Neurologic progress and prospects : chairman's address, delivered before the Section on Nervous and Mental Diseases of the American Medical Association, at the Fifty-fourth Annual Session, held at New Orleans, May 5-8, 1903 / F.W. Langdon.

  • Langdon, Frank Warren, 1852-1933.
Date:
1903
Catalogue details

Licence: In copyright

Credit: Neurologic progress and prospects : chairman's address, delivered before the Section on Nervous and Mental Diseases of the American Medical Association, at the Fifty-fourth Annual Session, held at New Orleans, May 5-8, 1903 / F.W. Langdon. 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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    be affected. The distribution is without definite relation to the muscles or nerve distribution. No hypothesis is advanced as to its cause. BLOOD CHANGES IN EPILEPSY. Pugh15 contributes an important article “On Certain Blood Changes in Idiopathic Epilepsy/’ based on an in- vestigation of forty cases. His conclusions are: 1. The alkalinity of the blood (in epileptics) in the interparoxysmal period is lower than the average of the control cases. 2. The diminution is gradual and progressive, and is more marked in those cases suffering from gastric catarrh and constipation. 3. There is a marked sudden and pronounced fall im- mediately prior to the onset of the fit. 4. There is a further fall in the alkalinity after the fit is over; this diminution is seen from three to ten minutes after the attack. 5. This after-diminution depends on the duration and severity of the muscular twitching and on the degree of the alkalinity in the inter-paroxysmal period. 6. There is a gradual return of the blood to its normal alkalinity, which takes place in five to six hours, the rise being more marked in the first hours.. 7. If the alkalinity keeps at a low value it may de- termine the onset of another fit. 8. The diminution after the fit is due to the chemical end products of muscular metabolism, i. e., sarcolactic and carbonic acids and not to substances in direct rela- tion to the epilepsy. 9. The diminution after a nocturnal fit takes a longer time to return to the normal than the diminution after a day fit. 10. It is impossible to elevate and maintain the al- kalinity within physiological limits for any appreciable length of time by the administration of drugs. 11. There is a leucocytosis after a fit. The increase is due to the small hyaline cells, also to a less extent to the large hyaline cells. The polymorphonuclear cells are diminished. There is an increase in the eosinophile cells some hours after the attack. 12. The leucocytosis is not so pronounced in status epilepticus; it diminishes with each seizure. Respecting treatment the author remarks: “The ef-