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an accurate account oscit is give under
this genus he has referre Ino esse hanesine-teen different species Gl of them instances in hicli dissiculi deglutition arose from different causes et the description os non of them, by an means, Correspondsto that in the caste no before us Ofthes sonae, a the paralytica, Sord ex amples of iis proceed in froni ant of the movin pomer; thera, as spasmodica, from the effect o stricture occurring in the mort o wallow and ali the thersaris froni soni particula loca affectiona boui the pharyn or oesophagus Hessias
the mere esse of pat in the action offwallowing ithout an obvious cause; and that too Where the patia Was solitu-ated that, is here Was an loca affection, it must necessarii have been visibie Assar, however, as u observation ent no
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obvious affection could hereae discovered. The patient her self, indeed, alleged thatshe had a feel in in her throa resemblingillat hich might be supposed to aris frona
vesication and a genti eman who ad CCcanon to reat his patient bes ore me came underisu care thought that at ne
time he could discover omething of this Lind. et although fuch might then have existed I an have litile oub that theyhad dis appearedi e re in carne underi ur
A the time, heres ore, hen eleganthe reatinent of this patient' case we aret considerier a subjected o dissiculi deglutition no froni obstruction, hut rompain and that ain, oo, ariun Domparis,hicli,ere visibi on inspecting the fauces, and seem est tot assected illi noapparent disea se. I have neve before ad Occanon to reat an casse here the symp- tonas ere simila to the present: and here, I apprehend there is no oona forenteriaining an suspicion a to the realityof the assection The patient could have
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no objecit either in deceivinius, o thos eunder hos care me had beenies ore etreate lier land me howed no indicationo that state os minit hicli ould eadher o deceive hei self Besides his pre- violas toler comin unde Our care, me had been subject o dis eases of the throat; in hicli, on different occasions the symp- tom Nere obvious These are describe lin the historylefore us, accordinito the account i ven by the patient ei self. Ima no , however add that in the formersore throat there a fomething whichine id not mention to the gentieman who
moman os a decent appearance, et herforme sore throat were venereat est Wason his account that he had ahen themercur mentioned in the history hicli, although it ealed the ulcerations in thethroat, hadiso effect in removing the particula patri ora deglutition. As to the cause of the present dis easse, then, I have litti doub that it derived iis origin froni a venerea infection, and rom
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that, too as inducinia venereat fore throaci Vetri rechon it tot a matteris ver greatuncertainty ho farcit could properi beeonsiderei as a Venerea symptom, henwelegan the reaiment of this cases thatis, o farcit could e vieme a stili dependinion the venerea virus. I mustown, that as illa latready resisted mercury,
Pwas inclined to consside it in a disserentlight. arom the circumstance of the patient hein able o wallo liquid and no solids, it is evident that thelain Wasnotii ven by the effor to wallois formith a bolus os a proper 1ge, es estior is required than in the deglutitionis fluids. Accor lingly, it is notinfrequent in the angina that patient have more ain infruallowin spitii than solis od altho' there are certain states of the inflamed paris in hicli the pati must aris Domthe ouch of an solid ; and then, pro bably, it arises frona the augmented sensibilit of the nerves, in consequence of theirbeing put pon the stretch.
