The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 2).
- Date:
- 1849-59
Licence: Public Domain Mark
Credit: The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 2). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![diet, laxatives, with a light chalybeate interposed and steadily continued, together with a course of diet consisting of milk, vegetables, fruits, and things prepared from them, and in moderate quan- tities, seldom fail of removing the disorder. In Heberdcri's Commentaries we have the fol- lowing pithy illustration of the importance of diet: Duo epileptici ab omni cibo animali abstinue- runt, et sanati sunt. And Dr. Abercrombie, no mean authority in this or in any practical point, is of opinion that the only remedies of real efficacy in such cases are purgatives, a strictly vegetable diet, and total abstinence from strong liquors. According to our experience it would not be easy to overrate the importance of diet in epilepsy, at the same time we admit that many changes may be necessary before the full advantage is obtained which diet is capable of yielding; one rule alone, in our opinion, being established, namely, that food ought ever to be taken in great moderation ^ in other words, that there is danger in a full meal, however unexceptionable the materials may be of which it consists. When, in medical works of respectability, we meet with a variety of remedies, many of them possessed of dissimilar qualities, recommended for the cure of the same disease, we must conclude that its species are dissimilar in their nature, and require to be treated differently. In examining the anti-epileptic remedies recommended by au- thors, we may discover four classes, viz. evacuants, tonics, nervines, and emmenagogues: first, those which reduce vascular congestion or action, venee- sectio, hirudines, fonticuli, setacca, cauterium, ve- sicatoria, irritantia, emetica, purgantia, antimoni- um, mercurius: secondly, those which invigorate the body and improve the digestion — aeris et dietae mutatio, balneum frigidum, cinchona, amara, acida, zincum, argenti nilras, cuprum [artemisia vulgaris] : thirdly, medicines which relieve disor- ders of the nerves — serpentaria, cardamomum, Valeriana, castoreum, moschus, campbora, guaia- cum, hyoscyamus, belladonna, stramonium, opi- um : fourthly, emmenagogues — ammonia, galba- num, assafoetida, aloes, ferrum, oleum tercbinthinse, ruta. A consideration of the foregoing catalogue would justify the division of the subject which in tliis article has been adopted. [Of late j-ears, indigo given in very large doses, has been extolled by many practitioners. The writer witnessed numerous trials with it in the Philadelphia Hospital; but its efficacy was not marked. (See his New Remedies, 4th edit. p. 363, Philad. 1843.) Where epilepsy has been caused by an external injury of the head, the ope- ration of trephining has been practised; and in some cases the results have been happy. The operation is, however, of a serious character, and ought I ot to be had recourse to, unless there is every ^yiospect that the cause of the disease is seated in parts which can be removed by the tre- phine.] If the necessity of more diligently studying epi- lepsy, of more carefully attending to its specific difl'erences; if the inapplicability to some cases of epilepsy of the treatment which has succeeded in others, be admitted and acted upon, happier prac- tical results will probably be the consequence. But, lest the reader should suppose that wr are j too sanguine in this our expectation, he shall have the concurrent testimony of the venerable com- mentator on Boerhaave produced, to whose au- thority he will more readily yield : Illis observa- tionibus sic collectis et in ordinem digestis, sedulo expendat medicus omnia, et facile deteget regulas agendorum et vitandorum, sed in singulari tantum hujus {Egri casu. Nam generales in omnibus epi- lepticis curandis regulae haberi nequeunt; quod enim uni prodest, saepe nocet alteri. Ubi hoc factum, tota difficultas evanuit, nam reliquum est tantum facilis executio bene perpensarum rerum. Certum est, medicos, luculenta praxi obrutos, saspe deficere in cura hujus moibi, cum tempus ipsis non sufficiat, ut singulari ocgro tantam curam impendant; verum et doluerunt toties, a;groruni custodes observasse ilia, quae ipsi neglexerant, non sine famae damno. Credo firmissime, si omnem animi attentionem adhiberent his medici, quod sanarent plures epilepticos, et levamen adferei.c fere omnibus.—Sect. lOSO. t /-^ J. Cheyne. EPISTAXIS, (derived from h\ and ardln. stillatio, from (rra'^o), siilo,') a flow of blood from the nose. This is one of the subdivisions of the natural class of disorders termed hemorrhages, to which article in this work (in order to avoid un- necessary repetition) we refer for a general expla- nation of the circumstances under which it takes place. Bleeding from the nose is a physical phenome- non too common and conspicuous to have escaped notice at any period ; and from the earliest times its consequences, together with the conditions of the body which have accompanied and preceded it, have been objects of medical observation. The word epistaxis has, also, from a very early period, been applied to this affection under whatever cir- cumstances existing ; but it is evident that Hip- pocrates, who has left us several observations on the subject, used its original always to signify an oozing, and a'lfioppayia, a rush of blood: we make, however, no such distinctions. Of the various hemorrhages, epistaxis is the most common; and so often is it attended with salutary effects, that its encouragement and sup- pression equally require the consideration of the medical practitioner. Its frequency is readily ac- counted for when we reflect on the structure of the Schneiderian membrane; its extreme tenuity, and the number as well as proportionate size of the ramifications of blood-vessels which traverse it in every direction, forming a complete net-work, with a comparatively smaller portion of interstitial cel- lular substance and thinner lamina of membrane enveloping it than is to be found in any other part of the body. The blood-vessels of this membrane being for the most part supplied by the internal maxillary artery, and inosculating with some of the extreme ramifications of the internal carotid, any increased impetus given to the latter, or to the trunk of the former, is less resisted in this part; and, in consequence of the rupture which i» very frequently occasioned, an escape of blood is eflfected, with relief of both these systems of ves- sels, and, in a very essential manner, to the ad- vantage of the brain. As in hemorrhages from every other part, it is important to observe that in epistaxis there ar-](https://iiif.wellcomecollection.org/image/b21116817_0093.jp2/full/800%2C/0/default.jpg)
