On paralysis agitans : with an account of the clinical features of other forms of tremor / by R. T. Williamson.

  • Williamson, R. T. (Richard Thomas), 1862-1937.
Date:
1901
Catalogue details

Licence: In copyright

Credit: On paralysis agitans : with an account of the clinical features of other forms of tremor / by R. T. Williamson. Source: Wellcome Collection.

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    Hyostine hydrobromate is the drug which I have found to be the most useful. It was recommended some years ago by Professor Erb of Heidelberg, and h^s been also recommended by many continental physicians ; but in some of the best recent accounts of paralysis agitans in English medical literature the use of hyoscine is not mentioned. Moreover, a number of writers have recorded, that they have not found the drug of any service whatsoever. Professor Erb has recommended the drug to be used hypodermically, and thinks its value, when given by mouth- is very much inferior; also by other continental physicians it is recommended chiefly hypodermically. The English patients suffering from paralysis agitans, who have come under my care, have always objected to treatment by any drug given hypoder- mically day by day ; and in such a chronic disease it does appear to be very desirable to give the medicine by mouth, if possible, for many reasons. The puncture of the skin with the hypodermic needle, once or twice daily for months or even years, appears to me very undesirable on account of the risk of septic infection ; also female patients usually object to the pain produced by the prick of the needle, and then there is always a greater risk of an overdose of the drug, if the hypodermic injections be left in the hands of the patient’s friends. I therefore commenced the treatment of paralysis agitans some years ago with hyoscine given by the mouth. I gave it in the manner and dose recommended, of a grain in a pill, three and afterwards four times a day, for long periods, without any effect. I increased the dose to j-Jtt of a grain in pill form, but I was never able to detect the slightest benefit. Whitla and others have had the same experience. I gave up the drug entirely, and concluded that it was useless. At a later date, I again gave it a trial and prescribed it in chloroform water, thinking that it would be perhaps absorbed more rapidly in this form, and that possibly, when given in the form of a pill, the absorption might be too slow to produce any marked effects. Whatever may be the reason of the failure of the drug in the first trial, I was pleased to find a slight but distinct effect when given in doses of of a grain in chloroform water. As many writers (including Prof. Erb) have recommended