Zoonomia/III.VI
ART. VI.
REVERTENTIA.
I. Those things, which restore the natural order of the inverted irritative motions, are termed Revertentia.
1. As musk, castor, asafœtida, valerian, essential oils.
2. Externally the vapour of burnt feathers, of volatile salts, or oils, blisters, sinapisms.
These reclaim the inverted motions without increasing the heat of the body above its natural state, if given in their proper doses, as in the globus hystericus, and palpitation of the heart.
The incitantia revert these morbid motions more certainly, as opium and alcohol; and restore the natural heat more; but if they induce any degree of intoxication, they are succeeded by debility, when their stimulus ceases.
II. Observations on the Revertentia.
I. The hysteric disease is attended with inverted motions feebly exerted of the œsophagus, intestinal canal and lymphatics of the bladder. Hence the borborigmi, or rumbling of the bowels, owing to their fluid contents descending as the air beneath ascends. The globus hystericus consists in the retrograde motion of the œsophagus, and the great flow of urine from that of the lymphatics spread on the neck of the bladder; and a copious salivation sometimes happens to these patients from the inversion of the lymphatics of the mouth; and palpitation of the heart owing to weak or incipient inversion of its motions; and syncope, when this occurs in its greatest degree.
These hysteric affections are not necessarily attended with pain; though it sometimes happens, that pains, which originate from quiescence, afflict these patients, as the hemicrania, which has erroneously been termed the clavus hystericus; but which is owing solely to the inaction of the membranes of that part, like the pains attending the cold fits of intermittents, and which frequently returns like them at very regular periods of time.
Many of the above symptoms are relieved by musk, castor, the fœtid gums, valerian, oleum animale, oil of amber, which act in the usual dose without heating the body. The pains, which sometimes attend these constitutions, are relieved by the secernentia, as essential oils in common tooth-ach, and balsam of Peru in the flatulent colic. But the incitantia, as opium, or vinous spirit, reclaim these morbid inverted motions with more certainty, than the fœtids; and remove the pains, which attend these constitutions, with more certainty than the secernentia; but if given in large doses, a debility and return of the hysteric symptoms occurs, when the effect of the opium or alcohol ceases. Opiates and fœtids joined seem best to answer the purpose of alleviating the present symptoms; and the sorbentia, by stimulating the lymphatics and lacteals into continued action, prevent a relapse of their inversion, as Peruvian bark, and rust of iron. See Class I. 3. 1. 10.
II. Vomiting consists in the inverted order of the motions of the stomach, and œsophagus; and is also attended with the inverted motions of a part of the duodenum, when bile is ejected; and of the lymphatics of the stomach and fauces, when nausea attends, and when much lymph is evacuated. Permanent vomiting is for a time relieved by the incitantia, as opium or alcohol; but is liable to return, when their action ceases. A blister on the back, or on the stomach, is more efficacious for restraining vomiting by their stimulating into action the external skin, and by sympathy affecting the membranes of the stomach. In some fevers attended with incessant vomiting Sydenham advised the patient to put his head under the bed-clothes, till a sweat appeared on the skin, as explained in Class IV. 1. 1. 2.
In chronical vomiting I have observed crude mercury of good effect in the dose of half an ounce twice a day. The vomitings, or vain efforts to vomit, which sometimes attend hysteric or epileptic patients, are frequently instantly relieved for a time by applying flour of mustard-seed and water to the small of the leg; and removing it, as soon as the pain becomes considerable. If sinapisms lie on too long, especially in paralytic cases, they are liable to produce troublesome ulcers. A plaster or cataplasm, with opium and camphor on the region of the stomach, will sometimes revert its retrograde motions.
III. Violent catharsis, as in diarrhœa or dysentery, is attended with inverted motions of the lymphatics of the intestines, and is generally owing to some stimulating material. This is counteracted by plenty of mucilaginous liquids, as solutions of gum arabic, or small chicken broth, to wash away or dilute the stimulating material, which causes the disease. And then by the use of the intestinal sorbentia, Art. IV. 2. 5. as rhubarb, decoction of logwood, calcined hartshorn, Armenian bole; and lastly, by the incitantia, as opium.
IV. The diabætes consists in the inverted motions of the urinary lymphatics, which is generally I suppose owing to the too great action of some other branch of the absorbent system. The urinary branch should be stimulated by cantharides, turpentine, resin (which when taken in larger doses may possibly excite it into inverted action), by the sorbentia and opium. The intestinal lymphatics should be rendered less active by torpentia, as calcareous earth, earth of alum; and those of the skin by oil externally applied over the whole body; and by the warm-bath, which should be of 96 or 98 degrees of heat, and the patient should sit in it every day for half an hour.
V. Inverted motions of the intestinal canal with all the lymphatics, which open into it, constitute the ileus, or iliac passion; in which disease it sometimes happens, that clysters are returned by the mouth. After venesection from ten grains to twenty of calomel made into very small pills; if this is rejected, a grain of aloe every hour; a blister; crude mercury; warm-bath; if a clyster of iced water?
Many other inverted motions of different parts of the system are described in Class I. 3. and which are to be treated in a manner similar to those above described. It must be noted, that the medicines mentioned under number one in the catalogue of revertentia are the true articles belonging to this class of medicines. Those enumerated in the other four divisions are chiefly such things as tend to remove the stimulating causes, which have induced the inversion of the motions of the part, as acrimonious contents, or inflammation, of the bowels in diarrhœa, diabetes, or in ileus. But it is probable after these remote causes are destroyed, that the fetid gums, musk, castor, and balsams, might be given with advantage in all these cases.
III. Catalogue of Revertentia.
I. Inverted motions, which attend the hysteric disease, are reclaimed, 1. By musk, castor. 2. By asafœtida, galbanum, sagapænum, ammoniacum, valerian. 3. Essential oils of cinnamon, nutmeg, cloves, infusion of penny-royal, mentha, pulegium, peppermint, mentha piperita, ether, camphor. 4. Spirit of hartshorn, oleum animale, spunge burnt to charcoal, black-snuffs of candles, which consist principally of animal charcoal, wood-soot, oil of amber. 5. The incitantia, as opium, alcohol, vinegar. 6. Externally the smoke of burnt feathers, oil of amber, volatile salt applied to the nostrils, blisters, sinapisms.
II. Inverted motions of the stomach are reclaimed by opium, alcohol, blisters, crude mercury, sinapisms, camphor and opium externally, clysters with asafœtida.
III. Inverted motions of the intestinal lymphatics are reclaimed by mucilaginous diluents, and by intestinal sorbentia, as rhubarb, logwood, calcined hartshorn, Armenian bole; and lastly by incitantia, as opium.
IV. Inverted motions of the urinary lymphatics are reclaimed by cantharides, turpentine, rosin, the sorbentia, and opium, with calcareous earth, and earth of alum, by oil externally, warm-bath.
V. Inverted motions of the intestinal canal are reclaimed by calomel, aloe, crude mercury, blisters, warm-bath, clysters with asafœtida, clysters of iced water? or of spring water further cooled by salt dissolved in water contained in an exterior vessel? Where there exists an introsusception of the bowel in children, could the patient be held up for a time by the feet with his head downwards, or be laid with his body on an inclined plane with his head downwards, and crude mercury be injected as a clyster to the quantity of two or three pounds?