Lectures on diseases of the nervous system / delivered at Guy's Hospital by Samuel Wilks.

  • Wilks, Samuel, Sir, 1824-1911.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on diseases of the nervous system / delivered at Guy's Hospital by Samuel Wilks. Source: Wellcome Collection.

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    When the brain is at work in the waking state it is then most highly vascularised.” Dr Caldwell, of America, held the same view, and alludes to cases given by Sir Astley Cooper and other surgeons, where the brain became visible as a result of accident, and the convolutions were seen to grow pale and subside during sleep. He mentions the case he knew of a girl who had lost a large part of the calvaria from venereal disease, and a portion of the brain was bare. When she was in a dreamless state her brain was motionless and lay within the cranium ; when her sleep was imperfect and agitated by dreams her brain moved and protruded beyond the cranium. When she was perfectly awake and engaged in conversation the protrusion was still greater. In a like spirit was a lecture delivered at Manchester by Dr Lyon Playfair in 1844, naturally bearing, however, on the chemical side of the subject. He showed how everything which diminished the supply of oxygen to the brain induced sleep; therefore sleep occurred after haemorrhage and after dinner, when with an increased flow of blood to the stomach there was a diminished flow to the brain. The winter sleep of hybernating animals he attributed to deficient oxygenation of the blood, as cold contracts the blood- vessels, and causes the circulation to be more sluggish. The phleg- matic person, whose heard beats slowly, rarely dreams. The greatest dreamer is the man of nervous temperament, whose heart and lungs are fitful in their action. These were the examples mentioned by Dr Playfair to show that activity of the brain and the converse are proportioned to the amount of arterial blood supplied to it. The subject is one of much clinical interest as explaining why the patient with throbbing arteries, from whatever cause, cannot sleep, and why the j>atient with cardiac disease should have his rest as intermittent as his heart’s action. The positive experiments of Mr Durham have since demonstrated to the eye the actual state of the brain during the periods of waking and sleeping, or, in other words, during the times of activity and repose. These states correspond to and confirm the general physiolo- gical law of ubi stimulus ibi fluxus—that where there is increased function there is a greater distribution of blood. If, then, during sleep the brain is quiet and comparatively bloodless, we can under- stand how all mental activity or worry, by keeping the thoughts in a constant strain, should prevent the occurrence of the needful rest; also how exhaustion and other causes which deprive the brain of its stimulus should tend to promote it. Now, these conditions have a close relation to the question of digestion and eating late at night. According to the physiological dictum just mentioned, the