Cheyne-Stokes respiration / by George Alexander Gibson.

  • Gibson, George Alexander, 1854-1913.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Cheyne-Stokes respiration / by George Alexander Gibson. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    presenting Choyne-Stokes broatliin;^, one condition nuiy Iju held to be constant—a reduction of the activity of the higher nervous structures. Whether the cause be in tlje nerve centres primarily, or in other structures, such as those of the digestive, circulatory, respiratory, or renal systems, or in general adections, such as the specific fevers, there is, when Cheyne-Stokes breathing is jjresent, the one constant condition of lowered nerve activity, such as normally occurs in deep sleep, or after a full narcotic dose. It must not be imagined, from the reference just made to circulatory changes as a cause of Cheyne-Stokes respiration, that there is any such direct nexus between the state of the circulalinn and the condition of llie breathing as has been postulated by Filehne and his followers. The fact that there is no cyanosis during the pause is in itself enough to negative such views, against which valid objections have been fully urged previously. There is, however, a more general connexion between the state of the circulation and the condition of the nerve centres. If at any time the quantity or quality of the blood should depart from the normal, the activity of the nervous structures suflers in a direct ratio. In this way, but in no other, is there in Nature a connexion between the function of the circulatory and nervous mechanisms. The explanation of all these phenomena is supplied by the interesting series of investigations of ]\LuekwaId,^ from which he has been led to the conclusion that periudic breathing can only occur when some of tiie higher brain tracts have ceased to exert their inlluence upon the respiratory centre. During sleep the action of these higher tracts is in abeyance to a greater or lesser extent; in certain individuals a greater degree may habitually be present, in others it only takes place after great fatigue. It is more likely to occur during the process of digestion, as in the after-dinner nap, because the nervous energy is then carried oil in another direction. In Case \l. the accession of the periodic breathing was obviously determined by the deviation of nervous influences into other channels by mental ellbrt. The eflect of many drugs which produce periodic breathing amply confirms this view, as all of them whieh have been fouinl i.» produce such changes have the power of lessening cerel»ral aclivitv. ' V. \K 81.