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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    fuse perspiration ; the face was swollen and livid, and the mouth half open ; the pupils were contracted and insensible to light, and the eyeball to touch. The stertor was very deep, and the breathing laboured. Whilst I was at the bedside of my patient she was very nearly suffocated, from the stomach ejecting a portion of its contents into the throat. I at once turned her on her side and emptied her mouth, when she not only breathed freely, but without the slightest stertor. I was somewhat surprised, but proceeded to place her in what appeared to be the most comfortable position, on her back. Immediately when I did so, her respiration sud- denly ceased, and she convulsively struggled for breath. Supposing it to be the tongue which had choked her, I thrust my finger into the mouth, and pressed it forward, when the breathing again became easy and free from stertor. The patient was now comfortably laid on her side ; and until her death, which took place two days afterwards, the stertor never recurred when she was in that position, but the respiration continued as naturally as if she slept. To convince myself that this was due to position, I several times turned her on her back for a few moments, and invariably, when I did so, the stertor was as marked as ever. The lateral position had another advantage, for it allowed the saliva and mucus to drain away instead of remaining in the bronchial tubes and giving rise to mucous stertor, and thus offering another impediment to the respiration. Other changes occurred coincidcntly with the change of position ; but how far they depended upon it, future experience must decide. The pulse became calmer; the skin cooler and less bedewed with moisture ; the eye sensible to the touch ;