The London practice of physick, or, The whole practical part of Physick contained in the works of Dr. Willis faithfully made English, and printed together for the publick good.

CHAP. IV. Of Convulsive motions, whose cause lyes about the Extremities, or within the Plexus's of the Nerves.

THat Convulsive affects, sometimes without any fault in the Head, arise from the Irritation and Explosion of the Spi∣rits lying about the extremities of the Nerves, it plainly appears even from this, because when Medicines smartly twitch the Coats of the Stomack or Intestines, or when Worms gnaw them, Con∣vulsions do not only follow in those parts, but likewise Convul∣sive motions are sometimes retorted on the Members and out∣ward Limbs: For as we have shewn elsewhere, when a sense of great pain torments any part, and is communicated from that to the Primum Sensorium, presently upon it, the Spirits being there irritated, an involuntary and irregular motion is wont to be thence reflected; and that not only by those Nerves, by which the sense of pain was brought, but sometimes the Convulsion is reciprocated also by others, either of the same pair, or belonging to a pair wholly differing: Thus a Stone fixt in the Ureter cau∣ses Convulsions, not only in the Vessel affected, but in a man∣ner in all the Viscera of the Belly, and cruel vomitings for the most part follow upon it: Wherefore it is not to be doubted but Convulsive Diseases also, and some such Symptoms are often caus'd by reason of some outward offence offer'd the extremities of the Nerves within the Membranes, Muscles or Viscera: Nay and if at any time in Hysterick, Hypochondriack, and certain other pas∣sions, Convulsive motions are rais'd through the fault of the Womb, Spleen, or some other of the Viscera, the Head being without hurt; truly those arise and are propagated on every side into various Regions of the Body only this way, viz. by the an∣noyances of the rest of the parts by the Way of the Nerves, and not at all by vapours convey'd to the Head. I shall now give you some instances and observations of Convulsions arising from the Extremities of the Nerves.

A delicate Virgin about the sixteenth year of her Age falling from a Horse, and dashing her self against a rough Stone, sorely hurt her left Brest, whence a Swelling with a pain arose, which Symptoms nevertheless at first seem'd to be mitigated by the use of Remedies, and afterwards for a long time to pass indifferently well; but after three years upon taking cold, and having us'd a

very ill Diet, all things began to return a new; the place hurt swelling up in a greater bull, was affected with a most acute and almost continual pain, so that the Diseased, through the mighty torment, passed many days and nights without sleep; nor could she indure that the Glandules of her Brest, then become more swollen, shonld be toucht or handled, nay nor any noise or con∣cussion to be made in her Chamber.

When to this Tumour, degenerating towards a Cancer, Fo∣mentations and Cataplasms of Hemlock and Man-drake, and other stupifying things, and Repercussives were apply'd, the noble Lady began to undergo certain Convulsive affects, which often molested her: In the first place as often as a violent pain came in her Brest she felt there prickings, and likewise Convulsions and Contractions shooting in and out: Presently after the Ven∣tricle and Hypochondres, and after that the whole Abdomen were wont to be blown up, and mightily distended with a rumbling and a straining to Vomit: By and by the same affect being con∣vey'd by degrees to the upper parts, took away her Senses, and shortly upon it so strong Convulsions followed in her whole Body, that the Diseas'd could scarce be heal'd by three or four robust Men.

These kinds of Fits at first came at random, and were only rais'd occasionally, viz. they ensued as often as the pain of the Brest was rendred more intense by some evident cause: After∣ward those Convulsions more frequently molested her, and at length becoming periodical and habitual, they return'd twice a day, viz. constantly justsomany set hours after Meals: And when Diseas'd had been miserably afflicted after this manner for six Months; at length she began to be troubled with a certain Ver∣tiginous affects which continually followed her: For which evil when a Fomentation of Aromatick and Cephalick Herbs had been for some time applyed, she grew better as to her Vertigo; but from thenceforwards she was continually molested with a new and very wonderful Symptom, viz. a violent dry Cough follow∣ing her day and night, unless when she was fallen asleep: After this noble Virgin had tryed divers sorts of Remedies, prescrib'd by several Physicians, without much benesit, at length vpon the use of the Baths of a moderate heat at Bathe, she was reliev'd, and being marryed presently upon it, after conception and her being delivered of a Child, she recovered by degrees.

As to the violent Cough above mention'd, it seems that that Symptom depended on the Origine of the nerves being affected, and not on any stuffing in the Lungs, for she spit forth nothing with the Cough; we say therefore that the Morbifick matter de∣por'd near the Origint of the Nerves being rarified and mov'd

by the Fomentation, entred deep in at the Mouths of the Nerves that go to the Lungs, and stirr'd up perpetual Convulsi∣ons in the Fibres and Filaments thereof.

A noble Matron Fifty years of Age, after that her Menses had ceas'd to flow for a year and a half, first began to complain of a pricking pain in her left brest, then afterward that affect ceasing, she was taken ill about the Stomack: To wit, a hard, and as it were schirrous Tumour arose there with an oppressing pain; this was presently followed by an inflation of the Ventricle, with a diffi∣cult Breathing, a Nauseousness and frequent Vomiting. Then the Disease growing worse and worse, with a more acute pain, and shooting in and out every way, she fell into Conulsive af∣fects of the Ventricle: To wit, the Convulsions shooting in that place several ways, she was almost continually in such a torment, as though the Stomack were torn in several pieces: Moreover a continual Perturbation of mind, and frequent Fainting Fits lead∣ing even to Death's door, accompanied with a Thirst and Watch∣ings, pursued the sick Lady; all which Symptoms she plainly per∣ceiv'd always to arise from that Tumour of the Ventricle (to wit, its sharp and heterogeneous Particles continually entring the Ex∣tremities of the surrounding Fibres and Nerves.) To this Per∣son all Vomitory, Cathartick, Antiscorbutick and Hysterick Me∣dicines, without giving any ease, seem'd rather to have prov'd offensive and prejudicial: After Bleeding by Leeches, and the use of Asses Milk she receiv'd some benefit, and afterward by long drinking Mineral Waters, she was very much reliev'd.

What has been said here of Convulsions from a Morbifick cause besetting each end of the Systema Nervosum will be made more clear when hereafter we shall treat particularly of the chief kinds of Convulsions, viz. of Hysterick, Hypochondriack and other Passions: In the mean while it will not be necessary to add a The∣rapeutick method to this Hypothesis of Convulsions hapning by reason of the Extremities of the Nerves being affected; because the ways of Curing this affect may better be accommodated to those that we shall hereafter deliver in particular.

I have found also by ocular evidence, that there are Convul∣sive affects whose cause, or Morbifick matter lyes within the Plexus's of the Nerves: For opening the Body of a noble Lady, who had been horribly troubled with those affects they call Hy∣sterical a little before her decease, I found the Womb wholly without fault, but along the Nervous Plexus's of the Mesentery, which (as it seem'd) had been wont to swell and rise up in a bulk, I found the Membranes of that Entral loosen'd and severed from each other, so that they appear'd every where swoll'n and lax, as if blown up in little bubbles or bladders. Nor is it less

probable that the pains of the Colick often proceed from a sharp and irritating matter contain'd in those same Plexus's Moreover such a kind of matter within the Pexus's of the Heart, seems to cause there horrible Tremblings and Passions, and with∣in the Plexus's of the Lungs or Neck, terrible Fits of the Asthma, &.