Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

69/440 (page 53)

■the vessels, Edlefsen attempts to prove tliat during muscular exertion the arterial pressure in the kidneys falls below the uormal, and he founds his view upon J. Ranke's (54) obser- vations on the subject of the interchange of activity among the organs of the body. According to these observations, during tetanus, the muscles contain more blood, the other organs, and especially the glands, less blood than when the muscles are at rest. But such a conclusion is most assuredly not justified by Ranke's observations, for the conditions nndor which these were made were fundamentally different from those associated with the muscular exertion of healthy subjects, and those which obtain in the majority of convulsive attacks. Ranke caused tetanus of all the muscles by administering poisonous doses of strychnia or irritating the spinal cord; or tetanus of single groups of muscles by electrically irritating the nerve trunk of one extremity. In the fi.rst form, causing tetanus by acting on the spinal cord, a violent contraction of all the small arteries takes place—a fact to which we have incidentally alluded (see p. 42), and this is least marked in the muscles, the arteries of which, according to Hafiz (55), are far behind those of the skin and the abdominal organs as regards both the degree and also the duration of the con- traction.-- It was therefore that Ranke noticed that little or no blood escaped from the incised vessels of the skin in tetanus, whereas the muscles were full of blood, and bled freely on incision. This fact alone would suffice to demon- strate the difference between the conditions in Rankers experiments and those which obtain in ordinary muscular exertion, even of the most severe character. But in the case before us, are the vessels of the skin abnormally empty ? On the contrary, there is visible and marked congestion, that is, an increased supply of blood to the skin, and not to the skin alone, but doubtless to other organs, such as the lungs, brain, &c. The cause of this fluxion, at least an important if not the only cause, is the increase of the bodily temperature which is associated with all muscular exertion, and therefore the conditions, so far as we are concerned with ' The albuminuria which is sometimes observed in connection with tetanic convulsions probably depends upon this intense constriction of the renal vessels, as explained above (see p. 42).