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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    before the 1)oi;inniiiLj of the respiratory pliase i.s not eorrect f(jr all cases; the recession may occur aftt-r IIk; phase has be;4un or during' the heif^ht of the breathing,', from which he concludes that the sinking may be caused by an acceleration of the l)lood-flow from the brain by means of the respiration. lie recalls Leube's state- ment re^'arding stimulation of the phrenic nerves, and says that stimulation of the vagi, causing a change in the pulse rate, effects no change in the phenomena of Ciieyne-Stokes respiration, showing that ihey are independent of tlie supply of arterialized blood to tlic luaiii. lie lays stress on the contraction of the pupils during tlie pause and their dilatation during the period of breathing, as well as on the rolling of the eyeballs or conjugate deviation, and the general twitchings of the body occurring during the period of respiration. He further dwells on the changes in the sensorium, and on the iniluence of such drugs as morphine, chloral, and liromide of potassium, and recapitulates that there are changes in Cheyne-Stokes respiration connected with the cortical as well as with the basal centres, such as those of intellection, the muscular system, the vision, the circulation, and the respiration. Passing by Traube's first e.Kplanation, he states his second, which, though not entirely tenable, has yet some good points. He points out that it does not explain the ascending character of the respira- tion. He then enunciates Filehne's earlier theory, based on periodic changes of blood-supply, caused by a higher degree of e.xcitability of the vaso-motor centre, and without hesitation rejects it, inasmuch as in some cases the blood-pressure rises before tlie recommencement of breathing, and when this rise is present it attains its maximum at a point between the ascending and de- scending respirations. Filehne's later theory, that the stimulation (tf the respiratory centre and medullary vessels may occur simul- taneously is also rejected, liosenbach is of opinion that both ]ihenomena are co-effects, and he is strengthened in his views by the fact that other phenomena, such as the mental, visual, and muscular, are bound up with the respiratory, not with the circu- latory, symptoms. He emphasizes the dilferences between the circulatory and respiratory phenomena in this type of breathing, the great variability of the former and the monotonous similarity of the latter being noteworthy. He brings forward the fact, noted by Leuhe -dWil confirmed by himself, that artificial respiration during