M. M. An emetic. Calomel, grains iv. once or twice. Then a blister. Peruvian bark. Valerian. Columbo. Steel. Opium and wine in small quantities, repeated alternately every three hours. Small electric percussions through the stomach.
[3]. Somnus interruptus. Interrupted sleep. In some fevers, where the inirritability is very great, when the patient falls asleep, the pulse in a few minutes becomes irregular, and the patient awakes in great disorder, and fear of dying, refusing to sleep again from the terror of this uneasy sensation. In this extreme debility there is reason to believe, that some voluntary power during our waking hours is employed to aid the irritative stimuli in carrying on the circulation of the blood through the lungs; in the same manner as we use voluntary exertions, when we listen to weak sounds, or wish to view an object by a small light; in sleep volition is suspended, and the deficient irritation alone is not sufficient to carry on the pulmonary circulation. This explanation seems the most probable one, because in cases of apoplexy the irritative motions of the arterial system do not seem to be impaired, nor in common sleep. See Incubus [III. 2. 1. 13].
M. M. Opium in very small doses, as three drops of laudanum. A person should watch the patient, and awaken him frequently; or he should measure the time between slumber and slumber by a stop-watch, and awaken the patient a little before he would otherwise awake; or he should keep his finger on the pulse, and should forcibly awaken him, as soon as it becomes irregular, before the disorder of the circulation becomes so great as to disturb him. See Class [I. 2. 1. 9]. and Sect. XXVII. 2.
[4]. Syncope. Fainting consists in the decreased action of the arterial system; which is sometimes occasioned by defect of the stimulus of distention, as after venesection, or tapping for the dropsy. At other times it arises from great emotions of the mind, as in sudden joy or grief. In these cases the whole sensorial power is exerted on these interesting ideas, and becomes exhausted. Thus during great surprise or fear the heart stops for a time, and then proceeds with throbbing and agitation; and sometimes the vital motions become so deranged, as never to recover their natural successive action; as when children have been frightened into convulsions. See Sect. XII. 7. 1.
Miss ——, a young lady of Stafford, in travelling in a chaise was so affected by seeing the fall of a horse and postillion, in going down a hill, though the carriage was not overturned, that she fainted away, and then became convulsed, and never spoke afterwards; though she lived about three days in successive convulsions and stupor.
[5]. Hæmorrhagia venosa. A bleeding from the capillaries arising from defect of venous absorption, as in some of those fevers commonly termed putrid. When the blood stagnates in the cellular membrane, it produces petechiæ from this torpor or paralysis of the absorbent mouths of the veins. It must be observed, that those people who have diseased livers, are more liable to this kind of hæmorrhages, as well as to the hæmorrhagia arteriosa; the former, because patients with diseased livers are more subject to paralytic complaints in general, as to hemiplegia, and to dropsy, which is a paralysis of the lymphatics; and the latter is probably owing to the delay of the circulation in the vena porta by the torpor of this hepatic vessel, when the liver is not much enlarged; and to its pressure on the vena cava, when it is much enlarged.
M. M. Vitriolic acid, opium, steel, bark. Sponge bound on the part. Steel dissolved in spirit of wine externally. Flour.
[6]. Hæmorrhois cruenta. In the bleeding piles the capillary vessels of the rectum become distended and painful from the defect of the venous absorption of the part, and at length burst; or the mucous glands are so dilated as to give a passage to the blood; it is said to observe lunar periods.
M. M. Venesection, poultices, cathartics, spice, cold bath, and sorbentia. External compression by applying lint, sponge, or cotton. Internal compression by applying a bit of candle smeared with mercurial ointment. Strangulate the tumid piles with a silk string. Cut them off. See Class [I. 2. 3. 22].
Mrs. —— had for twelve or fifteen years, at intervals of a year or less, a bleeding from the rectum without pain; which however stopped spontaneously after she became weakened, or by the use of injections of brandy and water. Lately the bleeding continued above two months, in the quantity of many ounces a day, till she became pale and feeble to an alarming degree. Injections of solutions of lead, of bark and salt of steel, and of turpentine, with some internal astringents, and opiates, were used in vain. An injection of the smoke of tobacco, with ten grains of opium mixed with the tobacco, was used, but without effect the two first times on account of the imperfection of the machine; on the third time it produced great sickness, and vertigo, and nearly a fainting fit; from which time the blood entirely stopped. Was this owing to a fungous excrescence in the rectum; or to a blood-vessel being burst from the difficulty of the blood passing through the vena porta from some hepatic obstruction, and which had continued to bleed so long? Was it stopped at last by the fainting fit? or by the stimulus of the tobacco?