This section is from the book "The London Medical Dictionary", by Bartholomew Parr. Also available from Amazon: London Medical Dictionary.
(From the same). See Catalepsis. It is also a name for the palsy of the tongue; one of the species of partial palsy. See Paralysis; called by some anaudia, see Anaudos, though Galen distinguishes them.
Dr. Cullen speaks of this loss of voice as a suppression of the full sound, which happens without coma or syncope. He ranks this genus of diseases in the class locales, and order dyscinesiae, and observes three species, viz.
1. Aphonia gutturalis; when the glottis and fauces are swelled.
2. Aphonia trachealis, when the trachea is compressed.
3. Aphonia atonica, when the nerves of the larynx are wounded. He also, in many cases, considers it as symptomatic.
If one of the recurrent nerves, formed by the par vagum with the nervus accessorius, extending to the larynx, is cut, the person is capable of only an imperfect pronunciation; but if both are cut, the speech and voice are lost. The loss of speech happening in hysteric patients is also called aphonia; but more properly that loss of speech is thus named which depends on some fault of the tongue.
As the motion of any part is destroyed, or lessened at least, by the interception of nervous influence, and as the nerves destined for the motion of the tongue arise U2 principally from the fifth pair, it appears that the seat of this disorder is in these nerves, and that the immediate cause is a diminution or total loss of nervous energy. Hence, a palsy of the tongue, which is either antecedent or subsequent to hemiplectic or apoplectic disorders, demands our utmost attention. If an aphonia appears alone, it generally shows an approaching hemiplegia or apoplexy; but if it succeeds these disorders, and is complicated with a weak memory, and a sluggishness of the mental powers, it threatens their return. That aphony usually terminates most successfully, which proceeds from a stagnation of serous humours compressing the branches of the nerves v. inch run to the tongue; but it is equally distressing and obstinate.
Other causes of this disorder arc, repelled eruptions on the skin, obstructed periodical evacuations in plethoric habits, spasmodic affections, worms, fear, too free a use of spirituous liquors, and whatever destroys the ligaments from the aretaenoid to the thyroid cartilages.
The prognostics vary according to the causes. That species which is owing immediately to spasms soon gives way in the removal of them. If a palsy of the tongue is the cause, it is very apt to return, if relieved; but often continues incurable.
In directing the cure, we must endeavour first to remove whatever impedes the nervous influence on the tongue; and secondly, to strengthen the weak parts. The particular causes must be next considered.
If worms are the cause, antispasmodics give temporary relief; but the cure depends on the destruction of these vermin. However, they seldom occasion the disease.
In congestions of blood about the head, bleeding, general and topical, with blisters constantly kept open, and active laxatives, are the best remedies.
That species of aphony which remains after the shock of an hemiplegia or apoplexy, particularly requires blisters to be applied to the nape of the neck, or under the fauces: other means are rarely effectual.
If spasmodic constrictions about the fauces and tongue are the cause, applications of opium are of the greatest service: anodyne antispasmodics may be laid under the tongue, and the feet bathed in warm water; carminative clysters also are useful; and 3 ij- of asafcetida may be dissolved in four ounces of warm water for this purpose.
When a palsy of the tongue produces this complaint, evacuations, according to the patient's habit, must be made, and warm nervous medicines externally applied, and internally administered; blisters also should be placed on the nape of the neck; and the patient should be constantly chewing bits of ginger, or biting corns of black pepper. Warm tonics are also highly proper.
In case of repelled cuticular eruptions, sudorifics should be given, and the patient's drink should be warm. The liquor c. c. succinatus, or the vin. antimonii may be mixed with tinctura benzoes composita, or with the balsamum Peruv. and given, at proper distances, in the patient's drink, or on a lump of sugar. In general, however, the eruptions will not be brought back by these means, and the disease must be treated as nervous.
Sometimes the serum flows so rapidly to the fauces and adjacent parts, in a salivation, as to deprive the patient of all power to speak; in this case, diaphoretics and laxatives, with a forbearance of all mercurials, are the speediest remedies.