Many for strengthening the nervous system (See NERVINES, p. 37), is very extensive, embracing nearly all the articles of the materia medica; denominated narcotics, anodynes, sedatives, hypnotics, soporifics, antispasmodics, stimulants, tonics, &c. &c. routine physicians prescribe tonic medicines and a generous diet in cases of general nervous excitability, under the idea that it is dependant on weakness; but the robust, as well as the weak, are its victims, and the general and local remedies which succeed in tranquillising the nervous system in the former, will disturb or irritate it in the latter. The irritability of the body is a property confined to or inherent in muscles, and probably also in membranes, whilst sensibility is dependant on nerves only; and between these two properties there is evidently a peculiar harmony or reciprocity of action, so that when the equilibrium is destroyed or interrupted, the nervous system becomes preternaturally susceptible of impressions. The effect of the east and north-east wind, which is very remarkable on some nervous subjects, may, perhaps, be attributed to an electrical influence in interrupting the harmony between the muscular and nervous systems; for certain it is, neither the temperature, the density, nor humidity of the air, at the time, has any thing to do with its baneful operation. Some nervous subjects are even sensible of the air having shifted from a friendly to an unfriendly quarter during the time they are warm in bed, and in a room in which the external air could scarcely find admittance, the windows and doors being well secured against its ingress.-(See TONICS, p. 49.) Hysterical and epileptic nervous invalids are very subject to a peculiar head-ache, accompanied with considerable diminution of temperature in the extremities, and frequently in the bowels, some hours, and sometimes days, before a paroxysm, which I have often heard an invalid attribute to an accumulation of nervous energy in the brain, and others to the suspension of the action of the nerves in the extremities; and in such cases, a paroxysm generally succeeds in removing the affection of the head, and restoring the limbs to their natural state of temperature and vigour, probably by re-establishing the harmony between the nervous and muscular systems. After this convulsive action has run its course, certain it is, both the systems (nervous and muscular) become tranquil. ** The treatment of the nervous habit I have particularly noticed under the head of NERVINES, p. 37, TONICS, p. 49, and SEDATIVES, p. 41). Epileptic convulsions appear to be similar to those which occur on dividing the spinal marrow close to the base of the skull, which shows a connection between the nervous and muscular systems. No medicines act more efficaciously in maintaining the reciprocity of action between the muscular and the nervous systems, or the harmonious sympathy between the various organs, than those which keep up the important processes of chylification and fæcification, and prevent accumulation of fæces and gas in the alimentary canal. (See NERVOUS MIXTURES A, B, C, and D, p. 113.) The fact of constipation being the forerunner of a variety of nervous affections, as head-ache, epilepsy, hysteric fits, St. Vitus's dance, asthma, palpitation of the heart, and even indigestion and coldness of the extremities, forcibly points out the necessity of attending to the state of the bowels. For the purpose of keeping up the peristaltic motion, rhubarb is a favourite remedy with many physicians, because, as they say, it is both stomachic and aperient; but there are two great objections to it,-viz. its tendency to increase the disposition of the intestines to constipation, and its continued use (like that of other stomachics) acting inju riously on the stomach. Such an aperient medicine should be employed that will not disorder the stomach or duodenum, but promote the secretion of the colon, and diminish the determination of the blood to the brain (a common cause of general nervous disturbance), by increasing it in the lower intestines, and, consequently, in the extremities. To answer these purposes, the extract of aloes is certainly a valuable remedy; but as it is too bitter, too drastic, and too stimulating to the rectum for continued use, I have been in the habit of prescribing it in conjunction with the alcaline extract of jalap, and the essential oil of juniper berries, in the following proportions: Take of Extract of Soeotrine Aloes, Alcaline Extract of Jalap, Essential Oil of Juniper Berries, drachm. I drachm. 10 Drops. Mix well together, and divide into twenty pills. One, two, or three of these pills to be taken every day, about two hours before dinner, so as to produce one fæcal evacuation. If this composition should not prove sufficiently strong to conquer the disposition to costiveness, the Purgative Pills (A), p. 117, may be taken. If these should not succeed, the Purgative Pills (B), in the same page, may be administered, and, if necessary, the Purgative Clyster, p. 103. If the patient be subject to piles, or irritation in the rectum, bladder, or urethra, the extract of aloes should be omitted. The addition of a diuretic to an aperient medicine considerably promotes its efficacy in harmonizing the abdominal nerves, by bringing the kidneys and absorbent system into action. The objection to the Epsom, Glauber's, Cheltenham, and other neutral salts, in nervous affections, I have particularly noticed, p. 58. There is a variety of indigestion common in this country, from nervousness of the viscera, &c. of the belly (probably from a disordered condition of the ganglions, brought on by severe mental distress), in which the buchu leaves have proved singularly beneficial. In this variety, although the presence of gas and acidity shows that the stomach does not perform its office, the appetite is generally good. The fæcal secretion is very irregular, and the intestines easily disordered by an aperient medicine; ripe fruit often occasioning purging. The belly is often almost suddenly distended, without any evident accumulation of gas or fæces; and there is frequently a sensation of distention when the bowels are soft, which is generally removed by eating or drinking. (See INDIGESTION FROM NERVOUS ExCITEMENT, p. 406, and Practical Treatise on Management of the STOMACH and BOWELS in various Temperaments, p. 302.) The effects of the blue pill, and other mild preparations of mercury, on nervous subjects, are often very opposite; on some, four grains of the blue pill, or one of calomel, producing a most happy quieting effect on the stomach and whole nervous system; and on others, a smaller dose disordering the stomach, intestines, and even the brain itself. In most cases of indigestion of long standing in nervous subjects, some degree of obstruction, or organic affection of the coats of the stomach, of