LINUM USITATISSIMUM.

Authority.

L. P. Lorut, Gaz. des Hôp., Sept. 1861, effects of two spoonfuls of linseed oil.

Miss X., aged nineteen years, of nervo-sanguine temperament, had always enjoyed excellent health.

January 21st, at about 11 P.M., I was sent for in great haste, and found her laboring under peculiar nervous symptoms, for which I was unable to account. She lay on her back; the face red and slightly moist; the head shaking spasmodically in measured time; the rigid and prominent temporal muscles jerking rapidly. The jaws were immovably clenched; the upper limbs shaken by spasms, but pliable and uncontracted. With all this nervous disturbance, there was no sign of cerebral disorder; the patient was perfectly conscious, and complained by signs of violent pain in the cheeks and temples. She could not articulate a syllable. She had never before, so her mother assured me, been troubled with her nerves. She had been very cheerful all that day, and had been working in the evening in a small room well heated by a pan of coals. About 8 o'clock, after taking a cup of cold milk, she fell asleep, but woke up in a few minutes, saying that her tongue was drawn down into her throat, and complaining also of a great weight in the stomach and severe colic.

She went to bed, but soon became speechless, and fell into convulsions.

I at one rejected the idea apparently entertained by her mother, that she had been poisoned by carbonic oxide gas, her symptoms bearing but a slight resemblance to those caused by that agent. The clearness of the intellect, the absence of frothing at the mouth, and the undistorded features, putting epilepsy out of the question, I began to think the attack must be hysterical. Yet the symptoms did not seem to wear the precise aspect of hysteria, and some of the leading features in that disease were absent. Here were violent trismus, and complete paralysis of the tongue, affections or rare occurrence in hysterical patients, although I was aware that the former had been noticed in some well-authenticated cases. Besides, there was neither globus hystericus, meteorism of stomach or bowels, nor any of those perversions of cutaneous sensibility so frequently accompanying the malady in question. Nevertheless, I decided on the employment of antispasmodics; and, as the patient was utterly unable to swallow, at once ordered the injection of 4 grams of Asafœtida. At the same time I rubbed the temples with a strong opiate liniment, and a large linseed plaster was applied to the abdomen. The injection was followed in ten minutes by decided relief; the patient began to sob violently; and in a few minutes more, passed a large quantity of pale limpid urine; after which she lay down again, much tranquilized. I soon succeeded in prying open the jaws with the handle of a fork, when I was surprised to see that the tip of the tongue was turned upwards and backwards, so as to touch the velum palati. On attempting to speak, the patient uttered only inarticulate sounds. I then got her to swallow a few spoonfuls of sweetened orange-flower water. This was very comforting; and her jaws could now be opened spontaneously. I then left her; recommending blisters on the thighs for a violent headache of which she complained. On visiting her, next morning, I was informed that shortly after I had gone, the symptoms had returned with great violence, especially the trismus, and that she had suffered the most intense pain for about an hour. At about 5 P.M. all was right again, and the patient had recovered her speech. Of last night's symptoms, there now only remained general prostration, with a bruised feeling in the elbow and knee-joints, heavy frontal headache, and a dull pain in the cheeks and temples. The patient then gave me the following account of the origin of her troubles. On the preceding night, wishing a drink of milk, she went, without a light, into an adjoining room, and took up a cup she knew to be half full of that article. To this she added two spoonfuls from another cup standing near, which she supposed also contained milk. In drinking, she felt something go down which was sour and greasy, and was not mixed with the rest of the draught; yet not suspecting anything wrong she swallowed the entire cupful. Almost immediately she felt a fulness of the stomach and a præcordial uneasiness, and soon went to bed, where she was seized with spasms. She had no idea of the cause of her symptoms until a short time before my second visit, which accounts for her answering in the negative when I requested her to tell me by signs if she had taken anything injurious.

I prescribed copious draughts of milk; to keep on the linseed plasters; and injections of a decoction of Iron. Next day she was quite well. She told me that the evening before she had vomited, with copious stools; and she thought her stomach had thrown off the oil. Since then her health has been imperfect.