Introductory lecture to a course of lectures on the theory and practice of physic : to be delivered at the Medical School in Aldersgate Street / by Marshall Hall.

Marshall Hall

Date:: [1835?]

Credit: Introductory lecture to a course of lectures on the theory and practice of physic : to be delivered at the Medical School in Aldersgate Street / by Marshall Hall. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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$LECTURES ON THE. NERVOUS SYSTEM AND ITS DISEASES. BY MARSHALL IIALL, M.D., F.R.S , Sfe. tfc. [From The Lancet, Apiil 21st, 1838.] XII. Diseases of the Nervous System.—Spas- modic asthma ; its simplest form. Symptoms and treatment of this species. Action of ipecacuan on the bronchia. Peculiarities produced by idiosyncrasy. Instrument for \ rapidly performing tracheotomy. Vomiting ; it is a reflex, spinal, act. Mechanism of \ vomiting. Opinions of M. Magendie, and other physiologists, examined. CEsophageal vomiting. Abortion. Spastnodic strabismus. Gentlemen:—In the present lecture I bring to a conclusion the Nervous System and its Diseases; yet, how much remains unsaid. I have thought it right, however, not to occupy your attention unduly with a favourite subject. As I proceed in my in- vestigations, I propose to lay the results before the profession as they may be esta- blished, so that your future reading will supply any defect in what you now hear. 1104. I proceed to treat of several other centripetal diseases of the true spinal sys- tem. I shall then lay before you some observations upon several affections which may very justly be designated centrifugal. You will remember I am not the first to employ these terms in medical language. I might have hesitated to do so; but with the example of Prof. Muller before me, I need not hesitate to use these very signi- ficant terms. 1105. The first subject of which I now propose to treat briefly is VIII.—Spasmodic Asthma. I have already alluded to this subject. The similarity between the croup-like disease, or the laryngeal asthma, and this, or the bronchial asthma, is most marked. A morbid state of the stomach induces both ; both come on in attacks, and in the first sleep; both cease, as by a charm, from change of air ; both are instances of reflected irritation : the difference consists iu the clo- sure of the larynx in the former disease, and its open state in the latter, a difference which is probably the cause of all the other differences between these two diseases. 1106. The simplest form of asthma is that immediately iuduced by taking some indi- gestible substance ; or, perhaps, still more immediately induced by the inhalation of certain kinds of dust diffused in the atmo- sphere, as that raised by shaking a feather- bed, the powder of ipecacuanha, &c. The incident branches of the pneumogastric, or internal excito-motory nerve, are excited ; the action is reflected by the medulla ob- longata upon the motor branches, and, as I believe, upon the circular muscular fibres of the bronchial tubes. These tubes are con- tracted, and the phenomena of asthma are induced. A constipated state of the large intestine acts in the same manner through the incident spinal nerves. Contracted bronchial tubes explain all the phenomena: the dyspnoea, the urgent, rapid, imperfect bronchial inspiration ; the protracted wheez- ing bronchial expiration ; the bronchial rat- tles under the stethoscope, especially during expiration; the excited secretion of mucus, the cough ; ultimately, the dilated air-cells, the dilated heart, &c. 1107. As certain additions to the atmo- sphere induce asthma, so certain others, as the smoke of tobacco, of stramonium, relieve the disease, and upon similar principles. As asthma is a morbidly excited state of the true spinal nerves, so remedies which sub- due the action of that system, as the hydro- cyanic acid, constitute our most prompt remedies in this disease. Swallowed, or inhaled, this remedy is invaluable, in this and in the cognate diseases, as the croup- like disease, pertussis, &c., &c., the first exciting cause or causes being removed. 1108. How singular is it, that ipecacu- anha, taken into the bronchia should excite asthma, and taken into the stomach should induce another affection of the respiratory$