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
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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.

    16/22 (page 14)
    A West Indian surgeon consulted Sir Charles Bell with these symptoms:— On falling asleep,just at the time Avhen volition and sensibility cease, the involuntary motions also stop, with a sensation of death, under which he awakes, generally convulsed. His medical friends have found, that when sleep is overpowering him the breathing becomes slower and weaker, the heart and pulse also fall low, and cease to beat as sleep comes on, and after a very short time he awakes in terror. This case is interesting, as showing that there are cases in which both the heart and lungs cease to act as sleep comes on; we may, therefore, infer that this condition may also arise during the waking state, and this is probably the condition in paroxysms of angina pectoris. Bell, in the work from which I have just quoted, and on the same page, records some most interesting particulars as to John Plunter's case, detailed by the great physiologist himself. On one occasion, when he had missed his usual attack of gout, but had a peculiar hard pain about the pylorus, he found that this Avas attended Avith great Aveakness, and having accidentally cast his eyes to a looking-glass, he fancied that his countenance Avas like that of a dead man. He could feel no pulse in either of the wrists. Finding the involuntary respiration ceasing, and fearing that he should die in consequence, he imitated the involuntary by a voluntary action of the muscles, and breathed altogether by force as well as he could. The condition Avhich Hunter experienced was probably premoni- tory of that diathetic structural degeneration of the coronary arteries, Avhich was found to have occurred in him, he having died in a paroxysm of angina pectoris, induced by emotion. My OAvn experience has led me to the conclusion that intermittent pulse, heart-ache, and other sensory conditions referred to the heart in first attacks of gout, and in cases of fatty degeneration preceded by depressing emotions, as grief and anxiety, are premonitory of structural change, and indicate the beginning of a trophic neurosis of the heart, the coronary arteries, and aorta. Such results follow after the depressing emotions and other causes have occurred, at indefinite periods of from a fcAV days to two or three years. Hence, to have a good history of the relations of the apno^a 1 have discussed to intermittent pulse and structural diseases of the heart, a more careful inquiry into the conditions of the nerve centres, Avhich influence the nutrition or functional activity of the heart is needed. Of this, the case of O'H. is an illustration. I would