Charles Gottleib Raue.

Special pathology and diagnostics : with therapeutic hints online

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It is brought on especially by the vapors of mercury ; lead-poison-
ing ; opium-eating, and abuse of alcoholic drinks. It may be the
result of typhus, and an effect of sexual excesses. Temporarily it
may be caused by mental excitements, over-exertions of the muscles,
too much cofi'ee or tea-drinking, and by too low a temperature. To the
latter corresponds the trembling during the chilly stage of intermit-
tens. Likewise we find trembling easily excited after being tiied
out, mentally depressed, or exhausted in any way; and therefore
it is frequently found during convalescence; after epileptic fits;
catalepsy ; neuralgia ; and during the periods of menstruation and
lactation.

Being a mere symptom of other disturbances, it may suggest :
Calc. c, Cicuta, Merc, Opium, Plat., Puis., Ehus t., Stram., Sulphur,

The feeling of internal trembling indicates ; Calc. c, Jod., Ehus t.,
Staph.

Paralysis Agitans.

It appears in its external manifestation as a tremor of high degree;
but difters from it by its constantly-increasing intensity, and by its
liability to terminate in paralysis and death.

It commences lightly, as a feeling of weakness, with slight trem-
bling of the extremities or of the head. The patient is still able to
execute all voluntary motions, and the trembling at first is not con-
stant, and may be mastered by the influence of the will. But at
length it increases in intensity, and becomes a perfect shaking of the
whole body, by which even the bed upon which the patient rests is
set in motion.

Sleep, and easy position, which at first will stop this shaking,
eventually lose this eflect; and the skin of the patient becomes sore
in different places from the friction occasioned by the continued



524: MOTOEY NEEVES.

shaking, wMcTi the patient is unable to control. In some cases the
patient has an irresistible desire to run, either forwards or backwards,
which at first he can resist to a certain degree, succeeding in making
some uncertain steps on his toes ; but at once he falls into a hasty
run, until he regains control over these involuntary motions. At
length, however, he cannot walk at all, but must be held back from
these irresistible pitching forward or retrograde motions.

To all this are gradually associated : general exhaustion, great
sensitiveness of the whole body, paralysis of the voluntary muscles,
difficult deglutition, relaxation of the sphincters, with involuntary
discharges of feces and urine, until, attended by the loss of mental
capacity and delirium, death relieves the patient from this dreadful
state.

Its causes are obscure. It is said to have followed after taking
cold, and after mental excitements ; and its seat is supposed to be a
morbid affection of the brain within the corpora quadrigemina and
adjacent parts.

Therapeutic Mints,

Compare Arsen., Rhus tox,, Stram.

The second form, in which the voluntary nerves may be affected, is

Paralysis, Akinesis,

Which is a want or loss of the normal contractility of the voluntary
muscles.

We have already seen, in our previous explanations, that this loss
of contractility is associated —

1. With ansesthesia of the sensory nerves. In anaesthesia of the tri-
geminus the face loses not only its feeling, but also its natural
form ; and a want of feeling in the lower extremities also causes un-
certainty in the gait.

It is likewise associated —

2. With the cessation of consciousness. Sleep for example relaxes
all muscles, and so does syncope or fainting. In the first, however,
all reflex motions go on vividly ; tickle one who sleeps, and you will
find him trying to get away from the disturbing cause. In syncope
he does not. In the first case consciousness only is at rest ; in the
other the reflex power of the sensory nerves is interrupted or sup-
pressed.

3. With disturhances of the brain; they may be the consequences of



PAEALYSIS. 525

faulty nutrition, poison, conciission, pressure of tumors, apoplectic
effusion, inflammatory softening, or sclerosis.

4. With lesions of the spinal cord. If tlie lesion lias its seat in tlie
anterior or lateral fibres, or in the gray substance, it destroys the con-
ducting power of the motory fibres, and all voluntary motion below
the affected part ceases.

5. With an interruption of the conducting power of the nerves loithin
their own course, or any place, from their origin to their termination,
may this be caused by concussion, pressure, or separation, the parts
below lose all power of voluntary motion.

