The diseases of children : a short introduction to their study / by James Frederic Goodhart.

  • Goodhart, James Frederic, 1845-1916.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of children : a short introduction to their study / by James Frederic Goodhart. Source: Wellcome Collection.

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

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    vasations of this kind. Consequently the greate.st care is necessary to preserve the patient from excitement or active bi'ain-woi’k foi' a considerable time after such an occurrence. Haemorrhage into the substance of the brain has in very rare cases been due to atheroma of the vessels, but it is commonly due to embolism from heart disease, and the hffimorrhage is liable to be preceded by the formation of an aneurism. Symptoms.—These would be those of apoplexy in the adult—viz., sudden onset of hemiplegia with more or le.ss coma, or some genei’al paralysis if the I'lug should block the basilar artery, instead of the more usual seat of left or right internal carotid at the base of the brain. The diagnosis would mostly depend upon the evi- dence of the existence of heart disease, or of some reason for the formation of clots, on the valves or in the cavities—either from recent rheumatism, or chorea for the valves; or scarlatina, or tyjrhoid, or other ex- hausting illness for dilatation of the left ventricle. It mu.st always be dithcult to say whether the embolism remains as such, and the par-alysis is embolic only; or whether an apoplexy has followed it. Prognosis is grave in all cases due to valvular dis- ease, becau.se the embolism most commonly occiu’s,oi'at any rate produces such sevei’e sym2itoms, in the worst cases only. The valvular di.sease is likely to be of fun- gating or ulcerative form ; the patient to be febrile, anaemic, and very likely with albuminuria. Ilamior- rhage following upon embolism denotes extensive softening, and, in the i-are ca.ses due to atheroma, the disease has been usually basilar and the hannorrhage into the j)ons or its neighbourhood. Hiqr^iosing that hamonhage could Ije excluded, and the case diagnosed to be one of embolism only, j)robably a slight distinc- tion might be made in favour of clots discharged from a dilated venti'icle. I think that these, not having an inflammatory origin, are less likely to provoke a local