Selected monographs.

  • Kussmaul, Adolf, 1822-1902.
Date:
1859
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    ariscj and can scarcely be conceived of otherwise than as a very- slight alteration of the whole brain, or of a narrowly circumscribed district; whilst the alteration which is the cause of the attacks, must always affect the whole substance of the brain, or at all events the greatest part of it, and that moreover in an energetic manner. The predisposition is not alone sufficient to bring on the attack. An internal or external cause has stUl to supervene to make the alteration more extensive and deeper; that finally the ontological characteristic of epilepsy may become conspicuous to us in the form of paroxysms. Thus the image is not manifested on the daguerreotype plate directly after the action of the light, but only upon the plates being exposed to a further influence, when, aU at once, the result of the two changes appears before the eyes as one uniform whole. Prom the intimate manner in which the various parts of the nervous system are imited in their nutrition, whereby even the remotest districts of the nerves are linked together in one common bond (we here call to mind the crossed and progressive atrophies of the nerves, and the important microscopical researches of Tikck, WaUer, Scliiff, and others; com- pare also Ludwig, 'Physiologic des Menschen,^ vol. i, p. 172), the supposition is certainly warranted that these visible anatomical alterations dispose to epilepsy only in the manner of gradual and invisible changes in the nutrition of certain districts. The epileptic affection is not, however, always so slow in developing itself; it often comes on rapidly, as though produced by a stroke. An influence may operate on the brain, and the attack immediately follow, and vtdth it the epileptic affection be manifested simulta- neously. The epilepsy has become fixed, and the whole of the brain or a portion of it has suddenly been affected by that delicate alteration that will henceforth manifest itself in the periodical appearance of the well-known symptoms. Wliat is sometimes the case in epilepsy, is the rule in eclampsia; In the latter the epileptic status is always rapidly induced, and leads quickly or immediately to the attacks, ending, contrarily to epilepsy, either in recovery or death. We regard it as the greatest merit of our work, the having inves- tigated more exactly a state which infallibly causes epileptic attacks in the vigorous rabbit and probably in all warm-blooded animals. We allude to that alteration in the brain produced by a rapidly arrested nutrition brought about by a sudden interruption in