6. With such morbid states as may prevent the motory nerves from
heing sufficiently nourished hy the arterial Mood.

A condition in which both motion and sensation are at the same
time lost is called paralysis completa ; when, however, motion alone
is lost it is called paralysis incompleta, or paresis.

The extent of the paralytic affection varies greatly. Sometimes it
is confined to the course of a single nerve, and in some cases it gradu-
ally extends over all the motory nerves, causing death, when it attacks
also the automatic motions. Those causes which have their origin
in the hrain are mostly followed by paralysis of the opposite side of
the body — hemiplegia.

When the lesion exists in both hemispheres, there is generally
paralysis of both sides of the body. In some cases, however, that
side only is paralyzed which is opposite to the severest lesion, or at
least, mostly that side.

Such paralytic states are always accompanied by more or less seri-
ous mental disturbances. We cannot conclude from the nature of the
paralysis upon the nature of the cerebral lesion. Only so much seems
certain, that a slow development of a brain disease generally causes
slight paralysis, which may disappear and reappear ; whilst sudden
disturbances are mostly associated with the most complete and general
paralysis. Neither can we judge from the paralytic state upon the
seat of the central lesion. Only this much may serve as a guide :

Lesions which exist in the spinal cord, on account of the small
diameter of this organ, generally cause a paralysis on both sides, or
at least a paralysis of all the motory nerves which lie below the
lesion on that side. When both sides are aft'ected, it is called para-
plegia.

Therefore a lesion in the lumbar region causes paralysis of the lower
extremities and muscles of the pelvis ; in the dorsal region, in addi-
tion to relaxation of the abdominal and lumbar muscles, causes a



526 MOTORY NERVES.

difficulty of expiration and inspiration, meteorisra, priapism and
paralysis of the sphincters ani and vesicae ; and a lesion in the cervi-
cal region causes, in addition to the above, paralysis of the upper
extremities, of the respiratory muscles, and those of deglutition.

Paralysis from a spinal cause is never attended with disturbances of
the mind.

Its prognosis is just as various as its causes.

Therapeutic SJinfs.

Aesculus glabra is recommended for paralytic affections of the lower
extremities.

Aesculus hipp., for paralysis of the upper extremities.

Aluminum met., paralysis from spinal diseases; loss of sensibility of
the feet ; inability to walk only with open eyes, and in the day-time.

Anacardium, after apoplexy ; loss of memory ; imbecility of mind;
loss of will.

Arnica, in consequence of exudations within the brain or spine ; in
consequence of apoplexy; weakening diseases; protracted intermit-
tent fevers and ischias.

Arsen., when associated with great prostration ; also in spinal affec-
tions with gressus gallinaceus, and as an antidote to lead-poisoning.

Baryta c, general paralysis of old age, with loss of memory and
trembling of the limbs ; also after apoplexy in old age, and especially
in paralysis of the tongue.

Bell, apoplexy ; congestion of the head ; paralysis of the one and
spasm of the other side of the body ; paralysis of the face.

Caulophyilum, paraplegia in consequence of retroversion and conges-
tion of the womb after child-birth, with partial loss of sensation in the
affected limbs; considerable emaciation, antemia and general debility.

Caust., paralysis of the face or tongue or hemiplegia, with giddiness,
weakness of sight, weeping mood ; hopelessness ; fear of death ; draw-
ing, lame feeling in the affected part ; after exposure to severe, cold
winds ; catarrhal and rheumatic conditions ; suppressed itch or other
chronic eruptions ; apoplexy.

China, after great loss of blood.

Cocculus, paralysis of face or tongue or pharynx ; paraplegia ; rheu-
matic lameness ; in weakened and nervous subjects, who are inclined
to fainting fits and palpitation of the heart ; also when the paralytic
affection originates in the small of the back after taking cold, with
cold feeling of the extremities and oedema of the feet ; likewise after
apoplexy.



PAEALYSIS. • 527

Colchicum, after a sudden suppression of general perspiration or of
sweat of ttie feet by getting wet.

