Researches on the pathology of the brain. Part II. On Apoplexy / by John Abercrombie.

Date:
[1818]
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Licence: Public Domain Mark

Credit: Researches on the pathology of the brain. Part II. On Apoplexy / by John Abercrombie. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    extremely obscure. In a case described by Dr Cheyne, * the attack commenced with a severe pain striking from the scrobi- culus cordis to the back; it was accompanied by headach, and soon followed by convulsion and coma. There had been for several days before the attack oedema of the legs. Large and repeated blood-letting was employed, and the coma subsided after 24' hours. Hemiplegia remained, which went off gradual- ly in seven or eight days, and the oedema disappeared along with, it. I have described a singular case (case 7th) which had very much the appearance of apoplexy, but in which the only morbid appearance was a remarkable emptyness of the heart and great vessels. This condition of the heart presents a subject of much obscurity. It has been observed as the only morbid ap- pearance in many cases of sudden death, some of which resem- bled syncope, and others apoplexy. Several examples of it are described by Mr Chevalier,f in one of which, in particular, he proceeded to the examination, “ fully prepossessed with the per- suasion that the patient had died of apoplexy.” On the most careful examination, however, nothing could be detected in the brain. The only morbid appearance was this complete empty- ness of the heart, and it extended into the vena cava, to the dis- tance of several inches from the heart. Two cases described by Mr Wood in the same paper, which recovered, are considered by Mr Chevalier as examples of the same affection. In one of them the patient was suddenly seized with extreme faintness and loss of muscular power, his speech was indistinct, and his pulse scarcely to be felt, but his face was suffused with blood ; he had difficult breathing, and great anxiety. In the other case, which was more severe, the pulse was only 29 in the minute, and very feeble, while the vessels of the skin and of the tunica adnata were loaded with blood. Both these cases seemed to be relieved by stimulants and opium j in the last, the symptoms continued nearly a whole day. A woman mention- ed by Bonetus was suddenly seized with headach, dimness pf sight, and ringing in the ears; she lost her voice, and died in four hours. The lungs were considerably diseased ; the only other re- markable appearance was, that there was not a drop of blood in the heart or great vessels, but the head was not examined.^ That these cases are not of the nature of syncope, appears from * Cheyne on Comatose Diseases, p. 87. •f Medico Chirurgical Transactions, Vol. I. J Boneti, Sepulchretum Anatomicum. Vol. I* p. 88S.
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