On the recurrent brief apnœa, or ascending and descending respiration, observed in cases of cardiac disease / by Thomas Laycock, M.D.

  • Laycock, Thomas, 1812-1876.
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: On the recurrent brief apnœa, or ascending and descending respiration, observed in cases of cardiac disease / by Thomas Laycock, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    26tli.—Over left leg, and a little over right a plentiful eruption of urticaria is seen. 28th.—Commencinsj: bed-sores on left nates. Progress of the Cast^.—On December 1st, complained of pain in right side ; friction sounds detected; roughs slightly ; no expectora- tion; delirium occurred during the succeeding night; the following morning said he was better, and the ascending and descending respiration was not observed; friction heard in right infra-axillary region; the right side moved but slightly in respiration, which was chiefly diaphragmatic; dulness was perceived over right base posteriorly, where also friction and fine crepitation were heard. Dr. Laycock attributed this defective movement of the right side, and the lesion of the right lung and pleura, to motor and trophic ])aralysis. On the 3rd December the respiratory phenomena were less marked, but on the 4th weeping was observed in the afternoon, although the patient was cheerful about himself, and the peculiar breathing was again manifested. On the 5th heart's action was calmer. Oedema of the left hand commenced; on the 9th, adema of the lower part of the left thigh; foot and lower part of leg very cold. On the 12th, a fresh pulmonary attack commenced—the left pleura now being the seat. During the three following days there was considerable delirium ; he was very troublesome at night, cry- ing out and groaning. On the evening of the 16th he had more frequent paroxysms of apnoea; the cardiac action was hurried— about 130 per minute, but regular. On the 18th, symptoms Avere found to have subsided somewhat, but on the evening of that day dyspnoea came on with greatly increased feebleness; pulse about 60, and irregular; respirations hurried and forcible, from 45 to 50 per minute. The pulmonary symptoms had become greatly aggravated, and the patient died about one o'clock on the morning of the 20th. Post-mortem was not permitted. Such are the details of the case, as recorded by my friend Dr. Taylor. In the absence of a post-mortem examination it would be useless to speculate on the lesions which affected the heart. It is not, I think,doubtful, however, that i\\epulmonarylesions were consecutive to the hemiplegia and dependent on centric change in the respira- tory trophic system. It is obvious too that the lesion was spinal, for changes of nutrition took place such as occur in paraplegia and other spinal neuroses. These trophic lesions were the lower temperature observed, the urticaria, the effusive inflammation, as *