Volume 1

The standard physician : a new and practical encyclopaedia of medicine and hygiene especially prepared for the household / edited by Sir James Crichton-Browne [and others].

Date:: 1908-1909

Credit: The standard physician : a new and practical encyclopaedia of medicine and hygiene especially prepared for the household / edited by Sir James Crichton-Browne [and others]. Source: Wellcome Collection.

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$TH1<: STAX DARI) PllVSKAAX syphilis of the brain. Not infrccpiently the formation of thrombi is brought about by septic infections, such as typhoid fever or pneumonia, and particularly by acute articular rheumatism. The rupture of a blood-vessel, with subsecpient How of blood into tlu* brain, is always the result oi a vascular affection, which is characterised b\- calcification and brittleness of the wall of the blood-vessel. This calcifica- tion of veins and arteries occurs especially in an advanced age ; it is furthered by the abuse of alcohol. The immediate cause of an apoplectic stroke is usualK a 1 usn of blood to the head, such as occurs alter mental emotions OI aftei an abundant meal oi a drinkmg-bout. So-called “ apoplectic '* indi- viduals- that is. broad-shouldered, corpulent persons, with short necks and flushed faces, who are fond of alcoholic drinks, and who often sutler from disturbances ot heart and respiration as indicative of an existing disease ot the blood-vessels -are more prone to lueniorrhages of the brain. 'Idle symptoms of apoplexy due to obstruction of the blood-vessels do not differ much from those of apoplexy due to luTmorrhage, except in that the latter are generally more severe. An attack is frequently preceded for days, weeks, and occasionally for months by cautioning “ forerunners ” in the form of headache, dizziness, ringing of the ears, rapidly passing disturb- ances of s])eech, and attacks of fainting, d'he attack proper sets in slowly, or rapidly and violently, according to whether the occlusion of the vessel, or the luemorrhage, took place graduall\- or suddenly. In the former case the ])atient becomes mentally uncertain, dull, confused, and staggering; Ik' loses the use of his arms and legs, and finally complete loss of consciousness takes place, accompanied with usually a one-sided paralysis. In an acuti- attack, such as usually occurs after severe IhTinorrhages, the patient falls to the ground as if struck down, and loses consciousness at once. His face is generally (but not always) flushed, his respiration snoring, and his lips and cheeks drawn in and puffed during breathing ; his limbs are without motion, and when raised thev fall back, completely relaxed ; urine and heces are discharged involuntarily. In case the Inemorrhage is \’ery profuse and affects a vital ])art of the brain, death occurs, sometimes at once, sometimes after a few hours or days, without the patient recovering consciousness. More frequently, however, the patients recover from such attacks. The blood extravasated into the brain is in part absorbed by the lymph-vessels ; in part it breaks down or is encapsulated ; or it leav'es a scar. Conscious- ness returns gradually, but a one-sided paralysis remains as a result of the destruction wrought in the brain. According to the e.xtent of the damage to the brain-tissue, these paralyses affect larger or smaller parts of the body. They may remain permanently, or they may pass entirely or in part. In contrast to paralysis of the spinal cord, brain-paralysis involves only one side of the body, and always the side which is opposite the site of the luemor- rhage or occlusion ; hence a Inemorrhage into the right side of the brain$