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fubject to wind in their stomach, and a swimming of the head, who, by looking into a mirror that was kept conftantly moving before them, became fo giddy, as to be in hazard of falling. Others upon the fudden opening of a door, or any other unexpected noife, have been liable to be feized with convulfions. Nay, there have been fome, whofe brain and organs of fenfe were fo fufceptible of impreffion, that they could fcarce abftain from imitating every motion and gefture they saw performed by

others.'

Soon after, our learned Author thus finifhes his difcuffion of the causes of this genus of diseases:

To conclude our obfervations on the causes of nervous difeases, it may be proper to take notice, that although it appears from the diffections of those who have died of them, that the ftomach and inteftines, liver, fpleen, omentum, mefentery, or uterus, have frequently been found obftructed, schirrous, or otherwise unfound; yet as in many other cafes of the fame diforders, no fuch morbid appearances have been obferved in the body after death; it follows, that these symptoms may frequently proceed from caufes, which, eluding our fenfes, are not to be discovered by diffection. Nay, obftructions, fchirri, and other disorders of the vifcera, obferved in those who have died after long fuffering from nervous ailments, feem, fometimes to have been the confequences of a long ftate of bad health, rather than the causes of it: particularly, by the frequent attacks of that arthritic or other morbid matter which is often the cause of these diforders; and, by the pains and fpafms attending them, fome obftructions may at length be formed in the fmall veffels of the ftomach or neighbouring parts; to which every new return adds a little, just as new inflammations of the cornea always increase fpecks on that membrane.'

The fixth chapter is thoroughly replenished with obfervations on fome of the moft remarkable fymptoms of the diseases profeffedly treated on. Thefe he diftinguishes into, 1. An uncommon sensation of cold or heat in different parts of the body. 2. Pains in different parts of the body, fuddenly moving from one place to another. 3. Hyfteric faintings and convulfions. 4. A catalepfis and tetanus. 5. Wind in the ftomach and bowels. 6. A great craving for food. 7. A black vomiting. 8. A fudden and great flux of pale urine. 9. A nervous atrophy. 10. A ner

vous or fpafmodic asthma. 11. A nervous cough. 12. Palpitations of the heart. 13. The pulfe often varying in quicknefs, ftrength and fulnefs. 14. Periodical head-achs. 15. A giddinefs. 16. A dimness of fight, without any visible fault in the eyes. 17. Low fpirits, melancholy and a mania. 18. The incubus or night-mare.

REV. Aug. 1765.

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As this chapter is confiderable, both for its length and im port, we fhall give a fpecimen of our Author's reafoning in it, principally from the first and last articles, which are not the least curious, and are also new. On the first he fays,

The fenfe of cold and fhivering in the beginning of moft fevers and inflammations, feems not to be owing, as fome have imagined, to vifcid fluids ftagnating in the fmall cutaneous veffels, but to a fpafmodic contraction of these veffels, in confequence of that irritation which the nervous fyftem fuffers from the febrile ftimulus, or the beginning inflammation. However, although all fevers proceed from irritation, and confequently from an affection of the nerves, and many fevers of the low kind have had the name of nervous peculiarly bestowed on them; yet a regular intermittent feems to deferve that appellation better than almoft any other fpecies of fever; for its paroxyfms, like thofe of the epilepty, or other convulfive diforders, are owing, not fo much to any fixed obftruction in the vafcular fyftem, or general acrimony, or vifcidity of the mafs of fluids, as to an irritation or affection of the nerves of fome particular part, fuch as the ftomach or inteftines; whence the whole fyftem fuffers by fympathy, and a fhuddering is produced, which is fucceeded by a hot fit and a fweating, that, for the time, removes the caufe of the difeafe. And as an intermittent agrees with epileptic and other convulfive diforders as to its caufe; fo its returning paroxyfms, like theirs, may be often prevented or weakened, by raifing, a fhort time before the approach of the fit, an acute pain or any great commotion in the body.'

