Medical cases, selected from the records of the Public Dispensary at Edinburgh : with remarks and observations

발행: 1784년

분량: 452페이지

출처: archive.org

분류: 미분류

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AN OBSERVATION S. 31'

ever case, impression on the extremit ofa nerve are immediatet communicated totis origin.

On these principies, then, I conside theincreased sensibilit heretis dependiniuponboth the circumstances hich have been potntediui. Perhaps, however, i dependsmore on a change in the state of the ner- uous fluid than in the sentient extremi ty of the nerve at east that this too place, with regari to the case o,hiches have compared the present, as evident romth uneas1nes remaining after the nerve was ut, and rom iis arisin above theincision Supposing this, heres ore, to belli cause of the augmented sensibility, the prope state is tot restored, both byan alteration in the condition of the nervo us fluid with whicli the par is supplied, and of the sentient extremities of the nerves with whicli it is furnis hed. Those holeard the observations hicli Posseredis the case of Janet iison, illnot be surprised that, illi these intentions Pinould have had recoui se to elec- tricity,

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aeto MEDICA L CASE s

trici ty, speciali as I as disposed to magine that it produce so good emeens in that casse. I may at sirstfght, indeed seem strange thata mould have here employed, fordiminis hin morbid sciisibili ty, a reme lywhich ichnown tote solo ei fui an agent in augmentiniit, o restoriniit hen it is diminime sor ost But Lam inclinesto

belleve, that these effect are produced in consequence of iis altering the state of secretion and thati an analogous alteration it,ill restore the nervous fluid tothe natura state hen it is therwis affected. But whateveri the principie faction, Lam persuaded, rom facts that electricityis capable os diministi in morbid sensibi- lily. Anii on thes ground I directed itto the present patient In a casse,'OWever, where, fron the lightest ouch, exquisite patri,as induced, it Was necessarycio be-gin illi the ulmos cautiora. On this account, Iiega b directing or ur present patient the electricat fomentation thatis the mere charginitiis hod with electrical

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AN OBSERVATION S. ar

trica fire. In his a os exhibition Iam os opinion that the electricit operates as a stimulus to the whole system. ut it does no affect an par so immediatet asi ei ther hocks are gi ven or spark dramn

fore that, at the fame time, Pordered thata tria inouldie made, hether the patient was able o have spark drawn froni theextremit of the finger of the len-hand. Almon contrary to expectation, I found that in his a he was ablesto bearcit; for although it excited omelain, et that pa in was ut os hori continuance. Asterae adiut foris hori time used the electricity in his manner, there asthe appearance of soni progress in thecure for although thelain frona the ouch stili continued, et he was ablesto move his finger a litile. At this time, however, Urelectrica machine et illi an accident, whicli necessarii gave an interruption tothei se of this remedy, and it a no againgo so oon ut of the hand of the work man a could have been wistaed. During

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this period the patient called severa time; without bella electrified anit, after repeated dis appotnimenis, helat ast fors okus. I must own thala was ver sorr forthis both on his own account, as I imagi- ned that he had sonte hance of recovery from it anilonours, as it prevented the triat

whicli,ea ad in iew. Is I mat e ver fallin with him again provide his dis eas is in the sanae siluation, I hali advis him torene the use of the electricity. Dother

ward tote alien stould the electricityprove abortive, it is uianecessar tessa any thing, since there istut litile prospecu that we mali hereaster have an opportunit ostreatinithis casse.

A this patient neve asterWard returne i to the Dispensary the future progress and the event of his case are not accurately known But some of the gentie men ho attended the lectures me him

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AN OBSERVATION S. ra

sonae monilis fierward in the street, and he informe them that his complain stili continue Mnearly in the sanae state a be fore. At that time he was unde the 1- rectionis nother pracstitioner. XXI.

by trade a sinoemaher, admitte 1 18 tho April 777, is affected almost very evening soon after goin to ed, it convulsive motion o disserent paris of his body, particulari of the leg and arms. The tength of time for hicli these sita continue is conriderabi varie l. Some- times the las for hal an our, ome- times for the pace of an hour, heia theyin genera terminate by induc in a pro-

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fuse weat. During the continuance of the sit heri affected with dyspnoe and vertigo and for the most par it is attende lalso illi an involuntary disicharge by stoolandirine Immediatet after the convul- sive motion cease, he in generat alis asseep, and resis et during the night He complains, however of being much distressed through the da with a sense of weightand oppression about the praecordia; and hecis also frequently distressed illi flatu-

His appetite is sontewhat impatred landitis elinis bound untes s lienis uses purgative pilis But his pulse and heat are

He has been assected illi these complaint for bout the pace of three wee s. Besore that he was neve subjectesto any simila affectioi, and none of his parenis,

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AND OBSERVATION S. et

Intemnittantur pilute albarlica , et

Laudant liquid guttas viginti quinque Syrusissmplicis drachmas duas., qua me/rthiae unciam unam . . Fiatha ius sumendus omni no ne hora mni nec non fumat omni mane silulam

Pruleiam unam.

Apri 26. He has taken his medicines asdirected, and he has ad n fit for these severa daysiast. ut about eleven 'clochthis forenoon, he had a light attach. Hisbeli has been very bound and in order

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εnerulene, et capiat alternis noctibus sitularum ex colocynthide cum aloe grana decem hora

o' cloc in the orning and continuennear an hour. ut he has had n otherssince the last report. Heris, hoWever, frequently assected with sichnes a stomach, and with vomiting. He has in genera aneas stoo every a since helegan the use of the purgative pilis.

Continuentur medicarmenta.

Ma 16. He hastadio fit since the last repori, andine has been but litti affected with the sichnes o vomitini: ut e complain much at present of pain about the regionis his stomach. Beli regular although he has alien but se of the purgative pilis.

Intermittantur pilula ex colocynthide cum aloe continuentur pilulae iam leae, et capiat pilulam unam omni mane et vespere. May 3. Heiadis severe fit on ridayxiight, an another on Saturday; ut since

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AN OBSERVATION S. 327

since that he has had n retur of them. Continuentur pilutae curruleae, ed capiat pilulas duas omni nocte et pilulum mam omni manc.

Ma 3 o. He has ad n sit since thelast repori; ut e complain much ffichnes at his stomach et his appetite

The case of this patient is in sonae res pedis, singular and affords I apprehend, an example of a diseas not ver da occurring in practice. His diseas consists of paroxysms,hich ive vident indication of their cinio the nervous ind.

These, at thei firs commenCement, erein ome respect periodicat, returning every evening at a certain hour. his state ofuppearances, howeVer, as ut os hortduration and in no long time e was subject to attack of them illi the fame irregularity ascis the had been fit of the hystericalis epileptic ind. I may far X et ther

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aa MEDICA L CASES

ther e observed that o hysterical ande pilepti sits the had, in severa particu

It would necessarily, heres ore, presentitself as a probabie supposition at east, that the dis eas of ou present patient mayhe a peculiar modificationis either. Whenwe examine, however, the case illi attention strong objections occvr o both suppositions. I cannot indeeille dented thathoth dis ea se put ora very Various appear ances ; et, mi is ali these there are certain characteristical fymptoriis, Whicli, illi each, re uniformi present, and whicli, whateve may be the variet in the appear-ances serve to potnt out thestrue nature of the affection. Hysteria, in ver instance, is attende twith a peculiar affection of the alimentar canal, and with a particula state fmind the patient ein subjecto a re- mari able luctuation os spiriis, both in Potni

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