These statements appear, then, sufficiently opposed to each other ; how shall we explain or reconcile them ? Before I proceed to discuss this question, I must beg the attention of the reader to a third series of observations and experiments, in a certain sense at variance with both those which have been detailed.
My own attention was first drawn to this interesting point by the fact, well known to physicians, that if we administer strychnine to patients affected with paralysis, it is frequently the paralytic limbs which first manifest the pe culiar influence of this powerful remedy. M. Fouquier has, I believe, too hastily generalized this effect of strychnine on the muscles of pa ralytic limbs. And how well do I remember the same remark being made by M. Louis, as, in our visit round his wards at La Pule, we came to a case in point. From that moment I did not cease to revolve the question in my mind, and to devise modes of observation and experiment to solve it. Certainly the conclu sion of M. &galas d'Etchepare, in regard to it, is any thing but satisfactory. AI. Segalas ob serves:— " Ces experiences reunies autorisent done a conclure que le tetanos produit par la noix vo mique a pour condition premiere de son deve loppement la presence du poison dans he sang, et que les phenomenes qui Faccompagnent sont dus a Faction anormale de ce fluide sur le sys teme nerveux.
" Cette maniere de considerer Faction de la noix vomique donne un moyen simple d'expli quer les diets de cette substance chez l'homme, et particulierement ce fait si remarquable de la contraction des muscles paralyses plus prompte et plus energique que celle des muscles sains, fait observe d'abord par AI. Fouquier,* ct con state depuis par tart de praticiens du premier ordre. Il est facile, en diet, de concevoir que les muscles sains, soumis A. la fois iS ]'empire du cerveau et A faction du poison, resistant a celle-ci plus que les muscles paralyses, soustraits a l'influence cerebrate, ne sont plus commandos que par le poison." Upon these observations of M. Segalas, M. 011ivier remarks--" dais s'il en est ainsi, com ment se rendre raison d'un fait observe depuis long-temps par sous les praticiens, et sur lequcl je viens d'appeler l'attention, c'est que la noix vomique cause souvent de violentes douleurs dans les membres paralyses, sans apportcr aucun trouble dans les parties saines ? Pour quoi cette action speciale sur les seuls organes paralyses ? et, d'un autre cote, la doulenr pervue ne prouve-t-elle pas que les parties paralysees ne sont point isolees entierement du centre nerveux, et qu'ainsi ce ne pout etre It cette inconstance qu'on doive attribuer la loath sation singuliere des effets de la strychnine ?" It will soon be seen that this view, like a former one, is far too general, far too indiscri minate—that it is not in every case of paralysis, that the strychnine would first display its in fluence on the paralytic limbs. Meantime,
however, I figured to myself the fact of the strychnine acting on the spinal marrow, and diffitsing its power equally along the nerves, to the right hand and to the left, to the muscles to which they proceed respectively: and I asked myself the question—Is the difference observed in its ultimate effects on those muscles, the power being obviously the same, owing to a difference in the degree of the irritability of the muscular fibre itself? Is the irritability of that fibre actually angmented ? If so, the pheno menon would be explained ! I waited with anxiety for opportunities of submitting this question to the decision of ex periment. This I entrusted, in the first in stance, to my young friend and intelligent pupil, Mr. Dolman. The result was as I an ticipated. A little child, aged two years, was perfectly paralytic of the left arm. The slight est shock of galvanism was directed to be ap plied which should produce an obvious effect. It was uniformly observed that the paralytic limb was agitated by a degree of galvanic energy which produced no effect on the healthy limb.
A similar patient, with paralysis of one leg, was subjected to the same experiment by my friend and former pupil Mr.1V. F. Barlow, and with the same result.
I repeated the trial on several patients af fected with hemiplegia, at my own house, uni formly with the same event: the paralytic limbs were always moved by an influence which was lower than that required to affect the healthy limb, or if both limbs were agitated, it was uniformly the paralytic limb which was more shaken than the other.