This plainly oppofes the doctrine of that morbid lentor, or vifcid ftate of the blood, which has generally been fuppofed an efficient caufe of intermitting fevers, to which it is not improbable many ftill may adhere; though we confefs Dr. W.'s ac count of them is more plaufible to us: the frequent degeneracy of inveterate intermittents into dropfies, inducing us, as it has done others, to doubt confiderably of this fuppofed vifcidity of the huinours in intermitting fevers.

After an accurate defcription of the incubus, or night-mare, our Author, having (on the credit of fome ftrong arguments) diffented from the received opinion, that this diforder arifes from a ftagnation of the blood in the finuffes of the brain, or in the veffels of the lungs, or from too great a quantity of blood being fent up to the head, propofes his own opinion in the following terms:

We know, that certain medicines or poifons, worms, and even corrupted bile or other humours, by difagreeably affecting the nerves of the ftomach, produce an opprefhon about the præcordia, wild imaginations, frightful dreams, raving and infenfi

bility:

bility and there is no doubt, that low fpirits, melancholy, and difturbed fleep, often proceed from a difordered ftate of the ftomach. Is it not probable, that the night-mare has its feat chiefly in the fame organ? If epileptic fits often proceed from the ftomach, why may not the incubus, which has been confidered by Galen as a nocturnal or flighter epilepfy, have its feat in that part? People troubled with nervous or hypochondriac ailments, and who have delicate or flatulent ftomachs, are more fubject than others to this diforder. A heavy or flatulent fupper greatly increases the night-mare in thofe who are pre-difpofed to it. The fympathy of the ftomach with the head, heart, lungs, and diaphragm, is fo remarkable, that there can be no difficulty in fuppofing the feveral fymptoms of the incubus to arife from a difagreeable affection of the nerves of that organ.

When my ftomach, adds he, has been out of order, and troubled with wind, I have perceived a flighter incubus feize me before I was fully afleep, the uneafinefs of which would make me get up fuddenly. As foon as I was quite awake, I was generally fenfible I had been affected with a weight and uneafiness about my ftomach, attended with a faintnefs, and fome fort of oppreffion or fuffocation about my breaft, as if the circulation in my lungs had been a good deal obftructed. While I fat up in bed, or lay awake, I felt nothing of thefe fymptoms, except, perhaps, fome degree of uneafinefs about my ftomach; but when I was just about to fall asleep, they began to return again. In this way, I have often gone on, for two hours or more, in the beginning of the night. At laft, I found, that a dram of brandy after the first attack, kept me eafy the whole night. This remedy has never failed to fucceed with me, the few times I have had occafion to try it; for of late, fince my ftomach has been pretty found, I have feldom felt in my fleep any of thofe uneafy fenfations which refemble the night-mare.'

In the eighth article of this chapter-on a fudden and great flux of pale urine,-he obferves by the way, p. 250- That he has met with feveral inftances of a great and long-continued flux of urine, from an arthritic humour turned to the kidneys.' We were the more ftruck with this affirmation, from a pofitive experience of an arthritic perfon, turned a little of fifty, who never had the gravel, nor any nephritic complaint, paffing with a fudden and confiderable initation, a large quantity of urine, with a very copious calcarious fediment, which quickly precipitated. This discharge was continued for at leaft two days and nights, and a confiderable quantity of this fediment was faved by filtring, which being kneaded, when of a due confiftence, into fmall maffes, like levigated crabs-eyes, was much of the fame colour with gouty chalk-ftones, and would fcore like chalk. This was a plain effect of the natural feparation and ex

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pulfion;

pulfion; as no complaint had preceded it, no medicine had been taken; and the perfon, to whom it happened, concluded it had faved him from a gouty paroxyfm, a few of which he had pretty regularly experienced.

