brated and the most frequently employed is copper, under various preparation. What preparation of it may be the most effectual, I dare not determine; but of late the cuprum ammoniacum has been frequently found successful.

1337. Lately the flowers of zinc have been recommended by a great authority as useful in all convulsive disorders; but in cases of epilepsy, I have not hitherto found that medicine useful.

1338. There have been of late some instances of the cure of epilepsy by the accidental use of mercury; and, if the late accounts of the cure of tetanus by this remedy are confirmed, it will allow us to think that the same may be adapted also in the cure of certain cases of epilepsy.

1339. With respect to the employment of any of the above-mentioned tonics in this disease, it must be observed, that, in all cases where the disease depends upon a constant or occasional plethoric state of the system, these remedies are likely to be ineffectual; and, if sufficient evacuations are not made at the same time, these medicines are likely to be very hurtful.

1340. The other set of medicines which we have mentioned as suited to obviate the effects of the too great mobility of the system, are the medi

cines named antispasmodics. Of these there is a long list in the writers on the Materia Medica, and by these authors recommended for the cure of epilepsy. The greater part, however, of those taken from the vegetable kingdom, are manifestly inert and insignificant. Even the root of the wild valerian hardly supports its credit.

1341. Certain substances taken from the animal kingdom seem to be much more powerful: and of these the chief, and seemingly the most powerful, is musk; which, employed in its genuine state, and in due quantity, has often been an effectual remedy.

It is probable also, that the oleum animale, as it has been named, when in its purest state, and exhibited at a proper time, may be an effectual remedy.

1342. In many diseases, the most powerful antispasmodic is certainly opium; but the propriety of its use in epilepsy has been disputed among physicians. When the disease depends upon a plethoric state, in which bleeding may be necessary, the employment of opium is likely to be very hurtful. but when there is no plethoric or inflammatory state present, and the disease seems to depend upon irritation, or upon increased irritability, opium is likely to prove the most certain remedy. What

ever effects in this and other convulsive disorders have been attributed to the hyoscyamus, must proba

bly be attributed to its possessing a narcotic power similar to that of the opium.

1343. With respect to the use of antispasmodics, it is to be observed, that they are always most useful, and perhaps only useful, when employed at a time when epileptic fits are frequently recurring, or near to the times of the accession of fits, which recur after considerable intervals.

1344. On the subject of the cure of epilepsy, I have only to add, that as the disease in many cases is continued by the power of habit only, and that, in all cases, habit has a great share in increasing. mobility, and therefore continuing this disease; so the breaking in upon such habit, and changing the whole habits of the system, is likely to be a powerful remedy in epilepsy. Accordingly, a considerable change of climate, diet, and other circumstances in the manner of life, has often proved a cure of this disease.

1345. After treating of epilepsy, I might here treat of particular convulsions, which are to be distinguished from epilepsy by their being more partial: that is, affecting certain parts of the body only, and by their not being attended with a loss of sense, nor ending in such a comatose state as epilepsy always does.

1346. Of such convulsive affections many dif

ferent instances have been observed and recorded by physicians. But many of these have been manifestly sympathic affections, to be cured only by curing the primary disease upon which they depend, and therefore not to be treated of here: Or, though they are such as cannot be referred to another disease, as many of them, however, have not any specific character with which they occur in different persons, I must, therefore, leave them to be treated upon the general principles I have laid down with respect to epilepsy, or shall lay down with respect to the following convulsive disorder, which, as having very constantly, in different persons, a peculiar character, I think necessary to treat of more particularly.

2

CHAP. III.

OF THE CHOREA, OR DANCE OF St. VITUS.

1347. THIS disease affects both sexes, and almost only young persons. It generally happens from the age of ten to that of fourteen years. It comes on always before the age of puberty, and rarely continues beyond that period.

1348. It is chiefly marked by convulsive motions, somewhat varied in different persons, but nearly of one kind in all; affecting the leg and

arm on the same side, and generally on one side only.

1349. These convulsive motions commonly first affect the leg and foot. Though the limb be at rest, the foot is often agitated by convulsive motions, turning it alternately outwards and inwards. When walking is attempted, the affected leg is seldom lifted as usual in walking, but is dragged along as if the whole limb were paralytic; and, when it is attempted to be lifted, this motion is unsteadily performed, the limb becoming agitated by irregular convulsive motions.

1350. The arm of the same side is generally affected at the same time; and, even when no voluntary motion is attempted, the arm is frequent ly agitated with various convulsive motions. But, especially when voluntary motions are attempted, these are not properly executed, but are variously hurried or interrupted by convulsive motions in a direction contrary to that intended. The most common instance of this is in the person's attempting to carry a cup of liquor to his mouth, when it is only after repeated efforts, interrupted by frequent convulsive retractions and deviations, that the cup can be carried to the mouth.

1351. It appears to me that the will often yields to these convulsive motions, as to a propensity,