Volume 2

A treatise on the practice of medicine / By George B. Wood.

  • Wood, George B. (George Bacon), 1797-1879.
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the practice of medicine / By George B. Wood. Source: Wellcome Collection.

    12/854 (page 6)
    rent nerve, as aneurism of the aorta and its primary branches. It is much more common in women than in men. The treatment must be directed to the cause, and is for the most part such as is adapted to cases of hysteria. Antispasmodics, narcotics, tonics, the cold or shower-bath, a proper regulation of the intestinal and uterine functions, counter-irritation to the spine, an appropriate diet, and’ exercise in the open air, are the chief remedies. rere | 8. Suppression of the Voice, or Aphonia.—Allusion is here made only to the affections of the voice of a nervous character, independ- ently of inflammation or organic alteration of the larynx. Changes of the voice of this kind are not uncommon. Sometimes it becomes acute, or of a higher key, though feeble. The voice of a man is thus rendered feminine, or puerile. Sometimes the alteration is of an opposite character, the voice becoming low, or hoarse, or croaking, so that a child or a woman will speak like a man. Jn many instances, it is entirely suppressed. No sound is formed above that of the breath, and speech is in whispers. The attack may be sudden or gradual, and brief or of long and indefinite duration. Causes.—These are numerous. Among the most frequent is the irre- gular distribution of nervous action consequent upon general debility, as after long continued or exhausting diseases. The affection is often nothing but a form of hysteria. Sometimes it depends upon debility of the laryn- geal muscles alone; as where these have been overstrained by protracted and excessive efforts in speaking or singing. Occasionally an attack is brought on by a sudden and strong mental emotion, as of joy, anger, or fright. Quick changes from a warm toa very cold air have induced it. In some instances, it appears to depend on sympathy with intestinal irritation, or disease of the sexual organs, whether in man or woman. It has attended the poisonous action of lead, and has been brought on by powerful narcotics, as belladonna and stramonium. Another frequent source of it is disease affecting the par vagum or recurrent nerve, or one of the nervous centres. Hence it may attend aneurisms in the upper part of the chest, and, in the form of partial or complete palsy of the larynx, may depend upon congestion or effusion in the brain, or other organic cerebral disease. T'reatment.—W hen the disease depends on general debility, the obvious plan of cure is to restore strength by tonics, the cold bath, nourishing food, and exercise. When a mere form of hysteria, it is to be treated like spasm of the glottis from the same cause. If the brain is in fault, our remedies must be addressed to that organ, and must vary with the na- ture of the affection. Aphonia arising from temporary causes often disap- pears spontaneously. When produced by cold, it is cured by hot teas, or warm stimulating drinks, given so as to induce perspiration. If the result of lead poison, it may be treated by mercury, and by measures calculated to stimulate the organ. Such measures are also obviously proper in all cases, where the modification of the voice depends on debility of the laryn- geal muscles. Under such circumstances, we may employ gargles of alum and other astringents whether vegetable or mineral, stimulating inhalations, electricity, external irritation by means of sinapisms, blisters, croton oil, or a-seton, and strychnia applied to a blistered surface, or taken internally. Solution of nitrate of silver has been applied directly to the internal surface of the larynx, with success in several cases, by M. Trousseau; but the Operation requires dexterity, and should be tried only by a skilful hand, . and after-a fruitless employment of other remedies. |