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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    great prostration and collapse. On the day of his death he had been to the Crystal Palace. He had had some vomiting in the morning, and again about two hours before he reached home. He walked from the Crystal Palace, and when he entered the room he staggered, and said he felt giddy and oppressed. He was placed on a bed, and cold was applied to his forehead; but he died in a short time with stertorous breathing [indicating pressure upon the medulla oblongata], but was sensible almost to the last moment.” If I were to select this opportunity to enlarge upon the apposite circumstances of this case, perhaps 1 might do so at too great length. I will merely observe that I think it an important and interesting experiment in reference to the circulation through the brain, the administration of food and stimulants, and various other matters. His brain could bear no fulness of blood, no increase of size, because the cerebro-spinal fluid could not escape from the interior of the brain. He could not take wine, beer, or spirits, and could bear no muscular exertion. The conges- tion of the brain produced vomiting by pressure upon the medulla oblongata, exerting its influence upon the pneumo- gnstric nerve. He died from pressure upon the medulla oblongata, with stertorous breathing—that pressure which could not be obviated. I shall dwell no longer either upon this case, or this kind of case, but I think that occlusion of the cerebro-spinal opening is a pathological condition which has not received due attention from the profession. Before quitting the subject of the circulation through the brain, let me say that I think it is generally supposed that during sleep the brain is in a state of congestion, or, rather, overcharged with blood; and that it is the pressure of that blood which in some measure induces or sustains the state of repose or cerebral quietude. Mr. Durham, one of our Demonstrators at Guy’s Hospital, has put into my hand this paper, containing the result of some experiments which tend to show that the brain is not in that condition during sleep : that it loses its congested character in order that it may assume what we should call its state of quiescence, or rest. The facts are very few, and they shall be allowed to speak for themselves.
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