A treatise on apoplexy, cerebral hemorrhage, cerebral embolism, cerebral gout, cerebral rheumatism, and epidemic cerebro-spinal meningitis / By John A. Lidell.

  • Lidell, John A.
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on apoplexy, cerebral hemorrhage, cerebral embolism, cerebral gout, cerebral rheumatism, and epidemic cerebro-spinal meningitis / By John A. Lidell. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    From the clinical and post-mortem observations related above, we draw the following conclusions : 1. That apoplexy and cerebral hemorrhage are not synonymous terms. 2. That in occasional instances, cerebral hemorrhage does begin with apoplectic stupor, and then the disease should be called hemorrhagic apoplexy, or apoplectiform cerebral hemorrhage. The lesions which cha- racterize these cases will hereafter be considered in the chapter especially devoted to hemorrhagic apoplexy. 3. That cerebral hemorrhage often runs its course without producing any apoplectic symptoms whatever, or, in other words, cerebral hemorrhage is not necessarily accompanied by apoplectic symptoms. Generally, these symptoms do not show them- selves unless the extravasation is profuse. Small hemorrhagic clots can be formed, not only without the patient presenting any of the phenomena of apoplexy, but without his having any impairment of intellect, or any afiection of the senses; in fact, without any symptoms indicating that the brain has been deeply modified in its functions. The only symptoms which then characterize the case are those of paralysis (hemiplegia) more or less complete, and more or less limited in extent on the opposite side of the body. {^Trousseau.) Apoplexy in the classical and real sense of the term is generally con- nected with pathological conditions of the brain which are widely differ- ent from cerebral hemorrhage. For instance, it not unfrequently results from sudden and excessive hypersemia (congestion) of the brain as it does in cases of the so-called ictus sanguinis, several original examples of which will be found related in the chapter on congestive and serous apoplexy. Again, it sometimes results from cerebral anaemia when suddenly pro- duced and extensive in scope, as it does in those cases of cerebral embol- ism where a cerebral artery of large size becomes suddenly occluded by a clot of blood or plug of fibrine swept into it by the torrent of the circula- tion from some distant part, and where a large portion of the brain be- comes, in this way, suddenly deprived of its supply of nutrient blood; or as it does in those rare cases where mental emotions of a powerfully de- pressing nature, such as terror, grief, and despair, produce syncope and death—emotions which suddenly whiten or render anaemic not only the face but the substance of the brain also. Finally, apoplexy is not unfre- quently occasioned by rapid and profuse effusion of serum, especially when it is associated with oedema of the substance of the brain. A number of original cases belonging to this category will also be found re- lated in the chapter on congestive and serous apolexy. Thus, we perceive not only that cerebral hemorrhage is but seldom attended by the pheno- mena of an apoplectic fit; but also that when an apoplectic fit does occur, it is almost always occasioned by some lesion of the brain that is quite