VERTIGO, in medicine, designates a sensation which the patient describes as one of going to fall, or of turning rc.ind, or of everything turning round him. It comes on without premonitory symptoms, excepting a sense of disturbed balance, which may either precede, accompany, or follow it. Associated with it are frequently some of the fol lowing symptoms: flashes of light before the eyes, buzzing in dm cars, painful sensa tions in the head, nausea, vomiting, trembling with cold perspirations, muscular tremors, .a full, slow, or small and frequent pulse, flushing or pallor of the face, and cold feet.
Giddiness and dizziness are only other names for vertigo, although giddiness is com monly applied to its milder forms. Attacks of it come on in paroxysms, usually repeated several times a day, and lasting from a few minutes to a quarter of an hour. This dis ease is frequently chronic, the chief predisposition to it being in middle and advanced age. Childhood is nearly exempt from it, an observation in accordance with the well known fact, that children can bear rapid rotatory movements without the induction of giddiness better than adults. A plethoric constitution, especially if associated with a sedentary mode of life, the so-called change of life in women, the debility brought on by exhausting discharges, and the abuse of spirituous liquors, may be regarded as pre causes to this affection. The direct cause of vertigo is doubtless an irregu larity of the supply of blood to the brain. Hence any condition that occasions either an increase or diminution in the supply of blood, is followed by vertigo. For example, it commonly accompanies disease of the heart, and especially hypertrophy of the left ventricle; it is also induced by suppressed hemorrhoids, or other constant form of dis charge or loss of blood. Injuries and diseases of the brain, and especially of the cere bellum, are often accompanied by this symptom, and so also are diseases of the spleen. Among the most common exciting causes are intoxication, not only from alcoholic drinks, but from narcotics, such as smoking tobacco, inhaling carbonic acid gas, or semi-poison-. ing by belladonna, digitalis, hyoscyamus, etc., gorging the stomach with indigestible food (especially if highly carbonated drinks are at the same time taken); unusual move ments or positions of the body, and especially of the head, as in sea-voyages, continued stooping, etc.
There is a peculiar kind of vertigo which occurs in dreams. The direction of the apparent movement is generally from above downward; dreams of tumbling down stairs being, according to Romberg, the most common; people alSo dream of sinking into the earth, of chasms opening before them, etc.
According to Beerhaave, "vertigo is the most easily cured of all the diseases of the i head." This statment is too positive; the vertigo that is caused by profuse discharges and exhaustion is curable, while it is beyond the aid of treatment when it accompanies cerebral disorganization. The treatment of course depends upon the cause; while in some cases tonics (the mineral acids, small doses of nux vomica, quassia, etc.) are required; in others, the local abstraction of blood from the nape of the neck, cold effusion, etc., arc required. The following rules are, however, generally applicable for the treatment of patients subject to giddiness. They should avoid violent, continuous, or rotatory exercise, abstain from highly nutritious or heating articles of diet, and from suppers; they should not indulge in much sleep, or the use of feather-beds or of warm baths. Counter-irritation to the skin by sinapisms, foot-baths with mustard, the use of the flesh-brush, with cold washing of the body, and the administration of cooling laxatives are to be recommended. (A good laxitive of this kind is obtained by mixing six drams of sulphate of magnesia [Epsom salts] with two drams of carbonate of magnesia, and taking a teaspoonful three times a day.) When thd patient feels the attack coming on, Romberg directs that he should "direct his full attention to movement. The phtients do this, in a measure, of their own accord; by supporting themselves firmly with their hands and feet, in order to resist the illusory movement. The sense of vision may be employed for the same purpose; thus, the vertigo produced by rotatory movement of the body may be suppressed by looking steadily at the finger held up to the eye, or by turning round in a direction opposite to the previous movement."—On Diseases of the Nervous System, Syd. Soc. Ed. vol. i., p. 102.