On stertor, apoplexy, and the management of the apoplectic state / Robert L. Bowles.

Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: On stertor, apoplexy, and the management of the apoplectic state / Robert L. Bowles. 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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    Noise in any part of the air-way is a danger-signal; its importance the physician must determine. The stertor of the apoplectic state may prove equal in danger to the crowing of the croupy child or the stridor arising from the pressure of a thoracic tumour. Stertor is therefore a symptom with two meanings ; the noise expresses the mechanical interference, and the mechanical interference is an accidental concomitant of the unconsciousness. The accident zvhidi determines whether the stroke be or be not accompanied by stertor, is in most cases due to the accident of the patient's happening or not happening to be on his back ; or should he exhibit stertor while upon his side, there must be some derangement of the ordinary relations of the pharynx, such as the chin being too near the sternum, the existence of a local oedema, long uvula, large tonsils, mucus in the air-tubes, pressitre from without, or indeed anything which narrows the respiratory channels or vibrates in their course. To display and make clear the differences which exist in the views entertained by earlier and modern writers and in those advocated in the following pages, it will be well here to present shortly both sides to the reader. For that purpose I select extracts from the American translation of Dr. Adolf Strumpfel's Text-book of Medicine, 1887 ; from Ziemssen's Cyclopaedia, under the heading Cerebral Haemorrhage, by Nothnagel ; and from the article Encephale in the Nouveau Dictionnaire de Medecine et de Chirurgerie Pratique, torn. xiii. Dr. Strumpfel has laboured with great success to bring into concordance pathology and symptomatology—to arrange them as cause and effect; and as his work is now generally accepted as fairly expressing the more modern views in Germany