Outlines of pathological semeiology / translated from the German of Professor Schill ; with copious notes by D. Spillan.
- Schill, Albert Friedrich, 1812-1839. Grundriss der pathologischen Semiotik. English
- Date:
- 1841
Licence: Public Domain Mark
Credit: Outlines of pathological semeiology / translated from the German of Professor Schill ; with copious notes by D. Spillan. Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![cerebral pressure. In acute diseases, it arises from these causes, before the crises have as yet taken place, as also in inflammations of important organs, in phthisis, scurvy, after the removal of cutaneous eruptions, ulcers, and tumours. Where apoplexy or cerebral inflammation is to be dreaded, somnolency should be considered as suspicious. 2d. Somnolency may arise from the want of sleep felt by the system, as in convalescence, particularly from acute diseases, after long sleeplessness, intense pain, after delirium with the occurrence of crisis; after the appearance of cutaneous eruptions, after paroxysms of hysteria, hypochondriasis, and gout [and too full a stomach]. In the last stage of phthisis, much sleep forbodes speedy death. 77. According to the depth and soundness of the sleep, several states of it have been distinguished, such as sopor, coma, lethargy, cams. Sometimes it is difficult to awaken the patient; in earns, most difficult, and generally impossible ; if he do awake, he is indifferent to the external world, as in sopor ; or he cannot collect his senses, nor determine well where he is, as in lethargy, and instantly falls again into a profound sleep. If the patient fall suddenly into this deep sleep, it is called coma. In many cases of this coma, the patient endeavours to resist the sleep, as in coma vigil in contradistinction to coma somnolentum. 78. These different degrees of deep sleep are always signs of some cerebral affection, either congestion or inflammation, as in nervous fevers, after suppressed hemorrhages, in intermittent fevers, in the acute exanthemata, in inflammations of other organs through irritation from worms, or in consequence of apoplexy, extravasa- tion of blood in injuries of the skull, from exudation of serum or lymph, from ramollissement, or concussion of the brain ; then come the higher degrees, lethargy and carus. Coma somnolentum appertains to epilepsy, catalepsy, eclampsy, hysteria, and many forms of cerebral inflammation; it also presents itself as a precursory symptom of death by intense cold. The coma vigil is a phenomenon of nervous fever. 79. The higher degrees, as lethargy and carus, are of a very unfavourable import, as is also coma vigil in nervous fevers. The coma somnolentum is not an alarming or suspicious phenomenon in itself, except in acute diseases. The lower degrees of profound sleep, as sopor, are a suspicious sign at the commencement of acute diseases ; they give occasion to dread the occurrence of cerebral inflammation and apoplexy, especially if habitual discharges, as hemorrhages, perspiration from the feet, chronic cutaneous erup- tions, and ulcers, have been suppressed. The more the signs of a disturbed cerebral action, as delirium, convulsions, subsultus ten- dinum, &c, are associated with sopor, the worse the case is. If the face be red, it indicates a more intense hyperemia of the brain and is more unfavourable than a pale face. If sopor takes place shortly before the occurrence of crisis, it is frequently a favourable sign; in hysteria, hypochondriasis, and epilepsy, these states are not dangerous.](https://iiif.wellcomecollection.org/image/b21152834_0036.jp2/full/800%2C/0/default.jpg)
