Medical diagnosis, with special reference to practical medicine : a guide to the knowledge and discrimination of diseases / by J.M. Da Costa.

Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: Medical diagnosis, with special reference to practical medicine : a guide to the knowledge and discrimination of diseases / by J.M. Da Costa. 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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    Diseases marked by Convulsions or Spasms. Epilepsy.—Epilepsy is a disease whose chief manifesta- tion consists in recurring attacks of sudden loss of conscious- ness, attended with convulsive movements. The patient falls to the ground without thought, without feeling, without the power of voluntary motion. He utters often a short piercing cry, then a fearful muscular struggle commences. The legs are stiff, and turned inward; the head is tossed backward, or from side to side; the mouth is distorted, the lips covered with foam; the arms outstretched and rigid, or thrown about with great force; the teeth are ground together, and the tongue is thrust between them, and often severely bitten; the eyelids are half closed; the pupils generally contracted, and always insensible to light. Gradually the convulsive movements become less violent and cease altogether, and the patient passes into a deep sleep, from which he wakes up fatigued and exhausted, and dull in intellect. But even these symp- toms disappear, and he returns to his usual state of health. But every paroxysm does not present the same phenom- ena, or run the same definite course. In many the attack is preceded by strange sensations: by a peculiar train of thought; by retching; by the feeling of a puff of air as- cending from the extremities to the head. This aura epileptica, on which so much stress has been laid, is, how- ever, very far from constant. Yet it may exist, as Brown- Se'quard teaches, without hardly being perceived: it may be an unfelt irritation starting from some centripetal nerve in any part of the skin, or from some organ not deeply seated, like the testicle, and its point of departure may be detected by observing, during the fit, in what neighborhood the first, or the most violent, or the most prolonged contractions occur. Some seizures are very light—a transient suspension of consciousness, a slight twitching of some of the muscles, a fixed gaze, perhaps a decided impression of vertigo, and all is over. These abortive fits, the petit mal of the French, are very apt to precede by some days a severe attack, or several of them take the place of the more turbulent form of the