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symptoms of an epileptic attack soon showed themselves, and a few days afterwards, on returning from a short walk, she had scarcely time to throw herself on a bed before she lost both sensation and motion. Skin hot; respiration loud, and as frequent as the pulse; pupil immovable; eyelids closed convulsively; limbs flexible; while the lips were convulsively moved, or else a sardonic smile sat upon them. Bleeding was about to be practised, when all of a sudden, after some horripilations, the skin became cold and colourless; the pulse and respiration were suspended; and the insensibility and immobility were such, that had it not been for some slight nervous contractions, it would have been thought that the patient was dead. Affusions of cold water on the head seemed alone to produce any effect; the respiration then became agitated, the pulse strong, and violent convulsions, with tetanic rigidity (pleurosthotonos), set in. Dr. Arguinosa considered the case to be one of catalepsy, with nervous irritation of the spinal marrow. Venesection; assafoetida injection.
During the night a less severe degree of excitement alternated with well-marked collapse. The patient was then enveloped in a sheet soaked in warm vinegar-and-water, which was renewed thrice daily. This was attended with a beneficial result; the symptoms lessened in severity, and the next day the patient could express her desires by gestures, and reply to the questions which were put to her. A glass of orangeade, however, having been offered her, she upset it suddenly, screamed out, and fainted. All efforts to cause her to swallow liquids were afterwards useless. Liquids were not the only excitants of her anger and of her attacks; but the light also, the noise or the steps of persons around her, the unexpected presence of any one, and the slightest contact with her body or the curtains of her bed: the influence of my voice, however, says the author of the case, in withdrawing her from her attacks of delirium, and the preternatural reason and intelligence with which she expressed herself as soon as she recovered her speech (the second day), were very singular. She had a presentiment of her approaching death, and stated that she had never been bitten by any animal. The next two days there were the same alternations, the delirium occurring less frequently, and lasting a shorter time; she foamed at the mouth, when regurgitation, or hiccough, occurred. slept but little that night (the fourth); the next day the only symptoms noticed were aversion to water, light, and air, with the pain of stomach previously complained of. The sixth day she asked for a bath, and the opium, which she took in the evening. A stool brought on strong convulsions and noisy delirium. The women who were attending to her believing her to be possessed by the devil, sprinkled her with holy
water, which increased her furious cries and bizarre contortions. The following night was dreadful—the mouth full of foam, the eyes injected, and the delirium almost continuous. About two in the morning immoderate laughter succeeded the previous complaints. She then expressed her thanks and gratitude to Dr. Arginuosa, and shortly afterwards expired.
The editor considers that this singular disease was neither catalepsy, tetanus, hydrophobia, nor epilepsy, but epileptiform hysteria. To us it appears more to resemble hydrophobia than any other disease we are acquainted with
PalSY OF THE TONGUE CURED BY GALVANO-PUNCTURE.—In 1813, an old woman, Rosa Ponti, was seized with general palsy of sensation and motion, in consequence of fright. Of this she was cured, except in the arms, head, and tongue. She could not articulate a word. In 1836, twenty-three years afterwards, Dr. Dacamina had recourse to galvano-puncture—one pole of the apparatus being applied to the occipital nerve by means of a needle introduced into the neck, and the other to the tip of the tongue. After two applications the patient could raise the organ, and after the third she could reply to some questions intelligibly, although with difficulty. After this the points of contact were varied, and the electricity applied to different parts. The patient gradually recovered her speech, and the other palsied parts were also cured.—Filiatre Sebezio.
APPARENT DEATH.—In a memoir on Apparent Death, and the Means of Preventing Premature Interment, presented to the Academy of Sciences, by M. Bouchut, a candidate for the Manni prize, it is stated, that all apparent deaths, particularly those which are owing to asphyxia or syncope, present, whatever may be the diversity of their symptoms, one character in common—the persistence of the pulsations of the heart —a character which distinguishes them from real death.
The immediate and certain signs of death, according to M. Bouchut, are, the prolonged absence of the heart's pulsations, as ascertained by auscultation; the simultaneous relaxation of all the sphincters, owing to the paralysis of those muscles; and, finally, the sinking of the globe of the eye, and loss of the transparency of the cornea. The Commissioners of the Academy, Messrs. Dumeril, Andral, Magendie, Serres, and Rayer, admit the correctness only of the first of these: the others they look upon as doubtful. The certain signs of death, which occur at a later period, --cadaveric rigidity, absence of muscular contraction under the influence of galvanic stimulants, and putrefaction,-are admitted by all medico-logists. The Manni prize was unanimously awarded to M. Bouchut, as the author of the best memoir which has been sent in during the last ten years.—Revue Médicale.
INSANITY.-M. Bouchet, principal physician to the asylum and hospital at Nantes, has addressed a letter to the Academy of Medicine, in which he expresses his opinion that vice and crime are the consequences of moral diseases, which should be repressed for the preservation of society, and treated in appropriate penitentiaries. For such cases he disapproves of the Auburn system, and considers the Pennsylvanian plan, under proper restrictions, more adapted, and more likely to prove of service. Insanity affecting the intellect is ameliorated generally, he observes, by the patients mixing in society, subject, of course, to certain restrictions; general insanity, however, is rendered worse under the influence of those conditions which incessantly excite the sensibility, and turn it from its normal course.—Revue Médicale.
