Nervous diseases : their description and treatment / by Allan McLane Hamilton.

  • Allan McLane Hamilton
Date:
1878
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Licence: Public Domain Mark

Credit: Nervous diseases : their description and treatment / by Allan McLane Hamilton. Source: Wellcome Collection.

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    the forms I have alhided to (ihc iijioplectic, convulsive, paralytic, or maniacal), we must order perfect quiet, darken the room, and use every means in our power to reduce the cerebral blood pressure. CEREBKAL HEMORRHAGE. Synonyms Apoplexy. Hiemorrhagia cerebria (Lat.). Apoplexie cerebrale; liivmatceiiceplialie; coup de sang; ha;morrhagie cer(5brale (Fr.). Hiniiipopk'xieen (Ger.). Definition When through disease of a vessel its walls are unable to withstand the pressure of contained blood, a hemorrhage takes place, and the nervous substance in the neighborhood may be subjected to pres- sure. The severity of the resulting symptoms depends, of course, upon the importance of the parts which may be the seat of the accident, and upon the extent of the hemorrhage. Symptoms I have already alluded, when speaking of cerebral con- gestion, to light forms of hemiplegia of temporary duration, which were dependent upon slight hemorrhages resulting from cerebral congestion. We will now deal with a form of cerebral hemorrhage of a more serious character, and it may be stated that the brain is probably more liable to hemorrhage than any other organ, with the exception, perhaps, of the spleen.^ Bastian has made the classification which I think it well to follow. He divides cerebral hemorrhage into three forms, in regard to the onset of symptoms: (1) The apoplectiform; (2) the epileptiform; (3) the simple, in which there is neither loss of consciousness, nor convulsions. The Jirst may be considered as a sudden and profound loss of consciousness, which may or may not disappear ; but, if it does, a certain amount of hemi- plegia will remain. The epilejytiform resembles the first, but, in addition to the coma, there are convulsions. As I have said, the simple variety may not be connected with any loss of consciousness, the patient, perhaps, awaking in the morning and finding himself deprived of power, or noticing such a loss when some movement is attempted. Prodromata—Cerebral hemorrhage occurs generally in individuals in whom some well-deve]oi)ed chronic trouble has paved the way. This is the rule, although in many cases it may be the result of some recent dis- ease. When we come to speak of pathology and morbid anatomy, these general diseases, and their influence in the production of degeneration of the cerebral arteries, will be discussed ; it is only necessary now to describe the forms of expression of the preparatory stages. It is not always neces- sary to look for indications spoken of by Hughlings Jackson.' The careful clinical observer considers minor degenerative changes, baldness, graynoss of hair, the state of skin, and worn teeth. He inquires for the history rrf goui and intemperance. ' ParaIysi-< from Brain Disease, ]>. 14. ' Cerebral Hemorrhage, lleyuolds' System of Medicine.