The Croonian lectures on some points in the pathology of rheumatism, gout and diabetes : delivered at the Royal College of Physicians, London, March 30, April 1, 6, 1886 / by P. W. Latham, M.A., M.D., F.R.C.P.
- Peter Wallwork Latham
- Date:
- 1887
Licence: Public Domain Mark
Credit: The Croonian lectures on some points in the pathology of rheumatism, gout and diabetes : delivered at the Royal College of Physicians, London, March 30, April 1, 6, 1886 / by P. W. Latham, M.A., M.D., F.R.C.P. Source: Wellcome Collection.
Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.
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![sometimes show themselves in from fifteen days to a month after the apoplectic seizure. As regards megrim, Dr Edward Liveing* writes, There can be no question then, I think, as to the frequent connexion of megrim, whether in its blind, sick, or simply hemicranial forms, with a gouty diathesis, and its occasional replacement by fits of regular gout. Some years ago I endeavoured to prove t that megrim was due to vaso-motor disturbance,—to uncontrolled action, or as I should now say, to stimulation of certain branches running fi-om the superior cervical ganglion of the sympathetic, followed by exhaustion. Dr Haig in a recent number of the Practitioner'!^ asks the question : May not excess of uric acid in the blood cause such vaso-motor irritation] Certainly; and in persons who are subject to megrim, whose sympathetic ganglia have this sensitive constitution, the causes which will lead to the formation of uric acid in the system, will with tolerable cei'tainty, develope an attack of this particular disorder. Again, with regard to chorea. If the vaso-motor fibres proceeding from the upper cervical ganglion to form the carotid plexus have, through prolonged stimulation, become exhausted or weakened, there would be, as the result of that exhaustion, vascular dilatation and circumvascular change in the track of the middle cerebral artery. But there would also be nutritive changes in the nerve cells of the brain, and exhaustion of their metabolic powers. We should, in fact, have a similar condition produced to that of the sub-maxillary gland when the chorda tympani is stimulated after the injection of atropine; and as far as the nerve cells are concerned, the same result would be produced as ensues from embolism. Their co-ordinating action would be paralysed in both cases, and such changes would produce the inco-ordinated movements of chorea. Nor is it difficult to suppose that sudden shock would * On Megrim and Sick-headache, 1873, pp. 404—5. t On Nervous or Sick-headache, Cambridge, 1873. + March, 1866, p. 181.](https://iiif.wellcomecollection.org/image/b21445278_0090.jp2/full/800%2C/0/default.jpg)
