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Equally uninformed are we also as to the peculiar kind of morbid action, which takes place in the ligaments of the joints; as well as that
which takes place in different instances of deep seated pains and affections of the parts contained in the head, thorax, and abdomen, and in all
which cases the inducing of a purulent discharge in their neighbourhood is so frequently productive of a cure.
Experiment has not indeed been yet employed to prove, but analogy certainly warrants the hope, that similar advantages might be derived from
the use of the means enumerated, in the present disease. It is obvious, that the chance of obtaining relief will depend in a great measure on the
period at which the means are employed.
As in every other disease, so here, the earlier the remedies are resorted to, the greater will be the probability of success. But in this
disease there is one circumstance which demands particular attention; the long period to which it may be extended.
One of its peculiar symptoms, Scelotyrbe festinans, may not occur until the disease has existed ten or twelve years, or more; hence, when
looking for the period, within which our hopes of remedial aid is to be limited; we may, guided by the slow progress of the malady, extend it to
a great length, when compared with that within which we should be obliged to confined ourselves in most other diseases.
But it is much to be apprehended, as in many other cases, that the resolution of the patients will seldom be sufficient to enable them to
persevere through the length of time which the proposed process will necessarily require.
As slow as is the progress of the disease, so slow in all probability must be the period of the return to health.
In most cases, especially in those in which the disease has been allowed to exist long unopposed, it may be found that all that art is capable
of accomplishing, is that of checking its further progress. Nor will this be regarded as a trifle, when, by reference to the history of the
disease, is seen the train of harassing evils which would be thus avoided.
But it seems as if there existed reason for hoping for more. For supposing change of structure to have taken place, it is extremely probable
that this change may be merely increase in mass or volume by interstitial addition, the consequence of increased action in the minute vessels of
the part.
In that case, should the instituting of a purulent discharge, in a neighbouring part, act in the manner which we would presume it may—should
it by keeping up a constant discharge, not merely alter the determination, but diminish the inordinate action of the vessels in the diseased
part; and at the same time excite the absorbents to such increased action as may remove the added matter; there will exist strong ground for
hope, that a happy, though slow restoration to health, may be obtained.
Until we are better informed respecting the nature of this disease, the employment of internal medicines is scarcely warrantable; unless
analogy should point out some remedy the trial of which rational hope might authorize.
Particular circumstances indeed must arise in different cases, in which the aid of medicine may be demanded: and the intelligent will never
fail to avail themselves of any opportunity of making trial of the influence of mercury, which has in so many instances, manifested its power in
correcting derangement of structure.
The weakened powers of the muscles in the affected parts is so prominent a symptom, as to be very liable to mislead the inattentive, who may
regard the disease as a mere consequence of constitutional debility.
If this notion be pursued, and tonic medicines, and highly nutritious diet be directed, no benefit is likely to be thus obtained; since the
disease depends not on general weakness, but merely on the interruption of the flow of the nervous influence to the affected parts.
It is indeed much to be regretted that this malady is generally regarded by the sufferers in this point of view, so discouraging to the
employment of remedial means.
Seldom occurring before the age of fifty, and frequently yielding but little inconvenience for several months, it is generally considered as
the irremediable diminution of the nervous influence, naturally resulting from declining life; and remedies therefore are seldom sought for.
Although unable to trace the connection by which a disordered state of the stomach and bowels may induce a morbid action in a part of the
medulla spinalis, yet taught by the instruction of Mr. Abernethy, little hesitation need be employed before we determine on the probability of
such occurrence.
The power, possessed by sympathy, of inducing such disordered action in a distant part, and the probability of such disordered action
producing derangement of structure, can hardly be denied.
The following Case seems to prove, at least, that the mysterious sympathetic influence which so closely simulates the forms of other diseases,
may induce such symptoms as would seem to menace the formation of a disease not unlike to that which we have been here treating of.
A.B. A man, 54 years of age, of temperate habits and regular state of bowels, became gradually affected with slight numbness and prickling,
with a feeling of weakness in both arms, accompanied by a sense of fulness about the shoulders, as if produced by the pressure of a strong
ligature; and at times a slight trembling of the hands.
During the night, the fullness, numbness, and prickling were much increased. The appetite had been diminished for several weeks; and the
abdomen, on being examined, felt as though containing considerable accumulation.
Before adopting any other measures, and as there appeared to be no marks of vascular fullness, it was determined to empty the bowels. This was
done effectually by moderate doses of calomel, with the occasional help of Epsom salts; and in about ten days, by these means alone, the
complaints were entirely removed.
Before concluding these pages, it may be proper to observe once more, that an important object proposed to be obtained by them is, the leading
of the attention of those who humanely employ anatomical examination in detecting the causes and nature of diseases, particularly to this
malady.
By their benevolent labours its real nature may be ascertained, and appropriate modes of relief, or even of cure, pointed out.
To such researches the healing art is already much indebted for the enlargement of its powers of lessening the evils of suffering humanity.
Little is the public aware of the obligations it owes to those who, led by professional ardour, and the dictates of duty, have devoted themselves
to these pursuits, under circumstances most unpleasant and forbidding.
Every person of consideration and feeling, may judge of the advantages yielded by the philanthropic exertions of a Howard; but how few can
estimate the benefits bestowed on mankind, by the labours of a Morgagni, Hunter, or Baillie.
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