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had here recoui se What has been the effecto it however, I have no since been ableto learia. ut besides biisters Lemployed alio a mixture, illi tincture os alap, whicha oped ould operate a a briscpurgative. his Ddirected as an evacuant of wateri a natura ouilet. But asof this Malliave more occasion to speala in other cases, I allia nothinios it here. And of in future plans,ith this patient, need malleio observations as e mallno probabi se her again.
This patient id no return to the Disia pensarn and as her residelice a at thetiistance of severa miles frona Edilaburgh, have neve been able to earn the eventos the casse.
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XX. Case in et hic there occurre Ha seculiar
fourth ear of his age, admitted Aprila Sth 777, complain os ver violentiain assectiniali the finger of his len-hand tosticli a degre as entiret to preven him from ein able to move them Theyare ali drawn in toward the palm of his hand and he alleges, that even the lightest attemptato Xtend them, occasion the most excruciatingialia. Non of them are disse coloured, or therisis obviousi assected Yet even the lightest ouch ives very great uneasines so that to avoid contactwith otheriodies, hecis obliged toleel his hand constanti in a very large ag Inevery other respectae is in good health. But the pati of his an totali incapacitates
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Twelve monilis ago he received a strokeon the metacarpatione of the mi lille finger, ear to the oint This ave immuchisai a the time, ut produced noWOUnd. It however prevented him rombein ablesto extend his finger for ometimes and a se monilis after his accident, at his finger began to contra' inwhicli state the have continued ver since. He has used wario fomentations an avariet of ther medicines, without effect . Habeat fotum electricum per horae quadrantis spatium ter in septimanti et ni exinde Uehemens oritur dolor, eliciantur scintillae electricae e manu soni ra.
Aprilis 6. He has been regulari elec- trifie since ast repori, and the electrical spark occasion some patia in his haud buti is no os long continuance He is no able o move his finger a litiles; ut thepain of his and onaeing ouched stili
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OBsΕRvAΤ1ON delivere L ne 6. The diseas of this patient furnimes uswith an ex ample of what Prechon a very singula allection. I mustiwn, that PhaveneVer efore et illi an casse hichcouldie aid very early to resemblecit. Nor an I assignta place for it in an nos logical system Theres ore, ithout attemptinito give any nam to this disease, vi must try ho far me an ive an pro babie conjecture a to iis nature. It is evident that the assection, hateve iis natur may be, is totali a loca one. It is confine J entiret to the est-hand and there marked meret by one symptom, that is, ain. The contraction of thes ingers, and os o motion, a far asme an learn, are to e considerei solelyas Consequences of this A the fame
time, here is no tumour, ulceration, inflammation, or an obviolas cause rom
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the consequence of impression communicate froni the sentient extremities of thenerves to thei origin and these impressession are varied by an different cir cumstances, particularly by the state of the sentient extremities, and by the condition of the nervous fluid. illi these, in a certain condition the force of the impression is illier totalty aken T, orgreatly diminis Ked Ohile, on the therhand when they are in a contraro condition iis influenc is greatly augmented, insomuch that an impression, hicli usa- allyris capable of iving very litele, o ra-ther no sensation, ill produc even an excruciatin degre of ain. Froni thesupposition heres ore os fuch a change in the state of the nervous fiuid, me may Ιapprehend account for the singula assection in the caseies reis. This patient is Tec ted illi excruciati rar
the mos gentie ouch, or lightest attemptio motion Arad e complain even os constant patia, probabi frona that irrita-
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tion hicli must everte occasioned by the circulation, and suchither causes. But whil such a sapposition would af ford om solution or his phenomenon, it is stili farther corroborated by the cause induc in the affection There an apprehend bestitit doub that ou patient is right in his conjecture, in attributing the diseas before usa a strohe. his stroke,
although not so violent a to occauon any wound produced suci patia a to prevent,
for sonae time, theis of the extenso mus cles of the fingers and with the continu-ance of thisiain the sensibilit soon aroset it present eight inso much that hedread the mos distant approach owarils his hand even in the most gentie manner. There an then, I apprehend, e litiledoubi that by the rohe, though nowound was produced, an injury wasione tofonte subculaneous nerves and that romthis the dis eas is tote considered a soletyoriginating. I ould then conside the caseo the present patient to e ne of those anomalous affections of the nervolas init,
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to whichio name cante iven, and whichis ather characteri sed by it peculiaritu, thani an particula sympto mS. To the present case, a Pliave at ready observed, I have neve seen an thin verysimilar. et in the a se of Janet ilsbia,
one o our patient during the winter coui se we had an affection whicli, o me,seemed in iis nature somethinito resembleit There, indeed, rom the eat of the affection, gaverit the nam os that genus
o diseas whicli the nos logist distinguisti by the titie of Dysphagia. But we had inher case, I imagine, an instanceis dissicultdeglutition totali arising rom increassensensibility And Doni his also here,as both a constant uneasiness, as in the casehefore us and an Xcruciatingiain onie in touchedi solid substances, as in theactio of swallo ing. have heard os a casse stili more nearly resembling the present, hicli is mentioned by a celebrate steacher of medicine alion don in his lectures. In that case, ithout an evident dis eased state, there asiniain
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simila to the present, arisin froni thesecond sint of the humi, and on thesightest o uch the mos excruciatin sensation was induced. With this patient theaffection resisted an almos infinite varietyos means os cure; and even the division fili nerve leadinifro in the thum had noother effect butho produc a change in thesea os t. Aster the nerve a divided, the patia began no a the thumb, a be fore, but immediatet above here thesincision had been made. What, at tength, as the fate of that case, I do notinow. Is emere, hoWever, to oriri an conjecture a to the terminationis the present, rom What, saw of
nervolas affections in genera are more
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A the fame time, in anomalous cases a udgment mould everte pronounced with Ver great confidence and it is hard tofa what turn the may bmetimes vensu ident talae. Dam sorry, hoWever, o Observe, that, haleve may be the progress of this disease, e mali probabi havel, ut litti opportunit os observiniit forour patient has no discontinued his attendance at the electricity, and I have notbeen able to learn here heclives. Is however, I an discove his place of residence, I mali rechon it orth hile to attend to thedis ease even although, ma noti ab leto prevali pon him to malae tria of any
Besore he came underisu care, his dis eas had continued, illi ver litile alteration, o the pace of twelve monili. and during that timeri had resisted the use of various remedies It is no improbablethat albour attempis, houldie everaeturia
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tote realed here, ill noti more fortunate . ad e, O ever, continued attendance withis, Mould, at east, avegi ven a fair tria to different medicines Dom hicli, Papprehend something mighthave been expected. Here it, ill naturali occur to ou, Domwhat Phave said of the natur of the disease, that I conside the great objec in the curet be the restorationis prope sensibilityto the nerves The sensibilit of the nerves, where there is no obstruction to the inter course illi the sensorium, conside asdependinionet o circumstances sirst, onthe condition of the sentient extremity; and secondiy, o the conditionis the nervoris fluid And a. vi e the brain tolen otine secreting organ, hut a great number of secretiniorgans Pimagine the fluidia be morbidly altered in ne nerve, while it is no so in anotherci and lam disposed ais t think, that rom an actionon the extremity of an nerve, the state offecretion, at that par of the brain furnilh-