This section is from the book "Materia Medica And Therapeutics Inorganic Substances", by Charles D. F. Phillips. Also available from Amazon: Materia medica and therapeutics.
Cold applied to the head, while hot mustard-water is used to the feet, is one of the simplest modes of equalizing the cerebral circulation. It must, however, be used with caution where cerebral anaemia is readily induced, as in weakly subjects. Ice to the nape of the neck also acts well, and sometimes the alternate use of cold and hot applications gives the best results. This is especially the case in the congestion of opium-narcosis, uraemia, and carbonic acid poisoning (Bar-tholow).
As a preventive of apoplexy, the remedy has a traditional, and perhaps not an easily proved, reputation, but one that would be quite in accord with our view of its action. Lemare-Piquot, after relating marked relief to giddiness, sense of oppression, epistaxis, and other premonitory symptoms, both in his own case and that of five other persons about sixty years of age, reasonably restricts its use to cases of cerebral congestion occurring in the strong and plethoric, who have an excess of blood-corpuscles (v. p. 33). He recommends from 4 milligr. to 1 ctgr. daily for about a month, taken at meal-times, and founds his latest conclusion upon forty-four cases occurring without one death (Bulletin de Therapeutique, 1859, and Recherches sur l'Apo-plexie, Paris, 1860). Cahen, writing upon its value in congestions generally, and cerebral hyperaemia in particular, traces it, as we do, to a regulating influence on vaso-motor nerves (Archives de Med., September, 1863), and Dr. Handfield Jones expresses similar views. Hirtz has had reason to think it efficacious in obviating apoplexy, and suggests that it would tend to prevent atheromatous degeneration ("Nouveau Diet."). It is extremely useful in cerebral congestion, and especially when there is puffiness below the eyes, drowsiness, and mental torpor, with sluggish, venous circulation, and suspicion of commencing atheroma. By a similar action, perhaps, it benefits the melancholy and those suffering from hypochondriasis, especially aged persons.
Epilepsy has been plausibly connected with congestion in and near the medulla oblongata, and certainly the older writers, such as Alexander and Duncan, have recorded cases cured under arsenical treatment. It is of necessity no more a universal cure than any other medicine is, but there seem to be some cases specially amenable to it - for instance, those that are connected, however remotely, with malaria. We must note a case recorded under the supervision of Dr. Bristowe, that of a lad of fourteen, described as anaemic, but free from evident organic disease, and who had suffered severely from epileptic attacks, mainly nocturnal, for about two years, and afterward from attacks, day and night, so frequently that he remained unconscious for some days, and was apparently dying; being roused, however, from this condition, he remained partly paraplegic, and the fits, preceded by screaming and by an aura in the feet, recurred on movement of the legs, or on excitement; for nearly a month he took zinc sulphate in increasing doses with valerian, but remained in the same state, sometimes disturbing the ward for a whole night; he was then ordered 5-min. doses of Fowler's solution thrice daily, and although he was not made aware of any change in treatment, the attacks ceased at once for many days; they recurred for a time under excitement, and the numbness of lower limbs persisted for some days; eventually, however, he got quite well. There is evidently some alliance between such a case and cases of chorea, but the periods of insensibility indicate a more serious condition; the exact character of the "fits" is not, however, described (Medical Times, i., 1862).
Dr. Clemens (Frankfort) strongly recommends a "liquor arsenici bro-midi," which he has used for twenty years in the treatment of epilepsy of all varieties with much success; it has relieved even in cases connected with thickening of skull and congenital malformation (Medical Record, 1877). This preparation is said to be more reliable than Fowler's, and to act well without increase of the daily dose: it is made by boiling potash carbonate and arsenious acid, of each 1 dr. in 1/2 pint of water: making up to 12 oz., adding 2 dr. of bromine, and mixing thoroughly.