Clinical lectures on important symptoms. On giddiness / by Thomas Grainger Stewart.

  • Stewart Thomas Grainger, Sir, 1837-1900.
Date:
1884
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Licence: Public Domain Mark

Credit: Clinical lectures on important symptoms. On giddiness / by Thomas Grainger Stewart. 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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    attended by a quite peculiar uneasiness. It is probable that, in the cranium and in the semi-circular canals a similar action may take place; but these we cannot so readily deter- mine as the visual and the visceral impressions. In sea-sickness, with its attendant giddiness, we find many elements contributing to the result. There are visual im- pressions—some very susceptible persons becoming affected even when they look at the sea ; but every one who suffers from it feels his discomfort increased if he watches the varying elevations of the bulwarks of the vessel and the surrounding waves, and feels the better of looking another way, or of closing his eyes. But in this condition also the visceral impressions are most important. As the vessel sinks into the trough of the wave the body seems to descend as in the swing, the viscera appearing to sink downwards at a slower rate than the body generally. And here, as on the swing, this is attended by a terrible uneasiness. I sup- pose that one of the great advantages of the sea-sick invalid laying himself down at full length is that he thereby diminishes the visceral movement. With the labyrinthine impressions also the nerve centres must be sorely puzzled, for from moment to moment the impression varies as the vessel rises or sinks, or roUs from side to side. The muscular sense, also, is brought into most unusual conditions, as is also the articular sense. But one other source of sensory impressions is also at fault, for the plantar pressure varies from moment to moment. At one moment, as the vessel sinks into the wave hollow, it seems as if the vessel were falling from be- neath the feet, and there is almost no plantar impression; and then, again, as the vessel rises, the pressure becomes greater. In such conditions it is clear that the sonsorium receives a great variety of ever-varying and contradictory impressions. But giddiness may be due to abnormalities of the sensory structures themselves. Notice, first, some ocular causes. In illustration of this I shall recount to you a typical case seen by some of your predecessors. When I first took charge of the clinical wards as professor, I found a patient who was un- able to walk or even to stand on account of fits of giddiness.