the substance of the liver, the pancreas, &c., generally exists, which often renders the introduction of a little mercury into the system necessary; for as long as the obstruction continues, the beneficial effects of a stomachic or a nervine medicine will be temporary. It should be administered with great caution, and its effects attentively watched; for what is termed the mercurial fever, or even irritation in the gums and salivary glands, never fails to disturb the brain and nervous system; and instances of insanity, from its incautious use, we suspect are very numerous. If there be no secretion from the nostrils, and especially if the sense of hearing or vision be weakened, either from local debility of nerves or fulness of blood-vessels of the head from languid circulation, a little of the compound asarabacca snuff (see p. 153) may be sniffed up the nostrils about once a day. This composition not only relieves the brain by its action on the nerves, and by increasing the secretion of mucus from the inner membrane of the nostrils, but, by occasioning sneezing, tends to remove congestion of the blood-vessels of the brain, by equalising the general circulation.* The increase of temperature in the extremities and in the skin of the trunk, which immediately follows sneezing, although previously as low as 56 Fahr., shews that it occasions a determination of blood to the surface and In cases of nervous head-ache, the Nervine Mixture (B), page 113, generally proves very beneficial. Some practitioners of eminence highly extol a combination of iron, valerian, ammonia, and camphor, as a remedy for nervous head-ache, especially when the circulation in the extremities is languid, or the skin pale, as the following: Mix. Take of Valerian Root, recently powdered, Alcaline Liquor of Iron, Compound Spirit of Ammonia, Three table-spoonsful to be taken three times a day. ounces. Or, Take of Valerian Root, recently powdered, 3 drachms. 14 drachms. Compound Spirit of Sulphuric Ether, 3 drachms. Camphorated Mixture, 7 ounces. Three table-spoonsful to be taken three or four times a day. Nervous head-ache is sometimes attended with symptoms so strongly indicative of compression of brain from over-distention of blood-vessels, that it is often a very nice point to determine, whether the complaint be purely nervous, or whether the brain is not disordered by a plethoric state of its blood-vessels. Giddiness, ringing in the ears, imperfect vision, confusion of mind, a sense of heaviness, nausea, and vomiting, are not only the consequences of compression of brain from over-distention of bloodvessels, but also of depletion. They precede the apoplectic fit from plethora, and also the fainting fit from the loss of blood. In nervous head-ache, the pupils are generally contracted, and in the head-ache from plethora, they are generally much dilated, often one more than the other; but in cases of nervous head-ache, when the cerebral system is in a state of debility, the pupils are also dilated. The pulse, in the nervous head-ache, is languid and small, and the extremities cold; but in the plethoric head-ache it is generally full, and the extremities warm: if, however, the brain be much compressed by the over-distended vessels, the pulse will be languid, and the skin cool. The nervous headache may be distinguished from the plethoric, by placing the head or body in a position which favours the afflux of blood to the brain, or checks its return from the brain. If in an horizontal position, or during stooping, or looking upwards or backwards when in an erect position, the giddiness or pulsation in the head be increased, the inference is, the blood-vessels of the head are overloaded, and the brain disturbed by compression or increased vascular action; but if they produce no aggravation of the lead extremities of the body, and is, consequently, capable of relieving internal parts affected with local congestion. It should be used when the stomach is most empty. ing symptoms, and especially if they afford relief, there can be no doubt of the complaint being nervous, and that the state of the blood-vessels has little to do with it. Some practitioners have asserted, that the nervous head-ache may be distinguished from the plethoric by a stimulus, as brandy or wine applied to the stomach; but when the plethoric state is merely local, that is, not dependant on general plethora, a cordial or stimulant applied to the stomach, by increasing the circulation in the bowels, will produce a diversion in favour of the overloaded brain. A bandage applied round the head (over the temples) affords great relief in the nervous head-ache, but in the plethoric produces. confusion. Nervous subjects, especially those who are of a gouty habit, are very liable to attacks of cough, termed nervous cough, on unfavourable changes in the atmosphere, from irritation at the top of the windpipe, or in the part termed larynx; and from the continued tickling sensation at the upper part of the windpipe, it is often very distressing. The irritation soon gives way to the Nervous Mixture (A), p. 113. The observations I have made on the stomach, under the head of INDIGESTION, point out the necessity of keeping that organ in a quiet state, in the nervous temperament. With this view, nervous subjects should be very particular in the choice of articles of diet. The peculiarities of the nervous habit, as I have already observed, are so very opposite, that the best advice a medical man can give to a nervous invalid, is, to avoid those articles which evidently disagree with the stomach, and not to oppress or over-stimulate it with too great a quantity of those which do agree. So far as a general rule can be laid down, I should say, avoid all green vegetables in a raw state (as celery, water-cresses, lettuce, onions, cucumbers, radishes, melons, &c.), pickles, cheese, pastry, nuts, walnuts, sweetmeats, soups, broths, new potatoes, sweet ale, green tea, coffee, and all burnt articles (as English coffee, crust of bread, and outside of roasted meat). The best article for breakfast is the sassafras cocoa (see p. 157) with sugar and milk, brown bread (not new), with a little broiled bacon instead of butter. The aromatic property of this cocoa promotes digestion, and prevents the accumulation of flatus in the stomach and intestines, a property which neither tea, common cocoa, chocolate, nor coffee possesses. For dinner, the interior of roasted or boiled mutton, beef, boiled or roasted fowl, lamb, partridge, hare, &c., with mashed potatoes, asparagus, green peas or cabbage, with pepper; and finish with an anchovy instead of cheese. With respect to beverage, he should take such which he finds to promote digestion; either diluted spirit or well-fermented malt liquor. After dinner he may encourage a nap in the chair for a few minutes, provided he be drowsy, and finds himself refreshed |