Cuprum, after apoplexy, when there is congestion in the chest;
strong palpitation of the heart, or slow, weak and small pulse ; the
eyelids keep closed and twitch ; when opening the eyes, the eyeballs
move about ; paralysis after cholera and typhus.

Dulcamara, after taking cold, and suppressed eruptions; paralysis
of the upper and lower extremities, and the tongue ; the paralyzed
arm feels icy cold.

Ferrum, after great loss of vital fluids.

Gelsem., loss of motion, but not sensation ; paralysis of the organs
of deglutition, and in aphonia, succeeding diphtheria.

Graphites, rheumatic, peripheric paralysis of the face.

Hepap, after mercurial poisoning.
• Ignatia, after great mental emotions and night- watching in the sick-
chamber.

Kali c, trembling ; paralytic weakness, with cramps in fingers and
hand ; also paralytic weakness in the hip-joint.

Lachesis, especially left side; awkward, stumbling gait; gressus
gallinaceus ; after apoplexy.

Merc, rigidity and immobility of all the limbs, although they can
be easily moved by others ; indescribable malaise of body and soul ;
trembling of limbs and body.

Natrum m., paralytic condition of the lower limbs ; painful contrac-
tion of the ham-strings ; after intermittent fevers ; diphtheria ; sexual
excesses, and violent fits of passion.

Nux v., incomplete paralysis of the face or arms or legs, with ver-
tigo; weak memory; darkness before the eyes; ringing in the ears;
loss of appetite ; burning in the stomach ; flatulence ; vomiting after
eating and drinking ; constipation ; especially in drunkards.

Oleander, painless stiffness and paralysis of the limbs; insensibility
of the whole body ; trembling of the knees when standing, and of the
hands when writing ; preceded by spells of vertigo a long time before
paralysis develops itself.

Opium, paralysis and insensibility after apoplexy ; in drunkards ; in
old people ; retention of stool and urine.

Phos., paralysis in consequence of spinal affections ; after sexual
excesses ; after confinement ; tingling and tearing pain from the back
down into the limbs ; gressus vaccinus.

Plumbum, paralysis complete, with atrophy of the affected parts ;
preceded by trembling; mental derangement.



528 - MOTORY NERVES.

Rhus f., rLeumatic paralytic affections after getting wet, and after
great or unwonted muscular exertions, strainings, &c. ; in consequence
of typhoid processes; with painful stiffness, tearing, drawing and
aching of the whole body ; sometimes with tingling and numbness of
the parts, or continued cold feet for a long time ; worse during rest,
and when commencing to move ; from washing in cold water ; with
every change of the weather ; better from dry heat near the stove ;
from continued gentle moving about, and flexion of the limbs.

Secale, paralysis after spasms and apoplexy, with rapid emaciation
of the affected parts, and involuntary discharges from bowels and
bladder.

Silic, paralysis of the left hand, with atrophy and numbness in the
fingers; paralysis of the legs, always worse in the morning, with
heaviness in the head and ringing in the ears.

Stannum, hemiplegia, especially on the left side, with a feeling of a
heavy load in the affected arm and corresponding side of the chest,
and frequent night- sweats.

Stram., after convulsions; also paralysis of the one and spasms of
the other side.

Sulphur, after typhus, exanthematic fevers, suppressed itch, or
chronic eruptions and spasms; also when other remedies seem to
fail.

Zincum, worse after drinking wine.

Besides, compare the following, which are partly taken from Jahr :
for —

Paralysis of the eyelids: Bell., Cocc, Nitr. ac, Opium, Plumb.,
Ehus t, Sepia, Spigel., Stram,, Veratp., Zinc.

Paralysis of the face: Bell., Caust., Cocc, Graph., Nux vom.,
Opium.

Paralysis of the tongue and organs of speech: Aeon., Arn., Arsen.,
Baryt. c. Bell., Caust., Cocc, Cupr., Dulc, Hepar, Hydro, ac, Hyosc,
Lach., Mur. ac, Opium, Plumb., Stram.

