rather excited. Some blood was taken from the arm, and presented the buffy coat. Then eighteen ounces were abstracted, and evinced the same quality. The detraction was repeated in a couple of days, and salines were exhibited. The fascial pain became sensibly diminished. Exposure to the inclemency of the weather in a journey to Brighton, produced a relapse, and on taking blood, it was not found buffy. The strychnine was now exhibited, and applied externally. In a month the pain was gone. The patient then went to the Continent, and the sequel of the case is unknown. After stating some other cases, Mr. Mart concludes with this sensible observation. "Strychnine must now be considered as a specific. It will not succeed in every case. Generally, however, its effects are beneficial, and considerable confidence may be placed in its virtues. It is not to be used to the exclusion of other remedies; but when cases occur which have resisted the usual modes of treatment, a trial of this remedy will generally be attended with mitigation of suffering, often with permanent relief." 148. NEURALGIA. This class of painful complaints has excited great attention for many years past. Our author is inclined to give neuralgia a very wide rangewider even than that which has been ascribed to it by a late talented writer -Dr. M'Culloch.* "When the facial nerves are affected, or when the pain is confined to the course of the nerves in the upper or lower extremities, little difficulty arises in * We were sincerely grieved to learn the melancholy fate of Dr. M'Culloch. It appears that, in jumping out of a chaise, he received so bad a fracture of one of his legs that amputation was rendered necessary, and that he died soon after the operation! He was a man of great, though eccentric talent-and his loss is deeply to be deplored by science in general, and medical science in particular! detecting the disease; but very frequently symptoms of an anomalous description appear, and assume various characters, the origin of which is in the majority of cases exceedingly obscure. Many of those indescribable and tedious complaints which principally affect persons in the higher ranks of life, especially females are often connected with functional disorder of the nervous system. They often manifest themselves by weakness in portions of the body, often in particular parts of the legs and arms, or of the back. Some of the symptoms are referable to the internal organs. Sometimes the urinary apparatus or bowels are affected. Occasionally disorder of the digestive and pulmonary organs appears under the various forms of asthma, palpitation, spasms, and head-ache. There are few physicians who may not on reviewing many cases which have occurred to them of anomalous pains in different parts of the body, so as to counterfeit gouty, bilious, and other internal affections of the stomach and bowels, perceive some analogy between them and the complaints here pointed out.'" 151. We need not detain our readers with an enumeration of the symptoms of neuralgia, as detailed by our author. Several cases, some of them wellmarked, are related by Mr. Mart, in which strychnine appears to have been very advantageous. In a disease, therefore, so generally intractable as neuralgia is known to be, the remedy in question may be fairly recommended as a dernier resort." We place more confidence in the statements of Mr. Mart, than in those who held their heads much higher in the medical world, because we know him to be a straight-forward 66 HONEST MAN"who, according to Pope, and many others, ought to be considered as the "noblest work of God." Of all arts, sciences, or avocations, MEDICINE is that which ought, for its own sake, and the sake of humanity, most dearly to cherish HONESTY. It is a science which contains the purest ore combined with the most worthless dross! From its nature and constitution, it will be exceedingly difficult of depuration. A thousand centuries will not constitute it a pure science. It is incapable of becoming one. It must always have a vast alloy of conjecture; and wherever there is conjecture, there will be Charlatanism and knavery! LEUR APPLICATION A LA Medecin de l'Hôtel Dieu, Soho Square.* RECHERCHES EXPERIMENTALES SUR LES FONCTIONS DU SYSTEME FUNCTIONS OF THE GANG WE remember to have heard a distinguished lecturer on physiology once declare that, if the functions of the ganglionic system of nerves were once In the 14th volume of this Journal we gave a short notice of this work, taken from a foreign Journal, not then having been able to procure the original. |