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upon to combat disease with his own re-sources, he will have become aware ofthose uncertainties which attend, and mustalways ’attend, the art of healing, andwhich, to employ the language of a greatforeign clinical teacher, " prescribes tothe artist a prudent moderation." In

superintending this part of your clinicalstudies, I shall reserve to myself the lightof approving or iiiodifn,iiig or rejectingwhat you propose; and besides holdingconsultations at the bedside of the patient,I shall point out to you, in greater detail,my private opinion of the case, and of

your views of it. In pursuing this course,Gentlemen, I trust we shall work togetherfor good; you shall walk with me, but Iwill be your guide; and, in being so, Ishall exert every power which I possessto enable you to use your senses as wellas your understandings, that whilst weobserve and learn, the sick may profit, andthe gratitude of our fellow men rewardour exertions.

CLINICAL OBSERVATIONS

ON

VARIOUS DISEASES,

BY

MR. WARDROP.

AFFECTIONS OF THE VOLUNTARY MUSCLES

TREATED BY 1’URGATJVES.

THE various phenomena accompanyingdiseases of the nervous system do not ap-pear to have as yet been so satisfactorilyexplained as those of some of the othersystems in the economy. What can bemore striking than the differences pro-duced in the functions of the voluntarymuscles in these diseases ? and yet howinexplicable are they! Why is it that inone disease the muscles lose their poweraltogether,-- in another experience un-

ceasing involuntary motions,- in a thirdsuffer spasmodic actions or cramps,-in afourth labour under a state of permanentcontraction or trismus ?Two of these affections of the muscles, iand the treatment employed for their re- i

lief, are exemplified in the following cases ,- !CASE.—Loss of l’oluntary Motion suc-cessfully treated by Purgatives.—A robust- I

looking man, about thirty-five years ofage,’suddenly felt, while walking in- thestreet, a numbness in the calf of the left; ileg, which gradually extended up the ilimb. In the evening of the same day he

had a similar sensation of numbness withloss of power in the left hand and arm.In a few days the same symptoms attackedthe right leg and thigh, and the righthand, and in ten days from the first

; symptoms making their appearance, he

completely lost the power of locomotion,and possessed no voluntary power butthat of turning his head from side to side,and of moving his toes. The skin remainedquite sensible to the touch, the functionsof the pi-imm viæ and urinary organs coi-t-tinned natural, and he had neither hcad-ach nor giddiness. By the advice of aphysician he was profusely bled and

purged, went through a course of mercury,and had blisters applied to the loins, but

without deriving the smallest benefit fromthese remedies.When I was consulted, which was

nearly four months from the beginning ofhis illness, he was very nearly in thesame state as at the commencement ofthe disease. I found him lying on hisback, and he could not without a greateffort move even in a slight degree eitherthe upper or the lower extremities, but hecould readily move his head and toes.The functions of the organs of sense wereentire. He had no difliculty in voidingwater : his appetite was good, and he hada daily alvine discharge. His pulse wasnatural, he had no febrile symptoms, and

he was not much reduced in flesh. He

stated, however, that for some time pre-I vious to this illness, the abdomen had! gradually become full and tense, and se-veral days previous to the attack he com-plained of diarrhoea, at which period he, had travelled on the outside of a coachI and caught cold.I I recommended to this patient a courseof purgatives, giving him a colocynth pill,in conjunction with half a grain of calo-mel, morning and evening. This pill, withlittle change, was continued for sometime, producing copious evacuations daily,and in about three weeks a decided amend-ment had commenced. This was remarked

by motion being first restored to the fin-gers, then to the arm, and next to thelower limbs, and every succeeding weekthere was a distinct amelioration of hiscondition, so that at the end of fourmonths, during which time the same pmr-gative system was continued, the dose

being varied according to the effects pro-duced, he was enabled to walk aboutwithout assistance, and to write. Fromthis period he continued perfectly well,and I saw him several years afterwardsin the enjoyment of good health, havingnever had any return of the symptoms.

