Essays chiefly on the theory of paroxysmal diseases of the nervous system / by Marshall Hall.

  • Hall, Marshall, 1790-1857.
Date:
[1849]
Catalogue details

Licence: Public Domain Mark

Credit: Essays chiefly on the theory of paroxysmal diseases of the nervous system / by Marshall Hall. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ON THE THJtEATENTNGS OF almost as slight as the spider’s web, which separates congestion from laceration, curable from incurable apoplexy. The arte- rial and the venous textures have ceased, and what remains is that system of “ intermediate* blood-channels, which, I believe, I first presented to the consideration of the profes- sion and of physiologists, in a communication ignorantly rejected at the Royal Society, at the instigation and under the direction of a mere biblio-physiologist, to be replaced by official error. Yet in these methcematous channels, these channels for the irrigation of the blood (in the lungs) and, through its means, of the tissues (in the other parts of the body), in the pneumonic and systemic arrangements, are effected the objects of the entire circulation. But to return to the “ minte apoplexice.” A patient in apparent health—one of whom Celsus not less beautifully than truly observes, “ Si plenior aliquis, et speciosior, et coloratior factus est, suspecta habere bona sua debet,”f is seized with vertigo, confusion of ideas, loss of recollection, perhaps of consciousness, with a tumid, purple flush, and the bystanders instinctively hasten, in alarm, to remove or loosen his cravat. As Heberden observes : “ Invadente apoplexia aut paralysi, continuo laxare oportet omnes istas vestium partes, quae collum cingunt; id enirn nonnunquam his morbis advenientibus adeo tumet, ut ab arctiore quovis vinculo stran- gulationis periculum instaret.”+ The paroxysm is of various intensity—it passes off and is forgotten; it recurs—recurs again; at length it remains permament, places the patient’s life in jeopardy, or leaves him a cripple ! What is the theory of this paroxysm ? In what does it consist ? Is it a tendency of blood to the head and neck l or an impeded flow of blood from that region of the body l Is it augmented arterial impulse, interrupted venous return, or both ? and in what degree respectively ? What are the causes of this paroxysm, and what their mode of operation ? Is emotion a principal cause, and does it act directly on the spinal system, inducing abnormal muscular actions in the neck, impeding the return of blood along the * See Voigt, Berres, &c. t Lib. ii. cap. i. sect. i. + Cap lxix. De Paralysi et Apoplexia.