not so generally understood that the same agent may be equally serviceable in cases produced by local injury. Of this, however, I will give you a proof. A gentleman, shortly after having had a bougie passed, was seized with ague of the most perfect kind; two days after, at the same hour, he had a return, and every alternate day it recurred, till he had experienced about twelve paroxysms; then, for the first time, he took quinine, and he had no repetition. He never had ague before that occasion, nor at any time afterwards, unless when compelled to use the bougie.

I do not know that I can better commence my proof of the intermittent nature of disease generally, than by entering into a short consideration of what are termed

SPASMODIC COMPLAINTS.

Such complaints being unattended with any structural change, are termed by the profession FUNCTIONAL; a word, as we have seen, expressive of their simplicity. What is the meaning of the term Spasm? It means an irregular or unnatural contraction of some muscle of the body; and in the case of the voluntary muscles, you cannot by any effort of the will control or counteract it. By rubbing and warming the part, you may sometimes succeed, and there are a great many medicines by which, when taken internally, the same effect may be produced; but what will answer in one case may not answer in another. The disease is sometimes termed Convulsion, and Cramp also,-more especially if the spasm be painful. The difference of locality in which spasm takes place in different persons has afforded professors an excellent opportunity of mystifying the whole subject. When it happens in the membranous lining of the lachrymal duct, the tears accumulate at the inner angle of the eye, from the passage to the nose being closed up by the contracting spasm. This disease is called Epiphora, and sometimes, though not quite correctly, Fistula Lachrymalis. Sneeze, Hiccough, and Yawn, are also effects of spasmodic action. Occurring in the muscular apparatus of the windpipe, or its divisions, spasm is familiar to you all in the

word Asthma; and it is also termed Dyspnoea, from the difficult breathing which it certainly occasions. When this spasmodic action affects the muscles about the jaws and throat, and the patient at the same time has convulsions of the face and limbs, there is usually loss of consciousness, with a sudden loss of power in all his members, which causes him to fall. This is the Epilepsy or "falling sickness." The subject of the disease termed Jaundice, in ninety-nine cases out of a hundred, owes the yellow colour of his skin to spasm—spasm of the gall-ducts-though any other obstruction of these passages-a gall-stone for example, may give rise to the same effect. Taking place in the ilium or small intestine, spasm is termed the Iliac Passion; in the colon or great intestine, Colic; in the urethra, Spasmodic Stricture. The Lockjaw affords yet an

other example of spasm. That all these various diseases are merely effects of the same action in different parts, is proved by each and all of them having been known to assume the most perfectly periodic type in individual cases, and by all being more or less amenable to the same class of remedies most generally influential in keeping off the ague-fit.

Like every other FORCE in nature, our Remedial Powers all act by causing Attraction or Repulsion; and, for a reason to be afterwards given, every remedy can act both ways in different individuals. All medicinal agencies have the power of producing inverse motion,—and, in this way, they cure or alleviate in one case, while in another they cause or aggravate disease. Opium, for example, will set one man to sleep, and keep another wakeful. Arsenic has cured the tremor, chill, and heat of ague, and produced them in a previously healthy person. The same results have followed the exhibition of Opium, Bark, and Copper. Moreover, to all four have I traced diseases with fits and remissions. A girl took a large dose of arsenic (sixty-four grains) for the purpose of suicide; her design. was discovered in sufficient time to prevent her death; but a periodic epilepsy ushered in by chills and heats was the result. A man of the 30th Foot, after a course of hard drinking, became epileptic; his disease came on

Quinine,

every second day at the same hour. silver, and calomel, were tried without success. I then gave him arsenic, after which he never had another fit. In these two cases, then, arsenic produced inverse motions, causing epilepsy in the first, and curing it in the second. When I come to treat particularly of the Passions, I shall show you that the same passion which has caused an ague or an epilepsy may cure either. In truth, I scarcely know a disease which the passions Rage and Fear have not cured and caused, according to their attractive or repulsive mode of action in particular cases.

