A treatise on the practice of medicine / by John Eberle.

  • Eberle, John, 1787-1838.
Date:
1831
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the practice of medicine / by John Eberle. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

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    ever, seldom takes place before the second or third hour from the attack. In most instances, indeed, from twenty to thirty hours, and in some cases five or six days pass, before the fatal termination occurs. Besides the unfavourable symptoms mentioned above, there are various others which are said to indicate especial danger. When the attack commences with sudden severe pain in the head,*^ or with vomiting,t or a general spasmodic rigidity of the muscles, the utmost degree of danger is to be apprehended. General, clammy, and profuse perspii^ation, with a small and fre- quent pulse, is also a peculiarly unfavourable sign, Hippocrates says that the supervention of fever in apoplexy is favourable ; but Richter observes that this observation can only be regarded as generally correct when the fever is of the synochal grade and commences early, for when it supervenes at a late period, and assumes a typhoid character, it never fails to increase the danger. (Loc. cit. 774.) The prognosis is also influenced by the character of the excit- ing cause, and still more by the presence or absence of that cor- poreal habit, which experience has shown to predispose especially to this affection. When there are evident manifestations of some degree of sen- sibility remaining; such as contraction of the pupils from the stimulus of light; some power of swallowing, &c., together with free and regular respiration, without stertor or discharge of sali- va from the lips; a warm and general perspiration; the occur- rence of sanguineous discharges, particularly from the nose or haemorrhoidal vessels; diarrhoea, or a copious flow of urine; rea- sonable hopes may be entertained of a favourable issue of the case. It was formerly supposed that apoplexy from the rupture of a vessel, and extravasation of blood into the substance of the brain, is always necessarily fatal. This opinion has, however, been satisfactorily controverted by the experience of many of the ablest pathologists of the present day. f The observations and dissections of Riobe, Rochoux,§ Cruvelhier, Bricheteau, and Serres;|| and we may add, of Baillie and Sir Astley Cooper,H place the occasional recovery from strong apoplexy beyond all doubt. From the numerous dissections made in the Parisian hospitals by the French pathologists just mentioned, we learn, that when sanguineous extravasation into the substance of the • Cheyne. f Richter, Specielle Therapie, Bd. viii. p. 773. I Recherches sur I'Apoplexie. § Considerations et Observations sur I'Apoplexie. !| Nouvelle Division des Apoplexies. Annuaire Medico-Chirurg. vol. i. 1 Cook, loc. cit. p. 129. Vol. II. 2