Paralysis of the organs of deglutition: Bell., Canth,, Caust., Cocc,
Cupr., Gelsem., Lach., Silic, Stram.

Paralysis of the Madder: Arsen., Bell., Canth., Dulc, Hyosc, Lach.,
Lycop., Natr. m.. Opium.

Paralysis of the rectum aud sphincter ani: Caustic, Coloc, Hyosc,
Lycop., Opium, Euta, Zincum sulphuricum.

Paralysis of all the limbs: Arn., Ars., Colch., Dulc, Merc, Nax v.,
Ehus t.

Paralysis of the upper extremities: Aeon., Arn., Bell., Calc c.



PARALYSIS. 529

Caust., China, Cocc, Colch., Dulc, Ljc, Merc, Nitrum, ISTus vom.,
Ehus t., Sepia, Tart, em., Yeratr.

Paralysis of the hands: Ambra, Arseu., Caust., Cupr., Ferr., Natr.
m., Elius t., Euta, Silic.

Paralysis of the fingers: Ambra, Calc. c, Cupr., Natr. m., Secale,
Silic.

Paralysis of the lower extremities : Aluminum, Arn., Bell., Bryon.,
China, Coco., Colch., Dulc., Kali c, Merc, Nus vom., Phos., Plumb.,
Ehus t, Secale, Sulphur, Veratr.

Paralysis of the feet: Arsen., China, Oleand., Plumb.

Paralysis in consequence of —

Mental emotions: Arn., Ign., Natr. m., Stann.

Bodily exertions : Ars., Arn., Ehus t.

Spasms : Arsen., Caust., Cocc, Cupr., Hyosc, Lauroc, Nux vom.,
Plumb., Ehus t., Sec, Silic, Stann., Stram., Sulphur.

Apoplexy: Arn., Anacard., Baryt. c, Caust., Cupr., Lach., Nus v.,
Plumb., Secale, Stann., Stram., Zinc

Taking cold: Arn., Caust., Colch., Dulc, Merc, Ehus t.

Getting wet: Canst., Ehus t.

Supp)ression of siveat: Colch.

Onanism, sexual excesses: China, Cocc, Ferr., Natr. mur,, Nux v.,
Sulphur.

Intermittent fevers: Arn., Ars., Lach., Natr. m., Nux v., Ehus t.

Typhus fever: Cocc, Cupr., Ehus t.. Sulphur.

Diphtheria: Arsen., Gelsem., Lach., Natr. ra.

Cholera: Cuprum, Secale, Sulphur, Veratr.

Sujjpressed ertqjtions : Caust., Dulc, Hepar, Sulphur.
■ Poisoning by arsenicum : China, Ferr., Graph., Hepar, Nus v.

Poisoning by lead: Cupr., Opium, Platina.

Poisoning by mere: Hepar, Nitr, ac. Staph., Stram., Sulphur.



THE BLOOD.



This being the fluid which nourishes all parts of the system, which
sustains respiration, which, in short, is the life of the body, must
necessarily cause great disturbances of the body when itself becomes
in any way abnormally changed. The blood consists of corpuscles
and serum. The corpuscles are of two kinds — red, and colorless or
white. The serum contains water, fibrin, albumen, salts, fatty sub-
stances, and extractive matters.

34



530 THE BLOOD.

Any of these constituents may be abnormally increased, decreased,
or altered, causing an abnormal condition in the quality of tbe blood.

The whole mass of the blood may be increased or decreased, caus-
ing an abnormal quantity. Obnoxious substances, like sugar, uric
acid, oxalic acid, ammonia, sulphuretted hydrogen, urates, gall, pas,
may be mixed with, and thus may impregnate, the blood, causing a
poisoned state of the whole fluid.

It is only within the last ten or twenty years that these different
changes of the blood have been made the subject of closer examina-
tions, and much of it requires still closer investigations. I shall,
therefore, confine myself to the most important facts which these
researches have brought to light.

\. Cyanosis.

