Essays on the theory of convulsive diseases / by Marshall Hall.

  • Hall, Marshall, 1790-1857.
Date:
[1848]
Catalogue details

Licence: Public Domain Mark

Credit: Essays on the theory of convulsive diseases / by Marshall Hall. Source: Wellcome Collection.

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

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    § 12. Effect on the Cerebrum. There is a cerebral form of this disease; the child lets its head, or head and trunk, fall; it is of momentary duration. But in other cases the head is drawn down suddenly and with violence, so as, for example, to break the window, if the little patient were near it. This has been termed the salaam con- vulsion. In one case the little patient falls backwards. Let actual convulsion once occur, and all is changed and complicated. It is no longer the spinal system only which is affected; the cerebrum has become congested, and effusion is threatened; and now double care is required to prevent the wreck of intellect or of limb, from the influence of pressure, or of counter-pressure, of the oi'gan of mind itself, or of the tissues occupying the base of the cranium—the membranes, the trifacial and pneumogastric nerves, the medulla oblongata. What a study for the physician enlightened by physio- logy ! How extensive, how complicated! How are we to be guided through this labyrinth ? By experiment. The tissues, to which I have referred, must be irritated and compressed, one by one, and the respective effects noted with the utmost care and attention; and the results must then be compared with the events witnessed in actual practice. We may imagine what is the precise condition of the brain and of the medulla oblongata, and indeed of the interior circulation generally, by carefully observing the congested state of the veins, and of the capillary vessels of the face. We should also carefully examine the condition of the bregma, or fontanelle : it is concave, plane, or convex, af- fording an index to the condition of the circulation, or it may be effusion, within the cranium. § 13. Sudden Dissolution. Sudden death may take us by surprise at amj period of convulsive disease. This event may be of two kinds: the first is asphyxia, from extreme laryngismus ; the second is what I have de- signated secondary asphyxia, and probably arises from the circulation of blood imperfectly arterialized in the coronary arteries.