ACUTE MANIA.—A robust man was brought to the Bicêtre, and placed under the care of Dr. Delasiauve, for an attack of acute mania. His clothes were in rags, and covered with mud; his chest, knees, face, and hands bearing numerous traces of bruises and scratches. He did not present any symptoms of disease, other than the disordered state of the brain. He was bled, and put into a warm bath for two hours. For two days all went on well; afterwards the bruises and scratches became inflamed, and those on the hands suppurated freely. The wound made by the lancet also inflamed, and yielded some unhealthy pus. These symptoms were scarcely relieved before erysipelas attacked the face, part of the scalp, and the parotid regions, and was accompanied by great disturbance of the circulation, the pulse being small and irregular, and so frequent that it could hardly be counted. An emeto-cathartic and simple diluents removed the disease in about forty hours; but it was followed the succeeding morning by extensive meteorization of the abdomen, so as to raise the false ribs, and render respiration very difficult. The patient did not complain of pain; the only symptom he presented was the tympanitis. Magnesian water and astringent fomentations relieved him for a short time; but the meteorization soon reappeared, and was attended with a great discharge of blood with the urine. Attention was thus directed to the urinary passages, and it was not difficult to ascertain, by percussion and by palpation of the hypogastric region, that the bladder was distended by a liquid—a distention which, acting sympathetically on the intestines, and mechanically, by compressing them backwards, evidently contributed to the abdominal meteorization,
On the introduction of the catheter, a quantity of a thick, red liquid, exhaling a fetid ammoniacal odour, and composed almost entirely of blood, mixed with a certain proportion of pus, was drawn off. It appeared afterwards, on inquiry, that the man had long been subject to lumbar pains and hematuria.
The evacuation of the bladder afforded considerable relief for a time, and the tympanitic state of the abdomen diminished; but unfortunately the hemorrhage continued, and again distended the bladder, requiring the catheter to be used night and morning, a liquid precisely similar, and more or less highly coloured, being drawn off on each occasion. The man gradually sunk, and died a few days afterwards.
The examination of the body showed that the kidneys were greatly hypertrophied, softened, and injected; the right kidney contained a large quantity of black and half-coagulated blood, which was also found in the calices and pelvis. The mucous membrane was of a blackish, livid tint, and presented signs of ramollissement. The disease had proceeded to a greater extent in the left kidney. There was very little blood effused, but its place was supplied by a thick, reddish, purulent liquid, which poured out of the calices, and filled the pelvis of the organ. The kidneys presented traces of most intense inflammation; the mucous membrane was in some parts destroyed, and in others covered with pseudo-membranes. The disease extended along the ureters. The parietes of the bladder were greatly thickened, owing, apparently, to the hypertrophy and induration of the cellular tissue between the membranes. Its internal surface resembled that of an uterus affected with chronic metritis. On scraping it with the scalpel, a layer of detritus, consisting of mucus, pus, and decomposed blood, was removed, exposing beneath a very adherent, strong, and rough false membrane. This state of disease extended partly into the urethra, especially to the prostatic portion and the fossa navicularis. The membranous portion was in a state of ramollissement; the bulb hypertrophied. At that part the canal was greatly dilated.
The abdominal and thoracic viscera were healthy, with the exception of the liver, which was increased in size, and, by its granular and yellow appearance, evinced a tendency to the fatty degeneration. The ventricles of the brain contained a small quantity of reddish serosity, as did also the cavity of the arachnoid. There was also infiltration in the subarachnoid cellular tissue, and a well-marked injection of the pia mater, especially on the sides of the posterior lobes. The grey substance of the brain was slightly discoloured.
M. Delasiauve, the reporter of this case, was inclined to attribute disease to some syphilitic alteration, but he was unable to trace it the to that source. Compression of the vesiculæ seminales showed that, instead of the spermatic fluid which they ought to contain, they were full of an abundant matter having the colour and consistence of pus. He was of opinion that the mental disease, especially as it assumed the characters of melancholia, was brought on by the extensive disease discovered in the urinary organs.—Revue Médicale.
EPILEPSY.-M. Péraire, considering epilepsy to depend on a momentary cerebral congestion, proposes to cure it by obliterating the numerous arterial branches which are distributed to the pericranium by subcutaneous incisions. -Revue Médicale.
COLD AFFUSION.-M. Baillarger communicated to the Société de Médécine de Paris, the case of an insane lady he attended fifteen years ago, for whom he ordered cold affusions, which were effected by pouring one or two pailsful of water over the body. Following one of these affusions, his patient was seized with severe hæmoptysis, and died eighteen months afterwards from pulmonary phthisis.-Revue Médicale.
TREATMENT OF DELIRIUM TREMENS.—M. Brierre de Boismont, in drawing the attention of the Societé de Médécine de Paris to the treatment of this disease, observes that the majority of practitioners have recourse to opium, exhibited by the mouth or in the form of enema ; while others, again, have effected a cure by the abstraction of blood, and again in other cases by isolation alone, and momentary abstinence from strong liquors. M. Brierre de Boismont seeks to point out the cases in which venesection may be useful, and those in which it should not be practised.
When the patient is strong, plethoric, sanguine, and subject to congestions or coups de sang, he is of opinion that bleeding may be practised, but in moderation, its results being carefully watched. This practice appears to be more suited when the trembling is but slight, there are not any convulsive signs, and the incoherence is not strongly marked. He avoids bleeding when the patient is nervous; a state which may very well co-occur with all the appearances of a sanguine temperament, when the drunkard has been rarely or never bled. Those persons also in whom the delirium supervenes suddenly and violently, when in its symptoms it resembles ataxic meningitis, or in whom the trembling is well marked, or there are convulsive symptoms, great incoherence of speech, small pulse, or a haggard expression of the eyes, are not fit subjects for bleeding.--Revue Médicale.
GASTRALGIA AND HYPOCHONDRIASIS. -- Under this title a case is recorded in the Revue Médicale, which appears to us to be one of the