. The blood-corpuscles absorb the oxygen, with which they come in
contact during their course through the lungs. Any cause which
prevents this absorption of oxygen by the blood-corpuscles hinders
the transformation of the venous into arterial blood. This is the
nature of cyanosis. It consists in a decreased absorption of oxygen
by the blood-corpuscles. Its causes are numerous, which may be
arranged under the following heads :

1. Imperfect respiration^ in consequence of spasms, or oedema, or
croupous inflammation of the glottis and larynx ; or in consequence
of obstructions within the trachea and bronchial tubes, caused by
spasms, mucus, blood, foreign bodies, false-membranes ; or in conse-
quence of obstacles which prevent the air from entering the air-cells
of the lungs, caused by infiltration, hepatization, exudation, (emphy-
sema, hydrothorax, pneumothorax;) or in consequence of paralytic
affections of the respiratory muscles and diseases of the abdomen, by
which the lungs become compressed ; enlargement of the abdominal
organs, tympanites, ascites, &c.

2. Imperfect circulation, in consequence of heart disease, obstruc-
tions within the pulmonary vessels, obliteration of the pulmonary
tissue and blood-vessels, immediate transmission of the venous blood
into the left ventricle, in consequence of the non-closure at birth of
the foramen ovale.

3. Inhalation of air, which contains too little oxygen, and is im-
pregnated with irrespirable gases, like carbonic acid gas, &c.

4. Inability of the hlood- corpuscles to absorb oxygen. This has been



DISSOLUTION OF THE COEPUSCLES. 531

observed in some severe illnesses, such as typhus, pjgemia, and in the
last stage of pulmonary tuberculosis ; cholera.

Symptoms. — Bliiishness of the surface of the body, especially of the
face and lips; coldness of the extremities and depression of the mus-
cular and nervous system ; sopor ; in a still higher degree, asphyxia.

Cyanosis is, therefore, not a disease in itself, but a mere conse-
quence and symptom of other derangements ; still as a symptom, it
has, nevertheless, some therapeutic value, suggesting Aeon., Amm. c,
Arn., Arsen,, Camphor, Carbo. veg.. Con., Cupr., Dig., Lach., Opium,
Puis., Ehus t., Samb., Sec. c, Veratr.

In new-born children, where the foramen ovale has not closed, Lach.

2. Dlssolutaon of the Red Blood-Corpuscles.

Each blood-corpuscle lives a certain period of time, and after that
it dissolves and disappears, and a new one forms in its place. Thus
a constant rotation between life and death goes on in these minute
bodies in order to sustain the life of the whole body. In disease, how-
ever, this equilibrium is sometimes destroyed; more corpuscles die
than are newly generated, and this causes a state of the blood which
is called Oligocythemia. It is characterized by weakness of the
muscular system, tired feeling all over ; nervousness, palpitation of
the heart, bellows-sounds of the heart and large arteries ; murmur in
the jugular veins.

In still other cases this dissolution of the blood- corpuscles goes on
so rapidly and to such an extent that the blood-serum becomes over-
loaded with the constituents of the destroyed corpuscles, and is thus
discolored. Even the excretions of the body assume a bloody or dark
appearance ; and the exudations are of a brownish, or still darker hue.
The skin and mucous membranes become tinctured with hsematin,
(the coloring matter of the blood,) and color it yellowish, which may
be mistaken for jaundice.

If such a profuse dissolution of blood-corpuscles is confined to a
certain portion of the circulation, it constitutes an essential part in
what is called local OANORiENE. A general putrid dissolution
through the whole system is general gangrene, septicemia. We
find such states of general dissolution in some forms of typhus, scurvy,
puerperal fevers, yellow fever, and various other forms of tropical
fevers. By what it is caused, we do not know.

Compare Alum. P. S., Ars., Carbo veg., China, Lach., Nitr. ac,
Secale.



532 THE BLOOD.

3. Leukaemia,

Whicli is an abnormal increase of colorless or wliite blood-corpuscles
and a decrease of red corpuscles at tlie same time. This state of the
blood is found mostly in complication with an enlarged spleen ; also
with enlargement of the liver, and with enlargement of the lymphatic
glands. Causes unknown.

