Comments on convulsive diseases / by Charles Bland Radcliffe.

  • Charles Bland Radcliffe
Date:
1851
Catalogue details

Licence: Public Domain Mark

Credit: Comments on convulsive diseases / by Charles Bland Radcliffe. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    this office; but in the transitory patency of epileptic asphyxia, where the pulse in question is wanting, the heart is weaker than natural, and nagging in its action at the very time ; and not only so, but the vein itself has not undergone any remarkable alteration in size. It is as natural, therefore, that there should be a pulse in the external jugular in the one case, as that there should not be such a movement in the other; and thus we may set aside this second objection to the idea that the cervical throbbing in question is a venous and not an arterial phenomenon. In the paroxysm itself, then, as well as in the state in which the paroxysm is impending, there are no symptoms which demonstrate the existence of increased vascular activity. It is the same also in the last stage of the paroxysm, and even more conclu- sively, for the circulation, which had gone on progressively fail- ing, is at this time well nigh arrested. The independence of increased arterial action is further seen in those forms of epi- lepsy where the suspension of the heart's action would seem to be the immediate occasion of the fit, and where the patient from beginning to end remains pale, cold, and comparatively pulse- less. It is seen in the admitted fact, that the fit is more apt to be violent in persons who are weak and bloodless than in those who incbne to a sanguineous habit. It is seen also in many other ways,—but sufficient has been said to show that the convulsion of epdepsy is independent of increased arterial action. In the second place, we find sufficient reason to doubt that venous congestion in the head and neck, (which is so marked a phenomenon in epilepsy,) is essentially connected with con- vulsion. A primary doubt suggests itself in the fact that hysteria, tetanus, catalepsy, and many other convulsive affec- tions, are without any such congestion 5 and this doubt receives weight and character in the existence of cases of epilepsy, and these as bad as any, in which the face and neck remain throughout the paroxysm in the pale and pinched condition in which they were at its commencement. Evidence of a similar Character is found in the history of the ordinary fit, and a short examination is sufficient to show that the convulsion holds no immediate relation to this particular fulness of the vessels. Thus, it is very certain that the spasms in the cervical muscles, which are the alleged cause of this congestion, cannot be the consequence of the congestion. It is certain also that the slight and fleeting spasms in the limbs, and elsewhere, which are dis- tinctly cotemporaneous with the cervical spasms, are equally
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