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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    ]iliriii)iii('ii;i ill lilt' hluiid. I'rrii)(licity of activity of all nervous apparatus, tluTt'l'drc, (lc'])t'U(l.s on iniiuancnt pcciiliiiritirs of cltunciit- ary structures, and the Ulood is nut the dii-ect stimulus tor the cells, lull has its power in ,L;i\ iii<i; the cells the possibility of regulatiuf; ti>sui' clinn-v. When the IiImhiI is altered there is necessarily a iuii(liiic;iti()ii in the alisor[)Liuu ut' oxygen and removal of tissue c]ianL,M' jirixhu'ts, and the mechanism will therefore be indirectly atlectetl; the blood is thus only one link in the chain of apparatus needful for life. The regular alteriialion of activity and repose characteristic of lile is seen in the complex of pathological phenomena, of which periodic breathing is only one symptom, and Cheyne- Stokes res[)iration is therefore a condition in which the ex- haiisiibilily of the central apparatus, normally following its activity, is greatly increased. The resjiiratory centre has its irritaljility lowered, as the breathing is at first shallow, but the irritabiliiy }progressively increases, for in spite of better aeration dyspncea gradually develops. The irritability then diminishes and the descending phase begins. The supposition may be hazarded that the first descending respirations following the deepest have their origin in 1)etter arterialization of the blood, or in removal of waste ]iroducts from the centre, and that the fall in irritability begins with the first normal breathing. Rosenbach shortly summarizes his views in this way:—Throufrh certain disturbances of nutrition, the brain suOers from lessened How of blootl or altered quality of blood, and the processes of tissue change are modified in the entire central organs, or in particular ]iarts (if it, especially in the medulla oblongata, and here a>'ain more jiarticularl}' in the respiratory centre, so that the normal irritability of the parts is lowered more or less, and the normal jieriodic exhaustibility is increased even to complete paralysis. Uosenbach mention.s, as an appendix to his paper, a case in which a patient ill with tubercular meningitis suddenly ceased to breathe except once or twice per minute, the pulse continuin*' to beat. After artificial respiration had been employed the pheno- mena of (Jheyne-Stokes breathing a])peared. Purjesz^ describes a case whiidi he met with in the I'niversity * J'ester medkinisc/i-chirunjimfie I'rcsn, xv. liuinl, SS. 771, 7^7, u. >4C!, 1>7J.