A slight increase of the white corpuscles is found after loss of blood ;
during inflammatory processes ; pregnancy ; typhus ; intermittent
fevers; sycotic contamination, and in various chronic diseases.

4. Hydraemia

Consists in a decrease of albumen, and an increase of water in the
serum sanguinis. In consequence of this the serum is much more
prone to exudation than in its normal state, and we therefore iind this
state of the blood associated frequently with dropsical effusions.
Its causes may be : —

1. Long -continued pathological secretions of clear albumen, or albu-
minous substances^ (mucus, milk, &c. ;) in consequence of albuminuria ;
serous diarrhoea; pus-formation; exudation; loss of blood; mucous
discharges ; too copious flow of milk ; too long- continued nursing.

2. Insufficient supply of nutriment or disturbed nutrition, so that the
received nourishment is not converted into albumen, and assimilated.
Hydrsemia is therefore found in connection with the most different
morbid processes. "We find it in combination with diseases of the
heart and lungs ; especially tuberculosis ; chronic indigestion ; pro-
tracted intermitting fevers, and Bright's disease, &c.

Therapeutic Hints must be referred to the above-named
morbid conditions.

5. Plethora.

The quantity of the blood must always be estimated, as a relative
mass. We cannot say, so much is just enough, one ounce more is
too much. And in fact during life we have no means for such
estimation. The whole plethoric theory therefore rests upon rather
weak legs. On the other hand, if we observe different individuals,
it seems clear enough that some are richer in this vital fluid than
others. And as objective signs, which indicate such repletion, there



CHLOEOSIS. 538

are stated : 1. A liigher degree of redness of the tody — sucli higher
color may be, however, often very fallacious ; it is of any account
only when it is perpetually so; and, 2. The greater fulness and reple-
tion of the circulatory vessels, arteries and veins. This is plethora of
olden times. More recent observers have split this theory into three
branches ; they divide plethora of the old into —

1. Plethora veea, true plethora, which is said to characterize
itself by fulness of the arteries and veins, repletion of single organs,
florid complexion and increased temperature of the body.

2. Serous Plethora, an increase of blood-serum, and decrease of
corpuscles, which characterizes itself by fulness of the arteries and
veins, paleness, or else quick change of color ; and,

3. Plethora ad vasa, or false plethora^ which is not too much
blood in general, but too great an afflux of blood into the blood-vessels,
as in fevers, in consequence of bodily and mental exertions, spirit-
uous, irritating drugs, &c.

All these distinctions are of little use for Homoeopathic practice, as
the Homoeopathic physician will scarcely have occasion to trouble
his brain with the question : Shall I bleed ? or shall I not ?

6. Anaemia, Ollgaemla.

In the strict sense it means a decrease in the normal quantity of
hlood, a state of things which now and then may happen. It is mostly
combined with hydrsemia. The blood is less in quantity — the serum
contains less albumen and more salts than is normal, and the red
blood-corpuscles are also diminished. Such states are found after
great loss of blood, and after exhausting diseases ; such as Bright's
disease ; tuberculosis ; cancer ; profuse pus-formation ; diarrhoea, &c..
and it generally ends in dropsy. The physical signs of anemia are
the following :

1. The helloios-sozmd in the heart; best heard at the apex of the
heart with the systolic tic.

2. The arterial murmur, which consists in a kind of intermitting
blowing noise, Synchronous with the pulse.

3. The venous murmur, which is a continuous, purring sound within
the larger veins.

7. Chlorosis.

Some writers use the name chlorosis as entirely analogous with
anaemia, (Andral, Gavarret, Bouillard ;) others make a difference be-



534 THE BLOOD.

tween the two, and call anaemia that state of the system in which the
insufficiency of the blood arises from known causes ; chlorosis, when it



Online LibraryCharles Gottleib RaueSpecial pathology and diagnostics : with therapeutic hints → online text (page 53 of 65)