Rest and pain : a course of lectures on the influence of mechanical and physiological rest in the treatment of accidents and surgical diseases, and the diagnostic value of pain / by the late John Hilton ; edited by W.H.A. Jacobson.

  • John Hilton
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Rest and pain : a course of lectures on the influence of mechanical and physiological rest in the treatment of accidents and surgical diseases, and the diagnostic value of pain / by the late John Hilton ; edited by W.H.A. Jacobson. Source: Wellcome Collection.

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    at its base does not rest upon the bones, but upon the fluid; secondly, this fluid isolates the various nerves passing near each other towards the same foramina; and, lastly, sup- ported by the cerebral circulation, it tends to bring back the internal organs of the brain to a state of comparative emptiness or quiescence after their state of activity.* I have already said that the thalamus nervi optici and the corpus striatum, which occupy the base of the lateral ventricles, superintend the movements and sensi- bility of the upper and lower extremities. I presume that when these functions are actively employed, these two parts especially are in a state of turgescence, and that if they were imbedded in the solid brain, it would be impossible for them to enlarge without encroaching upon some of the adjoining structures, and thus inflicting, at any rate, temporary injury. But the corpus striatum and optic thalamus have a large extent of surface, which projects towards the interior of the lateral ventricles, and in proportion as they become enlarged by congestion they displace the cerebro-spinal fluid through the foramen of Monro, through the third ventricle, iter a tertio ad quartum ventriculum, into the fourth ventricle, and thence through the cerebro-spinal opening, and thus provision is made for hypersemia of the thalamus and corpus striatum. When the activity of the corpus striatum and optic thalamus ceases, then the cerebro-spinal fluid, supported by the venous circulation of the brain and the elasticity of the dura mater in the vertebral canal, rises up again through the same channels, and thus gives a mechanical support to the thalamus and corpus striatum in their state of repose. It is worthy of notice that these collections of fluid in what we term “ the ventricles of the brain ” communicate with to conduct vibrations to the clinoid processes which lie surrounded by cerebro-spinal fluid, and that the vibrations arrested and lost in this fluid are thus prevented from damaging the base of the brain.—[Ed.] * In addition to tlie above the cerebro-spinal fluid plays two other important parts in the cranial circulation. By the above-mentioned collections at the base vp. 25) it prevents the large arterial trunks which there break up into branches from being pressed upon. Also as it follows the pia-mater into the sulci it prevents, by gently separating the convolutions, any pressure upon the arterioles which are there breaking up into capillaries.—[Ed.]
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