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I considered the present case then, altho' os a disserent nature, et to e in omemeas ure analogous to this viewed i asan instance of an increased sensibilit of the pharynx, rom a peculiar state of the extremit of the nerves; and I supposed this state of the nerves to have arisen there froin the venerea affection to hicli theseparis ad been formeri subjecit This, then, is in idea of the natur of the disse ease. merea to give a nam to it Ι couldoni refer it to the dysphagi of r Sau- vages and to the disserent species hichiae has enumerate would ad another, unde the ille os Dysphagi Dolorosa. Bucho far either the nam is proper orthe conjecture elliounded, may perhapsti matter of doues am far frona alleging that the supposition no suggested
probabie rounds am sensibi ilia itis ot ni liable o ma dissiculties, ut that here are other supposition on whichthe phenomen might be explaine l. et, ter attentivel considering the case, I as
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led to adopi the present conjecture, a What seemcd o me east improbabie. Ando cannot help hinking that by the esse iis of the reaiment, and the terminationwhicli it at ready seem to have had the conjecture has been insonte degre verisied;while, at the fame time, noth in occurre lduring the oui se of the dis eas to lead meto alter his opinion. I mustiwn, that hen this patient came Under Ur Care, I Wa very doubiful a tolli termination of this case. I was,lowever, by o means disposed to formis favourable udgment for supposita theconjecture to e et founded, no assections are more varied a to thei termination, than hos of the nervonsainy theywill ometimes ieid in the mostinexpected mannern and at ther times ill remain obstinatet fixed without alteration, hile even the mos powerfui medicines have been employed. When there ore it ad atready continued si long I id not Iown look or an sudden change for thebet ter ans imagined that is fuch achange
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dis eas turning ut tot of a differentia ture froni ha I expected But without that eing the case, it has no v I Ope, had a termination more avolarable than Ilooked for I ould not ho ever, positivel asser that his patient is ali ea lyradicali cured; et rom the reco verybein sonaewhat gradual, I cannot helpthinking that here is a better hance fit bella permanent. And a the same timea must wn that I in disposed toascribe it to the realmen to hicli urpatient was here subjected. Concerning the plan os cure orae fol-lowed in his case, Ι was nocies uncertainthan with regarii to the prognossis. et Iresolvet to try omething on the dea ali ead suggested respecting the nature of the discasse. It wil perhaps seem strange, that illi his vidi I mould have had re- course to electricity a remed wellinownto' os singula utilii as augmentinissensibiliis. Froni his circumstanc it mighthe conclude very ill adapte est a casse in
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bidi increasse l. have, however atready ostener than once observed that i considerihelower os electricii as a medicine ob as et neither horoughly underfloon nor properi explaine l. For in own part a far a I have been able o discoverthe action o electrici ty, Pam persuaded, that it is no more uses ut in augmentingnervous energ where it is deficient, hani restorinito a natural condition, henit is morbidi affected in ther respecns. In what manne it produces such a change, canno pretent to say, at east,ith any degree os confidence On this subject,lowever, I have somelimes indulged myself in conjectures and these Pinallio scruplesto submit o ou consideration considermorbid sensibilit a dependinion ne of
two circumflances on the state of the sentient extremities of the nerves, o on the conditionis the nervous fluid. Q cannot helpthinking that electricit ma have omeinfluencyon both. It wil affect the state of the extremities, froni actinias a stimulus
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mulus to movin fibres It wil affectili state of the nervous fluid, as very stimulus, applied to the extremit of thenerves, mus communicate iis esseCt tothe origin And by this means it may alter the state os action in the brain in generat, or at eas in that par of the brain furnishing secreted fluid to the nerves morbidi affected. ori an disposed to thinh, that heirain is tot considered, no asone secretin organ, ut asin collection offecretin organs and that the fluid separate at ne time, hichris conveyed into
different nerves may not posses the sanie genera properties.
It was in expectation o suci effect that thought os employiniit illi the presentpatient. Whena firs directe it, however had sonte idea that the pati might
also in ome meas ure, depend on a pas modi affectio : and it a on his account that, as an antispasmodic, Pordere lthe tinctura fuliginisci ut froni the patiabeinito soni degre constant, an frona the patientio complaining of any parti
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cilla sense offrieture, I was a last extodi op his opinion and a the tinctura fuliginis occasioned sichnes a stomach, Iomittet it employing the electricit alone. Here it a b propero observe, that employed electricit in the way of sparksonin a it is in his anne that it exeris principali iis actionin the extremities of the nervesn and this a the effect chiefJywanted in the present case. Even the fit stirials seemed o produce sonae good effeci; and rom continuiniit for the pace of a forinight Ialy, he wallowed more easilythan me had done or si monilis efore. Shelecame, however, at this time assiected with periodica complaint froni in sinher stomach. But his I considere iris
meret an accidental circumstance, and unconnected it the diseas atready mentione l. et Pthought proper toti de forthis complaint a mixture of the in tura aromatica with peppermini-water, hichin a s hori time was attended with the de-sired effect and by the continuance of the electricity the patient is no entii ely ree.