A treatise on the practice of medicine (Volume 2).

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

Licence: Public Domain Mark

Credit: A treatise on the practice of medicine (Volume 2). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    mains after the majority of apoplectic attacks. In some instances the palsied muscles soon resume their natural power; in others, they slowly recover a certain degree of power, without, however, ever regaining their natural state of activity; whilst in some cases little or no perceptible diminution of the paralytic affection ensues—the affected muscles remaining permanently palsied. In most cases in which permanent paralysis is left by an attack of apoplexy, the mind becomes very perceptibly weakened. The power of comprehend- ing complex ideas and the memory are often almost entirely oblite- rated in persons who recover from a severe apoplectic seizure. Paralysis from apoplexy is usually of the hemiplegiac variety; but in some instances, the palsy is confined to a single member or to certain muscles, more especially to such as derive their nerves im- mediately from the brain, as those of the face. 3. The apoplectic fit may terminate in a general febrile condition after the sensorial oppression has passed off. In some instances, strong synochal fever is developed in proportion as the nervous functions are restored; in others, fever of a typhoid character, with manifest gastric irritation, ensues. Several years ago, I was called to a gentleman who a few minutes before had been seized with a fit of strong apoplexy. Under the usual treatment he gradually re- covered so as to be able at the end of the fourth day to sit up and converse without difficulty. On the next day strong febrile reaction, with a hot and dry skin supervened, and notwithstanding the most vigorous antiphlogistic measures, violent delirium ensued, and con- tinued for several days before it subsided. The patient eventually recovered. Diagnosis.—The diagnosis of apoplexy is not, in general, at- tended with difficulty. Where a loss of consciousness of the senso- rial functions and voluntary motion suddenly come on, and continue with an active state of the pulse and full respiration, the case must be regarded as apoplexy. From syncope and asphyxia, this form of soporose disease is distinguished by the absence or almost imper- ceptible action of the pulse and respiration in the two former affec- tions. It is sometimes difficult, however, to distinguish apoplexy from deep intoxication. The habits of the individual, the smell of his breath, and the general relaxation of all the muscles, particularly those of the jaws and the sphincters, will generally lead to a correct diagnosis on this point. Dr. Cook observes, that as the treatment for true apoplexy would not be improper for intoxication, a mistake respecting the cause would not be hurtful to the patient. This is no doubt correct in reference to mistaking intoxication for apoplexy; but if a case of apoplexy were mistaken for intoxication, the conse- quence might be very injurious to the patient; for under this mistake the case would probably not be subjected to any efficient medical treatment whatever. Prognosis.—Apoplexy is always to be regarded as a highly dan- gerous affection. When the sensorial functions are completely abol- Vol. II.—2