I have said that ASTHMA is an intermittent disease. "The fits of convulsive Asthma," according to Darwin, “return at periods, and so far resemble the access of an intermittent fever." Had this physician's knowledge of the nature of Asthma been sufficiently complete, he would have told us that between ague and asthma there is something more than a resemblance-that the asthmatic patient, in fact, has an ague, with the further developement of spasm of some of the muscles of the windpipe. But call the disease what you please, I have generally cured it with one or other of the chrono-thermal remedies ; and with two or more in combination, I can most truly say I have seldom been compelled to complain of ill-success in its treatment. In one case, however, that of a gentleman who had the disease every second night,—I had the greatest difficulty in effecting a cure, for it was not till I had nearly exhausted all my best resources that I at last obtained success by applying a warm plaster all along his spine. Here you again see, in the most direct manner, the advantage of attention to temperature: the spine, in this case, was always chilly, but became warm and comfortable under the use of the plaster. The analogy which subsists betwixt Spasm and Tremor, has not been unnoticed by medical writers. Analyze "tremor," "shivering," "shaking," and you will find the motions so termed to be merely a rapid succession of incomplete spasms. In St. Vitus's dance, or as it is sometimes called, "the leaping AGUE," which is also a periodic disease, you may see every variety of spas

modic and tremulous action a muscle can exhibit. It is a frequent disease of children, and in most cases you may obtain success with minute doses of one or more of the chrono-thermal remedies; one remedy of course answering better in one case, another in another.

a

With the same agents, prescribed upon the same principle, I have been equally fortunate in the treatment of Urethral Stricture disease for which the bougie, in general practice, is far too indiscriminately employed. You all know the beneficial influence of the warm bath in this affection, and some of you may have heard of the same good result from the internal use of Iron. But the influence of Quinine over stricture is not so generally known. It is unnecessary for me to give any instance of my own in evidence of this, Sir Benjamin Brodie having published at length the case of a gentleman affected with spasmodic stricture of the tertian type-that is to say, a stricture which came on every alternate night about the same hour, and which yielded, in the hands of that surgeon, to quinine. The marked periodicity of this case doubtless suggested the proper treatment; but in cases where this is less striking, you have only to ask the patient if there are times when he passes his water better than at others; and if he answers in the affirmative, you may be sure the stricture depends less on a permanent thickening of the mucous membrane of the urethra, than upon a remittent spasmodic action of its muscular apparatus. Such a patient, on coming out of a warm room into a cold one, will find himself, all in a moment, unable to pass a drop of water. See then the effect of thermal change-of change of temperature-in producing spasm,— and hence too the benefit to be derived from the warm bath in the treatment of spasm generally. In the great majority of stricturecases, the surgeon may save himself the trouble, and his patient the torture, of passing the bougie at all, by treating the disease chronothermally ;—that is, if he prefers the interest, of the public to his own; but this mode of preventing the return of disease is obviously less lucrative than that which enables him to

PALSY OR PARALYSIS

an affection in which, when complete, there is an absolute loss of muscular power. From the suddenness with which the patient is in most instances affected or "struck," this disease is known to every body under the name of "Paralytic Stroke;" or, more familiarly still, "a Stroke." a Stroke." It consists either in a partial or complete inability to use the affected muscles for there are degrees of Palsy as of every other disease an inability to excite their action in any manner whatever by the will. Now it is a common error of the schools to teach that such disorder is always dependent on some PRESSURE on the Brain or Spine. There is no doubt that pressure on these parts can cause palsy; but much more frequently this disease is the effect of a weakness of the Brain or Spine, produced by exhaustion, the causes of such exhaustion being various of course-Paralytic disease has often been produced by a purge, and oftener still by loss of Blood. The recent case of Sir William Geary must be still fresh in every body's mind. That gentleman met with a sudden loss of blood from an accidental wound of the carotid artery; Palsy of the left side ensued. Weakly persons on suddenly rising from their chair, sometimes all at once lose the use of a leg or arm. Most cases of Paralytic disease, if properly sifted, will be found to be only the termination of previous constitutional disturbance; previous threatenings of such loss of power having been more or less frequently felt by the subjects of every case. Moreover, in a number of cases, palsy is an intermittent disease throughout its whole course, being preceded by chills and heats, and going off with a return of the proper temperature of the body. How can you reconcile the idea of permanent pressure with intermittent phenomena?

