Everyman in health and in sickness / edited by Dr. Harry Roberts.

  • Harry Roberts
Date:
[1935]
Catalogue details

Licence: In copyright

Credit: Everyman in health and in sickness / edited by Dr. Harry Roberts. Source: Wellcome Collection.

    781/841 page 686
    Feigned unconsciousness is common in hysteria, but will not resist these tests. Unconsciousness may follow excessive drinking, epileptic fits, injury to the skull or spine, or the taking of opium or other narcotic poisons, and occurs in certain pathological states such as diabetes and uraemia. In unconsciousness due to alcoholic excess, the previous history may give a clue to diagnosis, as also may the smell of the breath. This sign, however, may be misleading, as the stimulant may have been taken at the onset of faintness, for its restorative effect. In alcoholic unconsciousness, the pupils are usually dilated, the face flushed, the pulse rapid; and the brain may be so completely anaesthetized that not even supra-orbital nerve pressure will provoke a reaction. Occa¬ sionally severe vomiting may occur, with threatened collapse, the features becoming pale, cold, and drawn, and the pulse-rate slow. The treatment consists in the putting of the patient to bed with hot-water bottles, administering an emetic, and, when recovery has begun, giving hot coffee or tea. In severe cases, medical aid should be obtained. The unconsciousness of epilepsy follows the violent manifestations of the seizure. The fit, which is often dramatic in its suddenness, is sometimes preceded by a warning preliminary cry. The victim falls at once, wherever he may be, and fatal accidents often happen in consequence. The whole body is rigid and stiff, and, as the respiratory muscles are included in the muscular spasm, blueness of the face and lips from insufficient aeration of the blood is a common symptom. This period of rigidity lasts for a minute or so, and is followed by a stage of involuntary movements; the arms, the legs, the trunk, the tongue, and the lower jaw being jerked convulsively. After a variable time, these movements cease, but unconsciousness persists, changing imperceptibly into heavy sleep, from which the patient wakes dazed and with a headache. Very often, bowel and bladder control is lost during the attack, giving a definite indication of the epileptic origin of the fit. Known epileptics should, so far as is possible, be protected against the risk of a dangerous fall. The blueness of the face and lips in the attack, though alarming, calls for no treatment. Preparation must, however, be made for the convulsive stage. As the rigid spasm begins to pass, an attempt should be made to insert a gag of some kind between the teeth, to prevent biting of the tongue during the convulsion. This should not be too hard; wood and rubber being suitable materials. The thickness of the wedge should be just enough to prevent the jaws being closed. The clothing should be loosened. Movement must not be forcibly restrained, but the patient should not be allowed to injure himself by contact with surrounding objects. He should be left to sleep off the fit; and, if he can without much disturbance be
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