Gratuitous Medical Services

THE author's attention had first been directed to codliver oil as a remedy for affections of this class, in consequence of his obtaining some years ago an unexpected success with it in a case of chorea which had resisted all the ordinary modes of treatment. The convulsive diseases in which the author has employed cod liver oil are paralysis agitans, simple epilepsy, chorea and mercurial tremor, and in all these affections it has appeared to be more constantly useful than any other medicine. Of paralysis agitans, four cases were detailed, of which three were very decidedly improved and one of them may have been said to be cured, although the affection had been very severe. Of chorea, one case was detailed, and others were alluded to in which the benefit produced was very marked. Of mercurial tremor, one most remarkable case was related, in which the cause of the mischief was a very unnecessary salivation inflicted by medical authority some thirty years previously; the patient was attacked immediately afterwards with dreadful tearing pain in the muscles of the fore arms and calves, and with violent muscular tremors; and, ever since that time, she has been liable to a recurrence of the symptoms when much fatigued or depressed firom any cause. On application to Dr. ANSTIE, at the Chelsea Dispensary, cod-liver oil was prescribed and persisted with for five weeks, at the end of which time, all the syrDptoms had perfectiy disappeared; the patient declared that she had never been cured before in less than six or eight months, and she doubted whether any other medicine than the oil had ever really done her any good. Twice since she has had slight recurrence of the symptoms, but a short course of cod-liver oil has, on each occasion, given complete relief. Of simple epilepsy, twenty cases were given, in which the treatment had been confined to the use of cod-liver oil. Of these, there were five upon whom no good effect whatever was produced; seven had completely recovered; two had disappeared from supervision at a time when they were rapidly improvirng, altlhouglh they could not be said to be cured; in two othiers the mental syrnptoms had greatly improved, but the fits remained as before; four patients remain still under supervision; irn two, fits have ceased, although there are still frequent prodmomata; and in the remaining two but little good has yet been effected. Besides this general summary of results, Dr. ANSTIE detailed the particulars of three cases which, from their severity, itiighit be said fairly to test the remedial power of the oil. T'he patients were respectively a girl aged 17, a boy aged 13, anid an infant aged 7 moniths, in all of them the fits were very freqteuet and severe, and the nervous system exhibited signs of great depression. The case of the infant was specially noticeable, because it was proved by tnicroscopic inspection that the milk of the mother was very deficient in oily matter, and it appeared that in a former infant of the sanie mnother precisely the same train of symptoms had appeared, and had terminated fatally. In all these three cases, the treatment had proved perfectly successful, an-id the author comnmented itrongly on the fact, that in all these cases the general nutrition of the body had been excellent, and oDly that of the nervous system had appeared deficient, and said the conclusion appeared inevitable, that the oil had expended itself in enriching the nervous centres. This, indeed, was the principal point of the paper. The author directed attention to Dr. Radcliffe's renmarks on the necessity of fat to the nutrition of the nervous centres, and mentioned the fact that that gentleman had found cod-liver oil of the highest value in the treatmernt of convulsive diseases. He observed also, that the beneficial action of cod-liver oil was quite consistent with what we know of the action of the few other remedies which careful therapeutical investigation has credited with a really beneficial action in chronic convulsive diseases. Steel, arsenic, quinine, all these may fairly be spoken of as foo(ds. With regard to sedatives, the author remarked that, in the first place, the good effects which could be expected from them were chiefly temporary and suchi as result from breaking through for a time the evil habit, so to speak, of convulsive action. Secondly (and this was most important), there was strong reason to believe that it is not the really narcotic effect of these remedies which are of service in preventing or arresting convulsive action, but merely the stimulant effects which can be obtained from small doses; for there is no class of remedies which is more useful in preventing or arresting convulsions than the pure stimulants. The author concludedl his paper by deprecating strongly any return to the absurd system of hunting about blindly for specifics for chronic convulsive diseases. The progress of clinical observation was blasting the reputation of one after another of the strange onit of the way remedies, which had once been accepted with the blindest faith, and was pointing unmistakably to a rational treatment of convulsive diseases by means of medicines whose actions it is possible to understanid.