CASE.—Chorea successfully treated by

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Purgativeg.-A striking feature in the quality, they became less copious andtreatment of the subsequent case of cho- more healthy in appearance, and all the

rea, or St. Vitus’s dance, is the benefit symptoms of her disorder continued to hewhich was derived from a long-continued subdued. On these accounts the dose of thecourse of purgatives,-a course which was aloes was diminished, and during the nextnot interrupted by any untoward circum- fortnight she took only two aloetic pillsstance, and from no change in the thera- every morning, after which period thepeutic means being required during the course of purgatives was terminated.whole progress of the cure. I With the exception of an aloetic pill

I was consulted in the case of a young occasionally, and some cascarilla infusionlady who was suffering from chorea, with with soda,

she took no other medicines,which she had been afflicted about twenty and her health was perfectly restored.months, and during which time she had Many years have since elapsed, but shebeen under the care of several eminent has never had any return of chorea, andpractitioners in Paris. as well as in this has become the mother of a family.country. A great variety of different re- medies had in vain been tried, and I found There are several important pathologi-her in a most deplorable condition, for cal, as well as practical, points illustratedbesides the constant involuntary motions by the two preceding cases. In both, theof her face, head, and limbs, her intellec- affection of the involuntary muscles hadtual powers were much impaired, she had unquestionably been symptomatic of a de-become greatly emaciated, and her skin rangemeat in the alimentary canal, as waswas covered with an herpetic eruption. proved by the effect of the treatment whichThe only system of treatment which was employed.

appeared to me at all likely to improve her The extraordinary difference in the cha-condition, and which had not been tried, racter of the symptoms in the two caseswas a course of purgatives, conducted on is worthy of notice. In the first, the pa-the principles so ably pointed out by Dr. tient had lost the power of many of theHamilton, though at this time she had voluntary muscles, whilst, in the second,none of the more usual symptoms of de- the same class of muscles, though theyranged bowels. continued to act under the influence of the

I ordered two aloetic pills, to be taken will, were also affected with almost con-three times a day, and the person applied stant involuntary movements, affording ato to make up the prescription was so as- proof of the curious fact, that the power oftonishedatthedose,thathedecrneditproper the nerves to excite muscular action mayto warn the parents of the young lady that either be morbidly diminished or morbidlyher bowels were so irritable that on several increased. It remains, indeed, an into-occasions only three grains of aloes had resting subject of research, to discoverbeen ordered by Dr. Warren, who then what are the changes in the functions ofattended her, the effect being such that he the chylopoietic viscera, and the corre-

reduced it to two and then to one grain; spondiug alterations in the functions ofthat being found to act sufficiently. This particular nerves which those chylopoieticcircumstance, however, did not dissuade derangements produce. I have alreadythe parents from adhering strictly to the described those disorders of the nerve ofadvice which had been given, and ac- vision which are caused by certain dis-cordingly, when I saw her two days after, turbances in the digestive apparatus (pageI found that the large dose of aloes had not 96), and we are familiar with sympatheticcaused irritation, but had produced only a affections of the auditory and gustatoryfew copious evacuations. She continued nerves, as well as of the frontal, infra-to take the same quantity of the aloes orbital, and other nerves of the face.daily for a fortnight, which generally pro- In a practical view also the foregoingduced not more than four, nor less than cases are important, because they afford anthree evacuations in each twenty-four excellent illustration of the use of purga-hours. The evacuations were more or tives in a class of diseases which are stillless copious, of unnatural quality, and frequently considered and treated in a veryusually consistent, and seldom was there different manner. They also show theany tenesmus or irritation. All the differences in the evacuating effects, andsymptoms of the disease at the same time the mild action, of certain purgative medi-diminished in severity, and her general cines given in large quantities in casesappearance was improved, where small doses irritate the bowels,-

She now began to diminish the number an observation which has been so ablyof the aloetic pills, and during the suc- pointed out by Dr. Hamilton in his valu-ceeding fortnight took two only twice a able work.day. Though the evacuations still con-

tinued unnatural, both in quantity and ’