the causes are several of those just enumerated: the principal, plethora, suppressed hemorrhages; suppressed perspiration; luxurious diet, gluttony, somnolency; foul or disordered stomach; costiveness; intoxication; narcotick and tobacco fumes; unremitting attention of mind to study or business; restlessness, mental distress; hunger, inanition, debility; obstructions and diseases in the retina or optick nerves.
Palsy.
Paralysis, hemiplegia, paraplegia. During the last thirty years of the preceding century, paralytick mortality is only 630 in the London bills; but in the present century is doubled and trebled; and some part of this surge can be readily accounted for by the multiplication of the mechanical arts, in which lead and quicksilver are employed. At present, its mortality seems to stand in the proportion of one third or fourth to that of apoplexy. Of 310 patients afflicted with palsy and hemiplegy, and admitted in the course of 10 years into the Bath hospital, 57 were cured; that is, 7 per cent. or 1 of 15; there died 15, or 5 per cent.; and the remainder were found incurable and discharged, or received some trifling relief; and several of these might be added to the dead list. I doubt whether by the artillery of the shops we are so successful against this crippling foe. A considerable number of the community are rendered helpless and decrepit from this disease; to which some trades, more than others, are obnoxious; and adults and aged infinitely more than the young and adolescent.
Palsy and apoplexy often alternate, and may then be termed one bicipitous disease. Severe apoplectick strokes, if not immediately fatal, frequently remit, and pass into palsy: or the catastrophe may originate in hemiplegy, which is the most frequent form of palsy; and when fatal, it is through the apoplectick explosion. In palsy there is more or less diminution or privation of muscular motion and feeling, without pain or fever, or injury of appetite. This may affect the muscles of voluntary and of involuntary motion; the whole, or only a portion of each: as muscular impotency of one side, or half of the body; of one or both of the lower or upper extremities; of some smaller portion of the face, eyelids, tongue, œsophagus, stomach, intestines, the sphincters of the bladder and anus, the penis, bladder, kidneys, heart. Under this deplorable calamity many linger years; some confined like a shellfish, and motionless; others crawling upon crutches. Tremor may be ranked as an inferior vassal of palsy.
The predisposing and occasional causes of palsy are most of those of apoplexy; various diseases of the cerebrum, cerebellum, and medulla oblongata; diseases of the inherent muscular power; vapours from lead, mercury, arsenick; colica saturnina; compression of nerves; abscesses in the lumbar vertebræ; falls, external injuries, blows on the head or loins, luxations or sprains of the lumbar vertebræ; spinal dropsy; fractures; venery. Of Tremor many of the causes of apoplexy and palsy; hereditary; old age and decay of the inherent nervous and muscular energy; compression or obstruction of the nerves; poisons; opium; employments in lead and mercury; ebriety; suppressed evacuations; sanguine plethora; repelled cutaneous eruptions; lurking gout; general debility; external injuries; warm fluids; strong tea; excess of venery; long watching; anxiety; passions of mind; sedentary life; excessive evacuations.
Epilepsy.
Morbus sacer, demoniacus, caducus, falling-sickness. In the last thirty years of the preceding century, thirty-five deaths only are marked in the London bills to epilepsy; and in the first forty-five years of the present century, they dwindle to thirteen: at present the title and disease is omitted. Medical men know, that no inconsiderable number of the community are tormented with this frightful convulsion, which the ancient Jews could only ascribe to the malicious rancour of an infernal devil. In this instance also, professional experience and erudition must interfere and correct the omissions of the publick registers. We are certain, that epilepsy is much more destructive to the springs of life: perhaps it is cast by the reporters into either the apoplectick or convulsive abyss. It is alledged to be more frequent amongst the male than female sex; and in infancy, in those of delicate constitutions, lax habit, acute, nervous and muscular irritability. Vid. [Convulsions].
In many cases there is no previous monitory of the impending paroxisms; in some other cases the lowering storm is portended by lassitude, headach, giddiness, dimness of sight, broken sleep, frightful dreams, restlessness, terror, noise in the ears, palpitation of the heart, unusual smells, murmuring of the intestines, yawning, luminous flashes before the eyes, profuse urinary excretion, sense of the disease ascending from a particular part to the head. By the epileptic whirlwind the patient is suddenly and precipitously thrown down, with suspension of the internal and external senses, and universal convulsions of the external muscles, or those of voluntary motion: the muscles of the head, face, eyes, and mouth, are particularly agitated; the head is tolled in every direction, the teeth grind against each other, the eyes roll, the mouth emits froth and slaver; the tongue, thrust out of the mouth, is often wounded and lacerated by the teeth; the respiration is as if through a noose on the neck; the fingers are clinched into the hand; there is perpetual involuntary deglutition, palpitation of the heart, and sometimes involuntary excretion of urine, semen, or feces; the motions of the heart and of respiration are hurried, but not otherwise interrupted nor injured. Such is the powerful coercive muscular contractions and convulsions, that several strong assistants are requisite to secure each member. Some, at the first struggle and uproar, emit hideous groans or yells, resembling the bellowings of a wild beast; others, a more still and savage murmur. In most, the aspect is horrible: nor does any other disease exhibit such truculent spectacles of terror and abhorrence.