Zoonomia; Or, the Laws of Organic Life, Vol. II

by Erasmus Darwin

In those patients, who have not been subject to epilepsy before they have arrived to about forty years of age, and who have been intemperate in respect to spirituous potation, I have been induced to believe, that the fits were occasioned by the pain of a diseased liver; and this became more probable in one of the above subjects, who had used means to repel eruptions on the face; and thus by some stimulant application had prevented an inflammation taking place on the skin of the face instead of on some part of the liver. Secondly, as in these cases insanity had repeatedly occurred, which could not be traced from an hereditary source; there is reason to believe, that this as well as the epileptic convulsions were caused by spirituous potation; and that this therefore is the original source both of epilepsy and of insanity in those families, which are afflicted with them. This idea however brings some consolation with it; as it may be inferred, that in a few sober generations these diseases may be eradicated, which otherwise destroy the family.

M. M. Venesection. Opium. Bark. Steel. Arsenic. Opium one grain twice a day for years together. See the preceding article.

[8]. Epilepsia dolorifica. Painful epilepsy. In the common epilepsy the convulsions are immediately induced, as soon as the disagreeable sensation, which causes them, commences; but in this the pain continues long with cold extremities, gradually increasing for two or three hours, till at length convulsions or madness come on; which terminate the daily paroxysm, and cease themselves in a little time afterwards.

This disease sometimes originates from a pain about the lower edge of the liver, sometimes in the temple, and sometimes in the pudendum; it recurs daily for five or six weeks, and then ceases for several months. The pain is owing to defect of action, that is, to the accumulation of sensorial power in the part, which probably sympathizes with some other part, as explained in Sect. XXXV. 2. XII. 5. 3. and Class [II. 1. 1. 11]. and [IV. 2. 2. 3].

It is the most painful malady that human nature is liable to!—See Sect. XXXIV. 1. 4.

Mrs. C—— was seized every day about the same hour with violent pain on the right side of her bowels about the situation of the lower edge of the liver, without fever, which increased for an hour or two, till it became totally intolerable. After violent screaming she fell into convulsions, which terminated sometimes in fainting, with or without stertor, as in common epilepsy; at other times a tempory insanity supervened; which continued about half an hour, and the fit ceased. These paroxysms had returned daily for two or three weeks, and were at length removed by large doses of opium, like the fits of reverie or somnambulation. About half an hour before the expected return of the fit three or four grains of opium were exhibited, and then tincture of opium was given in warm brandy and water about 20 or 30 drops every half hour, till the eyes became somewhat inflamed, and the nose began to itch, and by the sharp movements of the patient, or quick speech, an evident intoxication appeared; and then it generally happened that the pain ceased. But the effects of this large dose of opium was succeeded by perpetual sickness and efforts to vomit, with great general debility all the succeeding day.

The rationale of this temporary cure from the exhibition of opium and vinous spirit depends on the great expenditure of sensorial power in the increased actions of all the irritative motions, by the stimulus of such large quantities of opium and vinous spirit; together with the production of much sensation, and many movements of the organs of sense or ideas in consequence of that sensation; and lastly, even the motions of the arterial system become accelerated by this degree of intoxication, all which soon exhausted so much sensorial power as to relieve the pain; which would otherwise have caused convulsions or insanity, which are other means of expending sensorial power. The general debility on the succeeding day, and the particular debility of the stomach, attended in consequence with sickness and frequent efforts to vomit, were occasioned by the system having previously been so strongly stimulated, and those parts in particular on which the opium and wine more immediately acted. This sickness continued so many hours as to break the catenation of motions, which had daily reproduced the paroxysm; and thus it generally happened, that the whole disease ceased for some weeks or months from one great intoxication, a circumstance not easily to be explained on any other theory.

The excess or defect of motion in any part of the system occasions the production of pain in that part, as in Sect. XII. 1. 6. This defect or excess of fibrous action is generally induced by excess or defect of the stimulus of objects external to the moving organ. But there is another source of excessive fibrous action, and consequent pain, which is from excess of volition, which is liable to affect those muscles, that have weak antagonists; as those which support the under jaw, and close the mouth in biting, and those of the calf of the leg; which are thus liable to fixed or painful contractions, as in trismus, or locked jaw, and in the cramp of the calf of the leg; and perhaps in some colics, as in that of Japan: these pains, from contraction arising from excess of volition in the part from the want of the counteraction of antagonist muscles, may give occasional cause to epileptic fits, and may be relieved in the same way, either by exciting irritative and sensitive motions by the stimulus of opium and wine; or by convulsions or insanity, as described above, which are only different methods of exhausting the general quantity of sensorial power.

Considering the great resemblance between this kind of painful epilepsy and the colic of Japan, as described by Kemfer; and that that disease was said to be cured by acupuncture, or the prick of a needle; I directed some very thin steel needles to be made about three inches long, and of such a temper, that they would bend double rather than break; and wrapped wax thread over about half an inch of the blunt end for a handle. One of these needles, when the pain occurred, was pushed about an inch into the painful part, and the pain instantly ceased; but I was not certain, whether the fear of the patient, or the stimulus of the puncture, occasioned the cessation of pain; and as the paroxysm had continued some weeks, and was then declining, the experiment was not tried again. The disease is said to be very frequent in Japan, and its seat to be in the bowels, and that the acupuncture eliminates the air, which is supposed to distend the bowel. But though the aperture thus made is too small to admit of the eduction of air; yet as the stimulus of so small a puncture may either excite a torpid part into action, or cause a spasmodic one to cease to act; and lastly, as no injury could be likely to ensue from so small a perforation, I should be inclined at some future time to give this a fairer trial in similar circumstances.

Another thing worth trial at the commencement of this deplorable disease would be electricity, by passing strong shocks through the painful part; which, whether the pain was owing to the inaction of that part, or of some other membrane associated with it, might stimulate them into exertion; or into inactivity, if owing to fixed painful contraction.