In this case there existed two injurious circumstances of different kinds; one the violent and continued action of the muscles, which destroys by exhausting the sensorial power; and the other, the application of cold, which destroys by defect of stimulus. The cold seems to have contributed to the paralysis by its long application, as well as the continued exertion; but as during the torpor occasioned by the exposure to cold, if the degree of it be not so great as to extinguish life, the sensorial power becomes accumulated; there is reason to believe, that the exposing a paralytic limb to the cold for a certain time, as by covering it with snow or iced water for a few minutes, and then covering it with warm flannel, and this frequently repeated, might, by accumulation of sensorial power, contribute to restore it to a state of voluntary excitability. As this accumulation of sensorial power, and consequent glow, seems, in the present case, several times to have contributed to restore the numbness or inability of those muscles, which at length became paralytic. See Class [I. 2. 3. 21].
M. M. Ether externally. Friction. Saline warm bath. Electricity.
[5]. Raucedo paralytica. Paralytic hoarseness consists in the almost total loss of voice, which sometimes continues for months, or even years, and is occasioned by inability or paralysis of the recurrent nerves, which serve the muscles of vocality, by opening or closing the larynx. The voice generally returns suddenly, even so as to alarm the patient. A young lady, who had many months been affected with almost a total loss of voice, and had in vain tried variety of advice, recovered her voice in an instant, on some alarm as she was dancing at an assembly. Was this owing to a greater exertion of volition than usual? like the dumb young man, the son of Crœsus, who is related to have cried out, when he saw his father's life endangered by the sword of his enemy, and to have continued to speak ever afterwards. Two young ladies in this complaint seemed to be cured by electric shocks passed through the larynx every day for a fortnight. See Raucedo catarrhalis, Class [II. 1. 3. 5].
M. M. An emetic. Electric shocks. Mustard-seed, a large spoonful swallowed whole, or a little bruised, every morning. Valerian. Burnt sponge. Blisters on each side of the larynx. Sea-bathing. A gargle of decoction of seneca. Friction. Frequent endeavours to shout and sing.
[6]. Vesicæ urinariæ paralysis. Paralysis of the bladder is frequently a symptom in inirritative fever; in this case the patient makes no water for a day or two; and the tumor of the bladder distended with urine may be seen by the shape of the abdomen, as if girt by a cord below the navel, or distinguished by the hand. Many patients in this situation make no complaint, and suffer great injury by the inattention of their attendants; the water must be drawn off once or twice a day by means of a catheter, and the region of the bladder gently pressed by the hand, whilst the patient be kept in a sitting or erect posture.
M. M. Bark. Wine. Opium, a quarter of a grain every six hours. Balsam of copaiva or of Peru. Tincture of cantharides 20 drops twice a day, or repeated small blisters.
[7]. Recti paralysis. Palsy of the rectum. The rectum intestinum, like the urinary bladder in the preceding article, possesses voluntary power of motion; though these volitions are at times uncontrollable by the will, when the acrimony of the contained feces, or their bulk, stimulate it to a greater degree. Hence it happens, that this part is liable to lose its voluntary power by paralysis, but is still liable to be stimulated into action by the contained feces. This frequently occurs in fevers, and is a bad sign as a symptom of general debility; and it is the sensibility of the muscular fibres of this and of the urinary bladder remaining, after the voluntarity has ceased, which occasions these two reservoirs so soon to regain, as the fever ceases, their obedience to volition; because the paralysis is thus shewn to be less complete in those cases than in common hemiplegia; as in the latter the sense of touch, though perhaps not the sense of pain, is generally destroyed in the paralytic limb.
M. M. A sponge introduced within the sphincter ani to prevent the constant discharge, which should have a string put through it, by which it may be retracted.
[8]. Paresis voluntaria. Indolence; or inaptitude to voluntary action. This debility of the exertion of voluntary efforts prevents the accomplishment of all great events in life. It often originates from a mistaken education, in which pleasure or flattery is made the immediate motive of action, and not future advantage; or what is termed duty. This observation is of great value to those, who attend to the education of their own children. I have seen one or two young married ladies of fortune, who perpetually became uneasy, and believed themselves ill, a week after their arrival in the country, and continued so uniformly during their stay; yet on their return to London or Bath immediately lost all their complaints, and this repeatedly; which I was led to ascribe to their being in their infancy surrounded with menial attendants, who had flattered them into the exertions they then used. And that in their riper years, they became torpid for want of this stimulus, and could not amuse themselves by any voluntary employment; but required ever after, either to be amused by other people, or to be flattered into activity. This I suppose, in the other sex, to have supplied one source of ennui and suicide.
[9]. Catalepsis is sometimes used for fixed spasmodic contractions or tetanus, as described in Sect. XXXIV. 1. 5. and in Class [III. 1. 1. 13]. but is properly simply an inaptitude to muscular motion, the limbs remaining in any attitude in which they are placed. One patient, whom I saw in this situation, had taken much mercury, and appeared universally torpid. He sat in a chair in any posture he was put, and held a glass to his mouth for many minutes without attempting to drink, or withdrawing his hand. He never spoke, and it was at first necessary to compel him to drink broth; he recovered in a few weeks without relapse.