A Synopsis OF THE DIASTALTIC NERVOUS SYSTEM. Being the Croonian Lectures, delivered at the Royal College of Physicians,
IT is obvious that the whole Class of the diseases of which trachelismus forms a part, must be distinguished from those which arise from, or consist in, organic change of structure of the nervous centres simply. Disease of the tissues of the cerebrum or of the spinal marrow may be of this latter class. They are recognised by a previous knowledge of anatomy, physiology, and experiment, and by observation and experience. Diseases involving trachelismus are of a very different character. Perhaps I
... haracter. Perhaps I cannot conclude these lectures better than by a brief view of several of them. I will first present you with a Sketch of Laryngismus. Not many years ago, this affection was supposed to be a disease of the brain. It is now well known to be a malady of which the cause is variously seated in the alveoli, the stomach, the intestine, of which amongst the earlier effects are strabismus, laryngismus, a contracted hand, a contracted foot, spasmodic affection of the sphincters, &c. and amongst the remoter, distorted features, trachelismus, generally torticollis, actual closure of the larynx, and convulsion more or less general, dilated pupil, insensibility; lastly, congestion of the encephalon, with eventual effusion, as an ultimate effect. The course of these events is very interesting. It is the reverse of that which attends primary disease of the encephalon. In this, the cerebral symptoms precede the spinal generally. We frequently see strabismus, and especially vomiting, before an y cerebral symptom manifests itself, the cause or source of irritation being probably seated in the arachnoid. A very interesting question arises here. Are children who have been the subject of convulsive affection peculiarly apt, in remoter years, to become the subjects of epileptoid affection! Does this question involve the question of the special cause of convulsive affections, whether dentition, or gastric or enteric irritation.