On the hypodermic administration of remedies in neuralgia and other affections : being a paper read before the St. George's Medical Society, on Decmeber 9th, 1858 / by Charles Hunter. Also a paper on the respiration therapeutically considered in certain cerebral conditions, read at the Western Medical Society, January 20th, 1860, and the St. George's Medical Society, February 2d, 1860.

  • Hunter, Charles, 1834 or 1835-1878.
Date:
1860
Catalogue details

Licence: Public Domain Mark

Credit: On the hypodermic administration of remedies in neuralgia and other affections : being a paper read before the St. George's Medical Society, on Decmeber 9th, 1858 / by Charles Hunter. Also a paper on the respiration therapeutically considered in certain cerebral conditions, read at the Western Medical Society, January 20th, 1860, and the St. George's Medical Society, February 2d, 1860. 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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    3. Coma from injury or disease, sanguineous or serous. 4. Cerebral narcotism. We shall chiefly consider the above-mentioned conditions, under two heads: 1. Whether, in the functional cerebral derangements (epilepsy in- cluded), there is not a deficiency of normal respiration ; and whether that deficiency is the cause or effect of the cerebral functional de- rangement. 2. Whether, in the more emergent cases of coma or narcotism (be they from accident or disease), we do not learn more from the state of the respiration than from anything else, not only as regards diagnosis, as to the site of the effusion; or prognosis—for it will be allowed, I think, that the more the respiration is affected in these cases the more likely the result is to be fatal—but especially as regards treatment; for the freer respiration is or can be rendered, the further the patient is or can be carried from impending (at all events from speedy) death. In these cerebral conditions, therefore, we must carefully observe the rate, volume, freedom or not from obstruction, &c, of the res- piration ; and, in both the more and less urgent cases, the most effectual mode of establishing free respiration must be our object. Now the brain and the lungs may each be the seat of a certain con- dition, which condition may manifest itself by symptoms, especially affecting the other ; thus, there may be deficient respiration from lung imperfection, inducing marked cerebral symptoms; to remove the cerebral symptoms the lungs must be treated. Reversing the order, certain cerebral states may induce serious lung symptoms; treating the brain may remove the lung symptoms, but aid may be called in too late to do so effectually ; in which case, the only chance remaining is to treat the lungs, which are secondarily affected, or the patient may be lost. If this is the case, we can do more by treating the lungs than by treating the brain ; for we can the better see their condition, whether it be the cause or effect of the state of the brain. The connection between the brain and the lungs is strictly anatomical, and far greater than between the brain and the heart. The heart has an action of its own, regulated by its own nervous ganglia; having these to guide it, it is independent of either brain or chord, and will act for hours after they are dead. But neither can the brain do without the lungs, nor the lungs without the brain ; insensibility is induced directly respiration is arrested; the lungs cease to act the moment the base of the brain is destroyed Pathologically, coma is comparatively harmless while the respiration is slightly impaired, fatal if greatly so; the patient whose respiration is suddenly stopped will die insensible, or in epileptic fits. To begin with the effects of cerebral injuries and sanguineous apoplexy upon the respiration: — Theoretically, the more superficial the injury to the brain is, or the further the apoplectic clot is from the medulla oblongata, the better for the patient, and the less the respiration is likely to be affected ; practically it is generally so.