The eleventh article of this chapter-a nervous cough-employs 20 pages, and contains a very particular account of a moft extraordinary cough of the truly nervous, or fympathetic kind. The cafe annexed to it was fo uncommonly rare and curious, that it engaged our Author's ftricteft attention and vigilance and the cough, after a long investigation, was finally cured as compleatly as it was poffible to expect, from a cause, that being inherent in the original conftitution, was not entirely to be removed for we are told, that, fince September 1762, the patient has been very rarely affected with the diforder in any confiderable degree. Dr. W. found the jufteft occafion, from this extraordinary cafe, of magnifying the efficacy of a pediluvium or leg-bath of warm water, which inftantaneously removed the cough, that was not prevented, nor even appeafed, by half a grain of opium, and three grains of affa fætida given morning and evening for feveral days. He adds, that from January 20 to March 25, vomits, blifters, an iffue between the shoulders, bark, powder of tin, rhubarb with calomel and boluffes of Venice treacle, with camphire and valerian, were equally ineffectual. This is a circumftance our most candid Author fcarcely ever omits, and may not be the least practical hint he affords us. He judges, with great probability, that warm water affects our nerves very differently, not only from a dry heat, but also from warm fteams, or cloths wrung out of warm water. We find thele pediluvia alfo, though without any theorifing about them, are very ftrongly recommended by Dr. Tiflot, in different acute difcafes, and particularly upon their invafion.

[To be concluded in our next.]

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An Account of the Incculation of the Small pox in Scotland. By Alexander Monro fenior, M. D. and F. R. S. Fellow of the Royal College of Phyficians, and Profeffor of Medicine and of Anatomy in the Univerfity of Edinburgh. 8vo. Is. Longman, &c.

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HIS account was written in confequence of five queries fent to the Author by the Dean and Delegates of the Faculty of Medicine at Paris, with respect to the practice of Inoculation and its confequences in Scotland. And though the dean and delegates, to whom it is addreffed, had made their re

port

port on Inoculation, to the faculty, before Dr. Monro had received all the information contained in this pamphlet, yet as several members of the philofophical fociety at Edinburgh, to whom it has been read, thought the public fhould be acquainted with the result of that enquiry the Author had made, by eftablishing a pretty general correfpondence on this occafion throughout Scotland, he determined to publish it.

As this fubject is very trite with us, and the practice is become popular, in consequence of long experience and plain calculation, we shall be very concife in any cita on from this small treatise, felecting only what is ftrictly matefial, or new. The five queftions are as follows:

1. Has Inoculation been long practifed in your country? and with what fuccefs?

2. Did fome of the Inoculated die?

3. Did fome who had undergone Inoculation take the natural Small-pox afterwards, and at what time?

4. Do you know that other diseases have been ingrafted with the Small-pox, by Inoculation?

5. Whether did many, after Inoculation, labour under various diseases, which feemed to be owing to that operation? and whether did this happen more frequently, or feldomer, than from the natural Small-pox?

In the course of our Author's circumftantial anfwer, to the first query, it appears, that from the year 1744 to 53, both included, one tenth part of all the deaths in Edinburgh, and St. Cuthbert's parish adjoining to it, were occafioned by the Smallpox, when Inoculation was but little ufed: and in the ten immediately fucceeding years, from 1754 to-63 inclufive (during which term Inoculation was more frequent) the total number of deaths was 1096 lefs than in the firft ten; and the number of deaths by the Small-pox were 71 lefs.

In answer to the second and most important query, our Author gives a lift of 5554 inoculated in different parts of Scotland by a great number of phyficians and furgeons. Of which five thousand five hundred and fifty-four, 72 died; fo that fcarcely one died out of 78. In this anfwer he alfo details the arguments used by the friends of the Inoculated, in order to deduct from the number of those dying after being inoculated, as dying less from that practice, than from an abuse or misapplication of it.

Dr. M. declares, in answer to the third query, that almost all his correfpondents agree in affirming, they never faw any attacked by the genuine Small-pox, after they had truly received it, whether by accident or art.

In answer to the fourth query, Dr. M. affirms, he never faw other diseases communicated by Inoculation; in which negative his correfpondents agree with him. He gives an inftance from

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