In one of the numbers of the Dublin Journal, I find a case of paralysis of some of

will show you that Palsy, like every other form of disorder, may exhibit the most perfect periodic intermissions. It is taken from a foreign journal. [Hecker's.] A peasant girl was attacked in the following manner :— Speechlessness came on every day at four o'clock, P.M., accompanied by a feeling of weight about the tongue, which remained a quarter of an hour. The patient, while it lasted, could not utter any sound, but occasionally made an indistinct hissing noise. Consciousness did not seem impaired during the fit. She ascribed her inability to speak to a feeling of weight in the tongue. The paroxysms went off with a large evacuation of watery urine, accompanied by perspiration and sleep. Ten such attacks had occurred, when Dr. Richter of Wiesbaden was called to see her; he ordered her considerable doses of sulphate of Quinine with immediate good effect from the first day. The attack returned, but in a mitigated form, and on the second day no trace of it was visible, except a certain degree of debility and fatigue felt at the usual hour of its coming on." The corporeal temperature is not stated by the reporter of this case, but the periodic manner in which it came on and went off, to say nothing of the mode of its cure, sufficiently illustrates its nature. Not long ago, I was consulted in a similar case, which was moreover complicated with palsy of one side. Sarah Warner, aged 25, married, had suffered periodically from loss of speech, and also from an inability to move the leg and arm of one side. Various remedies had been ineffectually prescribed by her medical attendants, who all looked upon her disease as APOPLECTIC-in other words, they supposed it to be caused by pressure on the brain. One of them, indeed, proposed to bleed her, but she would not consent. When she applied to me, I ordered her a combination of Quinine and Iron, after which she never had another fit.

I shall now give you the details of a case of palsy which I treated successfully after it had been long considered hopeless :-Mrs. Sargent,

complete use of her limb; nay, she returned to her service at Mr. Ward's, which she only left to get married.

I will now give you a case or two exemplifying the cure of palsy of a single limb.

Case 1.-Mary Boddy, 18 years old, from the age of eleven, had weakness of the back and loins, and she gradually lost the use of the right leg. In this state she remained for three years; sixteen months of this period she was an in-patient of the Gloucester Infirmary, in which establishment her mother held the situation of nurse. But cupping, bleeding, leeching, blistering, were all ineffectually tried. The same mode of treatment as in Mrs. Sargent's case, with the addition of a galbanum plaster to the loins, in which she complained of coldness, was adopted by me, and followed with like success. She had scarcely been a fortnight under my care, before she completely recovered the use of her paralytic limb; and she has had no relapse during the last four or five years.

Case 2.-Esther Turner, aged 30, when in the service of Mr. Ward, the master of a respectable boarding-school, at Painswick, fell down stairs, and from that moment, lost the use of her left leg. After a period of eleven years, during which she had been ineffectually under treatment in various hospitals and infirmaries, she came on crutches to my house. She explained that she was subject to severe shivering, with occasional convulsions. Her leg, she said, had more feeling on certain days than others. After trying her for some time with a combination of hydrocyanic acid and tincture of cantharides, without any improvement, I prescribed a pill, containing a combination of quinine, silver, and colchicum, night and morning. She progressed from that day; and in about six weeks, I had the

Case 3.-Miss Maged 25, had lost the use of both limbs for seven years; all that time she had been confined to her bed, and though she had had the advice of several professional persons of eminence, she never once could stand up during the whole of that period. She was brought up to town from Yorkshire, a distance of 260 miles, on a sofa-bed, to be placed under my care. I immediately put her on a course of chrono-thermal treatment, and we had not long to wait for improvement, for in five days this young lady could walk round the table with the partial support of her hands. At the end of two months, without any assistance whatever, without even the support of the balusters, she could run up and down stairs nearly as well as myself. Should this statement be considered to require better confirmation than my word, I am permitted to give Miss M- -'s name and address to any party who may take an interest in the case, the particulars of which she will readily communicate. Miss M is the daughter of an accomplished English clergyman, and is the niece of one of the judges of the supreme court of Scotland, who, being in town all the time she was under my care, saw her the day after she arrived, and had the satisfaction to witness the whole progress of her

cure.

I could here give you numerous other cases, all more or less explanatory of the manner in which Palsy of almost every muscle of the body may be developed and cured. For the present, I shall content myself with recording my experience of a disease, which until I explained its nature was never once imagined to depend on Paralysis, namely, the Curved or Crooked Spine.* By most authors, this dis

* When I first published my view of the nature of Curved Spine, in 1836, its correctness was called in question. When Stromeyer and others on the continent, without noticing my labours, afterwards adopted my explanation as their own, it was admitted by the whole profession to be true. What a reward to the real cultivators of science,-first to have their dis